Endocrine Abstracts

New UK growth charts using the new WHO standard for children from birth to four years should now be used for all babies born in England after May 11th 2009 (October 2009 in Scotland).

The WHO charts for the first time describe optimal rather than average growth, set breast feeding as the norm and are suitable for all ethnic groups. UK children fit the new charts well for length and height but will look appear relatively heavier by the age of one. This will mean that only around 0.5% children be below the weight 2nd centile and that weight centile falls will be much less common.

The new charts are going to look different and chart users need to familiarise themselves with the changes: there will be a disjunction at age 2 years when the WHO standard changes from length to height; parents tend to expect all healthy children to be on the 50th centile so this is no longer emphasised, but there are more subtle indicators of the 50th percentile.

The charts now include detailed instructions which draw on research evidence and UK policy on screening and referral. They define when a measurement or growth pattern is outside range of normality and advise when further assessment is advisable.

A new low birth weight chart is also available for very preterm and small infants. This uses a novel, simpler method of gestational correction and will be useful for all sick or vulnerable infants, as it is low reading and large scale.

The charts, educational materials and fact sheets are all freely downloadable from www.growthcharts.rcpch.ac.uk.