In this section
Key messages:94% of all children grow within the centile range (3rd - 97th centiles)3% of all children grow below the 3rd centile3% of all children grow above the 97th centileApproximately half the children at any age grow below the 50th centile, and half grow above the 50th centile.
Despite some parents and practioners' perceptions the 50th centile is not the goal for each child
The best indicator of poor growth is weight and / or length tracking downwards on percentiles on the weight and / or length for age growth charts.
Other popular, but less reliable definitions in the past have included:
Weight or length / height for age less than 3rd centile
Weight or length / height for age greater than 97th centile
Remember that there will always be a bottom and top 3%; these measures do not necessarily indicate a growth problem
Unexplained weight loss or weight not re-gained following acute illness
Weight or length / height 'plateau'
Weight for age, length / height for age, or BMI increasing or decreasing centiles on growth chart
BMI greater than 85th centile on the BMI for age growth chart
Chart 1: Weight is going up over time, but dropping on the percentile lines. This is a cause for concern.
Chart 1 (above)
Chart 2: Child has lost weight; this is a cause for concern
Chart 2 (above)
Chart 3: Weight value has not changed, but plotting shows decline on percentile chart. This is a cause for concern.
Chart 3 (above)
Chart 4: Weight is going up quicker than expected for age. This is a cause for concern.
Chart 4 (above)
Monitoring the growth of children with health issues such as prematurity, medical conditions known to alter growth, genetic disorders, developmental delays and disabilities requires additional considerations.
Corrected age should be used until 2 years of age (or until the child 'catches' up or whichever is sooner). The optimal rate of weight gain or catch up growth is not known. There are concerns that rapid weight gain early in life may promote growth of excess fat cells and increase later risk of chronic illness
Low birth weight
Low birth weight is defined as birth weight less than 2500g. Low birth weight infants born at, or near term are expected to track along a lower percentile on the weight for age growth charts. This includes infants with slow intra-uterine growth and infants from multiple births. Low birth weight infants may 'catch up' over time to a higher percentile, or may follow their own line below the 3rd percentile on the growth chart. Either way, weight and length should generally track in proportion. Breastfeeding is encouraged for all infants irrespective of birth weight.
Medical conditions / chromosomal disorders
Some conditions such as chromosomal disorders may change a child's growth potential. Specific charts have been developed for a range of different conditions, but are based on small numbers of children and are generally not recommended.
Further details on monitoring growth in children with special needs can be obtained at http://depts.washington.edu/growth/