GROWTH CHART

It has 2 reference curves. The upper reference curve represents the median(50th percentile) for boys & lower reference curve(3rd percentile) for girls which is slightly lower than for boys. Thus, this chart can be used for both sexes.

The space between 2 curves is called as ‘ROAD TO HEALTH’. If the growth line runs above 3rd percentile & parallel to the Road to Health then it is taken as normal.

THE WHO GROWTH CHART

Direction of growth chart is more important than the location of dots on the line. Flattening or falling of child weight curve indicates growth failure which is the earliest sign of PEM & it may preceed clinical signs by weeks or even months. Such a child needs special care. The objective of child care is to keep the child above 3rd percentile.

REFERENCE CURVE-For the purpose of comparison, growth charts are provided with reference curves. These reference curves are based on extensive cross-sectional data of well nourished healthy children assembled by US National Centre for heath status which are considered the best available for international use.

50th percentile corresponds to the value of 50th child if a group of 100 children are arranged in ascending or descending order, according to their weights. Here equal number of children will be above & below this reading. Similarly, the 3rd percentile means that only 3 % of the children have values below this reading.Space is also provided in the growth chart to record: Identification & registration number, birth weight, age, H/O siblings, immunization, introduction of supplementary foods, episodes of sickness, child spacing, need for special care etc.

The growth chart is easily understood by the mother as well as the health care workers. It provides the mother with a visual record of health & nutritional status of the child.

The topmost curve corresponds to 80% of the median (50th percentile of the reference standard of WHO curve). The lower lines represent 70%, 60%, 50% of the standard.

IAP GROWTH CHART

GRADE-I: If a child’s weight is between 70% & 80%, it is said to be grade-1 malnutrition.

GRADE-II: If the weight is between 70 & 60 %, then it indicates grade-2 malnutrition.

GRADE-III: If the weight is below 60% & above 50%.

GRADE-IV: If the weight is below 50%.

ANY WEIGHT BETWEEN TOP TWO LINES (BETWEEN 80% & 100%) IS CONSIDERED NORMAL.

GRADES OF MALNUTRITION

A child is born on 1st march, 2007. His birth weight is 3 kg. Then his weight was recorded in the month of September, 2007 which was found to be 6.5 kg. In the month of July 2008 he developed acute diarhhoea his weight dropped to 9 kg from previous month’s weight of 9.5kg. Thereafter, his weight steadily increased & was recoded as 10.5 kg in October 2008. In June 2009 the weight of child was recoded to be 12 kg & in Jan 2010 the weight of child was found to be 14 kg.

GROWTH CHART FOR NORMAL CHILD

Birth weight of an infant was 2kg.(DOB 10 FEB, 2008). His weight grew steadily & was recorded to be 5 kg in the month of July, 2008. His weight was recorded in the months of August, September, October, November & December(2008) & was found to be 6.5 kg in all these months & then in the month of Jan, 2009 it was found to be 7 kg.

GROWTH CHART OF LOW BIRTH WEIGHT BABY

DOB 15 APRIL,2007 Weight on 1st May, 2007: 2.5 kg Weight in the month of September, 2007: 5kg. March, 2008: 7.5 kg July, 2008: 8.5kg September, 2008: 8 kg December, 2008: 10 kg March, April, May 2009: 9.5 kg July, 2009: 10.5 kg Aug, 2009: 10kg Sept, 2009: 10.5 kg Jan, 2010 : 11.5 kg

GROWTH CHART OF CHRONIC UNDERNUTRITION (KWASHIORKAR)

DOB: 1st June, 2006 Weight on 15th June, 2006: 2.5 kg December, 2006, jan2007, Feb. 2007: 4.5 kg April, 2007: 3.5 kg June, 2007: 4.5 kg Sept, 2007: 6.5kg Jan,2008: 7.5kg March, 2008: 7kg June, 2008: 7.5 kg Dec, 2008: 7.5 kg Feb, 2009: 6.5 kg April, 2009: 7kg

GROWTH CHART OF CHRONIC UNDERNUTRITION(MARASMUS)

DOB 105th Jan 2006 Birth weight: 3kg June, 2006: 5kg Oct, Nov, Dec, 2006: 8.5 kg An episode of diarrhoea developed in Feb,

2007: 8kg April, 2007(an episode of ARI): 7kg July, 2007: 7.5 kg September, 2007: 8kg December, 2007: 9kg

GROWTH CHART OF ACUTE UNDERNUTRITION

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