July 2010 Code HP5140

Predicting adult height

Health Professionals’ Notes Please place sticker if available, otherwise write in space provided. Interpreting the chart
Assessing weight loss after birth (Note that this is in the Health Professionals’ Notes, but not the
Name…………………………………………………………………………… Well Child/Tamariki Ora Healthbook.)
Girls New Zealand – World Health Most babies lose some weight after birth, but 80% will have
Parents like to know how tall their child will be as an
NHI No………………………………………………………………………… regained this by 2 weeks of age. Careful clinical assessment
Organization Growth Chart 0–5 Years and evaluation of feeding technique is indicated when weight
adult. The child’s most recent height centile (aged 2–5
Date of birth……………………………………………………………… years) gives a good idea of this for healthy children.
This information is based on original materials developed by loss exceeds 10% or recovery of birth weight is slow.
and copyright © 2009 Royal College of Paediatrics and Child
Plot this centile on the adult height predictor to the
right of the height chart to find the average adult height
Health, United Kingdom. It was adapted by the New Zealand Percentage weight loss can be calculated as follows:
Data Recording (continued) Ministry of Health in July 2010. When to measure for children on this centile. Four out of five children will
Length or height should be measured at each Well Child/ Weight loss = current weight – birth weight have adult heights that are within 6cm above or below
Measurement 11 Tamariki Ora check or whenever there are any worries Percentage weight loss = Weight loss x 100% this value.
Recording Date Who should use this chart? about a child’s weight gain, growth or general health. Birth weight
Weight Anyone who measures a child, and/or plots or interprets Head circumference should be measured to age 1.
Head Circumference charts, should be suitably trained or be supervised by
For example, a child born at 3.500kg who drops to 3.150kg at 5 days Weight–height to BMI conversion chart
has lost 350g or 10%; in a baby born at 3.000kg, a 300g loss is 10%. BMI indicates how heavy a child is relative to his or her
Length/Height someone qualified to do so. For further information Plotting measurements
Location and training materials see www.moh.govt.nz/wellchild For babies born at term (37 weeks or later), plot each height and is the simplest measure of underweight
Health worker name and www.growthcharts.rcpch.ac.uk
What do the centiles mean? or overweight from the age of 2, when height can be
measurement on the relevant chart by drawing a small
A single point on these charts indicates a child’s size compared measured fairly accurately. This chart3 provides an
dot where a vertical line through the child’s age crosses
Measurement 12 with children of the same age and maturity who have shown approximate BMI centile, accurate to a quarter of a
A growth chart for all children a horizontal line through the measured value. The
Recording Date optimum growth. When there is more than one point, the centile space.
This chart, which is suitable for use with New Zealand lettering on the charts (‘weight’, ‘length’ etc.) sits on the
Weight chart shows how quickly a child is growing. The centile lines
children up to age 5 years, combines World Health 50th centile, providing orientation for ease of plotting.
Head Circumference on the chart show the expected range of weights and heights
Length/Height Organization (WHO) standards with United Kingdom (or lengths); each describes the number of children expected weight in kg
Plot birth weight (and, if measured, length and head BMI =
Location preterm and birth data. The chart from 2 weeks to 5 to be below that line (eg, 50% below 50th, 91% below the
circumference) at age 0 on the 0–1 year chart. The BMI = (height in m)2
Health worker name years of age is based on the WHO growth standard, 91st). Children come in all shapes and sizes, but 99 out of 100
coloured arrows at age 0 represent UK birth weight
derived from measurements of healthy, non-deprived, children who are growing optimally will be between the two
99.6
Measurement 13 data and show the child’s birth centile. 98
breastfed children of mothers who did not smoke.1 The outer lines (0.4th and 99.6th centiles); half will lie between the 99.6 91
Recording Date

BMI Centile
chart for birth measurements (32–42 weeks gestation) Weight gain in the early days varies a lot from baby to 25th and 75th centile lines. e) 75
Weight 98 bes
is based on British children measured around 1990.2 baby, so there are no lines on the chart between 0 and 2 t (O 50
igh ht
Head Circumference 91 we 25
The charts depict a healthy pattern of growth that is weeks. However, by 2 weeks of age most babies will be Being very small or very big can sometimes be associated with ver erweig

Weight Centile
Length/Height y O 9
75 Ver Ov
desirable for all children, whether breastfed or formula on a centile close to their birth centile. underlying illness. There is no single threshold below which a 2
Location 50 0.4
Health worker name
fed, and of whatever ethnic origin. child’s weight or height is definitely abnormal, but only 4 per
For preterm infants, use a separate low-birthweight 1000 children who are growing optimally are below the 0.4th
25

Measurement 14 Weighing and measuring chart for infants of less than 32 weeks gestation and any centile, so these children should be assessed at some point to
9

Recording Date Weight: use only clinical electronic scales in metric other infant requiring detailed assessment. For healthy exclude any problems. Those above the 99.6th centile for height
2

Weight setting. For children up to 2 years, remove all clothes infants born from 32 weeks and before 37 weeks, plot are almost always healthy. Also calculate BMI for children over
0.4
Head Circumference and nappy; children older than 2 years should wear all measurements in the preterm section (to the left of 2 if weight and height centiles appear very different (more than
Length/Height minimal clothing only. Always remove shoes. the main 0–1 year chart) until 42 weeks gestation, then two centile lines different). 0.4 2 9 25 50 75 91 98 99.6
Location plot on the 0–1 year chart using gestational correction, Height Centile
Length: (before 2 years of age): proper
Health worker name as shown below. What is a normal rate of weight gain and growth?
equipment is essential (length board
Measurement 15 or mat). Measurers should be trained. The preterm section can also be used to assess the Babies do not all grow at the same rate, so a baby’s weight often
Recording Date The child’s shoes and nappy should relative size of infants at the margin of ‘term’ (eg, 37 does not follow a particular centile line, especially in the first year. Date
Weight be removed. weeks gestation), but these measurements should also Weight is most likely to track within one centile space (the gap
Age
Head Circumference
be plotted at age 0 on the 0–1 year chart. between two centile lines, see diagram). In infancy, acute illness
Height: (from 2 years):
Length/Height can lead to sudden weight loss and a weight centile fall, but on BMI Centile
use a rigid rule with T piece,
Location Gestational correction recovery the child’s weight usually returns to its normal centile
or stadiometer; the child’s shoes
Health worker name Plot measurements at the child’s actual age and then within 2–3 weeks. However, a sustained drop through two or more
should be removed. Instructions for use
draw a line back the number of weeks the infant was weight centile spaces is unusual (fewer than 2 % of infants) and 1. Read off the weight and height centiles from the growth chart.
Measurement 16
Head circumference: use a narrow preterm. Mark the spot with an arrow: this is the child’s should be carefully assessed by the primary care team, including 2. Plot the weight centile (left axis) against the height centile
Recording Date
plastic or paper tape to measure0 where
2 4 6 gestationally
8 10 12 corrected
14 16 18 centile.
20 22 Gestational
24 26 28 30 correction
32 34 36 measuring
38 40 42 length/height.
44 46 48 50 52 (bottom axis) on the chart above.
Weight
the head circumference is greatest. 1 should
2 continue 3 until4 one year5 for infants
6 born7 32 to 368 9 10 11
13.5 3. If between centiles, read across in this position.
Head Circumference 4. Read off the corresponding BMI centile from the slanting lines.
Any hat or bonnet 13 weeks and two years for infants born before 32 weeks. Because it is difficult to measure
13 length and height accurately
Length/Height 5. Record the centile with the date and child’s age in the data box.
should be removed. Age in weeks/ months in pre-school children, successive measurements commonly
Location 12.5 12.5 are worries about growth, it
Be aware of cultural Centile terminology show wide variation. If there
Health worker name
issues around
99.6th
is useful to measure on a 12 few occasions over time; most Interpretation
12
Measurement 17 touching heads. If the point is closer than ¼ of a centile
healthy children will show a stable average position over time. In a child over 2 years of age, the BMI centile is a better
Recording Date 11.5 space from a centile line they are 11.5
Head circumference centiles usually track within a range of indicator of overweight or underweight than the weight
described as being on that centile. 98th centile; a child whose weight is average for their height
Weight 11 If not they should be described as one centile space. After the11first few weeks, a drop or rise
Head Circumference When to weigh being between the two centiles: through two or more centile spaces is unusual (fewer than will have a BMI between the 25th and 75th centiles,
Length/Height Babies should be weighed in the first week as10.5
part of the e.g, 75th–91st. 1 % of infants) and should
10.5
be carefully assessed. whatever their height centile. BMI above the 91st
91st
Location assessment of feeding. Recovery of birthweight10 usually 10 centile suggests that the child is overweight; a child
Health worker name occurs by 10 to 14 days, and indicates that feeding is A centile space is the distance between above the 98th centile is very overweight (clinically
two of the centile lines, or equivalent Why do the length/height centiles
9.5 change at 2 years?
effective and that the child is well. Once 9.5feeding is 75th
The growth standards show length data up to 2 years of age, and
obese). BMI below the 2nd centile is unusual and may
Measurement 18 distance if midway between centiles.
established, babies should usually be weighed 9 at the 9 reflect undernutrition.
Recording Date height from age 2 onwards. When a child is measured standing
time of routine checks. If there is concern, weigh more 50th
up, the spine is squashed a little, References
Weight 8.5 8.5 so their height is slightly less
often; however, weights measured too close together Plotting for preterm infants than their length; the centile lines shift down slightly at age 2 to
1. www.who.int/childgrowth/en
Head Circumference 2. Cole TJ, Freeman JV, Preece MA. 1998. British 1990 growth reference
are often misleading, so babies should not be8routinely (less than 37 weeks gestation): 25th 8
allow for this. It is important that this difference does not worry centiles for weight, height, body mass index and head circumference
Length/Height Draw a line back the number of
weighed more frequently than at each Well Child/ Gestational age
parents; what matters fitted by maximum penalized likelihood. Stat Med;17:407–29.
Location 7.5 (7 weeks preterm) weeks preterm and mark spot 9this whether
7.5 the child continues to follow the
Weight(kg)

Tamariki Ora check. with arrow. same centile after the transition.
3. Cole TJ. 2002. A chart to link child centiles of body mass index, weight
Health worker name Actual age and height. Eur J Clin Nutr;56:1194–9.
7 7
2nd
6.5 6.5
0.4th
6 6
5.5 5.5
 GIRLS
14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 12 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47 49
GIRLS
2 Adult Height Data Recording
3 4 5 6 7 8 9 10 11 11/2 21/2 3 31/2 4 Prediction
Preterm 50cm 50cm
552cm 128cm
Birth Measurement
0 –1 year 1– 5 years
ft/in cm
99.6th
Age in weeks/ months Age in months/ years 5.11 Recording Date
49 49 50 98th 124 180
Weight
99.6th 5.10
Birth 48 48 91st
99.6
th
Head Circumference

head
98th 48 75th 120
Head Circumference 47 47 50th
5.9
99.6th 175 Length/Height
39 91st 98th
25th 5.8 Location
46 46 46 116 98th
38 Measure length until age 2; measure t
75th ●
91s

d
9th Health worker name
45 45 height after age 2. 5.7 170

a
50th 2nd 91st
Measurement 2
37 44 A child’s height is usually slightly less 75t
h 112

e
●
44 44 0.4th 5.6
25th Recording Date
than their length. 75th

h t
36 50th Weight
43 9th 43 42 108 5.5 165

h
50th
Head Circumference
35 42 42 25th

ig
2nd 5.4
th

Length/Height
.6

40cm 104 25th

99

34 41 0.4th 41 5.3

he
160
Head Circumference (cm)

9th Location
h

h
t

9th
t
98

40 .6 40cm 100cm Health worker name

33 99 2nd
100 5.2
st

th 2nd
Measurement 3
91

39 98 5.1 155
32 st 0.4th Recording Date
96 96
th

91 0.4th
75

38 th 82cm 5.0 Weight

31 75
th

th
th 99.6
50

99.6th
37 50 80 92 92 4.11 150 Head Circumference
30 98th
th 98th
th

36 Length/Height
25 78
25

th
88cm Plot child’s
91st
29 h 91st 88 Location
35 9t
76 height centile on
9th

75th

g
d 75th Health worker name
2n the pink lines

h
28

n
50th
34 th
d

4t
h 74 84 .6 30kg above; the black Measurement 4
2n

t
0. 50th 99

le
25th th numbers show Recording Date
th

27 33 98

g
25th 72
0.4

9th
80 s t 29 average female Weight
91

len
26 2nd 32 9th 70 th adult height for
75 Head Circumference
Gestation in weeks
2nd th this centile;
0.4th
31cm 68 76 50 28 80% of children Length/Height
32 34 36 38 40 42 th
0.4th 25 h will be within
66cm 66 .6t Location
9th 99 ±6 cm of this
72 27 Health worker name
Plotting preterm infants 64 64 2n
d
value.
Use the low birthweight 0.4
th
Measurement 5
chart for infants less than 32 62 62 68 26
Recording Date
weeks gestation and any th
other infants requiring 60 .6 60 Weight
99 25
0 2 4 6detailed
8 assessment.
10 12 14 16 18 20 22 24 26 8t
h 28 30 32 34 36 38 40 42 44 46 48 50 52 64cm Head Circumference
Use this 58 9 13.5 58cm th
1 2 section for3 infants 4 5 916
st 7 8 9 10 11 98 Length/Height
of less than 37 weeks 56 th 24kg 24
13 gestation. As with term 99.6th 75 13 Location
th
infants there may be some 98th Age 54 in weeks/
50 months 14kg
12.5 weight loss in the early days. 91st 25
th 12.5 23 23 Health worker name
From 42 weeks, plot on the 75th 99.6th Measurement 6
52 9t
h 13.5
12 0–1 year chart with d
12
2n 22 st 22 Recording Date
gestational correction. 50th
50 4t
h 13 91
11.5 25th 0. 11.5 Weight
Gestational age 48 98th th 12.5 21 Head Circumference
11 (7 weeks preterm)
9th
11 99.6 21
2nd
46 12 Length/Height
Actual age
10.5 0.4th 10.5 20 h 20 Location
44cm 91st 11.5 75t
Gestational correction 98th Health worker name
10 10
Plot actual age then draw a 11kg 11 19 19
line back the number of Measurement 7
9.5 10.5 75th 9.5 10.5 Recording Date
weeks the infant was preterm Some degree of weight 91st
and mark the spot with an loss is common after birth. 18 50t
h 18
9 arrow; this is the gestationally 10 9 10 Weight
Calculating the percentage 50th Head Circumference
corrected centile. 75th
8.5 9.5 weight loss is a useful way 8.5 9.5 17

t t
17 Length/Height
to identify babies who

h h
8 Birth Weight 9 need assessment. 25th 8 9 25th Location

g
5.5 50th 16 16

ei ig
8.5 8.5 Health worker name
7.5 9th 7.5
Weight (kg)

8
25th
8 15 Measurement 8
15

we
7 5 7 9th Recording Date

w
2nd
7.5 9th 7.5 Weight
6.5 6.5 14 14
4.5 0.4th
UK-WHO chart 2010 based on DH copyright 2009 reproduced with permission

7 2nd 7 2nd Head Circumference

h
6 6 9.6
t
Length/Height
6.5 0.4th 6.5 13 9 13
h
.6t

5.5 4 5.5 0.4th

Location
99

6 6 8th
12 9 12 Health worker name
5
th

5
98

3.5 5.5 5.5 Measurement 9

st
st

4.5 4.5 91 11 Recording Date

91

11
Weight (kg)

5 th 5
99.6th 75 Weight
th 0th 5th 1st 8th 9.6th

4 3 4.5 th 4 4.5 75
th
98th
50 10 10 Head Circumference
9

th 3.5
3.5 91st
4 25 4 50t
h Length/Height
7 9 9

2.5 75th h
3.5 9t 3.5 9 9 Location
3 50th d 3 25t
h
2n h
25th 4t Health worker name
2.5 2 3 0. 2.5 3 9th 8
9th 8 Measurement 10
5

2nd 2.5 2.5 2nd

2
25

2 Recording Date
1.5 0.4th 7 0.4th
7
h

2 2 Weight
9t

1.5 2n
d 1.5
h Head Circumference
4t 1.5 in weeks/ months
Age 1.5 6 6
1 0. 1 Age in months/ years
1 Age in weeks/ months
Length/Height
1 Gestation
2 in weeks
3 4 15 6 7 8 9 10 11 1
Location
0.5 1 2 3 4 5 6 7 0.5
8 9 10 11 5kg 11/2 2 21/2 3 31/2 4 41/2 5kg
0 2 4 6 8 10 12 14 16 18 0.5kg
20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 0.5kg Health worker name
32 34 36 38 40 42 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 12 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47 49 50 51 52 53 55 56 57 58 59 60