Growth chart recommendations

Which growth chart should I use for my baby?

Appropriate growth charts are now based on data created by the World Health Organization (WHO). They represent the normal growth of breastfed babies. Growth charts assume that your baby is born at full or normal term. If your baby is premature, use the Fenton chart.

A) Choosing a growth chart

The World Health Organization undertook to measure the growth of healthy breastfed babies around the world. In 2006, they produced growth charts based on this information (WHO 2006).

The weight-for-age charts for boys and girls are available on the WHO website and are described as:

  • Boys: Child Growth Standards, Weight-for-Age Charts, Boys
  • Girls: Child Growth Standards, Weight-for-Age Charts, Girls

Some national pediatric organizations have created growth charts that look a little different but are still based on the information collected by the WHO.

B) Charts for premature babies

Unless otherwise specified, growth charts assume that your baby is born at full or normal term, which is 40 weeks after conception. There are charts, such as the Fenton chart, that are specifically designed for premature babies. 

C) Growth chart for 0-6 month-old babies

WHO weight-for-age girls; birth to 6 months

The above WHO growth chart is the most sensitive for baby girls from birth to six months of age. A similar one is available for baby boys.

D Growth chart for babies between 6 months and 2 years of age

Weight-for-age girls; birth to 2 years

A baby girl's weight gain between six months and two years of age is followed on the above WHO growth chart. A similar one is available for baby boys. 

E) Other charts

Growth charts are also available for babies with genetic problems that result in rapid or slow growth. Examples include Down, Marfan, and Prader-Willi syndromes.

F) Growth charts that are no longer in use

Health-care providers used to rely on growth charts generated by the U.S. Centers for Disease Control and Prevention (CDC 2010). However, these were generated from the measurements of both infant formula-fed and breastfed American babies and are therefore not appropriate for breastfed babies as these two groups have different rates of growth. 

When compared to the WHO chart, the CDC chart shows babies growing more slowly for the first three months and then faster afterwards (Grummer-Strawn et al. 2010). This resulted in health-care providers wrongly assuming that breastfed babies were growing too slowly after three months of age and their mothers were inappropriately advised to supplement the baby extra milk or wean.

References

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. Growth Charts. Atlanta: Centers for Disease Control; 2010 Sep 9 [cited 2017 Aug 29]
 
Grummer-Strawn LM, Reinold C, Krebs NF; Centers for Disease Control and Prevention (CDC). Use of World Health Organization and CDC growth charts for children aged 0-59 months in the United States. MMWR Recomm Rep. 2010 Sep 10;59(RR-9):1-15
 
WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl. 2006 Apr;450:76-85