14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 12 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 Adult Height

Preterm 50cm
GIRLS 3 4 5 6 7 8 9 10 11
50cm
552cm 11/2
2
21/2 3 GIRLS 124cm Prediction
ft/in cm
Data Recording
Birth Measurement
49
0 1 year Age in weeks/ months
49 50
99.6th
98th
Age in months/ years 1 4 years 120
5.11 180
Recording Date
Weight
99.6th 91st 5.10
Birth 48 48 Head Circumference
98th 48 75th 116

head
Head Circumference 47 47 50th
Measure length until age 2; measure
5.9
99.6th 175 Length/Height
39 91st 99.6
th
25th height after age 2. 5.8 Location
46 46 46 112 98th
38 75th 9th
A childs height is usually slightly less 98th Health worker name
45 45 than their length. 5.7 170

d
50th 2nd 91st
37 44 91st 108 Measurement 2

a
44 44 0.4th 5.6
Recording Date
25th

e
75th
36 75th Weight
43 43 104 5.5 165
9th 42

h t
50th
50th Head Circumference
35

h
42 2nd 42 5.4
th
.6

100 Length/Height

g
25th
99

40cm 25th
0.4th

i
34 41 41
Head Circumference (cm)

5.3 160 Location

th

e
th 9th
98

.6 9th Health worker name

40 99 40cm 96cm 96 5.2

h
33
st

th 2nd
91

98 2nd Measurement 3
39 5.1 155
32 s t Recording Date
th

91 92 92
75

0.4th
38 h 82cm 0.4th 5.0
t Weight
31 75
th

th
50

99.6th
37 t h 99.6 80 88 88 Head Circumference

h
50 4.11 150

t
30 98th
th

th 98th Length/Height
36 25
25

g
78
84cm Plot childs
91st h
91st .6t Location

len
29 9t
h 84 99
35 height centile on
9th

75th 76 th Health worker name

2n
d 75th 9 8
the pink lines
28
d

50th t
34 th 74 91s
2n

4 50th
80 30kg above; the black Measurement 4
0.

h
25th 5 th
numbers show
th

t
27 7 Recording Date
33 25th 72
0.4

h
9th 50t 29 average female

g
76 t h
Weight
26 2nd 32 9th 70 25 adult height for

n
Gestation in weeks this centile; Head Circumference
0.4th 2nd 9th
31cm 68 72 28 80% of children

le
2nd
Length/Height
32 34 36 38 40 42 0.4th
66cm 66 0.4
th will be within Location
68 27 6 cm of this
Plotting preterm infants Health worker name
64 64 value.
Use the low birthweight Measurement 5
chart for infants less than 32 62 62 64 26
Recording Date
weeks gestation and any th
other infants requiring 60 .6 60 Weight
99 25
detailed assessment. th 60cm
58 98 58cm
Head Circumference
Use this section for infants st
91 Length/Height
of less than 37 weeks 56 5th 24kg 24
gestation. As with term 99.6th 7 h Location
th .6t
infants there may be some 98th 50 99
54 th 14kg Health worker name
weight loss in the early days. 91st 25 23 23
From 42 weeks, plot on the 75th 52 9t
h 13.5 Measurement 6
01 year chart with d Recording Date
gestational correction. 50th 2n 22 22
50 4t
h 13
25th 0. Weight
th
Gestational age 48 th 12.5 98 Head Circumference
9th 99.6 21 21
(7 weeks preterm)
2nd Length/Height
46 12
Actual age 0.4th
20 20 Location
44cm 11.5
Gestational correction 98th Health worker name

www.healthforallchildren.co.uk
t
Plot actual age then draw a 11kg 11 91s
19 19 Measurement 7
line back the number of
weeks the infant was preterm 10.5 Some degree of weight 91st
10.5 Recording Date
and mark the spot with an loss is common after birth. 18 18 Weight
arrow; this is the gestationally 10 10 h
Calculating the percentage 75t Head Circumference
corrected centile. 75th
9.5 weight loss is a useful way 9.5 17 17
Length/Height
to identify babies who

t
Birth Weight 9 9 Location
need assessment.

h
5.5 50th 16 16
50th Health worker name

g
8.5 8.5

Harlow Printing Limited Tel: 0191 455 4286

t
25th Measurement 8

e
8 8 15 15

h
5 Recording Date
25th

ig
7.5 9th 7.5

w
Weight
14 14
4.5

e
7 2nd 7 Head Circumference
h 9th
.6t
99 13 Length/Height
6.5 6.5 13

w
0.4th
h
.6t

4 Location
99

6 6 h 2nd
12 98t 12 Health worker name
st 8th

5.5
9

3.5 5.5 Measurement 9

t 0.4th
91s
91

11 Recording Date
Weight (kg)

5 5 11
th
75 Weight
6th

99.6th
3 4.5 th 4.5 75t
h
9t 25 50 75 91 98t 99.

50

DH Copyright 2009
98th
10 10 Head Circumference
h

91st t h
4 25 4 50t
h Length/Height
2.5 75th
th th th st

h 9
3.5 9t 3.5 9 Location
50th
n d 25th
2 h
25th 4t Health worker name
2 3 0. 3 9th 8
9th 8 Measurement 10
2nd 2.5 2.5 2nd Recording Date

UK - WHO Chart 2009

1.5 0.4th 7 0.4t
h 7
h

d
2 2 Weight
2n Head Circumference
h 1.5
.4t 1.5 6 6
1 0 Age in months/ years Length/Height
1 Age in weeks/ months 1
Gestation in weeks Location
1 2 3 4 5 6 7 8 9 10 11 5kg 1
1 /2 2 2 /2 1
3 3 /2 5kg 1

0.5kg 0.5kg Health worker name

32 34 36 38 40 42 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 12 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47 48
Data Recording (continued)

GIRLS UKWHO Interpreting the chart

Measurement 11 Predicting adult height
Please place sticker (if available) otherwise write in space provided.
Recording Date Assessing weight loss after birth Parents like to know how tall their child will be as an adult. The
Weight Most babies lose some weight after birth but 80% will have childs most recent height centile (aged 2 4 years) gives a good
Name: ________________________________________ idea of this for healthy children. Plot this centile on the adult
Head Circumference regained this by 2 weeks of age. Fewer than 5% of babies lose
Length/Height
Location
Growth Chart 0 4 years NHS / CHI No:
more than 10% of their weight at any stage; only 1 in 50 are
10% or more lighter than birth weight at 2 weeks.
height predictor to the right of the height chart to find the
average adult height for children on this centile. Four out of five
Health worker name
children will have adult heights that are within 6cm above or
Hospital No: Percentage weight loss can be calculated as follows: below this value.
Measurement 12 Weight loss = current weightbirth weight
Recording Date
Weight
Date of Birth: Percentage weight loss = Weight loss 100% Weightheight to BMI conversion chart
Birth weight BMI indicates how heavy a child is relative to his or her height
Head Circumference
For example, a child born at 3.500kg who drops to 3.150kg at and is the simplest measure of thinness and fatness from the age
Length/Height Who should use this chart? When to measure length or height
5 days has lost 350g or 10%; in a baby born at 3.000kg, a of 2, when height can be measured fairly accurately. This chart4
Location Length or height should be measured whenever there are provides an approximate BMI centile, accurate to a quarter of a
Anyone who measures a child, plots or interprets charts 300g loss is 10%.
Health worker name any worries about a childs weight gain, growth or general centile space. For greater accuracy, calculate BMI and plot
should be suitably trained, or be supervised by someone
Measurement 13 health. directly on a BMI centile chart.
qualified to do so. For further information and training Careful clinical assessment and evaluation of feeding technique
Recording Date
materials see www.growthcharts.rcpch.ac.uk is indicated when weight loss exceeds 10% or recovery of birth weight in kg
Weight Plotting measurements weight is slow. BMI =
Head Circumference For babies born at term (37 weeks or later), plot each BMI = (height in m)2
Length/Height
A growth chart for all children measurement on the relevant chart by drawing a small dot
The UKWHO growth chart combines World Health What do the centiles mean? 99.6
Location where a vertical line through the childs age crosses a These charts indicate a childs size compared with children of the 98
Organization (WHO) standards with UK preterm and birth
horizontal line through the measured value. The lettering on same age and maturity who have shown optimum growth. The 91

BMI Centile
Health worker name
data. The chart from 2 weeks to 4 years of age is based on 99.6 e)
Measurement 14 the WHO growth standard, derived from measurements of
the charts (weight, length etc.) sits on the 50th centile, chart also shows how quickly a child is growing. The centile lines (Obes 75
98 t
providing orientation for ease of plotting. on the chart show the expected range of weights and heights (or igh 50
we eight
Recording Date healthy, non-deprived, breastfed children of mothers who did
lengths); each describes the number of children expected to be 91 er 25

Weight Centile
v w
y O Over
Weight not smoke.1 The chart for birth measurements (3242 weeks 9
Head Circumference gestation) is based on British children measured around Plot birth weight (and, if measured, length and head below that line (e.g. 50% below 50th, 91% below the 91st). 75 Ver 2
Length/Height 1990.2 The charts depict a healthy pattern of growth that is circumference) at age 0 on the 01 year chart. The coloured Children come in all shapes and sizes, but 99 out of 100 children 50 0.4
arrows at age 0 represent UK birth weight data and show who are growing optimally will be between the two outer lines
Location desirable for all children, whether breast fed or formula fed, 25
the childs birth centile. (0.4th and 99.6th centiles); half will lie between the 25th and
Health worker name and of whatever ethnic origin.3
75th centile lines. 9
Measurement 15
Weighing and measuring Weight gain in the early days varies a lot from baby to baby, 2
Recording Date
Being very small or very big can sometimes be associated with
Weight When measuring children up to 2 years, remove all so there are no lines on the chart between 0 and 2 weeks. 0.4
underlying illness. There is no single threshold below which a
Head Circumference clothes and nappy; children older than 2 years should However, by 2 weeks of age most babies will be on a centile
childs weight or height is definitely abnormal, but only 4 per
Length/Height wear minimal clothing only. Always remove shoes. close to their birth centile.
1000 children who are growing optimally are below the 0.4th
0.4 2 9 25 50 75 91 98 99.6
Location Weight: use only class III clinical electronic scales in centile, so these children should be assessed at some point to
For preterm infants a separate low birth weight chart is exclude any problems. Those above the 99.6th centile for Height Centile
Health worker name metric setting.
available for infants of less than 32 weeks gestation and any height are almost always healthy. Also calculate BMI if weight
Measurement 16
Length: (before 2 years other infant requiring detailed assessment. For healthy and height centiles appear very different.
Recording Date Date:
of age): proper infants born from 32 weeks and before 37 weeks, plot all
Weight
equipment is essential measurements in the preterm section (to the left of the main What is a normal rate of weight gain and growth? Age:
Head Circumference
(length board or mat). 0 1 year chart) until 42 weeks gestation, then plot on the Babies do not all grow at the same rate, so a babys weight often
Length/Height Measurers should be trained.
0 1 year chart using gestational correction, as shown below. does not follow a particular centile line, especially in the first BMI Centile:
Location
Health worker name
Height: (from 2 years): use a rigid year. Weight is most likely to track within one centile space (the
rule with T piece, or stadiometer. The preterm section can also be used to assess the relative gap between two centile lines, see diagram). In infancy, acute Instructions for use
Measurement 17 illness can lead to sudden weight loss and a weight centile fall 1. Read off the weight and height centiles from the growth
Position head and feet as illustrated size of infants at the margin of term (e.g. 37 weeks
Recording Date
with child standing as straight as Frankfurt gestation), but these measurements should also be plotted but on recovery the childs weight usually returns to its normal chart.
Weight Plane
centile within 23 weeks. However, a sustained drop through
possible. at age 0 on the 0 1 year chart. 2. Plot the weight centile (left axis) against the height centile
Head Circumference two or more weight centile spaces is unusual (fewer than 2% of
(bottom axis) on the chart above.
Length/Height infants) and should be carefully assessed by the primary care
Gestational correction 3. If between centiles, read across in this position.
Location team, including measuring length/height.
Plot measurements at the childs actual age and then draw a
Health worker name 4. Read off the corresponding BMI centile from the slanting
line back the number of weeks the infant was preterm. Mark
Measurement 18 Because it is difficult to measure length and height accurately in lines.
the spot with an arrow (see diagram): this is the childs
Recording Date pre-school children, successive measurements commonly show
Head circumference: use a gestationally corrected centile. Gestational correction should wide variation. If there are worries about growth, it is useful to 5. Record the centile with the date and childs age in the data
Weight
narrow plastic or paper tape to continue until at least 1 year of age. months measure on a few occasions over time; most healthy children will box.
Head Circumference
measure where the head Centile terminology show a stable average position over time.
Length/Height Interpretation
circumference is greatest.
Location If the point is within 1/4 of a space of In a child over 2 years of age, the BMI centile is a better indicator
the line they are on the centile: e.g. 91st. UK children have relatively large heads compared to the WHO of overweight or underweight than the weight centile; a child
Health worker name
standard, particularly after the age of 6 months. After the age of whose weight is average for their height will have a BMI
Measurement 19 6 weeks a head circumference below the 2nd centile will be seen
If not they should be described as between the 25th and 75th centiles, whatever their height

Issue 2
Recording Date When to weigh being between the two centiles: in only 1 in 250 children. A head circumference above the centile. BMI above the 91st centile suggests that the child is
Weight Babies should be weighed in the first week as part of the e.g. 75th91st. 99.6th centile, or crossing upwards through 2 centile spaces,
overweight; a child above the 98th centile is very overweight
Head Circumference assessment of feeding and thereafter as needed. Recovery of should only cause concern if there is a continued rise after 6

UK-WHOA4G
A centile space is the distance between (clinically obese). BMI below the 2nd centile is unusual and may
Length/Height birthweight indicates that feeding is effective and that the months, or other signs or symptoms.
two of the centile lines, or equivalent reflect undernutrition.
Location child is well. Once feeding is established, babies should
distance if midway between centiles.
Health worker name usually be weighed at around 8, 12 and 16 weeks and 1 year Why do the length/height centiles change at 2 years? References
Measurement 20 at the time of routine immunisations. If there is concern, The growth standards show length data up to 2 years of age, 1. www.who.int/childgrowth/en

weigh more often; however, weights measured too close
Recording Date
Weight together are often misleading, so babies should be weighed
no more than once a month up to 6 months of age, once
Plotting for preterm infants
(less than 37 weeks gestation):
Gestational age Draw a line back the number of
and height from age 2 onwards. When a child is measured
standing up, the spine is squashed a little, so their height is
slightly less than their length; the centile lines shift down slightly
Nov. 12
2. Cole TJ, Freeman JV, Preece MA. British 1990 growth reference centiles for
weight, height, body mass index and head circumference fitted by maximum
penalized likelihood. Stat Med 1998;17:407-29.

Manufacture 13
Head Circumference 3. www.sacn.gov.uk/reports_position_statements/index.html
every 2 months from 6 to 12 months of age, and once every (7 weeks preterm) weeks preterm and mark spot with at age 2 to allow for this. It is important that this difference does 4. Cole TJ. A chart to link child centiles of body mass index, weight and height.
Length/Height arrow.
3 months over the age of 1 year. However, most children do Actual age not worry parents; what matters is whether the child continues Eur J Clin Nutr 2002;56:1194-9.
Location
not need to be weighed this often. to follow the same centile after the transition.
Health worker name DH Copyright 2009