Monitoring children's growth

New charts will help

Children whose growth is extremely abnormal are easily recognised. The aim of growth monitoring is to identify children with less obvious but treatable growth disturbances,1 2 3 4 such as growth hormone insufficiency, Turner's syndrome, and hypothyroidism.

Cheap, accurate, self calibrating equipment5 such as the Leicester height measurer and better training should ensure that children are measured accurately. Interpreting measurements is more difficult: there is no easy way of separating children with true growth problems from the more numerous “short normal” children. For this, growth charts are essential.

The Tanner-Whitehouse charts, which have been used in Britain for 30 years to assess height, weight, and head circumference, are now out of date. The average height of British children has increased (the so called secular trend). The increase in breast feeding and the “humanising” of formula feeds are responsible for more rapid weight gain in the first few months of life, followed by a deceleration. Thus the typical appearance of a weight chart for an infant born in 1995 is different from that indicated by the Tanner-Whitehouse …