Toddler and Infant Growth Chart - a pediatrician explains how to monitor

The toddler and infant growth chart page has links to growth charts for boys and girls from birth to 2 years of age and for boys and girls over 2 years of age, as well as head circumference charts for infants under 2 year of age.

You can also read about how to interpret these charts for your child.

The growth charts are those used by the Center for Disease Control (CDC) - the under two year charts are based on data from the WHO (World Health Organisation) as the WHO data is better for children under 2 years.

How are growth charts interpreted?
What is normal growth?
What does it mean if my baby has crossed centile lines?
Is length in babies reliable?
What if weight and height centiles are different?
What if weight centile is much more than height centile?
When to see your doctor
Download growth charts

How are Growth Charts Interpreted?

Before you open the links to the infant growth chart of your choice, you will want to understand how growth charts are made.

Growth Charts are created by looking at a cross section of the population at one time and then plotting the weight and height of all the infants and toddlers.

There is a range because we are not all the same size. That range is represented by centile (or percentile) lines on the child or infant growth chart.

The growth charts here have lines representing the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles (also called percentiles) for the over 2 year olds and lines representing 2nd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 98th centiles for under 2 year olds.

The 3rd centile line gives an indication where the lower end of the normal range is - actually 3% of normal infants and toddlers will be below the 3rd centile (or for the 2nd centile, 2% of the population will sit below this centile).

The 50th centile is where 50% of the population will sit.

The 97th centile gives an indication where the upper end of the normal range is - actually 3% of normal infants and toddlers will be above the 97th centile.

So anywhere between the 2nd and 98th centiles is appropriate growth. It can be normal to be slightly above the 98th centile or slightly below the 2nd centile. What is more important than an individual reading is the trend.

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What is normal growth?

It is far more important to look at the toddler or infant growth chart trend than one reading. Generally infants and toddlers should follow one centile line (or grow parallel to one centile line) for height and weight.

Trends are easier to see when time has passed so don't be concerned if there isn't an appropriate increase in weight over 1 week - wait and see what happens over 3 months. Children get lots of viral illnesses so they may have weight that fluctuates with those illnesses - over time, they will usually manage to put on the required weight.

Normal growth is a trend that follows a centile line and is similar for height and weight on the infant growth chart.

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What does it mean if my baby crossed centile lines?

Sometimes, there will be a natural moving across the centile lines for weight on the infant growth chart in the first 6 months or so. This is because babies who are destined to be small people, because of their genes, can be big babies. They have to get on their "right" centile line and will do this over the first months.

This is called "Catch Down Growth" but once your baby finds her growth centile, she should follow that line on the infant growth chart. If she keeps crossing centile lines, that is not normal. Usually, "catch down growth" involves starting at a high centile like 90th and then crossing no more than 2 centile lines, say to the 50th on the infant growth chart.

I often have babies referred to me because their weight is falling away from the initial centile on the infant growth chart. If the baby is well and is feeding appropriately, I don't worry too much and just wait and see what happens over the next month. I don't advocate weekly weighing in these cases because it can be misleading and stressful. Particularly if you are breast-feeding your baby, you don't need to be stressed about your baby's weight.

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Is length in babies a reliable measurement?

Not usually. It depends how much your baby is stretched out before measuring. Height is a more reliable measurement when your child can stand up straight.

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How do I interpret weight centiles that are different from height centiles?

As well as looking at the trend, it is also important to look at the weight in relation to the height - being on the 90th centile for weight is not appropriate if your toddler is on the 2nd or 3rd centile for height.

Often infants and toddlers are one centile apart for weight and height and this is usually not a problem - so on the 10th centile for height and the 25th centile for weight or vice versa is fine.

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What if my child's weight on a centile line is much more than her height centile line?

If your toddler's weight is more than 2 centiles above the height centile (weight on the 50th centile but height on the 10th centile or below), she is overweight. Your doctor can confirm this by calculating the BMI (Body Mass Index).

Be aware of her eating habits and watch her weight closely to prevent it moving even further away from her height centile. It is much easier to prevent obesity than to try and treat it later.

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When to be concerned about you baby or toddler's growth

You should see your doctor if:

your baby crosses more than 3 centile lines
your child's weight centile is more than 2 centiles greater than her height centile
your baby is less than the 3rd centile for weight and is growing away from the centiles

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