Growth monitoring of infants and toddlers include serial, accurate measurements of weight, length and head circumference. These values are then plotted on appropriate growth charts. The WHO Growth Charts for Canada (Set 2) should be used to assess the growth of all Canadian children.1 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 They represent the goal for growth of all healthy Canadian infants, regardless of ethnicity or type of feeding.
It is important to remember an infant’s individuality when assessing their growth. 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. Early identification of potential nutritional concerns and behavioural changes implemented by the family helps promote optimal growth.
Tips for Promoting Optimal Infant Growth:
- Children should be weighed and measured at all regularly scheduled well-child visits and/or visits when a child is ill.
- Corrected age should be used for preterm infants to assess growth until 24-36 months of age.1
- 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.
- The typical range for healthy weight-for-age and weight-for-length is between the three to 85th percentile. Measurements outside of this range may indicate potential nutrition concerns and further investigation or referrals are needed.
- An infant or child does not need to cross a certain number of major percentiles before further investigation is initiated.
- Family education is an important part of promoting optimal growth. Families should be provided with information about optimal growth that includes information about the use of growth charts, age-appropriate nutrition and healthy feeding relationships.
Key Documents/Best Practice Guidelines
- A Health Professional's Guide for using the WHO Growth Charts for Canada
- Promoting Optimal Monitoring of Child Growth in Canada: Using the New Growth Charts
- 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
- The WHO Child Growth Standards