WHO Child Growth Standards

***This book is a winner of the British Medical Association's 2007 annual Medical Book Competition. Highly commended in the Paediatric category***

A comprehensive review of the uses and interpretation of anthropometric references undertaken by WHO in the early 1990s concluded that new growth curves were needed to replace the existing international reference.

To develop new standards, a multi-country study was carried out to collect primary growth data and related information from 8440 healthy breastfed infants and young children from diverse ethnic backgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman, and the USA).

The first set of growth standards (length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age) are presented in this report. The curves represent the best description of physiological growth for children under five years of age. The standards depict normal early childhood growth under optimal environmental conditions and can be used to assess children everywhere, regardless of ethnicity, socioeconomic status and type of feeding.

This report will be useful to pediatricians and other healthcare providers, nutritionists, policy makers, researchers, national institutes of health, schools of medicine, and professional associations.

Inside this report

The MGRS

- The study in which primary growth data and related information were collected from 8440 children and their families in six country sites by over 200 field staff according to a common protocol.

- The study in which primary growth data and related information were collected from 8440 children and their families in six country sites by over 200 field staff according to a common protocol.

- In each site, a sample of children was followed from birth to 24 months (receiving a total of 21 home visits), while older children aged 18 to 71 months were visited once.

The growth standards

The most up-to-date statistical methodology was applied in the construction of the curves and the resulting standards have the following innovative features:

- The MGRS was designed with the objective of providing curves that depict how children should grow when their needs are met rather than merely describing how they grow in a particular region and time.

- The new standards establish the breastfed infant as the normative growth model.
- The pooled sample from the six participating countries creates a truly international standard and reiterates the fact that child populations grow similarly across the world's major regions when their health and care needs are met.

- Beyond addressing the perennial problem of under nutrition, novel indicators among the standards (i.e. BMI-for-age, triceps skin fold-for-age, and sub scapular skin fold-for-age) will be particularly useful in monitoring the epidemic of childhood obesity.

- The development of accompanying motor development reference data will provide a unique link between physical growth and motor development.

This technical report

- Describes the methodical process followed in the development of the first set of the WHO Child Growth Standards, namely, length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age.

- Presents the growth standards in tabular and graphical forms.

- Provides comparisons between the National Center for Health Statistics/WHO growth reference curves and the new standard curves.