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Pediatric Examination
Pediatric Examination
28 3 28
26 26
24 2 24
22 22
20 20
18
0 18
Weight (kg)
16 16
14 -2 14
12
-3 12
10 10
8 8
6 6
4 4
2 2
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 3 of 62
Weight-for-age BOYS
5 to 10 years (z-scores)
3
55 55
50 50
45 2 45
40 40
Weight (kg)
1
35 35
0
30 30
-1
25 25
-2
20 -3 20
15 15
Months 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9
Years 5 6 7 8 9 10
Age (completed months and years)
2007 WHO Reference
Page 4 of 62
Weight-for-age GIRLS
Birth to 5 years (z-scores)
30 30
3
28 28
26 26
2
24 24
22 22
20 20
0
Weight (kg)
18 18
16 16
14 -2 14
12 -3 12
10 10
8 8
6 6
4 4
2 2
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 20 of 62
Weight-for-age GIRLS
5 to 10 years (z-scores)
60 60
3
55 55
50 50
2
45 45
40 40
Weight (kg)
1
35 35
0
30 30
-1
25 25
-2
20 -3 20
15 15
Months
10 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 10
Years 5 6 7 8 9 10
Age (completed months and years)
2007 WHO Reference
Page 21 of 62
Length/height-for-age BOYS
Birth to 5 years (z-scores)
125 125
3
120 120
2
115 115
110 0 110
105 105
100 -2 100
95
-3 95
Length/Height (cm)
90 90
85 85
80 80
75 75
70 70
65 65
60 60
55 55
50 50
45 45
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 1 of 62
Height-for-age BOYS
5 to 19 years (z-scores)
200 200
3
190 2 190
1
180 180
0
170 170
-1
160
-2 160
-3
Height (cm)
150 150
140 140
130 130
120 120
110 110
100 100
90 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9
90
Months
Years 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Age (completed months and years)
2007 WHO Reference
Page 2 of 62
Length/height-for-age GIRLS
Birth to 5 years (z-scores)
125 125
3
120 120
2
115 115
110 0 110
105 105
100 -2 100
95 -3 95
Length/Height (cm)
90 90
85 85
80 80
75 75
70 70
65 65
60 60
55 55
50 50
45 45
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 18 of 62
Height-for-age GIRLS
5 to 19 years (z-scores)
3
180 180
2
170 1 170
0
160 160
-1
150 -2 150
Height (cm)
-3
140 140
130 130
120 120
110 110
100 100
Months 90 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 90
Years 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Age (completed months and years)
2007 WHO Reference
Page 19 of 62
Head circumference-for-age BOYS
Birth to 5 years (z-scores)
3
54 54
2
52 1 52
0
50 50
-1
48 48
-2
Head circumference (cm)
46 -3 46
44 44
42 42
40 40
38 38
36 36
34 34
32 32
30 30
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 8 of 62
Head circumference-for-age GIRLS
Birth to 5 years (z-scores)
54 3 54
2
52 52
1
50 0 50
48
-1 48
-2
Head circumference (cm)
46 46
-3
44 44
42 42
40 40
38 38
36 36
34 34
32 32
30 30
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 25 of 62
Weight-for-length/height GIRLS
Birth to 5 years (z-scores)
34 34
32 32
3
30 30
28 2 28
26 26
1
24 24
0
22 22
20
-1 20
Weight (kg)
-2
18 18
-3
16 16
14 14
12 12
10 10
8 8
6 6
4 4
2 2
Length/height (cm)
WHO Child Growth Standards
Page 22 of 62
Weight-for-length/height BOYS
Birth to 5 years (z-scores)
34 34
32 32
30 3 30
28 28
2
26 26
24
1 24
22 0 22
20 -1 20
Weight (kg)
18
-2 18
-3
16 16
14 14
12 12
10 10
8 8
6 6
4 4
2 2
Length/height (cm)
WHO Child Growth Standards
Page 5 of 62
BMI-for-age BOYS
Birth to 5 years (z-scores)
22 22
21 21
3
20 20
19 19
2
18 18
17 17
BMI (kg/m2)
1
16 16
15 0 15
14 -1 14
13 -2 13
12 -3 12
11 11
10 10
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 6 of 62
BMI-for-age BOYS
5 to 19 years (z-scores)
32 32
30
Obesity 2
30
28 28
26 Overweight 26
1
24 24
BMI (kg/m²)
22 0 22
Normal
20 20
18 18
-2
16
Thinness -3 16
14 14
12 Severe thinness 12
Months
10 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 10
Years 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Age (completed months and years)
Page 7 of 62
BMI-for-age GIRLS
Birth to 5 years (z-scores)
22 22
21 3 21
20 20
19 19
2
18 18
17 1 17
BMI (kg/m2)
16 16
0
15 15
14
-1 14
13 13
-2
12 12
-3
11 11
10 10
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
Page 23 of 62
BMI-for-age GIRLS
5 to 19 years (z-scores)
32 32
30
Obesity 2
30
28 28
26
Overweight 26
1
24 24
BMI (kg/m²)
22 22
Normal 0
20 20
18 18
-2
Thinness
16 16
-3
14 14
12 Severe thinness 12
Months
10 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 3 6 9 10
Years 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Age (completed months and years)
2007 WHO Reference
Page 24 of 62
The Tanner Stages
Because the onset and progression of puberty are so variable, Tanner has proposed a scale,
now uniformly accepted, to describe the onset and progression of pubertal changes (Fig. 9- I
Preadolescent
24). Boys and girls are rated on a 5 point scale. Boys are rated for genital development and no sexual hair
pubic hair growth, and girls are rated for breast development and pubic hair growth.
The stages in male pubic hair development are as follows (Fig. 9-24, B):
V
Adult in quantity
• Stage I (Preadolescent) - Vellos hair appears over the pubes with a degree of development similar to and type with
that over the abdominal wall. There is no androgen-sensitive pubic hair. spread to medial
thighs
• Stage II - There is sparse development of long pigmented downy hair, which is only slightly curled or
Fig. 9-24, B
straight. The hair is seen chiefly at the base of penis. This stage may be difficult to evaluate on a
photograph, especially if the subject has fair hair.
• Stage III - The pubic hair is considerably darker, coarser, and curlier. The distribution is now spread over the junction of the pubes, and at this point that
hair may be recognized easily on black and white photographs.
• Stage IV - The hair distribution is now adult in type but still is considerably less that seen in adults. There is no spread to the medial surface of the thighs.
• Stage V - Hair distribution is adult in quantity and type and is described in the inverse triangle. There can be spread to the medial surface of the thighs.
Page 51 of 62
In young women, the Tanner stages for breast
development are as follows (Fig. 9-24, C):
Page 52 of 62