WHO Growth Charts for Children (Boys and Girls)

Children's Growth Charts: WHO versus CDC

WHO growth charts for infant and toddler boys.
WHO growth charts for infant and toddler boys. Photo courtesy of the CDC

Since 1977, pediatricians and other health professionals have used standardized growth charts to help parents keep track of their children's growth.

In 2000, the original National Center for Health Statistics (NCHS) growth charts were replaced with growth charts from the Centers for Disease Control and Prevention (CDC). The revised CDC growth charts include eight charts each for boys and girls, such as charts that follow a child's height, weight, head circumference, and body mass index at various ages.

Growth charts help a parent figure out whether a child's measurements are average, above average, or below average. For instance, say a parent discovers through a BMI measurement that his or her kid is overweight or obese. This knowledge allows a parent to work with the pediatrician to make changes to the child's eating habits or exercise routines to help the child get back into a healthy, normal BMI range. This type of early action can help prevent the child from developing complications that are related to being overweight, such as high blood pressure or high blood sugar. 

WHO Growth Charts

The World Health Organization (WHO) released its own set of revised growth charts in 2006. Unlike the CDC versions, which are a growth reference, the WHO charts are true growth standard. They describe the ideal growth of healthy children in optimal conditions, measuring children who were being breastfed in many different countries (Brazil, Ghana, India, Norway, Oman, United States).

One issue that some experts have had with the CDC growth charts is that they simply describe how children—most of whom were fed formula—grew at a particular time and place, instead of representing how children should grow.

The real problem with the CDC growth charts occurs when you try to observe the growth of an infant who is exclusively breastfed, as it often seems like the child is not gaining weight well enough.

Often, the baby is gaining weight just fine, though. It's just that his or her pattern of weight gain is different from an infant who is fed formula. This pattern of weight gain for breastfeeding babies—faster weight gain than formula fed babies in the first few months, but then slower weight gain for the rest of the first year—is easier to see on the WHO growth charts.

It is now recommended that the WHO growth charts be used for infants and toddlers who are under two years old. The CDC growth charts can still be used for older children.

The WHO growth charts can be used for all children, no matter their ethnicity or socioeconomic class, or whether they are breastfed or formula fed.

WHO Growth Charts for Girls

WHO growth charts are available from the World Health Organization and from the CDC:

WHO Growth Charts for Boys

Separate WHO growth charts for boys are also available:

WHO Growth Charts vs. CDC Growth Charts

If your pediatrician thinks that your exclusively breastfed infant isn't gaining weight well enough, make sure that he or she is using the WHO growth charts to monitor your child's growth.

Does it really matter which growth chart is used? Well, consider the following scenario. 

Think about a baby who is growing at the 25th percentile on the WHO growth charts. She would be about 12 pounds at three months of age, 14 1/2 pounds at six months, 16 1/4 pounds at nine months, and 18 pounds at the one-year mark.

In contrast, if those same weights were referenced on the CDC growth charts, she would have started at the 50th percentile at three months of age, moved down to the 25th percentile at six months, down again to the 10th percentile at nine months, and ended up just below the 10th percentile on her first birthday. If using the CDC growth chart, a health professional may have thought that something was wrong with the way that the baby was growing, even though it was likely a normal pattern for a breastfeeding baby.

Sources:

MMWR: Use of the WHO and CDC Growth Charts for Children Aged 0-59 Months in the U.S. MMWR. September 10, 2010 / 59(rr09);1-15.

World Health Organization. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Health Organization, 2006.

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