The WHO Child Growth Standards

Summary: New international Child Growth Standards for infants and young children released by the World Health Organization (WHO) provide evidence and guidance for the first time about how every child in the world should grow.

[27 April 2006, GENEVA] - New international Child Growth Standards for infants and young children released by the World Health Organization (WHO) provide evidence and guidance for the first time about how every child in the world should grow.

The new WHO Child Growth Standards confirm that children born anywhere in the world and given the optimum start in life have the potential to develop to within the same range of height and weight. Naturally there are individual differences among children, but across large populations, regionally and globally, the average growth is remarkably similar. For example, children from India, Norway and Brazil all show similar growth patterns when provided healthy growth conditions in early life. The new standards prove that differences in children's growth to age five are more influenced by nutrition, feeding practices, environment, and healthcare than genetics or ethnicity.

With these new standards, parents, doctors, policymakers and child advocates will know when the nutrition and healthcare needs of children are not being met. Under-nutrition, overweight and obesity, and other growth-related conditions can then be detected and addressed at an early stage.

"The WHO Child Growth Standards provide new means to support every child to get the best chance to develop in the most important formative years," said Dr LEE Jong-wook, Director-General of WHO. "In this regard, this tool will serve to reduce death and disease in infants and young children."

The new Standards are the result of an intensive study initiated by WHO in 1997 to develop a new international standard for assessing the physical growth, nutritional status and motor development in all children from birth to age five. WHO and its principal partner, the United Nations University, undertook the Multicentre Growth Reference Study (MGRS) which is a community-based, multi-country project involving more than eight thousand children from Brazil, Ghana, India, Norway, Oman, and the United States of America.

The children in the study were selected based on an optimal environment for proper growth: recommended infant and young child feeding practices, good healthcare, mothers who did not smoke, and other factors associated with good health outcomes.

Since the late 1970s, the National Center for Health Statistics / WHO growth reference has been in use to chart children's growth. This reference was based on data from a limited sample of children from the United States. It contains a number of technical and biological drawbacks that make it less adequate to monitor the rapid and changing rate of early childhood growth. It describes only how children grow in a particular region and time, but does not provide a sound basis for evaluation against international standards and norms.

The new standards are based on the breastfed child as the norm for growth and development. This brings coherence for the first time between the tools used to assess growth, and national and international infant feeding guidelines which recommend breastfeeding as the optimal source of nutrition during infancy. This will now allow accurate assessment, measurement and evaluation of breastfeeding and complementary feeding.

“The WHO Child Growth Standards are a major new tool for providing the best health care and nutrition to all the world’s children,” said Dr. Adenike Grange, President of the International Pediatric Association (IPA). Dr. Jane Schaller, Executive Director of the IPA added, “We encourage all of our IPA Member Pediatric Associations and Societies from countries and regions throughout the world to adopt and use these standards in the best interests of all children, and to advocate that these standards be adopted by their governments.”

The first of this set of new growth charts to be released includes growth indicators such as weight-for-age, length/height-for-age, and weight-for-length/height. For the first time, there now exists a Body Mass Index (BMI) standard for children up to age five, as well as the Windows of Achievement standard for six key motor development milestones such as sitting, standing and walking.

“The new standards are important for parents, health professionals, and other caregivers to assess the growth and development of children at the individual and population level,” said Dr Cutberto Garza (Boston College, USA), Director of the United Nations University Food and Nutrition Program and Chair of the Multicentre Growth Reference Study.