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Girl’s Growth Record
For use by parents and other care providers to monitor and
promote her health, growth, and development
This is the main record of your daughter’s health, growth and development.
This booklet contains recommendations for feeding and caring for your daughter at
different ages: as a girl grows, her needs change.
The record is to be used jointly by you and others who care for her. Therefore, keep it
in a safe place and carry it with you whenever you bring her to:
x a health centre (whether it is for a well-baby visit or because she is sick)
x a doctor or other health care provider
x a hospital outpatient department or emergency department
x any other health appointment
Personal Data
Child’s name _____________________________________ Girl If a boy,

must use a
Identification/Record number ___________________ Boy’s Growth
Parents’ names ______________________________________________ Record
_____________________________________________________
Address ___________________________________________________
_____________________________________________________
Birth information:
Date of birth _______________________
Gestational age at birth ____________ Single/multiple birth? ________
Measurements at birth:
Weight _________ Length __________ Head circumference _________
Birth rank _________
Date of birth of next younger sibling (born to mother)________
Feeding:
Age at introduction of any foods or fluids ____________ More details of feeding history
Age at termination of breastfeeding ___________ may be recorded in Visit Notes
Adverse events (dates):
(such as death of parent, death of sibling age <5 years) ________________________
_________________________________________________________________
1
Table of Contents
Page
Personal data ..........................................................................................................................1
Table of contents...................................................................................................................2
Recommended immunization schedule ............................................................................4
Other national programme recommendations...............................................................5
Visit notes.........................................................................................................................6–11
When special care or advice may be needed............................................................... 12
Recommendations for feeding

Up to 6 months of age ........................................................................................ 14
Recommended foods for babies and children age 6 months to 5 years .. 15
Age 6 months to 1 year....................................................................................... 16
Age 1 to 2 years .................................................................................................... 18
Age 2 to 5 years .................................................................................................... 19
Recommendations for food safety and hygiene ............................................. 20
Care for development messages
Key messages about care for all times ............................................................. 21
Age 0 to 4 months................................................................................................ 22
Age 4 to 6 months................................................................................................ 23
Age 6 months to 1 year....................................................................................... 24
Age 1 to 2 years .................................................................................................... 25
Age 2 years and older .......................................................................................... 26
2
Growth charts for girls ......................................................................................................27
Understanding growth charts ................................................................................................... 28
Birth to 6 months GIRLS

Length-for-age ........................................................................................................29
Weight-for-age .......................................................................................................30
Weight-for-length .................................................................................................31
BMI-for-age .............................................................................................................32
Age 6 months to 2 years GIRLS

Length-for-age .......................................................................................................33
Weight-for-age .......................................................................................................34
Weight-for-length..................................................................................................35
BMI-for-age .............................................................................................................36
Age 2 to 5 years GIRLS

Height-for-age ........................................................................................................37
Weight-for-age .......................................................................................................38
Weight-for-height..................................................................................................39
BMI-for-age .............................................................................................................40
Gross motor milestones....................................................................................................41
Annex: Immunization schedule for infants recommended by the

WHO Expanded Programme on Immunization............................................42
3
Sample Immunization Schedule (EPI)
Date
Age Vaccine Place received
received
DPT-1
2–3 Hib
months Hepatitis B
OPV-1
DPT-2
4–5 Hib
months Hepatitis B
OPV-2
DPT-3
6–7 Hib
months Hepatitis B
OPV-3
12–15 MMR
months Yellow fever
DPT
18 months
OPV
DPT
5 years OPV
MMR
Bring your child back for the next immunizations on:

________________ ________________ _____________ ______________
________________ ________________ _____________ ______________
4
Other National Programme Recommendations
for Children under Age 5 Years
(Recommendations to be inserted with space to record supplements given, etc))
Micronutrient supplementation given, such as iron, Vitamin A:

(note date, supplement, amount given)
Deworming:
Developmental assessment:
5
Date of birth:
Visit Notes
Age Measurements
(Record below; then plot on
today Reason for visit, observations,
Date of charts)
(Completed
visit Length/ recommendations
years/months Weight
Height BMI*
or weeks) (kg)
(cm)
* BMI (body mass index) = weight in kilograms divided by length or height in meters squared (kg/m2)
6
Visit Notes
Feeding: Notes on history, any problems, counselling given
Other information ( such as drug or food allergies, chronic conditions):
7
Date of birth:
Visit Notes
Age Measurements
charts)
(Completed
Date of Length/ recommendations
years/months Weight
visit Height BMI*
or weeks) (kg)
(cm)
8
Visit Notes
Other information (such as drug or food allergies, chronic conditions):
9
Date of birth:
Visit Notes
Age Measurements
charts)
(Completed
Date of Length/ recommendations
years/months Weight
visit Height BMI*
or weeks) (kg)
(cm)
10
Visit Notes
Other information (such as drug or food allergies, chronic conditions):
11
When Special Care or Advice May be Needed
Any time that you have concerns about your child’s growth or development, seek the
advice of a health care provider. He or she can assess your child and advise you.
Other times that special care or advice may be needed include:
j If the child’s growth curve is too far from the centre line (labelled '0'), it may be a
sign that she is undernourished or overweight. If she is not within the normal range,
a health care provider can help you find ways to help her grow normally. For
example, changes may be needed in the type of foods she is given, or the frequency
or quantity of feeding. Or she may need more emotional support, or stimulation,
or physical activity that will help her become healthy.
j If the child is severely undernourished, she needs urgent specialized care.
j If the child is obese, she needs medical assessment and specialized management.
Discuss this with the health care provider.
j If a mother suspects that she may be HIV positive, she should be encouraged to go
for counselling and testing.
j If a pregnant woman or the mother of an infant knows that she is HIV positive, she
needs specialized counselling about her options for feeding the baby.
12
and care of
infants and children
Recommendations for Feeding and Care

j If your child is sick, feed her according to the recommendations for her age group provided in
this section. Also give more fluids (breastfeed more for a breastfed child) and encourage her to
eat soft, varied, appetizing, favourite foods. After illness, give food more often than usual and
encourage the child to eat more.
13
an infant up to 6 months of age
x Feed your baby only breast milk until she is 6 months of age (180 days).
x Breastfeed as often as your baby wants, day and night, at least 8 times in 24 hours.
x Breastfeed when your baby shows signs of hunger: beginning to fuss, sucking fingers, or
moving her lips.
x At each feeding, encourage your baby to empty the breast and then offer the other breast.
x Do not give her other foods or fluids. Breast milk quenches your baby’s thirst and satisfies
her hunger.
14
Recommended foods for babies and children
age 6 months to 5 years
Breast milk continues to be an important source of nutrients up to age 2 years and beyond. Your
baby needs other foods and liquids in addition to breast milk once she reaches 6 months of age
(180 days). This page lists examples of recommended foods. The following pages recommend
how much, how often and how to feed your child at different ages.
x Staple foods give your child energy. These foods include cereals (rice, wheat, maize, millet,
quinoa), roots (cassava, yam, potato), and starchy fruits (plantain, breadfruit).
x Staple foods do not contain enough nutrients by themselves. You also need to give animal-
source and other nutritious foods. Your child should eat a variety of these foods:
¾ Animal-source foods: Liver, meat, chicken, fish, eggs
¾ Milk products: Cheese, yoghurt, curds (milk, for non-breastfed children)
¾ Pulses: Chickpeas, lentils, cow peas, black-eyed peas, kidney beans, lima beans (For
vegetarians, these are important alternatives to animal-source foods.)
Feeding recommendations
¾ Green leafy and yellow-coloured vegetables: Spinach, broccoli, chard. sweet potatoes,
carrots, pumpkin
¾ Fruits: Banana, orange, guava, mango, peach, kiwi, papaya
¾ Oils and fats: Vegetable oils, butter
¾ Groundnut paste, other nut pastes; soaked or germinated seeds such as sesame,
pumpkin, sunflower, melon seeds
x Feed your child different foods from the groups above, together with the staple food.
15
an infant age 6 months to 1 year
x Breastfeed as often as your baby wants.

x To initiate complementary feeding, begin offering her small amounts of other foods at age 6
months (180 days). Introduce new foods one at a time. Wait 3–4 days to be sure that she
can tolerate a new food before introducing another food.
x Give her staple foods and a variety of animal-source and other nutritious foods (listed on
page 15).
x Increase the quantity of food as she grows older while continuing to breastfeed frequently.
¾ At 6–8 months of age, start by offering 2–3 tablespoons of thick porridge or well-
mashed foods 2–3 times per day. Increase the amount gradually to 1/2 cup.* By 8
months, give her small chewable items to eat with her fingers. Let her try to feed herself,
but provide help. Avoid foods that can cause choking (such as nuts, grapes, raw carrots).
Give 1–2 snacks between meals depending on her appetite.
¾ At 9–11 months of age, offer finely chopped or mashed foods and foods that baby can
pick up, about 1/2 cup, at 3–4 meals per day plus 1–2 snacks depending on her appetite.
16
x Feed her from her own plate or bowl.
x Patiently help your baby eat. Talk to her lovingly, look into her eyes and actively
encourage her to eat, but do not force her.
x If she loses interest while eating, remove any distractions and try to keep her interested in
the meal.
x After 6 months of age, babies may need more water even when they drink the
recommended amounts of milk. To find out if your baby is still thirsty after eating, offer
her some water (that has been boiled and cooled).
* In these recommendations, a cup refers to 250 ml or an 8 ounce cup and a tablespoon refers to a 15 ml
tablespoon. Each country should specify customary measures that mothers will understand.
The suggested amounts assume an energy density of 0.8–1.0 Kcal/g. If the foods given are thin and lower in
nutritional content (i.e. about 0.6 Kcal/g), meals should increase to 2/3 cup at 6–8 months and to 3/4 cup at 9–
11 months.
17
a child age 1 to 2 years
x Breastfeed as often as your child wants up to age 2 or beyond.

x Continue to give 3–4 meals of nutritious foods, chopped or
mashed if necessary, ¾–1 cup* at each meal. Also give 1–2
snacks per day between meals depending on her appetite.
x At each meal, feed your child a staple food along with different
nutritious foods from the groups listed on page 15.
x Feed her from her own plate or bowl. Continue to actively help her to eat.
* The suggested amount assumes an energy density of 0.8–1.0 Kcal/g. If the foods given are thin and lower in
nutritional content, the child should receive a full cup at each meal.
18
a child age 2 to 5 years
x Give family foods at 3 meals each day. Also, twice daily between meals, give nutritious
snacks such as:
________________________________________________________________
_________________________________________________________________
________________________________________________________________
x Offer a variety of foods such as those on page 15. If she refuses a new food, offer her
“tastes” of it several times. Show that you like the food.
x Do not force her to eat. Give realistic portions depending on her age, size and activity
level. Increase the quantity of food as she grows older.
19
Recommendations for Safe Food Preparation and Hygiene
Practise good hygiene to prevent illness:
x Wash your hands with soap before preparing food, before feeding a baby, and after using
the latrine or toilet.
x Obtain clean water for drinking, treat it properly,* store it in clean covered containers, and
use a clean scoop to draw it.
x Wash your child's cup or bowl thoroughly with soap and clean water or boil it.
x Avoid using feeding bottles which are difficult to clean.
x Prepare food using clean utensils. Feed a baby with a clean spoon.
x Keep food preparation surfaces clean by using water and soap or detergent to clean them
after each use.
x Cook foods thoroughly, especially meat, poultry, eggs and seafood. Reheat cooked food
thoroughly, for example, bring soups and stews to boiling point.
x Cover food that is left over, and refrigerate it if possible. Discard cooked food that is left at
room temperature for longer than two hours.
x Avoid contact between raw and cooked foods and store them in separate containers.
x Have a clean, functioning latrine that is used by all family members old enough to do so.
Quickly collect the stool of a young child or baby and put it into a latrine. Promptly clean a
child who has passed stool. Then wash your hands and hers.
* Boil water vigorously for a few seconds. Cover and let it cool down on its own without adding ice. This water
is safe for the baby to drink.
20
Key Messages about Care for All Times
Care Messages
j Brain development is most rapid in the first two years of life, so young children need to be
stimulated by playing with others, moving around, hearing sounds, and having things to see, touch,
and explore.
j Daily routines regarding eating, sleeping, hygiene, etc. help children to develop regular patterns and
to feel secure.
j Teach your child to communicate by speaking to her, listening to her, and playing with her.
j Play is children's work. It gives them many chances to learn and develop the ability to solve
problems. They learn by trying things out and by observing and copying others.
j Fancy toys are not needed for development. Toys to stimulate development can be made at home.
j Illness interferes with normal growth and development. To prevent illness, have your child
immunized and feed her as described in the Growth Record. When she is ill, take her to a health care
provider.
j Children learn most rapidly when they are in nurturing and stimulating relationships with their
caregivers. The mother, father, and siblings can all contribute to the child's development by caring
for and playing with her.
j Protecting children from physical harm and emotional distress (due to violence or strong anger)
helps them gain confidence to explore and learn.
21
Age 0 to 4 months
Emotional development
x A healthy child can see, hear, and smell at birth. She recognizes her mother from her voice, scent,
and face.
x Her father plays an important role in the child's development and should be involved in caring for
her.
x She can learn a lot from older siblings, and they from her, so they too should play with and help care
for her.
x Soothing her when she is distressed will help her learn to trust and communicate with you.
x Breastfeeding is a good time for cuddling, nurturing, and emotional bonding.
Communication
x Look into your child’s eyes and smile at her (for example, when feeding). Talking face to face with
her, repeating her sounds and gestures, and singing to her will teach her to communicate.
x She will respond to her mother's touch, looks, smiles and sounds. She will try to communicate her
needs through movements, cooing sounds, and cries.
Movement
x She will soon discover her hands and feet. Letting her move her arms and legs freely will help her
grow strong.
x She will begin to reach for objects and put them in her mouth because she learns by taste and touch.
x She will try to raise her head to see around. Help by carrying her, raising her head and back so she
can see. Letting her roll on a safe surface will help her develop her muscles.
22
Age 4 to 6 months
Care Messages
x Children love to see people and faces, so family members should hold and carry the baby, smile,
laugh, and talk with her.
x She is now attaching to her mother and may feel uncomfortable with strangers. Leaving her with
people she knows will help her feel secure.
Communication
x She enjoys making new sounds like squeals and laughs. She will
respond to someone's voice with more sounds, copy the sounds she
hears, and start learning about making a conversation with another
person.
x To prepare her for talking, repeat her sounds and talk to her about
what she feels, sees and wants.
Movement
x As she sees her world, she will want to touch, taste, and explore. Giving her safe clean colourful
household objects that she can touch, bang, throw, and put into her mouth will help her learn and
develop hand skills. Keep away small objects that can go into the mouth and be swallowed.
x Letting her sit with support and roll around safely will help her muscles develop.
23
Age 6 months to 1 year
x She may not want to separate from you. Help her cope with separation by gently telling her when you
will need to leave her and by leaving her with people she is familiar with. Peek-a-boo and hide-and-seek
are well-known games to teach her that you are not gone forever when she cannot see you.
x She will notice when people express strong anger and may be upset by it. Avoid exposing her to such
emotional distress and reassure her if it does happen.
x The love and time you give her, your interest in what she is doing, and your support for her curiosity
will help her self-confidence.
Communication
x Respond to her sounds and interests. Talk to her, sing for her, give meaning to her babbling, take notice,
and respond when she tries to tell you something. Telling her stories, reading to her, and telling her the
names of things and people will help her learn to speak and communicate.
Movement
x Playing with safe clean household items like non-breakable plates,
cups and spoons, banging pots and pans, opening and closing lids,
stacking and sorting objects, and feeding herself with her fingers will
help her learning and hand skills.
x Letting her move freely and play in a safe environment will help her
muscles develop.
24
Age 1 to 2 years
Care Messages
x Give her opportunities to do things for herself, and rejoice in what she does to help her develop self-
esteem.
x She may be angry and frustrated when she cannot have all that she wants. Tell her about her feelings.
She will learn rules quicker if there are not many of them and if they are clear and consistent.
x She may want to do everything on her own and appear stubborn. She may want to stay an infant and
also be grown up at the same time. Understanding this phase of her childhood, holding her when she
wants to be a baby, and giving her some independence when she wants to be grown up will help her.
Communication
x This age is important for her to learn to speak and understand words. Encourage her learning by
watching what she does and naming it. Use every chance to make conversation with her (for example,
when feeding, bathing, or working near her).
x Ask her simple questions and respond to her attempts to talk. Encourage her to repeat words.
Listening when she uses gestures or words will increase her efforts to talk. Imaginary play, books,
songs, rhymes, stories, and taking turns in games will enrich her development.
Movement
x She will begin to use one hand more frequently and skilfully. Let her use whichever
hand the brain has selected. She can practice hand skills while she is feeding and
dressing herself, drawing, scribbling, playing with water, playing with things she can
stack or combine, and putting things in and out of containers.
x Take her outside so that she can run, jump, climb, and grow strong.
25
Age 2 years and older
x The love and time you give her, your interest in what she is doing, your belief that she will succeed, and
your support for her curiosity will help her self-confidence and desire to learn.
x At this age she can understand what is right and wrong. She can be taught how people should behave
through stories, songs, and games. She will learn better if she is told what is correct first, and she should
be corrected gently so that she does not feel ashamed.
x Cooking and doing errands together, sorting clothes, and doing other household chores will boost her
self-confidence and improve her learning.
Communication
x Listen to what she is telling you, encourage her to ask questions, and try to answer them. Let her talk
about whatever she has experienced or wants to tell you. Encourage her to tell stories. Teach her to
name things, to count, and to compare and match sizes, shapes and colours of things around her.
Movement
x Drawing, writing, colouring, stacking, sorting, and helping prepare
food will improve her hand skills.
x Playing out of doors and with other children will enrich all of her
development.
x Encourage her active play and movement. Provide opportunities for
activities such as marching, jumping, kicking and hopping.
26
Girl’s Growth Charts
Girl’s Growth Charts
27
Understanding Growth Charts
Normal growth in individual children can vary a great deal. Plotting a child’s measurements over
time on growth charts can show whether a child is growing normally or not.
A health care provider weighs and measures your child and records these measurements. Then
the child’s measurements are plotted as dots on the charts. Measurements taken at later visits are
also plotted, and the dots are joined by a line. This line is your child’s growth curve or trend.
Interpreting Growth Curves

x The line labelled 0 on the growth chart is the median which is, generally speaking, the average.
The other lines, called z-score lines, indicate distance from the average. A point or trend
which is far from the median, such as 3 or –3, indicates a growth problem.
x The growth curve of a normally growing child will usually follow a track that is roughly parallel
to the median. The track may be above or below the median.
x Any quick change in trend (the child’s curve veers upward or downward from its normal
track) should be investigated to determine its cause and remedy any problem.
x A flat line indicates that the child is not growing. This is called stagnation and may also need to
be investigated.
x A growth curve that crosses a z-score line may indicate risk. A health care provider can
interpret risk based on where (relative to the median) the change in trend began and the rate
of change.
28
Length-for-age GIRLS
Birth to 6 months
Birth to 6 months (z-scores)
3
This
70 2 70 Length-for-
age chart
1 shows
attained
65
0 65 length
relative to
-1 age in
comparison
-2 to the
Length (cm)
60 60 median (0
-3 line).
x A child
55 55 whose
length-
for-age is
below the
line –2 is
50 50 stunted.
x Below –3
is
severely
stunted.
45 45
Weeks 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Months 3 4 5 6
Age (Completed weeks or months)
29
Weight-for-age GIRLS
3
This Weight-
10 10 for-age chart
shows body
2 weight relative
9 9 to age in
comparison to
8
1 8
the median (0
line).
0 x A child whose
Weight (kg)
7 7 weight-for-
age is below
-1 the line –2 is
6 6 underweight.
-2 x Below –3 is
severely
5 -3 5 underweight.
Clinical
signs of
4 4 marasmus
or
kwashiorkor
3 3 may be
observed.
2 2
Weeks 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Months 3 4 5 6
30
Weight-for-length GIRLS This Weight-
for-length
Birth to 6 months
chart shows
14 14 body weight
relative to
3 length in
13 13
comparison to
the median (0
12 2 12 line).
11 1 11 x A child
whose
10 0 10 weight-for-
length is
above the
9 -1 9 line 3 is
Weight (kg)
-2 obese.
8 8 x Above 2 is
-3 overweight.
7 7 x Above 1
shows
possible
6 6 risk of
overweight.
5 5
x Below the
4 4 line –2 is
wasted.
x Below –3 is
3 3 severely
wasted.
2 2 Refer for
urgent
45 50 55 60 65 70 75 80 specialized
care.
Length (cm)
31
BMI-for-age GIRLS
Birth to 6 months (z-scores) This BMI-for-
age chart
22 3 22 shows Body
Mass Index
21 21 (BMI, a ratio of
body weight to
20
2 20 length) for the
child’s age in
comparison to
19 19
the median (0
1 line). BMI-for-
18 18
age is
especially
BMI (kg/m²)
17 0 17 useful for
screening for
16 16 overweight.
-1
15 15 x A child
whose BMI-
14 -2 14 for-age is
above the
13 -3 13 line 3 is
obese.
12 12 x Above 2 is
overweight.
11 11 x Above 1
shows
10 10 possible
risk of
overweight.
Weeks 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Months 3 4 5 6
32
Length-for-age GIRLS
6 months to 2 years (z-scores)
95
3 95 This
Length-for-
2 age chart
shows
90 90
1 growth in
length
0 relative to
85 85 age in
comparison
-1
6 months to 2 years
to the
Length (cm)
median (0
80 -2 80
line).
-3 x A child
75 75 whose
length-for-
age is
below the
70 70
line –2 is
stunted.
x Below –3
65 65 is
severely
stunted.
60 60
Months 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
1 year 2 years
Age (Completed months and years)
33
17 3 17
This Weight-
16 16 for-age chart
shows body
weight relative
15 15
2 to age in
comparison to
14 14 the median (0
line).
13 1 13
x A child whose
Weight (kg)
12 12 weight-for-
0 age is below
11 11 the line –2 is
underweight.
10 -1 10 x Below –3 is
severely
underweight.
9 -2 9
Clinical
signs of
8 -3 8 marasmus
or
7 7 kwashiorkor
may be
6 6 observed.
5 5
Months 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
1 year 2 years
34
Weight-for-length GIRLS This Weight-
for-length
Birth to 2 years (z-scores) chart shows
body weight
3 relative to
24 24
length in
comparison to
22 2 22 the median (0
line).
20 1 20
x A child
18 0 18 whose
weight-for-
-1 length is
6 months to 2 years
16 16 above the
-2
Weight (kg)
line 3 is
14 -3 14 obese.
x Above 2 is
12 12 overweight.
x Above 1
10 10 shows
possible
risk of
8 8
overweight.
6 6 x Below the
line –2 is
4 4 wasted.
x Below –3 is
2 2 severely
wasted.
45 50 55 60 65 70 75 80 85 90 95 100 105 110 Refer for
urgent
Length (cm) specialized
care.
35
BMI-for-age GIRLS
This BMI-for-
age chart
22 22 shows Body
Mass Index
body weight to
3 length) for the
20 20 child’s age in
comparison to
the median (0
19 19 line). BMI-for-
2 age is
BMI (kg/m²)
18 18 especially
useful for
screening for
17 17 overweight.
1
16 16 x A child
whose BMI-
0 for-age is
15 15 above the
line 3 is
14 -1 14
obese.
x Above 2 is
overweight.
13 -2 13 x Above 1
shows
12 -3 12 possible
risk of
Months 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 overweight.
1 year 2 years
36
Height-for-age GIRLS
2 to 5 years (z-scores)
125 125
3
120 120 This Height-
2 for-age
chart shows
115 115 growth in
1 height
relative to
110 110 age in
0 comparison
to the
105 -1 105 median (0
Height (cm)
line).
100 -2 100 x A child

whose
height-for-
95 -3 95
age is
below the
90 90 line –2 is
stunted.
x Below –3
85 85 is
severely
stunted.
80 80
2 to 5 years
75 75
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
2 years 3 years 4 years 5 years
37
29
3 29
28 28 This Weight-
for-age chart
27 27
shows body
26 26 weight relative
25 2 25 to age in
24 24 comparison to
the median (0
23 23
line).
22 22
21 1 21 x A child whose
Weight (Kg)
20 20 weight-for-
19 19 age is below
the line –2 is
18 0 18 underweight.
17 17 x Below –3 is
16 16 severely
-1 underweight.
15 15
Clinical
14 14
-2 signs of
13 13 marasmus
12 -3 12 or
11 11 kwashiorkor
may be
10 10
observed.
9 9
8 8
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
38
Weight-for-height GIRLS
This Weight-
2 to 5 years (z-scores) for-height chart
32 32 shows body
3 weight relative
30 30 to height in
comparison to
28 2 28 the median (0
line).
26 26 x A child
1 whose
24 24 weight-for-
0 height is
22 22 above the
line 3 is
-1
Weight (Kg)
20 20 obese.
-2 x Above 2 is
18 18 overweight.
-3 x Above 1
16 16 shows
possible
14 14 risk of
overweight.
12 12
x Below the
10 10 line –2 is
wasted.
8 8 x Below –3 is
severely
6 6 wasted.
Refer for
2 to 5 years
urgent
65 70 75 80 85 90 95 100 105 110 115 120
specialized
Height (cm) care.
39
BMI-for-age GIRLS
This BMI-for-
21 3 21 age chart
shows Body
Mass Index
body weight to
length) for the
19 19 child’s age in
2 comparison to
the median (0
18 18 line). BMI-for-
age is
especially
BMI (kg/m²)
17 17
1 useful for
screening for
overweight.
16 16
x A child
15
0 15 whose BMI-
for-age is
above the
14 14 line 3 is
-1 obese.
x Above 2 is
13 13 overweight.
-2 x Above 1
12 12 shows
possible
-3 risk of
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 overweight.
40
Gross Motor Milestones
Windows of Achievement
Walking alone
Standing alone
Motor Milestone
Walking with assistance
Hands-&-knees crawling
Standing with assistance
Sitting without support
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Age in months
These windows show when the reference population for the WHO Child Growth Standards achieved these motor milestones.
41
Annex: Immunization schedule for infants recommended by
the WHO Expanded Programme on Immunization
This chart would be used when developing the immunization schedule for a country,
such as on page 4 of this booklet. (This page is not for mothers.)
Age
Vaccine Birth 6 weeks 10 weeks 14 weeks 9 months
BCG x
Oral polio x* x x x
DTP x x x
Hepatitis B Scheme Aa x x x
Scheme Ba x x x
Haemophilius
x x x
influenzae type b
Yellow fever xb
Measles xc
*
In polio-endemic countries
a
Scheme A is recommended in countries where perinatal transmission of hepatitis B virus is frequent (e.g.
in South-East Asia). Scheme B may be used in countries where perinatal transmission is less frequent
(e.g., in sub-Saharan Africa).
b
In countries where yellow fever poses a risk.
c
A second opportunity to receive a dose of measles vaccine should be provided for all children. This may
be done either as part of the routine schedule or in a campaign.
42

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4RAINING#OURSEON#HILD'ROWTH!

Child’s name _____________________________________ Girl If a boy,

Recommendations for feeding

Birth to 6 months GIRLS

Age 6 months to 2 years GIRLS

Age 2 to 5 years GIRLS

Annex: Immunization schedule for infants recommended by the

Bring your child back for the next immunizations on:

(Recommendations to be inserted with space to record supplements given, etc))

Micronutrient supplementation given, such as iron, Vitamin A:

Feeding: Notes on history, any problems, counselling given

Other information ( such as drug or food allergies, chronic conditions):

Feeding: Notes on history, any problems, counselling given

Other information (such as drug or food allergies, chronic conditions):

Feeding: Notes on history, any problems, counselling given

Other information (such as drug or food allergies, chronic conditions):

Recommendations for Feeding and Care

x Breastfeed as often as your baby wants.

x Breastfeed as often as your child wants up to age 2 or beyond.

Interpreting Growth Curves

100 -2 100 x A child

Walking with assistance

Standing with assistance

Sitting without support

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Child’s name _____________________________________ Girl If a boy,