Growth Chart Basics

A growth chart turns separate measurements into a time-based pattern. Weight, length or height, head circumference, and body mass index (BMI) are plotted against age so that the child’s growth can be compared with a standard population and, more importantly, followed over time. Use the 2014 WHO Growth Charts adapted for Canada for term infants and children from birth to 19 years. Set 1, which displays the 3rd, 15th, 50th, 85th, 97th, and 99.9th centiles, is the version recommended for routine health-professional use. Growth monitoring is also incorporated into the Rourke Baby Record well-child schedule for infants and children through five years of age. A centile is a position on the chart, not a health score. A child who tracks steadily near the 10th centile may be growing normally, while a child who drops from the 75th to the 25th centile may need assessment even though the latest point remains within the chart. The direction and rate of change often tell the nurse more than one isolated value.