Saturday, 14 March 2009

• An Introduction to Growth Charts

     

  

  Growth charts show the expected growth trend of children of the same gender within a certain age group. They are the result of extensive population-based studies conducted on infants and children. Pediatricians and doctors often compare the actual growth of children against the reference growth charts, so as to determine whether the children are developing normally and proportionally.

  The three most commonly used growth charts are Weight-for-Age, Length/Height-for-Age and Head circumference-for-Age. Growth charts typically differ for boys and girls because they grow at a different rate and pattern.

  Why are head circumferences of children tracked? Head circumference typically refers to the distance around the largest portion of the head. Especially in the case of babies, head circumference provides important clues about brain development. If a baby's head is unusually bigger or smaller than most other babies of the same age group, it may indicate a problem which is worth looking into. 

  Reliable growth charts include those that are published by the World Health Organisation (WHO). WHO growth charts are established based on studies conducted on infants and children from major cities that span across 6 countries. The three common types of growth chart for children aging from birth to 5 years are presented below in percentile charts.

  Girls Growth Charts (Percentile)

  Weight-for-age: Birth to 2 years

  Weight-for-age: 2 to 5 years

  Length-for-age: Birth to 2 years

  Height-for-age: 2 to 5 years

  Head circumference-for-age: Birth to 13 weeks

  Head circumference-for-age: Birth to 5 years

   

  Boys Growth Charts (Percentile)

  Weight-for-age: Birth to 2 years

  Weight-for-age: 2 to 5 years

  Length-for-age: Birth to 2 years

  Height-for-age: 2 to 5 years

  Head circumference-for-age: Birth to 13 weeks

  Head circumference-for-age: Birth to 5 years

  (Source: World Health Organisation Child Growth Standards)

   

  

  What are percentiles and how do you interpret the above percentile charts? Percentiles are measurements that show where a child is compared to others. On each of the  growth charts, notice the individual percentiles that are shown as curved lines drawn across the charts. WHO growth charts are plotted with the 3rd, 15th, 50th, 85th and 97th percentiles.

  When you plot your child's measurements on the chart, observe which percentile line those measurements land on. The higher the percentile number, the bigger your child is compared to other children of the same age and gender.

  Example: Using the Boy’s chart (Weight-for-age: Birth to 2 years), if a 1-year-old boy's weight is about 12kg, his weight falls roughly into the 97th percentile line. This means that he is heavier than 97% of boys in the population, and that only 3% of boys are heavier than him.

  Is there an ideal percentile which signifies a healthy body? No, there isn’t one ideal number. A baby that falls in the 3rd percentile can be as healthy as a baby who is in the 97th percentile. A baby that falls into a low percentile simply means that he/she is smaller than other babies of the same age, and there may not be anything wrong. Doctors need to assess and consider other aspects such as whether is the baby eating and sleeping well, the overall responsiveness of the baby, as well as other signs of healthy developments, before they can conclude anything.

  As much as parents should be vigilant in monitoring their child’s health, they should not be “obsessed” with growth charts, and be overly worried should their child’s growth fall in the low percentile. We know better because we used to be very worried initially when Curtis' weight falls in the low percentile. After various check-ups, we were assured by all the Pediatrician and doctors that Curtis is healthy. After a while we sort of come to terms with it that probably Curtis is just smaller in size than other infants.

  As far as possible, growth charts should be used just as references, and definitely not a litmus test to judge the health of children. In case of doubts or concerns, parents should always consult their Pediatrician or family doctor for clarification.

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