The childhood growth charts used by most centers in North America are the charts produced by the National Center for Health Statistics (NCHS) in 1977.  There are a number of problems with those charts that have been overcome in the newly produced charts from CDC.  Specifically, the 1977 charts did not fully represent a cross-section of children living in the U.S. They were also deficient in including breast-fed infants. They did not make the transition well, using the recumbent lengths on the infant charts and standing heights on the childrens-adolescents growth charts, and only heights up to 18 years of age were utilized. The new charts follow adolescents up to 20 years of age. The new charts also allow both percentiles and z-scores to be determined and provide body mass index for age charts and smooth the percentile curves.

The national data collection in a series of five surveys between 1963 and 1977 were used to develop the 2000 CDC charts. Other sources of data were also included. There were two important exclusions. Very low birth rate infants were excluded from the infant growth charts and, secondly, all infants excluded from the NHANES III study were also excluded.

The growth charts are not presented here as they are available on the internet (http://www.cdc.gov/growthcharts). They should be very helpful for all physicians and nurses caring for children.

Ogden CL, et al. Pediatrics 2002;109:45-60.

Editor’s Comment: We certainly agree that the new growth charts are an improvement over previous charts available for monitoring growth in children in the United States.  The editorial on childhood growth charts written in the same journal as an accompaniment to the publication of the growth charts should be carefully read. Careful measurements of children for both height and weight, and the plotting of the data on an appropriate growth chart MUST BE a routine in all pediatric practices.

Fima Lifshitz, MD; Judith G. Hall, OC, MD