Part of the normal ongoing monitoring of the newborn infant development is the simple measurement of weight, length, height and simple motor skills compared to large data sets of clinically normal infants. The original standards differed between countries and the time when the control data was collected (some based on data from 1970s or earlier). This has recently changed with the release of WHO international child growth standards using entirely new data sets.
New international Child Growth Standards 2006 for infants and young children released (27 Apr) by the World Health Organization (WHO) provide evidence and guidance for the first time about how every child in the world should grow.
"The new standards prove that differences in children's growth to age five are more influenced by nutrition, feeding practices, environment, and healthcare than genetics or ethnicity."
Earlier growth charts had been prepared independently for children of different countries and nationalities (see WWW Links) using large numbers of clinically normal children.
In Australia, following advice from National Health and Medical Research Council (NHMRC), the Australian Department of Health has determined that percentile charts from the U.S. National Centre for Health Statistics be used for Australian children (this may be updated to the new WHO standard). The percentiles on these charts are generally similar to the previous NHMRC Charts (1980) except that, above the age of 8 years, American children tend to be taller and heavier, this becoming more marked in the teenage years.
Page Links: Introduction | WHO Child Growth Standards 2006 | Clinical Growth Measurements (USA) | Growth Charts Program | Chinese Growth Charts | Earlier 1998 WHO Information | WWW Links | References | Glossary
Until page is updated please use the external links to the WHO resources listed below. Standards are available for download as PDF documents in either English, French and Spanish (and other languages).
Links to the first set of the WHO child growth standards (0 - 60 months):
Study data set: "WHO Multicentre Growth Reference Study (MGRS) was undertaken between 1997 and 2003 to generate new growth curves for assessing the growth and development of infants and young children around the world. The MGRS collected primary growth data and related information from approximately 8500 children from widely different ethnic backgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman and the USA)."
Some text extracted from United States Clinical Growth Charts
Links below are to local PDF documents of the 2001 CDC Growth charts. These can be opened and printed without internet access.
Important Note: this program is based upon USA Clinical Growth Charts not the new WHO Child Growth Standards.
Growth Charts version 1.1 by David Hanauer is based upon USA Clinical growth charts. A copy of the program is included on the Embryology CD. It can be found in the EXTRAS folder on the CD the file is called "Growth_Charts.dmg.sit" and requires stuffit to decompress.
Excerpt from program description:
"Growth Charts is a Macintosh OS X application that allows for tracking and charting of growth data for children/teens from birth through age 20 years. It can track weight, length/height, head circumference, and even body mass index (BMI). Using the program, data can be stored, edited, and subsequently plotted on growth charts. The growth charts come from the Centers for Disease Control (CDC) and are the same ones used by pediatricians throughout the United States to monitor for abnormal or concerning growth patterns. If you have ever been curious to follow the growth of your child (or yourself) the same way that the doctor does, this program will allow you to do that using the same charts that your doctor probably uses."
The original program can also be found at (http://www-personal.umich.edu/~hanauer/Growth_Charts) (Email: David Hanauer)
Data is also available for ethnic Chinese girls and boys in Hong Kong from the early 1960s. Environmental and nutritional factors may have altered these values over the last 40 years. (More? http://fwcc.org/growthchart.html)
Reference: Standards of height and Weight of Southern Chinese Children"; K.S.F Chang, Marjorie M.C. Lee, W.D. Low, Sylvia Chui, and Mary Chow; Far East Medical Journal, 1 101-109 (1965).
The World Health Organization is revising pediatric growth charts to better reflect the growth of breast-fed babies. (NEW ORLEANS 1998)
The revisions may take 5 years. In the meantime pediatricians should be aware that breastfed babies tend to gain 600-650 g less in their first year than formula-fed babies, with the most marked differences seen between ages 3 and 9 months, Kathryn C. Dewey, Ph.D., said at the annual meeting of the American Academy of Pediatrics.
Pediatricians who are unaware of the differences tend to assume that breastfed babies lagging behind the growth charts are inadequately nourished. As a result, too many mothers are advised to begin supplementing earlier than necessary, she said.
Existing growth charts for children aged 2-18 years were based on a nationally representative sample, but charts for those up to age 2 were based on a study since shown to have several limitations, said Dr. Dewey, associate director of the Program in International Nutrition and professor of nutrition at the University of California, Davis.
The sample was too homogeneous, growth measurements were made infrequently, and most babies were bottle-fed, she said.
Several studies have been conducted in the past several years to evaluate differences in growth patterns. One study that Dr. Dewey worked on--the Davis Area Research on Lactation, Infant Nutrition, and Growth study--found that breastfed babies generally weighed less in their first year because they voluntarily took in less milk than did formula-fed babies.
The breastfed babies met developmental milestones at similar ages to bottle-fed babies, they were just as active, and they were healthier. Bottle-fed babies had twice the incidence of diarrhea and 20% more cases of otitis media.
Most other studies found similar results, and this year WHO acted on its own 1994 report recommending that existing growth charts be revised. A multicountry study is underway, and in keeping with guidelines for infant care, the new chart will be based on babies breastfed for their first year, Dr. Dewey said.
Text extracted from Pediatric News 32(1): 1, 1998.
"Evaluation of Infant Growth" report from the WHO working group that recommended the revisions can be obtained by writing to the Nutrition Unit, WHO, 1211 Geneva 27, Switzerland.
The study assessed the growth of breast-fed infants living under favourable environmental conditions indifferent parts of the world. In one of its most important conclusions, the study found that infants fed according to WHO recommendations and living under conditions that favour the achievement of genetic growth potential grow less rapidly than, and deviate significantly from, the current reference. While it is probable that differences in growth patterns in the first 4-6 months are due mostly to technical inadequacies of the current reference, this is unlikely to be true of growth differences in later periods. The report placed particular emphasis on the risks associated with misdiagnosis resulting in premature introduction of complementary foods.
Text extracted from WHO Publications.
WHO- The Growth Chart A Tool for Use in Infant and Child Health Care 1986, 33 pages [Ar, E, F, S]
ISBN 92 4 154208 X Sw.fr. 12.-/US $10.80; in developing countries: Sw.fr. 8.40 Order no. 1150252
Explains the features and uses of a simple visual chart for monitoring childhood growth and detecting changes in nutritional and health status. The first part of the book introduces the basic principles and procedures for measuring changes in growth and knowing when these changes signal a deterioration in health. Highly practical information on the design and use of growth charts is then presented on the basis of what has been learned from extensive field experience with a WHO prototype chart developed in the 1970s. In order to ensure that growth charts are understood and properly used by community health workers, the book alerts programme managers to specific problems of design, presentation, recording, or interpretation that should be considered when developing or adapting a chart for local use. Illustrations show the WHO prototype chart and modified versions that have been developed to meet special needs in different developing countries.
Text extracted from WHO Publications.
Standards of height and Weight of Southern Chinese Children"; K.S.F Chang, Marjorie M.C. Lee, W.D. Low, Sylvia Chui, and Mary Chow; Far East Medical Journal, 1 101-109 (1965).
Normal population statistics derived from a number of different sources (as shown on individual pages).