Assessing your child's growth
After completing measurements it is important to try to identify trends, or patterns, of growth for your child. Please follow the below steps to assess your child’s growth.
Important notes:
- If you own a child weight and height growth chart with previous growth measurements plotted (i.e. from your previous medical appointments), new measurements should be plotted on the existing growth chart to provide you with a trend
In this case, please skip step 1 and move directly to step 2.
- If you do not have a child weight and height growth chart start plotting all growth measurements on a new growth chart
In this case, please follow all the below steps.
Reminder: If you have previous measurements (i.e. from your previous medical appointments) but these have not been plotted on a growth chart, please plot all growth measurements together on a new growth chart and follow all the below steps.
Step 1. Use WHO Growth Charts
Use the World Health Organization (WHO) growth charts in the link below, or WHO-based local country growth charts, which may be obtained online from your country’s local health department.
Choose the appropriate chart for your child based on their age and gender:
a) Gender adapted child weight and height growth charts:
Note: For home growth measurements, it is best to focus on 2 categories of charts:
Weight-for-age and Height-for-age
b) Age-adapted child weight and height growth charts:
- Weight measurement and age: weight for age graph according to age
- Height measurement and age: height for age graph according to age
Step 2. Plot your measurements on the relevant growth chart and identify growth trends or patterns
Find the age on your child’s growth chart first (this will be on the x-axis/the line at the bottom of the chart) and use a ruler to help guide you to plotting the weight/length/height (on the y-axis/the line on the left hand side on the chart) that correspond to the child’s measurements. Please see the example below.
Note: It is important to establish your child’s age in weeks accurately. It is easier to use an online age calculator to obtain the exact age in weeks for a young baby, to ensure that the plotting of growth is as accurate as possible.
Example 1:
Boy, 5kg weight, 6 weeks of age
Use the weight-for-age growth chart and plot the points as outlined above
Example 2:
Boy, 3 different measurements over time as shown below:
9 months: 8kg, 13 months: 9kg, 18month: 9kg
The chart opposite shows the growth measurements of a boy plotted on a weight-for-age chart at 3 different times over the course of a year (at 9 months, 13 months, 18 months).
Step 3. Interpreting growth trends/plotted points
Before you start to interpret a growth trend, it is important to understand:
- The curved lines on the graph are reference lines that will help you interpret the plotted points and identify trends or patterns.
- The line labelled 0 on each chart represents, the average. The other curved lines are z-score lines, they indicate difference from the average either lower {-1 to -3}, or higher {+1 to +3}. Being higher or lower than average is not necessarily a ‘bad’ thing, it is more important to see if your child’s growth is changing pattern.
Defintion of Z-score curves
| Above 2,3 | Significantly above average |
| Above 1 | Moderately higher than average |
| Above 0 | Average |
| Below -1 | Moderately lower than the average |
| Below -2, -3 | Significantly lower than average |
Interpretation of weight/growth trends scenarios
| Growth trend | Action | Examples below |
|---|---|---|
| Child is growing well in weight for age, following the same line | Your child is growing well. Continue to measure growth and observe for any different trend that may develop | Example 1 |
| Child is dropping 1 or more z-score(s) in weight for age (crossing from 1 z-score line to the line below) | Closely monitor and contact your HCP | Example 2 |
| A child that is gaining weight and is going up 1 or more z-score(s) (crossing from 1 z-score line to the line above) | Closely monitor and contact your HCP | Example 3 |
| A child is growing between z-score lines, but has not yet changed z-score | Closely monitor and contact your HCP if you are concerned | Example 4 |
Note: Please look at the 4 below examples and familiarize yourself with the method in order to better support you with the identification of your child’s growth trends or patterns
Example 1: Weight-for-age BOYS, 6 months to 2 years (z-scores)
Example 2: Weight-for-age BOYS, 6 months to 2 years (z-scores)
Example 3: Weight-for-age BOYS, 6 months to 2 years (z-scores)
Example 4: Weight-for-age BOYS, 6 months to 2 years (z-scores)
