Practice Practice Pointer

Using the new UK-WHO growth charts

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c1140 (Published 15 March 2010) Cite this as: BMJ 2010;340:c1140

This article has a correction. Please see:

  1. Charlotte M Wright, professor of community child health1,
  2. Anthony F Williams, reader in child nutrition2,
  3. David Elliman, consultant in community child health3,
  4. Helen Bedford, senior lecturer in children’s health4,
  5. Eileen Birks, senior lecturer, health visitor5,
  6. Gary Butler, honorary professor in paediatric endocrinology4, consultant in paediatric and adolescent medicine and endocrinology6,
  7. Magda Sachs, public health manager (infant feeding)7,
  8. Robert J Moy, senior lecturer in community child health8,
  9. Timothy J Cole, professor of medical statistics4
  1. 1Faculty of Medicine, University of Glasgow, Glasgow
  2. 2St George’s, University of London
  3. 3GOSH@Haringey, Great Ormond Street Hospital, London
  4. 4Institute of Child Health, University College London, London
  5. 5Division of Childhood and Family Studies, Northumbria University, Newcastle upon Tyne
  6. 6University College London Hospital, London
  7. 7Salford NHS Primary Care Trust, Salford
  8. 8Institute of Child Health, University of Birmingham
  1. Correspondence to: C M Wright, Professor of Community Child Health, PEACH Unit, QMH Tower, Yorkhill Hospitals, Glasgow G3 8SJ cmw7a{at}clinmed.gla.ac.uk
  • Accepted 17 February 2010

Summary points

  • The new UK growth charts for children aged 0-4 years (designed using data from the new WHO standards) describe the optimal pattern of growth for all children, rather than the prevailing pattern in the UK (as with previous charts)

  • The new charts are suitable for all ethnic groups and set breast feeding as the norm

  • UK children match the new charts well for length and height, but after age 6 months fewer children will be below the 2nd centile for weight or show weight faltering, and more will be above the 98th centile

  • The new charts look different: they have a separate preterm section, no lines between 0 and 2 weeks, and the 50th percentile is no longer emphasised

  • The charts give clear instructions on gestational correction, and there is a new chart for infants born before 32 weeks’ gestation

  • The instructions advise on when and how to measure and when a measurement or growth pattern is outside the normal range

  • The charts include a “look-up” tool for determining the body mass index centile from height and weight centiles without calculation and aid for predicting adult height

  • The charts and supporting educational materials can be downloaded from www.growthcharts.rcpch.ac.uk

In April 2006 the World Health Organization published a new growth standard for children aged under 5 years.1 The United Kingdom was one of the first developed countries to adopt it, and the Department of Health commissioned the Royal College of Paediatrics and Child Health to design new growth charts and develop new evidence based instructions and supporting educational materials. These charts (known as the UK-WHO growth charts) are now in use for monitoring the growth of children aged under 4 years. This article explains how the new charts differ from the previous ones and how they should be used by …

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