Free Girls Growth Chart 0 5 Years PDF Download
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July 2010 Code HP5140
Health Professionals’ Notes
Girls New Zealand – World Health Organization Growth Chart 0–5 Years
This information is based on original materials developed by
Please place sticker if available, otherwise write in space provided.
Name………………………………………………………………………… NHI No ………………………………………………………………………
Date of birth ……………………………………………………………
Interpreting the chart
Assessing weight loss after birth
Most babies lose some weight after birth, but 80% will have regained this by 2 weeks of age. Careful clinical assessment and evaluation of feeding technique is indicated when weight
loss exceeds 10% or recovery of birth weight is slow.
Predicting adult height
(Note that this is in the Health Professionals’ Notes, but not the Well Child/Tamariki Ora Healthbook.)
Parents like to know how tall their child will be as an adult. The child’s most recent height centile (aged 2–5 years) gives a good idea of this for healthy children.
and copyright © 2009 Royal College of Paediatrics and Child
Plot this centile on the adult height predictor to the
Data Recording (continued)
Health, United Kingdom. It was adapted by the New Zealand Ministry of Health in July 2010.
Measurement 11 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
Who should use this chart?
Measurement 12 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
Anyone who measures a child, and/or plots or interprets charts, should be suitably trained or be supervised by someone qualified to do so. For further information and training materials see www.moh.govt.nz/wellchild and www.growthcharts.rcpch.ac.uk
A growth chart for all children
Measurement 13 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
This chart, which is suitable for use with New Zealand children up to age 5 years, combines World Health Organization (WHO) standards with United Kingdom preterm and birth data. The chart from 2 weeks to 5 years of age is based on the WHO growth standard, derived from measurements of healthy, non-deprived, breastfed children of mothers who did not smoke.1 The chart for birth measurements (32–42 weeks gestation) is based on British children measured around 1990.2 The charts depict a healthy pattern of growth that is desirable for all children, whether breastfed or formula fed, and of whatever ethnic origin.
Measurement 14 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
Weighing and measuring
Weight: use only clinical electronic scales in metric setting. For children up to 2 years, remove all clothes and nappy; children older than 2 years should wear minimal clothing only. Always remove shoes.
Measurement 15 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
Length: (before 2 years of age): proper equipment is essential (length board or mat). Measurers should be trained.
The child’s shoes and nappy should be removed.
Height: (from 2 years):
use a rigid rule with T piece,
Measurement 16 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
or stadiometer; the child’s shoes should be removed.
Head circumference: use a narrow plastic or paper tape to measure where the head circumference is greatest.
Measurement 17 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
Any hat or bonnet should be removed. Be aware of cultural issues around touching heads.
When to weigh
Measurement 18 |
Recording Date |
Weight |
Head Circumference |
Length/Height |
Location |
Health worker name |
Babies should be weighed in the first week as part of the assessment of feeding. Recovery of birthweight usually occurs by 10 to 14 days, and indicates that feeding is effective and that the child is well. Once feeding is established, babies should usually be weighed at the time of routine checks. If there is concern, weigh more often; however, weights measured too close together are often misleading, so babies should not be routinely weighed more frequently than at each Well Child/ Tamariki Ora check.
When to measure
Length or height should be measured at each Well Child/ Tamariki Ora check or whenever there are any worries about a child’s weight gain, growth or general health. Head circumference should be measured to age 1.
Plotting measurements
For babies born at term (37 weeks or later), plot each measurement on the relevant chart by drawing a small dot where a vertical line through the child’s age crosses a horizontal line through the measured value. The lettering on the charts (‘weight’, ‘length’ etc.) sits on the 50th centile, providing orientation for ease of plotting.
Plot birth weight (and, if measured, length and head circumference) at age 0 on the 0–1 year chart. The coloured arrows at age 0 represent UK birth weight data and show the child’s birth centile.
Weight gain in the early days varies a lot from baby to baby, so there are no lines on the chart between 0 and 2 weeks. However, by 2 weeks of age most babies will be on a centile close to their birth centile.
For preterm infants, use a separate low-birthweight chart for infants of less than 32 weeks gestation and any other infant requiring detailed assessment. For healthy infants born from 32 weeks and before 37 weeks, plot all measurements in the preterm section (to the left of the main 0–1 year chart) until 42 weeks gestation, then plot on the 0–1 year chart using gestational correction, as shown below.
The preterm section can also be used to assess the relative size of infants at the margin of ‘term’ (eg, 37 weeks gestation), but these measurements should also be plotted at age 0 on the 0–1 year chart.
Gestational correction
Plot measurements at the child’s actual age and then draw a line back the number of weeks the infant was preterm. Mark the spot with an arrow: this is the child’s gestationally corrected centile. Gestational correction should continue until one year for infants born 32 to 36 weeks and two years for infants born before 32 weeks.
If the point is closer than ¼ of a centile space from a centile line they are described as being on that centile.
If not they should be described as being between the two centiles: e.g, 75th–91st.
A centile space is the distance between two of the centile lines, or equivalent distance if midway between centiles.
Plotting for preterm infants (less than 37 weeks gestation):
Gestational age Draw a line back the number of (7 weeks preterm) weeks preterm and mark spot
Actual age with arrow.
Centile terminology
Percentage weight loss can be calculated as follows:
Weight loss = current weight – birth weight Percentage weight loss = Weight loss x 100%
Birth weight
For example, a child born at 3.500kg who drops to 3.150kg at 5 days has lost 350g or 10%; in a baby born at 3.000kg, a 300g loss is 10%.
What do the centiles mean?
A single point on these charts indicates a child’s size compared with children of the same age and maturity who have shown optimum growth. When there is more than one point, the chart shows how quickly a child is growing. The centile lines on the chart show the expected range of weights and heights (or lengths); each describes the number of children expected to be below that line (eg, 50% below 50th, 91% below the 91st). Children come in all shapes and sizes, but 99 out of 100 children who are growing optimally will be between the two outer lines (0.4th and 99.6th centiles); half will lie between the 25th and 75th centile lines.
Being very small or very big can sometimes be associated with underlying illness. There is no single threshold below which a child’s weight or height is definitely abnormal, but only 4 per 1000 children who are growing optimally are below the 0.4th centile, so these children should be assessed at some point to exclude any problems. Those above the 99.6th centile for height are almost always healthy. Also calculate BMI for children over 2 if weight and height centiles appear very different (more than two centile lines different).
What is a normal rate of weight gain and growth?
Babies do not all grow at the same rate, so a baby’s weight often does not follow a particular centile line, especially in the first year. Weight is most likely to track within one centile space (the gap between two centile lines, see diagram). In infancy, acute illness can lead to sudden weight loss and a weight centile fall, but on recovery the child’s weight usually returns to its normal centile within 2–3 weeks. However, a sustained drop through two or more weight centile spaces is unusual (fewer than 2 % of infants) and should be carefully assessed by the primary care team, including measuring length/height.
Because it is difficult to measure length and height accurately in pre-school children, successive measurements commonly show wide variation. If there are worries about growth, it is useful to measure on a few occasions over time; most healthy children will show a stable average position over time. Head circumference centiles usually track within a range of one centile space. After the first few weeks, a drop or rise through two or more centile spaces is unusual (fewer than 1 % of infants) and should be carefully assessed.
Why do the length/height centiles change at 2 years?
The growth standards show length data up to 2 years of age, and height from age 2 onwards. When a child is measured standing up, the spine is squashed a little, so their height is slightly less than their length; the centile lines shift down slightly at age 2 to allow for this. It is important that this difference does not worry parents; what matters is whether the child continues to follow the same centile after the transition.
right of the height chart to find the average adult height for children on this centile. Four out of five children will have adult heights that are within 6cm above or below this value.
Weight–height to BMI conversion chart
BMI Centile
Weight Centile
Very Overweight (Obese)
Overweight
BMI indicates how heavy a child is relative to his or her height and is the simplest measure of underweight or overweight from the age of 2, when height can be measured fairly accurately. This chart3 provides an approximate BMI centile, accurate to a quarter of a centile space.
BMI = weight in kg
(height in m)2
99.6
98
91
75
50
25
9
2
0.4
99.6
98
91
75
50
25
9
2
0.4
0.4 2 9 25 50 75 91 98 99.6
Height Centile
Date | ||||
Age | ||||
BMI Centile |
Instructions for use
Read off the weight and height centiles from the growth chart.
Plot the weight centile (left axis) against the height centile (bottom axis) on the chart above.
If between centiles, read across in this position.
Read off the corresponding BMI centile from the slanting lines.
Record the centile with the date and child’s age in the data box.
Interpretation
In a child over 2 years of age, the BMI centile is a better indicator of overweight or underweight than the weight centile; a child whose weight is average for their height will have a BMI between the 25th and 75th centiles, whatever their height centile. BMI above the 91st centile suggests that the child is overweight; a child above the 98th centile is very overweight (clinically obese). BMI below the 2nd centile is unusual and may reflect undernutrition.
References
Cole TJ, Freeman JV, Preece MA. 1998. British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood. Stat Med;17:407–29.
Cole TJ. 2002. A chart to link child centiles of body mass index, weight and height. Eur J Clin Nutr;56:1194–9.
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14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
99.6th
12 13 14 15 16 17 19 20 21 22 23 2 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47 49
Adult Height
Data Recording
Preterm GIRLS 3 4
5 6 7
8 9 10 11
52cm
11/2
21/2
3 31/2 4
GIRLS
128cm
Prediction
98th
Birth
Head Circumference
39
38
37
36
99.6th
35
Head Circumference (cm)
98th
34
91st
33
75th
32
50th
31
50cm 49
48
47
46
45
44
43
42
41
99.6th
40
39
38
91st
98th
75th
50th
he
h
e
2nd
99.6th 37
0–1 year
0.4th
2nd
9th
hea 50th 25th
d75th
91st
75th
98th
91st
a
50th
d
Age in weeks/ months
50cm 49
99.6th
98th
48
91st
47
75th
46
50th
45
25th
44
9th
43
2nd
42
0.4th
41
40cm
25th
99.6th
82cm 80
50
48
46
44
42
40cm 100cm 96
ng
92
Age in months/ years
e Measure length until age 2; measure height after age 2.
ight
25th
9th
e A child’s height is usually slightly less than their length.
1–5 years
124
99.6th
120
116
112
108
104
100
0.4th
96
92
ft/in
5.11
5.10
5.9
5.8
5.7
5.6
5.5
5.4
5.3
5.2
5.1
5.0
4.11
99.6th
98th
91st
75th
50th
25th
9th
2nd
0.4th
cm
180
175
170
165
160
155
150
Birth Measurement
Recording Date
Weight Head Circumference
Length/Height
Location Health worker name
Measurement 2
Recording Date
Weight Head Circumference
Length/Height
Location Health worker name
Measurement 3
Recording Date
Weight Head Circumference
25th
98th
30 98th
36 78
9th
91st
29
91st 88
9th
0.4th
2nd
75th
50th
75th 35 76
88cm Plot child’s
height centile on
Length/Height
le
Location Health worker name
2nd
28 50th 34
74 84
the pink lines
98th
30kg above; the black
Measurement 4
0.4th
99.6th
th
gt
h
25th
25th
27 33 72
91st
n
9th 80
Gestation in weeks
l
e
9th
26 2nd 32 70
numbers show
29 average female adult height for
25th
this centile;
Recording Date
Weight Head Circumference
50th
32 34
36 38 40 42
0.4th 31cm
2nd
66cm
68 76
2nd
0.4th
66
28 80% of children
99.6th
75th
will be within
Length/Height
Location
9th
Plotting preterm infants Use the low birthweight chart for infants less than 32 weeks gestation and any other infants requiring detailed assessment.
98th
99.6th
75th
91st
50th
25th
91st
Use this section for infants of less than 37 weeks gestation. As with term infants there may be some weight loss in the early days. From 42 weeks, plot on the
64
62
60
58
99.6th 56 98th 54
91st 75th 52
64
62
60
58cm
2nd
14kg 13.5
72
0.4th
68
64cm 24kg
9th
23
27 ±6 cm of this value.
26
98th
25
24
23
Health worker name
Measurement 5
Recording Date
Weight Head Circumference
Length/Height
Location Health worker name
Measurement 6
0–1 year chart with
22 Recording Date
0.4th
gestational correction.
Gestational age (7 weeks preterm)
50th 50
25th
9th 48
13 22
99.6th
12.5 21
Weight
21 Head Circumference
Actual age
2nd 46 12
ght
e
i
g
h
t
0.4th 20
Length/Height
75th
20 Location
Gestational correction
Plot actual age then draw a line back the number of weeks the infant was preterm and mark the spot with an arrow; this is the gestationally corrected centile.
Birth Weight
Gestation in weeks | ||||
5.5
5
4.5
4
Weight (kg)
3.5
99.6th
98th
3
91st
2.5
44cm 11kg 10.5
10
9.5
9
8.5
8
UK-WHO chart 2010 based on DH copyright 2009 reproduced with permission
7.5
7
99.6th
6.5
98th
6
91st
5.5
75th
5
50th
99.6th 98th 4.5
91st 4
75th
50th 3.5
Some degree of weight loss is common after birth. Calculating the percentage weight loss is a useful way to identify babies who need assessment.
11.5
98th
11 19
91st
10.5
10 18
75th
9.5 17
50th
9
25th
8.5 16
8 15
9th
7.5
14
2nd
7
0.4th
6.5 13
6
12
5.5
5 11
4.5 10
4
9th
3.5 9
Health worker name
19 Measurement 7
Recording Date
50th
18 Weight
Head Circumference
17 Length/Height
25th
Location
16
Health worker name
9th
15 Measurement 8
Recording Date
14 Weight
2nd
Head Circumference
13 Length/Height
0.4th
Location
12 Health worker name
Measurement 9
11 Recording Date
Weight
10 Head Circumference
Length/Height
9 Location
75th
50th
25th
9th
2nd
0.4th
99.6th
98th
91st
75th
w
50th
w
ei
25th
2
8
25th 3 3
25th
2nd
9th
Health worker name
8 Measurement 10
0.4th
2nd
2.5
2.5
Recording Date
9th
2nd
1.5
0.4th
1
0.4th
2
1.5
1
Age in weeks/ months
2 7
1.5 6
1
Age in months/ years
7 Weight
6 Head Circumference
Length/Height
Location
1 2 3 4
5 6 7
8 9 10 11
0.5kg
5kg
11/2
2 21/2 3
31/2 4 41/2
5kg
32 34
36 38 40 42
0.5kg
0
2 4 6 8 10 12 14 16 18 20
22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
12 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47 49 50 51 52 53 55 56 57 58 59 60
Health worker name
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