Growth charts are used by pediatricians to follow a child's growth over time.

They compare specific measurements of a child compared with expected parameters of children of the same age/gender, including:

• Prenatal/intrauterine, for 26 weeks gestation forth: → can indicate SGA/IUGR, LGA
  • Birth length
  • Head circumference
  • Birth weight
• Postnatal:
  • Height
  • Weight
  • Head circumference

Where an infant is born preterm (<37 weeks), they are initially monitored by a pediatrician. After the infant has reached their expected birth date, they are classified as "0" weeks old, and plotted on the chart. This artificial age is called the corrected age, which is the actual age minus the number of weeks premature. Corrected age should be used until 2yo.

• Single measurements are usually not important, because for every population, some proportion must lie at the extremities
• Deviation from an established growth curve however (especially, decrease in growth velocity) can indicate:
  • Onset of a chronic illness (e.g. inflammatory bowel disease)
  • Genetic diseases (Down syndrome, Turner syndrome)
• They can also predict the expected adult height/weight of a child
• They can be used for population studies, to determine more or less ideal environments (e.g. nutrition conforming to pediatric guidelines, no maternal smoking, and particularly, breastfeeding <2yo)

Paperwork for growth chart, depends on the age, and gender.

Source: APEG

• 1841%20girls%2024-42%20weeks.pdf">Girls 0-3yo
• 1841%20girls%202-18%20years.pdf">Girls 2-18yo
• 1841%20boys%2024-42%20weeks.pdf">Boys 0-3yo
• 1841%20boys%202-18%20years.pdf">Boys 2-18yo

It includes:

• Affix Pt label
• Head circumference: Measuring technique: The tape should be placed over the eyebrows, above the ears and over the most prominent part of the occiput taking a direct route. A paper tape is preferable to plastic, which stretches unacceptably under tension. The maximum measurement should be recorded to the nearest 0.1cm
• Graph, of Head circumference (in cm) against the Age (years), or from 28 weeks gestation to 40 weeks (equating 0 weeks), and so forth
• Length percentile: Mother's height. Father's height. Supine length (recommended up to the age of 3 so that there is overlap with standing height at 2 to 3) is taken on a flat surface, with the child lying on her back. One observer holds the child's head in contact with a board at the top of the table and another straightens the legs and turns the feet upward to be at right angles to the legs and brings a sliding board in contact wiht the child's heels. C=M[1+L.S.Z]^(1/L) where C is the centile required, LMS are those parameters published by the CDC, and Z is the standard deviation equivalent to the centile required
• Graph, of Length percentitile (from 40-100cm), and from 0 mo-3yo, or as appropriate for the graph
• Weight percentile: Weight should be taken in the nude, or as near thereto as possible If a surgical gown or minimum underclothing (vest and pants) is worn, then its estimated weight (about 0.1kg) must be subtracted before weight is recorded. Weights are conventionally recorded to the last completed 0.1kg above the age of 6 months. The bladder should be empty
• Graph, with various rows, with the columns, Date, Age, Length, Weight, Head circum. Simplified calculation of body surface area (BSA) (m^2)=sqrt(Ht (cm)*Wt (kg))/3600
• Graph, of weight in kg (or lb) against 0 mo-3yo
• Intrauterine growth curves: Measuring technique: As for ages 0-36mo (see previous pages). Additional notes: Gestational ages are recorded in completed weeks from the first day of the mother's last menstrual period. Fetal growth is influenced by many factors including age, body weight, height, parity, ethnic origin of th emother and sex of the fetus. Corrections for some of these factors are found in the quoted reference
• Graph of Birth length and Head circumference in cm and in, against 26-44 weeks gestation
• Graph of Birth weight in kg and lb, against 24-44 weeks gestation

• Development
• Head circumference
• Blue book (medical record, which can help establish previous growth velocity)