Variation of growth in height and weight of children. II. After infancy

Abstract

To provide for early detection of abnormal changes in growth, we propose the monitoring of all children for changes in relative height and relative weight as indirect indicators of growth velocity. To this end we analyzed the growth of 2,156 children, as recorded by the child health surveillance services at ages 2 to 19 years. From their data we constructed growth standards on charts of a novel type, which allow direct reading of relative height (SD score, SDS) and relative weight (percentage deviation of weight from median weight for height and sex, %DW). Variation in height explained most (mean 60%) of the variation in weight, and age did not contribute significantly. Hence, our weight charts are height-based. Next, we defined the variations of changes in (delta) SDS and %DW during the different periods of growth. The group means of changes in each period were zero. Variation in delta SDS is widest at the earliest ages, then decreases until year 9-10 (girls) and 10-11 (boys), and again increases. For delta %DW the picture is similar. We present these variations as diagrams for use in growth screening.