In this section
Chart 1: Timeline of growth charts in Australia - Download (Doc)
The WHO growth charts are based on measurements of children from birth to 5 years of age, from 6 countries representing different regions of the world: Brazil, Ghana, India, Norway, Oman and the United States. The families met strict eligibility criteria including:
Children's growth was measured more than 20 times over 5 years.The WHO promotes these charts for children from all ethnic backgrounds, irrespective of the type of infant feeding.
Previous growth charts used in Australia (NCHS 1977 and CDC 2000) were based on health surveys of children in the US and included:
Recommended charts for girls and boys at different ages are listed below:
0 - 24 months
Weight for age
Length for age
3rd - 97th
3rd - 97th
2 - 18 years
Height (stature) for age
BMI for age
Table 2: Recommended growth charts for use in Australia
Girls WHO chart 0 – 2 year olds length (PDF)
Girls WHO chart 0 – 2 year olds weight (PDF)
Girls WHO chart 0 – 2 year olds head circumference (PDF)
Boys WHO chart 0 – 2 year olds length (PDF)
Boys WHO chart 0 – 2 year olds weight (PDF)
Boys WHO chart 0 – 2 year olds head circumference (PDF)
Girls CDC charts 2 – 18 year olds Weight for age and Height for age (PDF)
Girls CDC charts BMI for age (PDF)
Boys CDC chart 2 – 18 year olds Weight for age and Height for age (PDF)
Boys CDC chart 2 – 18 year olds BMI for age (PDF)
Charts are available from the WHO growth standards and the CDC growth charts websites
The recommendation for adopting the WHO standards for children 0 - 2 years in Australia is based on several considerations. (NB: WA use WHO charts for children 0- 5 years; NT use WHO charts for children 0- 18 years)
This is consistent with the advice of the NHMRC Australian Dietary Guidelines (2013) which recommend exclusive breastfeeding until around six months and then continued breastfeeding while solid foods are introduced and until 12 months of age and beyond for as long as the mother and infant wish.
Growth standard versus growth reference:
Children in the WHO sample were raised under ideal circumstances and health conditions. The WHO describes these charts as growth standards; identifying how children should grow in optimal conditions. On the other hand, CDC charts show the growth of a sample population of children in the US, and included some children with poor growth (due to illness etc) and other children who were overweight.
Longitudinal versus cross-sectional growth monitoring:
Infants in the WHO growth study were measured 21 times between birth and 2 years. Frequent measures are better at showing the rapid and changing rate of growth in early infancy
The CDC charts were based on national survey data - the infants and children were each measured only once. Measurements from the first 2 -3 months of life were not available, so different data was incorporated into the charts. In summary, the CDC charts show the size of a group of infants, not the actual growth as shown in the WHO longitudinal charts.International sample population:
The WHO charts are based on children from a range of ethnic groups and are considered relevant for all Australian children regardless of their cultural background.
For more information about the strengths and limitations of different growth charts refer to background reading.
Regardless of which charts are used, serial measurements of a child's weight and length / height plotted on a growth chart are needed to assess the child's growth.
Health practitioners need a broad understanding of the way different growth charts were constructed, and consider this when interpreting growth of individual children. For example, WHO infant charts are based on the growth of healthy breastfed infants living in ideal conditions; CDC charts are based on a snapshot of children's weight and heights living in the US.