Pediatric Nutrition in Practice

4 Annexes

Key Words

Growth standards · Growth references · Nutritional

status · Anthropometry · Nutritional assessment

Key Messages

• Growth assessment is a key screening tool for as-
  sessing child health and nutritional wellbeing


• Anthropometry is the most universally applicable,
  noninvasive method of assessing the growth status
  of children


• Interpretation of the growth trajectory is highly de-
  pendent on the growth charts used


• The WHO Child Growth Standards, based on the
  physiological growth of healthy breastfed infants,
  are the growth charts recommended by the WHO
  for universal application


• Anthropometric measurements need to be accu-
  rate; adequate equipment and the use of standard-
  ized techniques are essential for reducing measure-
  ment error and minimizing bias
  © 2015 S. Karger AG, Basel

Introduction

Assessing childhood growth remains a mainstay
of pediatric care in all settings, from the most ad-
vanced healthcare centers to those faced with se-
vere resource constraints. If adequate growth is
achieved, the probability is high that children will

be healthy and well-nourished. The documenta-

tion of abnormal growth, on the other hand, sig-

nals that something is not going well and flags the

need for careful diagnostic follow-up and action.

The value of growth assessment is thus its princi-

pal utility as a key screening tool in order to assess

children’s general wellbeing, to identify faltering

and excessive growth, to evaluate maternal lacta-

tion performance and infant feeding practices,

and to monitor children with medical conditions

known to adversely affect growth, such as renal

and cardiac conditions.

Growth assessment is best done by the appro-

priate use and interpretation of anthropometric

indexes [1]. Anthropometry is the single most

universally applicable, inexpensive and noninva-

sive method available for assessing the propor-

tions, size and composition of the human body.

The successful assessment of growth using an-

thropometry is founded on (a) the selection of an

appropriate anthropometric indicator, (b) the ac-

curacy and reliability of the anthropometric

measures taken, and (c) the proper interpretation

of the values by selecting suitable growth charts

and cutoffs to assess risk or classify children ac-

cording to variable degrees of undernutrition and

overweight/obesity.

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 278–294
DOI: 10.1159/000360352

4.1 The WHO Child Growth Standards

Mercedes de Onis

The WHO holds copyright of the WHO Child Growth Standards.