WHO Growth Charts

WHO Growth Charts

The following was adapted from the collaborative public policy statement on "Promoting Optimal Monitoring Of Child Growth In Canada." Please see the full statement for the full recommendations from the Dieticians of Canada, Canadian Paediatric Society, the College of Family Physicians of Canada and the Community Health Nurses of Canada.

The World Health Organization (WHO) Growth Charts are accepted as the gold standard for tracking the optimal growth of infants, children and adolescents. The Canadian Pediatric Society and many other professional bodies recommend the use of these growth charts for all children with few exceptions. The WHO Growth Charts for Canada have been adapted for ease of use and can be found at the following link:

Background: Originally released in 2006 and 2007, these charts are based on a large body of evidence. For children from birth to age 5, the data is based off a large sample of children in six different countries which measured the growth of children with optimal socioeconomic and environmental conditions, who were primarily breastfed.  Interestingly the data showed that given favourable conditions for growth, there was markedly little variance in growth between countries, suggesting that these charts can be applied to children from any ethnic group. For children aged 5 to 19 years, the WHO updated previous data in light of the increasing prevalence of childhood obesity to construct charts based on healthy growth, and not simply the average size of the population. For these reasons, the WHO growth charts are now preferred over previous growth charts from the CDC.

Key Points:

  • Preterm and Low Birth-weight Infants - The WHO growth charts lack data on preterm and low birth-weight infants.  While these infants are in the neonatal intensive care unit, and shortly after discharge, alternative charts specific to these populations are recommended.  After discharge, the growth of these children should be monitored using the WHO Growth Charts with postnatal age correction for prematurity for the first 24-36 months. A good resource for this population is the Fenton Preterm Growth Chart.
  • Children with Intellectual, Developmental, Genetic or Other Disorders - Specific growth charts have been developed for a number of other disorders as these children may have growth patterns that differ from standard trends.  These charts may have limitations, and it is therefore recommended that children be tracked using both disorder-specifc charts and the WHO growth charts in conjunction.
  • Body Mass Index (BMI) - The measurement of BMI is not recommended in children less than two years of age.  For children over 10 years of age, weight-for-age is not an accurate measure of being overweight/obese as this can vary widely with differing stages of puberty. Therefore BMI-for-age is recommended for assessing weight status in children over ten years of age.

Last updated by PedsCases: January 4, 2015

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