Tips for Promoting Optimal Infant Growth Assessment:

1. Children should be weighed and measured at all regularly scheduled well-child visits and/or visits when a child is ill. Ideally, the child is nude or only in a dry diaper when growth measurements are taken.
2. Corrected age should be used for preterm infants to assess growth until 24-36 months of age.
3. Assessing growth involves looking at the overall trajectory of weight-for-age, length-for-age, head circumference-for-age and weight-for-length rather than focusing on one measurement.
4. The typical range for healthy weight-for-age is between the 3rd and 97th percentiles. Weight-for-length is considered to be proportional between the 3rd to the 85th percentiles. Measurements outside of these ranges may indicate potential concerns and further investigation or referrals are needed.
5. An infant or child does not need to cross a certain number of major percentiles before further investigation is initiated.
6. Family education is an important part of promoting optimal growth and development. Families should be provided with information about optimal growth that includes information about the use of growth charts, age-appropriate feeding, and responsive feeding relationships.

Assessing Child Growth

The WHO Growth Charts for Canada should be used to assess the growth of all Canadian children.¹

• Please consider the following:
• These growth charts reflect optimal growth of children following recommended nutritional and health practices, which varies from previous growth charts that depicted growth whether or not it was optimal.¹
• The fiftieth percentile is not the goal for all children. Monitoring the trajectory of growth and identifying any major increases or decreases in percentiles is critical.
• Parent stature is a factor to consider.
• Remember an infant’s individuality when assessing their growth. These charts represent the goal for growth of all healthy Canadian infants, regardless of ethnicity or type of feeding.
• Early identification of potential nutritional concerns, and behavioural changes implemented by the family helps promote optimal growth.

Growth Charts for Special Populations

• Fenton Growth Charts are available to assess the growth of preterm and low birth weight infants. Once the child has reached term age, the growth should be monitored using the WHO Growth Charts for Canada with corrected age until 24 to 36 months.
• Children with intellectual, developmental, or other disorders often have growth patterns that are different from reference populations.
• Disorder-specific charts may not be accurate, may not reflect newer treatment protocols and may conceal an existing nutrition or growth problem.  They should only be used in conjunction with the WHO Growth Charts for Canada.

Healthcare Provider Tools

• Dietitians of Canada - WHO Growth Charts
• Fenton Preterm Growth Chart Apps
• Look See Developmental Screens (1 month to 6 years of age)

Programs and Services

• MLHU Telephone Support for Families
• Healthy Babies Healthy Children

Patient Handouts

• Dietitians of Canada - How can I help my Child Gain Weight
• Dietitians of Canada – Is My Child Growing Well
• MLHU Child Growth webpage
• Look See Checklist provided by the Nipissing District Developmental Screen (1 month to 6 years of age)

Key Documents/Best Practice Guidelines

• A Health Professional's Guide for using the WHO Growth Charts for Canada
• Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months
• Nutrition for Healthy Term Infants: Recommendations from 6 to 24 Months
• The Toddler Who is Falling off the Growth Charts