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WHO Growth Chart Training

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Using the WHO Growth Standard Charts

Assessing Growth Using the WHO Growth Charts

  • Use recommended protocols to measure the weight and recumbent length of the child accurately. Record the measurements correctly.
  • Accurately measuring and recording this information is critical for growth charts to be used as an effective screening tool.
  • Calculating age correctly is also critical for accurate growth determinations and interpretations.
  • Plot these measurements on the appropriate WHO growth chart.
    • Use the percentile lines on the chart to assess body size and growth and to monitor growth over time.

WHO Percentile Cutoff Values Differ from Traditional CDC Cutoff Values

The cutoff values for the 2nd and 98th percentiles used in the WHO growth standard charts are different from those used in the CDC growth references chart. CDC uses the 5th and 95th percentiles. Different methods are used to create the WHO and CDC charts.

  • Historically, CDC used the 5th percentile to define shortness and low weight-for-length, and the 95th percentile was used to define high weight-for-length.
  • Using the WHO growth chart cutoff values indicates a change in clinical protocol.
  • Theoretically, children in the WHO population would be expected to be healthy. Thus, more extreme cutoff values are more appropriate to define the extremes of growth of children rather than the values used in the CDC growth reference.2


1World Health Organization. WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development. Geneva, Switzerland: World Health Organization; 2006.

2Mei Z, Ogden CL, Flegal KM, Grummer-Strawn LM. Comparison of the prevalence of shortness, underweight, and overweight among US children aged 0 to 59 months by using the CDC 2000 and the WHO 2006 growth charts. J Pediatr. 2008;153(5):622-628.

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