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
BOYS 3 4 5 6 7 8 9 10 11
50cm
552cm 11/2 99.6th
2
21/2 3 BOYS 124cm Prediction Data Recording
Birth Measurement
49
0 –1 year Age in weeks/ months 99.6th
49 50
98th
91st
Age in months/ years 1– 4 years 120
Recording Date
98th 75th
ft/in cm Weight

head
Birth 48
91st
48
50th
6.5 195
Head Circumference
48 ● Measure length until age 2; measure 116 6.4
Head Circumference 47 75th
47 25th height after age 2. th
99.6th
Length/Height
40 99.6 6.3 190
9th ● A child’s height is usually slightly less Location
46 50th 46 46 112 6.2 98th

d
39 2nd than their length. 98th
Health worker name

a
25th 6.1
45 45 0.4th 91st 185
38 91st Measurement 2

he
9th 44 108 6.0
44 44 5.11
75th Recording Date
37 2nd 75th 180
43 43 Weight

t
42 104 5.10 50th
0.4th 50th

h
36 5.9 Head Circumference
42 42 175

g
25th
th

i
40cm 25th 100 5.8 Length/Height
.6

35
99

th

e
41 41
Head Circumference (cm)

.6 5.7
9th
Location
99 9th
170

h
th

34 h
98

40 t 40cm 5.6 Health worker name

98 96cm 96 2nd

st 2nd
st

33 1 5.5 165 Measurement 3

91

39 9 84cm 0.4th
99.6th th 0.4th 92 5.4 Recording Date
75 92
th

32
75

98th
38 th th 82 5.3 160 Weight
50 99.6

h
th 0th

31

t
37 t h
98th 80 88 88 Head Circumference
5

91st
25

g
Plot child’s
91st Length/Height

len
30 h
25

75th 36 9t 78 h height centile on

.6t
84 99 84cm the blue lines Location
2n
d 75th th
h

29 50th 35 76 98
9t

h above; the black

4t 50th t Health worker name
0. 91s

h
th nd

30kg numbers show

25th
28 34 74 80 h Measurement 4
25th 75t
2

t
9th h
average male
33 72 50t Recording Date
0.4

9th

g
27 h adult height for
2nd 76 25t 29 this centile; Weight
2nd

n
26 32 70 9th 80% of children Head Circumference
Gestation in weeks 0.4th 0.4th 2nd

le
31cm 68 28 will be within
72 0.4t
h Length/Height
32 34 36 38 40 42 ±6 cm of this
66cm 66 value. Location
68 27 Health worker name
Plotting preterm infants 64 64
Use the low birthweight Measurement 5
chart for infants less than 32 62 62 64 26
th Recording Date
weeks gestation and any .6
60 99
other infants requiring t h 60 Weight
detailed assessment. 98 25
st 60cm Head Circumference
58 91 58cm
Use this section for infants 99.6th
th
of less than 37 weeks 75 Length/Height
98th 56 t h 24kg 24
gestation. As with term 50 Location
infants there may be some 91st th
54 25 14kg Health worker name
weight loss in the early days. 23 6th 23
75th
9t
h 99.
From 42 weeks, plot on the 52 d 13.5 Measurement 6
50th 2 n
0–1 year chart with h Recording Date
50 .4t 22 22
gestational correction. 25th 0 13
th Weight
99.6
Gestational age
9th 48 12.5 21 Head Circumference
98t
h 21
(7 weeks preterm) 2nd
46 12 Length/Height
Actual age 0.4th 98th
20 20 Location
44cm 11.5
Gestational correction Health worker name

www.healthforallchildren.co.uk
Plot actual age then draw a 11kg 91st 11 91st
19 19 Measurement 7
line back the number of
weeks the infant was preterm 10.5 Some degree of weight 10.5 Recording Date
and mark the spot with an loss is common after birth. 75th 18 18
10 10 Weight
arrow; this is the gestationally Calculating the percentage 75th
Head Circumference

t
corrected centile.
9.5 weight loss is a useful way 50th 9.5 17 17

h
Length/Height
to identify babies who

ig
Birth Weight 9 9 Location
need assessment. 25th 50th
5.5 16 16

t
8.5 8.5 Health worker name

Harlow Printing Limited Tel: 0191 455 4286

h
9th
8 8 15 15 Measurement 8
25th

g
5 Recording Date

i
2nd

w
7.5 7.5

e
Weight
14 14
4.5 0.4th 9th
7 7 6th Head Circumference
99.

w
h
.6t

13 13 Length/Height
6.5 6.5
99

4 98t
h 2nd Location
th

6 6
98

12 12 Health worker name

t
91s 0.4th
th st

5.5 5.5 Measurement 9

50 75 91

3.5
11 11 Recording Date
Weight (kg)

h
5 5 75t
6th

99.6th
th

Weight
9t 25 50 75 91 98 99.

3 98th 4.5 4.5

10 50th

© DH Copyright 2009
th 10
th th th st th

Head Circumference
91st 25
4 h 4 25th Length/Height
2.5
75th 9t
2n h
d 9 9 Location
50th 3.5 3.5 9th
.4t
25th 0 Health worker name
2 3 3 2nd
9th 8 8
h Measurement 10
2nd 2.5 2.5 0.4t
Recording Date
h

UK - WHO Chart 2009

1.5 0.4th 7 7
2n
d 2 2 Weight
h
.4t Head Circumference
0 1.5 1.5 6 6
1 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 1
2 /2 3 1
3 /2 5kg
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)

BOYS UK–WHO Interpreting the chart

Measurement 11 Predicting adult height
Please place sticker (if available) otherwise write in space provided.
Recording Date Parents like to know how tall their child will be as an adult. The
Assessing weight loss after birth
Weight child’s most recent height centile (aged 2– 4 years) gives a good
Name: ________________________________________ Most babies lose some weight after birth but 80% will have
Head Circumference idea of this for healthy children. Plot this centile on the adult
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 weight–birth weight
Recording Date
Weight
Date of Birth: Percentage weight loss = Weight loss ✕ 100% Weight– height to BMI conversion chart
Birth weight BMI indicates how heavy a child is relative to his or her height
Head Circumference
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 For example, a child born at 3.500kg who drops to 3.150kg at
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 child’s 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 BMI =
weight is slow. BMI = (height in m)2
Head Circumference For babies born at term (37 weeks or later), plot each
Length/Height
A growth chart for all children measurement on the relevant chart by drawing a small dot
The UK–WHO growth chart combines World Health What do the centiles mean? 99.6
Location where a vertical line through the child’s age crosses a 98
Organization (WHO) standards with UK preterm and birth These charts indicate a child’s size compared with children of the
horizontal line through the measured value. The lettering on 91

BMI Centile
Health worker name same age and maturity who have shown optimum growth. The 99.6 e)
Measurement 14
data. The chart from 2 weeks to 4 years of age is based on the charts (‘weight’, ‘length’ etc.) sits on the 50th centile, chart also shows how quickly a child is growing. The centile lines (Obes 75
the WHO growth standard, derived from measurements of 98 t
providing orientation for ease of plotting. igh 50
on the chart show the expected range of weights and heights (or we eight
Recording Date
healthy, non-deprived, breastfed children of mothers who did 91 er 25

Weight Centile
lengths); each describes the number of children expected to be v w
y O Over
Weight
not smoke.1 The chart for birth measurements (32–42 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 circumference) at age 0 on the 0–1 year chart. The coloured Children come in all shapes and sizes, but 99 out of 100 children 50 0.4
1990.2 The charts depict a healthy pattern of growth that is
Location arrows at age 0 represent UK birth weight data and show who are growing optimally will be between the two outer lines
desirable for all children, whether breast fed or formula fed, 25
Health worker name the child’s birth centile. (0.4th and 99.6th centiles); half will lie between the 25th and
and of whatever ethnic origin.3 9
75th centile lines.
Measurement 15
Weighing and measuring Weight gain in the early days varies a lot from baby to baby, 2
Recording Date
When measuring children up to 2 years, remove all so there are no lines on the chart between 0 and 2 weeks. Being very small or very big can sometimes be associated with 0.4
Weight
clothes and nappy; children older than 2 years should However, by 2 weeks of age most babies will be on a centile underlying illness. There is no single threshold below which a
Head Circumference
wear minimal clothing only. Always remove shoes. close to their birth centile. child’s weight or height is definitely abnormal, but only 4 per
Length/Height
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 Height Centile
Health worker name metric setting. exclude any problems. Those above the 99.6th centile for
available for infants of less than 32 weeks gestation and any
Measurement 16 height are almost always healthy. Also calculate BMI if weight
Length: (before 2 years other infant requiring detailed assessment. For healthy
Recording Date and height centiles appear very different. 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 Age:
Head Circumference
(length board or mat). What is a normal rate of weight gain and growth?
Length/Height
0 –1 year chart) until 42 weeks gestation, then plot on the Babies do not all grow at the same rate, so a baby’s weight often
Measurers should be trained. BMI Centile:
Location
0 –1 year chart using gestational correction, as shown below. does not follow a particular centile line, especially in the first
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 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 illness can lead to sudden weight loss and a weight centile fall
Recording Date
with child standing as straight as Frankfurt gestation), but these measurements should also be plotted but on recovery the child’s weight usually returns to its normal chart.
Weight Plane
possible. at age 0 on the 0 –1 year chart. centile within 2–3 weeks. However, a sustained drop through 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
Gestational correction infants) and should be carefully assessed by the primary care
Location team, including measuring length/height. 3. If between centiles, read across in this position.
Plot measurements at the child’s 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
the spot with an arrow (see diagram): this is the child’s Because it is difficult to measure length and height accurately in lines.
Recording Date
gestationally corrected centile. Gestational correction should pre-school children, successive measurements commonly show 5. Record the centile with the date and child’s age in the data
Weight Head circumference: use a wide variation. If there are worries about growth, it is useful to
narrow plastic or paper tape to continue until at least 1 year of age. months box.
Head Circumference measure on a few occasions over time; most healthy children will
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

Issue 2
Recording Date between the 25th and 75th centiles, whatever their height
When to weigh being between the two centiles: in only 1 in 250 children. A head circumference above the
Weight centile. BMI above the 91st centile suggests that the child is
Babies should be weighed in the first week as part of the e.g. 75th–91st. 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-WHOA4B
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