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Canadian Paediatric Society

Leading health groups recommend WHO Growth Charts to track babies’ and children’s growth

Feb 8 2010

TORONTO - Four leading national health professional associations have collectively recommended the adoption of the World Health Organization (WHO) Growth Charts for monitoring the growth of Canadian children in all primary health care and clinical settings. The Collaborative Statement - Promoting Optimal Monitoring of Child Growth in Canada - Using the New World Health Organization [WHO] Growth Charts – is supported by Dietitians of Canada (DC), Canadian Paediatric Society (CPS), The College of Family Physicians of Canada (CFPC) and Community Health Nurses of Canada (CHNC). The statement is an update to an earlier version released in 2004 that supported the use of growth charts developed by the US Centres for Disease Control and Prevention.

Advantages of the WHO charts include:

  • The WHO Growth Standards for children 0-5 years of age are based on a population of infants and children nurtured under optimal health conditions, including breastfeeding for at least four to six months. These charts show how children should grow rather than how they do grow.
  • The WHO charts address the growth of a multi-ethnic international population and are therefore reflective of our Canadian ethnic makeup.
  • The WHO Growth Reference 2007 recommended for older children [5 to 19 years] are a better tool for identifying children at risk for obesity.

Says Dr. Donna Secker, author of the Collaborative Statement and Clinical Dietitian at Toronto’s Hospital for Sick Children, “The way a child grows says a lot about his or her health.  Growing too quickly or too slowly can be a sign of possible problems with health or nutrition.  The use of standardized methods and tools by health care providers to monitor growth is one way to help identify problems early so that appropriate action can be taken to prevent serious problems with growth and development.”

Dr. Valérie Marchand, Chair of the CPS Nutrition & Gastroenterology Committee explains, “We are recommending that children be weighed and measured by their health care provider within one to two weeks of birth, at 2, 4, 6, 9, 12, 18 and 24 months, then once per year for children over 2 years and for adolescents.  For those children that may not visit their care provider regularly, growth assessment should also occur at acute care visits when a child is ill, keeping in mind that illness may affect weight.”

According to Dr. Leslie Rourke, CFPC representative and an author of the Rourke Baby Record, a system for well baby/child care used across Canada, “Growth charts alone should not be used to make a diagnosis about a child’s health.  It is equally important to consider other factors such as parents' size, infant feeding method and known health problems. When used correctly, growth monitoring can be an important source of information to guide health professionals in counselling parents about their child’s health.”

“Advice to encourage exclusive breastfeeding up to six months and when and how to introduce complementary foods to infants are examples of supportive information that health professionals may share with parents to promote optimal growth and health,” says Cheryl Armistead, representative of the CHNC on the Collaborative Advisory Group.

To access the full statement, visit: Promoting optimal monitoring of child growth in Canada: Using the new World Health Organization growth charts.

About the Canadian Paediatric Society

The Canadian Paediatric Society is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,000 paediatricians, paediatric subspecialists and other child health professionals across Canada.

Last updated: Jan 21 2013