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Pediatric Growth Charts

Monitoring physical growth is fundamental to pediatric health care delivery. As part of our ongoing efforts to support you in your delivery of care to children, we want to remind you that the most current pediatric growth charts are available on the Centers for Disease Control and Prevention (CDC) website.

The regular use of pediatric growth charts by health professionals in tracking the physical growth of infants, children, and adolescents is considered standard care for children in the U.S.

According to the CDC, there are several new features to the clinical growth charts:

• the addition of the age specific BMI-for-age for children and adolescents 2 to 20 years;
• the addition of the 85th percentile to identify children at risk of overweight on the BMI-for-age chart and weight-for-stature chart;
• the addition of the 3rd and 97th percentiles. Pediatric endocrinologists and other health care professionals may choose to use these charts when caring for children;
• extension of the lower limits for length and height: on the chart for children from birth to 36 months old, length was extended — 45 vs. 49 — and, on the optional weight-for-stature chart, length was also extended — 77 vs. 90 cm — allowing almost all 2-year-old children to be plotted on the chart.
• the agreement of smoothed percentile curves and z-scores;
• correction in the disjunction that occurred between 24 and 36 months of age when switching from length to stature using the 1977 NCHS growth charts.

The format of the individual charts have been updated. In addition to the two individual charts appearing on a single page, data entry tables have been added. The clinical charts have grids that have been scaled to metric units (kg, cm), with English units (lb, in) as the secondary scale. Clinical charts are available for boys and girls. The clinical charts for infants and older children are published in two sets:

• Set 1 contains ten charts (five for boys and five for girls), with the 5th, 10th, 25th, 50th, 90th, and 95th smoothed percentile lines for all charts, and the 85th percentile for BMI-for-age and weight-for-stature. This set contains the outer limits of the curves at the 5th and 95th percentiles.
• Set 2 contains ten charts (five for boys and five for girls), with the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed percentile lines for all charts, and the 85th percentile for BMI-for-age and weight-for-stature. This set contains the outer limits of the curves at the 3rd and 97th percentiles.

Preventive medicine is most effective when health care professionals, administrative staff, and patients work as a team. Please use these growth charts to assist the preventive health efforts of your office.

The CDC provides an instructional guide to clinicians on how to use and interpret the CDC Growth Charts to assess physical growth in children and adolescents. By using these charts, providers can compare growth in infants, children, and adolescents with a nationally representative reference based on children of all ages and racial or ethnic groups. Comparing both measurements with the appropriate age- and gender-specific growth chart enables health care providers to monitor growth and identify potential health or nutrition-related problems.

Go to the CDC’s web-based interactive training modules and tools. You can also download the clinical growth charts or call the CDC at 301-458-4636 to request copies of the charts.

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