Postnatal - Growth Charts

From Embryology
WHO report- child growth standards.jpg

Introduction

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 [#WHO 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 External 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.

Postnatal Links: birth | neonatal | neonatal diagnosis | milk | Nutrition | growth charts | Disease School Exclusion | vaccination | puberty | genital

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Some Recent Findings

WHO Child Growth Standards

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).

Main introduction page WHO Child Growth Standards, data is available as Charts, tables and Simplified Field tables. (The WHO Child Growth Standards English documents link page)

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)."

Links: ABC (Australia) News Item 28Apr06 | Nature News Item 11Aug04 |

Clinical Growth Measurements (USA)

  • Infants (birth to 24 months) must be measured for length, and the sex appropriate length-for-age or weight-for-length charts for infants from birth to 36 months must be used to plot the measurements.
  • At age 24 months and older, if children can stand unassisted and follow directions, stature should be measured and plotted on the stature-for-age chart for older children (2 to 20 years).
  • BMI-for-age charts are recommended to assess weight in relation to stature for older children (2 to 20 years). The weight-for-stature charts are available as an alternative to accommodate children ages 2-5 years who are not evaluated beyond the preschool years. However, all health care providers should consider using the BMI-for-age charts to be consistent with current recommendations.
  • Note- Body Mass Index (BMI), an evaluation of a person's weight status in relation to height, is the most commonly used approach to determine if adults are overweight or obese, and is now the recommended measure for assessing overweight in children.

Some text extracted from United States Clinical Growth Charts

Growth Charts

This link is to local PDF document of the 2001 CDC Growth charts. CDC Growth Charts - United States.pdf (16 pages 300 kb)

Data includes:

  • Weight-for-age percentiles
    • Boys, birth to 36 months
    • Girls, birth to 36 months
    • Boys, 2 to 20 years
    • Girls, 2 to 20 years
  • Length-for-age percentiles
    • Boys, birth to 36 months
    • Girls, birth to 36 months
  • Stature-for-age percentiles
    • Boys, 2 to 20 years
    • Girls, 2 to 20 years
  • Head circumference-for-age percentiles
    • Boys, birth to 36 months
    • Girls, birth to 36 months
  • Weight-for-length percentiles
    • Boys, birth to 36 months
    • Girls, birth to 36 months
  • Weight-for-stature percentiles
    • Boys
    • Girls
  • Body mass index-for-age percentiles
    • Boys, 2 to 20 years
    • Girls, 2 to 20 years

Growth Charts Program

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)

Chinese Growth Charts

Data is also available for ethnic Chinese girls and boys in Hong Kong from the early 1960s.[1] Environmental and nutritional factors may have altered these values over the last 40 years.

WHO - Breastfed Babies

The World Health Organization is revising pediatric growth charts to better reflect the growth of breast-fed babies. 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.


Links: WHO Publications.

External Links

Statistics: Australian Birth Statistics | International and Australian Population Statistics | WHO Normal Population Statistics | Global Perinatal and Maternal Causes of Death | Population Comparisons between Countries | Developed and developing | Australian neighbours | Australian Trading Partners

Normal population statistics derived from a number of different sources (as shown on individual pages).

WHO: Fact Sheets

This page is being updated to include the WHO Growth Chart (Apr 2006) information.

References

  1. ↑ <pubmed>14185528</pubmed>

Reviews

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Cite this page: Hill, M.A. (2024, May 4) Embryology Postnatal - Growth Charts. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Postnatal_-_Growth_Charts

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