Growth Problems. Compare the points plotted on the child's growth charts with the z-score lines to determine whether they indicate a growth problem. Measurements in the shaded boxes are in the normal range. Growth indicators Z-score | Lengthiheight- | Weightfor- | Weight-for- for-age age | tengthiheight | &MMorage Above | See note 1 Obese Obese Above 2 see note 2 |Ovemeiant | Overweight Possible risk | Possible risk Above 1 ofoverweighe | of overweight (seenote 3) _| (See note 3) 0 (median) Below—4 ‘Stunted Betow-2 | Stmed | undenvennt | waster wei Severely Severely Below-3 | stunted underweight | Severely Serinly, See note 4) | ;See note 5) _| “284 sone Notes: 1. A child in this range fs very tal. Tales ie rarely a problem, unless it ie so excessive that may indicate an endocrine disorder euch 26 2 growth-hormene-producing tumor. Refer 3 child inthis range for acsecomentifyou suspect an endocrine disorder (e.g. F parents of normal height have 2 child who i exeeesively tall for hig or her age). 2. A chid whose weight-for-age fall in this range may have 2 growth problem, but this is better aecezeed from weight-fordengthvheight or BMI-for-age. 3. Aplotted point above 7 chows possible risk A trend lowards the 2 z-score line shows definite rick. 4. Ite possible for 2 ctunted or severely stunted child fo become overweight. 5. Thies referred to ae very low weight in IMC! training modulee. (Integrated Management of Childhood linees, in-service training. WHO, Geneva, 1997)