Data Recording

Measurement 1
Recording Date BOYS Please place sticker (if available) otherwise write in space provided.
Pubertal Assessment
The puberty ‘phase’ may be ascertained through simple
questions about the appearance of secondary sexual
Growth patterns before and during puberty
Successive height measurements can show wide variation,
because it is difficult to measure height accurately. If there are
Weight
Length/Height UK Growth chart Name: ________________________________________

NHS / CHI No:

characteristics as well as by clinical examination.

By history from parents, carers or young person

concerns it is useful to measure on a few occasions over time.
Assessing growth during puberty is complex because the age

2-18 years
Location when puberty starts varies.
Health worker name Pre-puberty In Puberty Completing Puberty
Hospital No: (Tanner stage 1) (Tanner stages 2-3) (Tanner stages 4-5) What does a height in the shaded area below the 0.4th
Measurement 2
If both of the following: If any of the following: If any of the following: centile mean?
Recording Date Date of Birth: High voice Slight deepening of the voice Voice fully broken This chart provides some extra guidance about the lower limit
Weight
No signs of pubertal Early pubic or armpit Moustache and early facial (0.4th centile) for height in boys 9-14 years. If a plot falls within
Length/Height When is further assessment required? development hair growth hair growth the shaded area on the height chart between 9 and 14 years,
Location Anyone who measures a child, plots or interprets charts If any of the following: Enlargement of testes or penis Adult size of penis with pubertal assessment will be required and mid-parental centile
should be suitably trained or supervised. For further pubic and axillary hair should be assessed.
Health worker name • Where weight or height or BMI is below the 0.4th
information and training materials see fact sheet and centile, unless already fully investigated at an earlier If they are In puberty or Completing puberty, they are below
Measurement 3
presentation on www.growthcharts.rcpch.ac.uk age. the 0.4th centile and should be referred. In most instances a Pre-
Recording Date • If the height centile is more than 3 centile spaces below Is the timing of puberty normal?
pubertal boy plotted in this area is growing normally, but
Weight This chart is mainly intended to assess the growth of school the mid-parental centile. The three vertical black lines (puberty lines) on the right hand
comparison with the mid-parental centile and growth trajectory
Length/Height age boys. It combines data from the UK 1990 growth • A drop in height centile position of more than 2 centile page (9-18 years) of the chart indicate the normal age limits for will assist the assessment of whether further investigation is
reference for children at birth and from 4 -18 years(1), with spaces, as long as measurement error has been the phases of puberty described above.
Location needed.
the WHO growth standard for children aged 2 years to 4 excluded. • Boys with measurements plotted on the left page will
Health worker name months
years(2). The growth of children under 2 years of age should • Smaller centile falls or discrepancies between child’s usually be in the ‘Pre-puberty’ phase. Puberty before 9
and mid-parental centile, if seen in combination, or if Centile terminology
Measurement 4 be plotted on the more detailed UK-WHO 0-4 years growth
years in boys is likely to be precocious and further
Recording Date charts. associated with possible underlying disease. If the point is within 1/4 of a space of
• If there are any other concerns about the child’s assessment is necessary.
the line they are on the centile: e.g. 91st.
Weight growth. • Between 9-14 years most boys will be either ‘Pre- puberty’
As well as simply using this chart for plotting growth data, it
Length/Height also includes a number of new features which you may wish or ‘In puberty’. If there are no signs of puberty by 14 If not they should be described as
to use to help interpret the growth data. years, then puberty is delayed and further assessment is being between the two centiles:
Location Adult Height Predictor e.g. 75th–91st.
Health worker name • birth centile plotting scale This allows you to predict the child’s adult height based on indicated.
• BMI look-up and plotting grid • From 14-17 years most boys will be either ‘In puberty’ or
Measurement 5 their current height, but with a regression adjustment to A centile space is the distance between
• scales to estimate adult height and mid-parental ‘Completing puberty’. two of the centile lines, or equivalent
allow for the tendency of very tall and short children to be
Recording Date centile • After 17 years boys will usually be ‘Completing puberty’. distance if midway between centiles.
less extreme in height as adults. Four boys out of five will
Weight • guide to assessing puberty
have an adult height within ±6 cm of the predicted adult If this is not the case, maturation is delayed and further
Length/Height assessment may be needed.
height.
Location
Measurement procedure
Accurate measurement is essential and shoes must be Instructions for use
Health worker name
removed for all measurements Plot the most recent height centile on the centile line on the Body Mass Index (BMI) centile look-up
Measurement 6 Height: Adult Height Predictor (on the flap to the right of the height
If weight is above the 75th centile or if 99.6
99.6
Recording Date Measure height recorded to the last centile chart) and read off the predicted adult height for this
Frankfurt weight and height centiles differ, the BMI
Weight Plane millimetre. A correctly installed centile. 98
98
centile should be calculated, as the BMI
Length/Height stadiometer or approved portable 91
91
Mid-Parental Centile centile is the best indicator of thinness and 99.6 )
ese
measuring device is the only
Location
equipment that can be reliably used fatness. The BMI look-up allows you to read b 75
75
t (O
The ‘mid-parental centile’ is the average adult height centile
98

www.healthforallchildren.co.uk
Health worker name (see illustration). If a child cannot to be expected for all children of these parents. It off the BMI centile, accurate to a quarter of a
h 50
50
ig t
Measurement 7 stand, measure lying down, using incorporates a regression adjustment to allow for the centile space. There is a BMI centile grid at
91 erwe eigh 25
25

Weight Centile
an approved length measuring the top of the growth chart where the v w
y O Over
Recording Date tendency of very tall and short parents to have children with 9
device and plot as for height. less extreme heights. Comparing this to the child’s current centiles for children with high or low values 75 er
V tile 2
Weight
Position head height centile can help assess whether the child’s growth is can be plotted.
e n
Ic
Length/Height proceeding as expected. The larger the discrepancy between 0.4
0.4
and feet as 50
BM

Harlow Printing Limited Tel: 0191 455 4286

Location illustrated with the two, the more likely it is that the child has some sort of Instructions for use
Health worker name child standing as growth disorder. Most children’s height centiles (nine out of 25
1. Note the weight and height centiles from
straight as ten) are within ±two centile spaces of the mid-parental
Measurement 8 the growth chart.
possible. centile, and only 1 percent will be more than three centile 9
Recording Date spaces below. 2. Plot the weight centile against the height
centile on the the BMI look-up. 2
Weight Weight: Instructions for use
Length/Height Remove heavy clothing and shoes and 3. If between centiles, read across in this
The Mid-parental Centile Comparator is on the flap to the months
weigh using class III clinical electronic position. 0.4
Location right of the height centile chart. If possible measure both
scales in metric setting. 4. Read off the corresponding BMI centile
Health worker name parents’ heights, or else use reported heights. Plot their
from the blue slanting lines.
heights on the Mother’s and Father’s height scales. Join the
Measurement 9 5. Plot the centile in the BMI grid at the top
Plotting two points with a line between them. The mid-parental
0.4 2 9 25 50 75 91 98 99.6

Issue 2
Recording Date Plot each measurement by placing a small dot where a of the growth chart at the appropriate
centile is where this line crosses the centile line in the middle.
Weight vertical line through the child’s age crosses a horizontal line Compare the mid-parental centile to the child’s current age. Height Centile
Length/Height through the measured value. height centile, plotted on the adult height predictor centile What does a high or low BMI mean?

UK2-18A4B
Location The lettering on the charts (‘weight’, ‘length’ etc.) sits on the scale. A BMI above the 91st centile suggests overweight. A child above the 98th centile is very overweight (clinically obese). BMI below the
Health worker name 50th centile to provide orientation. 2nd centile is unusual and may reflect undernutrition, but may simply reflect a small build.
Mid-parental target height
Measurement 10 Birth centile plotting scale

Recording Date The chart starts at age 2 years, but there is a plotting scale on
Weight the left of the chart where for term infants, birth weight (and
if measured, length) can be plotted to allow comparison of
Jan. 13
This can be obtained by plotting the mid-parental centile on
the main chart at age 18 and reading off the corresponding References
height. Four boys out of five will have an adult height within 1. Freeman JV, Cole TJ, Chinn S, Jones PRM, White EM, Preece MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 1995; 73:17-24.

Manufacture 4
Length/Height ±7 cm of this target height. However the predicted adult 2. www.who.int/childgrowth/en
the birth centile with later growth. For further relevant references see fact sheet downloadable from www.growthcharts.RCPCH.ac.uk
Location height (above) is usually closer than mid-parental target © Copyright RCPCH 2012
Health worker name height to the child’s final height.
 99.6th 99.6th 99.6th 99.6th
Very Overweight (obese) Very Overweight (obese) Parent Height Comparator
98th 98th 98th 98th
91st Overweight 91st 91st Overweight 91st Mother’s
height
75th 75th 75th 75th Father’s ft/in cm
50th BMI CENTILE FROM LOOKUP OVERLEAF 50th 50th BMI CENTILE FROM LOOKUP OVERLEAF 50th height 6’1” 185
25th 25th 25th 25th cm ft/in
months 200 6’7”
9th 9th 9th 9th Mid-parental 6’
2nd 2nd 2nd 2nd 6’6” centile
0.4th 0.4th 0.4th 0.4th
91st 5’11” 180
155cm 155cm 200cm 200cm 195 6’5"
31/2 4 41/2 5 51/2 6 61/2 7 71/2 8 81/2 9 11 12 13 14 15 16 17 18
5’10”

150
BOYS 150
195 BOYS 99.6th
195
190
6’4”

6’3" 5’9” 175

2-9 years 190 9-18 years 98th
190 6’2" 5’8”
.6t
h 75th
21/2 3 99 10 91st
185 6’1" 170
185 185 5’7”
145 145
6’
th 75th
98 5’6”

Puberty starting before 9 years is precocious

Puberty is delayed if no signs are present by 14 years

Puberty completing after 17 years is delayed

180 180

t
180 5’11”
140 months 91
st 140
175

igh 50th
175 5’10” 50th
5’5” 165

e 25th 5’4”
175 5’9”

135 75

50
th

th
135
170

165
h 9th

2nd
170

165 170
5’8”

5’7”
25th
5’3”

5’2”
160

130 130 5’6” 5’1” 155

160 160
th 0.4th 165
25 5’5”
5’

t
155 155
5’4” 150
125 125 h
.6t 4’11”

h
9th 99
Transit point 160 5’3”
150 150 9th
from UK-WHO h 4’10”

g
98t
to UK90 data. 5’2”

i
d
120 2n 120 145 145 4’9” 145
t
91s 155 5’1”

115

he 0.4
th

115
140

135
75t

50t

25t
h

h
Pre-pu
berty
0.4th
140

135cm
Father’s height: ____________

Mother’s height: ___________

Mid-parental Centile
110 110 130 105kg • Plot the the Mother’s and
9th Father’s heights on their
99.6th respective scales and join the
125 2nd
100 two points with a line. The
105 105cm mid-parental centile is where
h this line crosses the centile line
120 0.4t 95
2 For all Children in the middle.
plotted in this • Compare the mid-parental
th 115 shaded area see 98th 90
Birth .6 centile to the child’s current
100 99 50kg instructions. height centile, plotted on the
centiles adult height predictor centile
th

110cm 85
98

th scale.
.6
Length st 99 • Nine out of ten children’s
91 91st
95 45 80kg 80 height centiles are within
th
75 ±two centile spaces of the
th
mid-parental centile.
50 75 75
58 90 h 40 75th Adult Height Predictor
th 98t
99.6th 25
70 70 ft/in cm
98th 56
9t
h 99.6th 192

Puberty starting before 9 years is precocious

Puberty is delayed if no signs are present by 14 years

Puberty completing after 17 years is delayed

t
91st
54 50th 6’3”

h
85 2n
d t 35 65 65 190
75th 91s 98th

ig
52 h 6’2”
50th 4t
0.

we
60 25th 60
25th 50 6’1” 91st 185
75th
80 30
9th 48 9th
6’0”
55 h 55 75th

t
2nd
50th .6t
99 5’11” 180

h
46

g
0.4th 2nd 50th

i
44cm 75cm 25th 25 50 50 5’10”

Weight

99.6th
5
20kg
99.6
98th
th we 9th
2nd
0.4th 20
45

40
98t
h

91st
0.4th
45

40
5’9”
5’8”
5’7”
5’6”
25th

9th

2nd
175

170

91st 35 35
98th 4.5 15 15 75th 5’5” 165
91st
75th 0.4th
4 50th 5’4”
30 50th 30
75th 25th
9th 5’3” 160
50th 3.5 2nd 25th
25th 10 0.4th 10 25 9th 25
9th
3 2nd
Predicted Adult Height
0.4th • Plot the most recent height
2nd 2.5 20 20 centile on the relevant centile
0.4th
Age in years Age in years line and
2kg 5 5 • Read off the predicted adult
2 21/2 3 31/2 4 41/2 5 51/2 6 61/2 7 71/2 8 81/2 9 15 9 10 11 12 13 14 15 16 17 18 15 height for this centile.
1 • Four out of five children will
months be within ±6 cm of this value.
0kg 0kg 10kg 10kg