Normal Growth Patterns in Infants and Prepubertal Children

8/13/2019 Normal Growth Patterns in Infants and Prepubertal Children

1/15

Normal growth patterns in infants and prepubertal childrenAuthorJulie A Boom, MDSection EditorTeresa K Duryea, MD

Deputy EditorMary M Torchia, MDDisclosures

All topics are updated as new evidence becomes available and ourpeer review processis complete.Literature review current through: Oct 2012. | This topic last updated: Jun 19, 2012.

INTRODUCTION Normal growth is the progression of changes in height, weight, andhead circumference that are compatible with established standards for a givenpopulation. The progression of growth is interpreted within the context of the geneticpotential for a particular child [1]. Normal growth is a reflection of overall health and

nutritional status. Understanding the normal patterns of growth enables the earlydetection of pathologic deviations (eg, poor weight gain due to a metabolic disorder,short stature due to inflammatory bowel disease) and can prevent the unnecessaryevaluation of children with acceptable normal variations in growth.

A review of normal growth patterns during infancy and childhood will be provided below.Growth during puberty is discussed separately. (See"Normal puberty".)

DETERMINANTS OF NORMAL GROWTH Somatic growth and biologic maturationare influenced by several factors that act independently and in concert to modify achild's genetic growth potential. The influence of maternal nutrition and intrauterine

environment are reflected primarily in the growth parameters at the time of birth andduring the first month of life, whereas genetic factors have a later influence [2]. Thecorrelation coefficient between length and adult height is only 0.25 at birth, butincreases to 0.8 at two years of age [3,4].

Although primarily reflected in the growth parameters at birth, long-term influences ofmaternal nutrition and intrauterine environment on subsequent growth and pubertaldevelopment have been described [5,6]. Studies in various populations havedemonstrated an association between catch-up growth or rapid growth in infancy orearly childhood and subsequent obesity, suggesting that mechanisms that signal andregulate catch-up growth in the postnatal period may play a role in the development ofobesity. (See"Definition; epidemiology; and etiology of obesity in children andadolescents", section on 'Metabolic programming'.)

NORMAL PATTERNS Most healthy infants and children grow in a predictablefashion, following a typical pattern of progression in weight, length, and headcircumference. Normal human growth is pulsatile; periods of rapid growth ("growthspurts") are separated by periods of no measurable growth [7-9]. Growth is alsoseasonal, with growth velocities increased during the spring and summer months [10].
http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://home/editorial-policyhttp://home/editorial-policyhttp://home/editorial-policyhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H14http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H14http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H14http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H14http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H14http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H14http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://home/editorial-policyhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm


2/15

Growth velocity Growth velocity, the change in growth over time, is a more sensitiveindex of growth than is a single measurement. Current growth points should becompared to previous growth points, if possible, to determine the interval growthvelocity.

Twins After birth, the growth velocity of twins is increased compared to singletons[11]. Nonetheless, their weight, length, and body mass index (BMI) usually are less thanthose of singletons during the first 2.5 years of life, even after correcting for gestationalage [11,12]. By age four years, the weight, height, and BMI of twins are comparable tothose of their nontwin siblings [12].

Weight gain General guidelines regarding weight gain during infancy and childhoodfor infants with growth parameters that were appropriate for gestational age at birthinclude the following:

Term neonates may lose up to 10 percent of their birth weight in the first few

days of life and typically regain their birth weight by 10 to 14 days [13-15] Newborns gain approximately 30 g/day (1 oz/day) until three months of age Infants gain approximately 20 g/day (0.67 oz/day) between three and six months

of age and approximately 10 g/day between 6 and 12 months Infants double their birth weight by four months of age and triple their birth weight

by one year Children gain 2 kg/year (4.4 lbs/year) between two years and puberty

A prepubertal child whose weight velocity is


3/15

foods or cessation of breastfeeding if the slowed weight gain is perceived as lactationalinadequacy [24,26]. The use of a weight chart derived from a population of breastfedinfants may prevent this misperception. Such a curve has been developed forinternational use by the World Health Organization (WHO) [27]. (See'WHO growthcharts'below.)

In 2010, the CDC recommended that the WHO growth charts be used in the UnitedStates for infants and children


4/15

4 to 10 years 2 to 2.4 inches (5 to 6 cm) per year

A prepubertal child whose height velocity is


5/15

Head growth General guidelines regarding head growth, a reflection of brain growth,include the following [34-36]:

The average head circumference at birth is 13.7 inches (35 cm) Head circumference usually is 0.4 to 0.8 inches (1 to 2 cm) larger than chest

circumference at birth Head circumference increases approximately 0.4 inches/month (1 cm/month)

during the first year of life, with the most rapid growth occurring during the first sixmonths, with an increase of 0.8 inches (2 cm) in the first month and 2.7 inches (6cm) in the first four months.

Brain weight doubles by four to six months of age and triples by one year of age The majority of head growth is complete by four years of age

EVALUATION OF GROWTH Evaluation of growth in children focuses on historicalfeatures related to growth, accurate measurement of growth parameters, determinationof growth percentiles for age and sex (including assessment of proportionality), and

assessment of the growth trajectory. The laboratory and radiologic evaluation ofnutritional status and measurement of body composition in children are discussedseparately. (See"Laboratory and radiologic evaluation of nutritional status inchildren"and"Measurement of body composition in children".)

The accurate measurement and charting of growth may prevent unnecessary evaluationor intervention in a child who has a normal pattern of growth (eg, a child whose lengthchannel shifts toward the channel of the midparental height in the first 12 to 15 months;a child with familial short stature whose growth velocity is normal). (See'Method offeeding'above and"Causes of short stature", section on 'Intrinsic shortness'.)

History The history should include:

The weight, length, and head circumference at birth Prenatal history: maternal infection, intrauterine exposures (cigarettes, drugs,

alcohol, and other toxins) Interval growth points Past medical history Dietary history (see"Dietary history and recommended dietary intake in children",

section on 'Dietary history') Developmental history Review of systems for symptoms of systemic disease (particularly vomiting or

diarrhea) Family history, including parental heights, parental growth patterns, and timing of

pubertal onset in parents

Measurement The physical examination should include careful measurements ofweight, length, and head circumference. (See"The pediatric physical examination:General principles and standard measurements", section on 'Standard measurements'.)
http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H5http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H5http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H5http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H2http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H2http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H2http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H2http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H2http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H2http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H5http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm


6/15

Growth charts To determine the child's growth percentiles, weight and length (orheight) should be plotted on the appropriate growth chart at each well-child visit and asindicated at interval visits [37]. Head circumference and weight-for-length should beplotted between birth and two years of age, and BMI after two years of age [37]. When agrowth point deviates from the normal percentile range or from the patient's growth

trajectory, the clinician should repeat the measurement to verify its accuracy.

In 2010, the CDC recommended that the WHO growth charts be used for children


7/15

Body mass index-for-age (figure 8)(calculator 3)

For girls aged 2 to 20 years:

Weight-for-age (figure 9)

Height-for-age (figure 10)(calculator 4)

Charts combining these curves are also available and may be most practical forclinical use:

Weight-for-age and stature-for-age girls

Body mass index-for-age (figure 11)(calculator 5)

WHO growth charts The WHO growth charts are based upon data from theMulticentre Growth Reference Study, which combined longitudinal data from birth to 24

months and cross-sectional data from 18 to 71 months of age [27]. The study populationincluded 8440 healthy breastfed infants and young children from diverse ethnicbackgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman, United States).The study population was chosen to reflect a standard for children living under optimalenvironmental conditions.

The WHO growth charts are growth standards that describe how healthy childrenshould grow under optimal conditions [28]. They are intended to be used for all children,regardless of ethnicity, socioeconomic status, and type of feeding. However, they maynot be suitable for all populations [38,39].

In 2010, the United States Centers for Disease Control and Prevention recommendedthat the WHO growth charts be used for children younger than 24 months [28]. TheWHO growth charts are available at the CDC Web site(www.cdc.gov/growthcharts/who_charts.htm)and the WHO Web site(www.who.int/childgrowth/standards/en). The weight, length, head circumference, andweight-for-length charts for boys and girls aged zero to two years are reproduced here;they can be printed out for use in clinical practice.

For boys aged zero to two years:

Weight-for-age (figure 12)(calculator 6)

Length-for-age (figure 13)(calculator 7) Head circumference-for-age (figure 14)(calculator 8) Weight-for-length (figure 15)(calculator 9)


Weight-for-age and length-for-age boys
http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.cdc.gov/growthcharts/data/set1clinical/cj41c022.pdfhttp://www.cdc.gov/growthcharts/data/set1clinical/cj41c022.pdfhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.cdc.gov/growthcharts/who_charts.htmhttp://www.cdc.gov/growthcharts/who_charts.htmhttp://www.cdc.gov/growthcharts/who_charts.htmhttp://www.who.int/childgrowth/standards/enhttp://www.who.int/childgrowth/standards/enhttp://www.who.int/childgrowth/standards/enhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24LW_9210.pdfhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24LW_9210.pdfhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24LW_9210.pdfhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.who.int/childgrowth/standards/enhttp://www.cdc.gov/growthcharts/who_charts.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.cdc.gov/growthcharts/data/set1clinical/cj41c022.pdfhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm


8/15

Weight-for-length and head circumference-for-age boys

For girls aged zero to two years:

Weight-for-age (figure 16)(calculator 6)

Length-for-age (figure 17)(calculator 7) Head circumference-for-age (figure 18)(calculator 8) Weight-for-length (figure 19)(calculator 9)


Weight-for-age and length-for-age girls Weight-for-length and head-circumference-for-age girls

The WHO growth charts show a faster rate of growth for the first three months of life

than the CDC growth charts [28]. When plotted on the WHO growth charts, formula-fedinfants typically appear to have slow weight gain during this time period (figure 1). (See'Method of feeding'above.)

The WHO growth charts for children from birth to four years of age have been adoptedfor use in the United Kingdom (UK-WHO growth charts). UK-WHO growth charts andsupporting educational materials can be downloaded fromwww.growthcharts.rcpch.ac.uk[40]. When using the UK-WHO growth charts for weight,fewer children will be less than the 2nd percentile, and more children will be greaterthan the 98th percentile after the age of six months than when using the former UK90growth charts.

CDC versus WHO growth charts A comparison of the CDC/NCHS and WHO growthcharts is presented separately. (See"Measurement of growth in children", section on'Recommended growth charts'.)

Premature infants Most clinicians use standard growth charts to monitor the growthof preterm infants after discharge from the neonatal intensive care unit. Corrections forgestational age should be made for weight through 24 months of age, for staturethrough 40 months of age, and for head circumference through 18 months of age [41].(See"Growth management in preterm infants".)

Other growth charts Special growth charts have been developed for a variety ofconditions that are associated with altered patterns of growth. As examples:

Turner syndrome (see"Clinical manifestations and diagnosis of Turner syndrome(gonadal dysgenesis)")

Down syndrome (see"Clinical features and diagnosis of Down syndrome") Williams syndrome (available at:

pediatrics.aappublications.org/cgi/content/full/107/5/1192 )[42]
http://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24HdCirc-L4W_rev90910.pdfhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24HdCirc-L4W_rev90910.pdfhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Girls_24LW_9210.pdfhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Girls_24LW_9210.pdfhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Girls_24HdCirc-L4W_9210.pdfhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Girls_24HdCirc-L4W_9210.pdfhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://www.growthcharts.rcpch.ac.uk/http://www.growthcharts.rcpch.ac.uk/http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H31542395http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H31542395http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H31542395http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H31542395http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://pediatrics.aappublications.org/cgi/content/full/107/5/1192http://pediatrics.aappublications.org/cgi/content/full/107/5/1192http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://pediatrics.aappublications.org/cgi/content/full/107/5/1192http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H31542395http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H31542395http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.growthcharts.rcpch.ac.uk/http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H7http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Girls_24HdCirc-L4W_9210.pdfhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Girls_24LW_9210.pdfhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24HdCirc-L4W_rev90910.pdf


9/15

Achondroplasia (available atpediatrics.aappublications.org/cgi/content/full/116/3/771 )[43]

Proportionality Proportionality is the degree to which individual growth parameterscorrelate with each other. Measures of proportionality are useful as screens of

nutritional status, to diagnose overweight and obesity, and in generating a differentialdiagnosis for short or tall stature. Assessment of proportionality is particularly usefulwhen growth parameters are abnormal. (See'Abnormal patterns of growth'below.)

Weight-for-length Weight-for-length should be plotted in children between zero andtwo years of age (figure 15andfigure 19)(calculator 9)[37]. A weight-for-lengthbetween the 2.3rd and 97.7th percentile reflects normal variation, whereas a weight-for-length less than the 2.3rd percentile or greater than the 97.7th percentile may indicateundernutrition or obesity, respectively [28]. Rapid increases in weight-for-length fromzero to six months of age are associated with an increased risk of obesity at age threeyears [44]. (See"Clinical evaluation of the obese child and adolescent"and"Etiology

and evaluation of failure to thrive (undernutrition) in children younger than two years",section on 'Terminology'.)

The weight-for-length (or weight-for-height) typically is normal in children who haveconstitutional growth delay or familial short stature. (See'Variants of normal'above.)

BMI The body mass index (BMI) characterizes the relative proportion between thechild's weight and the height squared. The BMI should be calculated for children olderthan two years (calculator 3andcalculator 5)[37]. BMI is a valid predictor of adiposityand the best clinical standard for defining obesity. The BMI percentile can be used as ascreening tool for undernutrition and to diagnose overweight and obesity (figure 8and

figure 11). (See"Measurement of growth in children", section on 'Body mass index(BMI)'.)

A child with a BMI less than the 15th percentile is "at risk" for undernutrition. (See"Poor weight gain in children older than two years of age", section on 'Growthparameters'.)

A child with BMI between the 85th and 95th percentiles is overweight, and a childwith BMI 95th percentile is obese. (See"Definition; epidemiology; and etiologyof obesity in children and adolescents"and"Clinical evaluation of the obese childand adolescent".)

At the extremes (>97th percentile or


10/15

years [45]. One method is to plot the child's height on the height curve; draw ahorizontal line from the height to the 50 percent height line, then draw a vertical line tothe 50 percent weight line; the intersection with the 50 percent weight line is the IBW[46]. Another method is to determine the weight percentile that is proportionate to theheight percentile for chronologic age using standard growth charts (figure 20).

Percent IBW = actual weight divided by IBW x 100. The assessment of nutritional statusaccording to percent IBW is as follows:

>120 Obese 110 to 120 Overweight 90 to 110 Normal variation 80 to 90 Mild wasting 70 to 80 Moderate wasting


11/15

greater in approximately one-fourth, and 10 cm greater in approximately 1 percent[49].

The arm span-to height ratio is helpful in identifying conditions with a disproportionbetween the limbs and the trunk (eg, Marfan syndrome, in which the arm span usually

exceeds height by at least 5 cm) [49]. (See"Genetics, clinical features, and diagnosis ofMarfan syndrome and related disorders".)

ABNORMAL PATTERNS OF GROWTH Growth can be slowed or accelerated by avariety of conditions. Changes in growth may be the first sign of a pathologic condition(eg, inflammatory bowel disease, hypercortisolism, thyroid dysfunction) [51-53]. Theevaluation and management of abnormal growth patterns in children are discussedseparately:

Poor weight gain (see"Malnutrition in developing countries: Clinicalassessment"and"Poor weight gain in children older than two years of age",

section on 'Definition'and"Management of failure to thrive (undernutrition) inchildren younger than two years", section on 'Initial management'and"Etiologyand evaluation of failure to thrive (undernutrition) in children younger than twoyears", section on 'Patterns of growth').

Obesity (see"Definition; epidemiology; and etiology of obesity in children andadolescents"and"Clinical evaluation of the obese child and adolescent"and"Comorbidities and complications of obesity in children and adolescents").

Short stature (see"Causes of short stature"and"Diagnostic approach to shortstature").

Tall stature (see"The child with tall stature or abnormally rapid growth"). Microcephaly and macrocephaly (see"Etiology and evaluation of microcephaly in

infants and children"and"Etiology and evaluation of macrocephaly in infants andchildren", section on 'Etiology').

COMMUNICATING WITH PARENTS ABOUT GROWTH CHARTS Although someparents may appreciate viewing their child's growth and hearing their healthcareprovider's interpretation of the graphic information, the usefulness of the growth curveas an education tool for parents is questionable. The general population may not easilyunderstand growth chart data, as illustrated below [54-56]:

In a survey of 1000 parents (demographically representative of the United Statespopulation), nearly two-thirds responded that it was important to see their child'sgrowth chart [55]. However, 36 percent incorrectly determined a child's weightwhen shown a point plotted on a growth chart, 32 percent incorrectly identifiedthe percentile associated with a plotted point, and up to 77 percent inaccuratelyinterpreted data plotted on combined height and weight graphs.

In another survey of 279 parents who were asked to rank six growth charts,almost one-half selected the curve with consistent growth along the 10thpercentile as "least healthy" and 29 percent chose growth patterns along the 90thpercentile or trending upward to the 90th percentile as the "healthiest" [56].
http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H6http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H6http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H6http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H6http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H6http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H6http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm%23H3http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm


12/15

Pediatric healthcare providers who choose to share growth chart information withparents must recognize the limitations of using growth charts as an educational tool.

SUMMARY

Normal human growth is pulsatile. Periods of rapid growth are separated byperiods of no measurable growth. Growth is also seasonal, with growth velocitiesincreased during the spring and summer months. (See'Normal patterns'above.)

Growth velocity, the change in growth over time, is a more sensitive index ofgrowth than is a single measurement. (See'Growth velocity'above.)

Compared with formula-fed infants, breastfed infants gain weight relativelyrapidly during the first three to four months of life and relatively slowly thereafter.(See'Method of feeding'above.)

Weight and height should be plotted on the appropriate growth chart at eachwell-child visit. Head circumference and weight-for-length should be plotted forchildren younger than two years of age and body mass index for children older

than two years. The accurate charting of growth may prevent the unnecessaryevaluation or intervention of a child who has a normal pattern of growth. (See'Growth charts'above.)

The World Health Organization growth charts should be used for infants andchildren


13/15

2. Touwslager RN, Gielen M, Derom C, et al. Determinants of infant growth in fourage windows: a twin study. J Pediatr 2011; 158:566.

3. HEALY MJ, LOCKHART RD, MACKENZIE JD, et al. Aberdeen growth study. I.The prediction of adult body measurements from measurements taken each yearfrom birth to 5 years. Arch Dis Child 1956; 31:372.

4. Tanner JM. Fetus into Man: Physical Growth from Conception to Maturity,Harvard University Press, Cambridge 1989.5. Ong KK, Ahmed ML, Emmett PM, et al. Association between postnatal catch-up

growth and obesity in childhood: prospective cohort study. BMJ 2000; 320:967.6. Adair LS. Size at birth predicts age at menarche. Pediatrics 2001; 107:E59.7. Lampl M, Johnson ML, Frongillo EA Jr. Mixed distribution analysis identifies

saltation and stasis growth. Ann Hum Biol 2001; 28:403.8. Lampl M, Veldhuis JD, Johnson ML. Saltation and stasis: a model of human

growth. Science 1992; 258:801.9. Thalange NK, Foster PJ, Gill MS, et al. Model of normal prepubertal growth. Arch

Dis Child 1996; 75:427.

10.Gelander L, Karlberg J, Albertsson-Wikland K. Seasonality in lower leg lengthvelocity in prepubertal children. Acta Paediatr 1994; 83:1249.11.van Dommelen P, de Gunst M, van der Vaart A, et al. Growth references for

height, weight and body mass index of twins aged 0-2.5 years. Acta Paediatr2008; 97:1099.

12.Estourgie-van Burk GF, Bartels M, Boomsma DI, Delemarre-van de Waal HA.Body size of twins compared with siblings and the general population: from birthto late adolescence. J Pediatr 2010; 156:586.

13.Crossland DS, Richmond S, Hudson M, et al. Weight change in the term baby inthe first 2 weeks of life. Acta Paediatr 2008; 97:425.

14.Macdonald PD, Ross SR, Grant L, Young D. Neonatal weight loss in breast andformula fed infants. Arch Dis Child Fetal Neonatal Ed 2003; 88:F472.

15.Wright CM, Parkinson KN. Postnatal weight loss in term infants: what is normaland do growth charts allow for it? Arch Dis Child Fetal Neonatal Ed 2004;89:F254.

16.Whitehead RG, Paul AA. Growth charts and the assessment of infant feedingpractices in the western world and in developing countries. Early Hum Dev 1984;9:187.

17.Dewey KG, Heinig MJ, Nommsen LA, et al. Growth of breast-fed and formula-fedinfants from 0 to 18 months: the DARLING Study. Pediatrics 1992; 89:1035.

18.Hediger ML, Overpeck MD, Ruan WJ, Troendle JF. Early infant feeding andgrowth status of US-born infants and children aged 4-71 mo: analyses from thethird National Health and Nutrition Examination Survey, 1988-1994. Am J ClinNutr 2000; 72:159.

19.Kramer MS, Guo T, Platt RW, et al. Feeding effects on growth during infancy. JPediatr 2004; 145:600.

20.Dewey KG, Peerson JM, Brown KH, et al. Growth of breast-fed infants deviatesfrom current reference data: a pooled analysis of US, Canadian, and Europeandata sets. World Health Organization Working Group on Infant Growth. Pediatrics1995; 96:495.
http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm


14/15

21.Cole TJ, Paul AA, Whitehead RG. Weight reference charts for British long-termbreastfed infants. Acta Paediatr 2002; 91:1296.

22.Dewey KG. Growth patterns of breastfed infants and the current status of growthcharts for infants. J Hum Lact 1998; 14:89.

23. Committee on Nutrition American Academy of Pediatrics. Breastfeeding. In:

Pediatric Nutrition Handbook, 6th ed, Kleinman, RE (Ed), American Academy ofPediatrics, Elk Grove Village, IL 2009. p.29.24.Mei Z, Ogden CL, Flegal KM, Grummer-Strawn LM. Comparison of the

prevalence of shortness, underweight, and overweight among US children aged0 to 59 months by using the CDC 2000 and the WHO 2006 growth charts. JPediatr 2008; 153:622.

25.van Dijk CE, Innis SM. Growth-curve standards and the assessment of earlyexcess weight gain in infancy. Pediatrics 2009; 123:102.

26.Whitehead RG. The importance of diet-specific growth charts. Acta Paediatr2003; 92:137.

27. World Health Organization. The WHO child growth standards. Available at:

www.who.int/childgrowth/standards/en/. (Accessed on February 21, 2008).28.Grummer-Strawn LM, Reinold C, Krebs NF, Centers for Disease Control andPrevention (CDC). Use of World Health Organization and CDC growth charts forchildren aged 0-59 months in the United States. MMWR Recomm Rep 2010;59:1.

29.Smith DW, Truog W, Rogers JE, et al. Shifting linear growth during infancy:illustration of genetic factors in growth from fetal life through infancy. J Pediatr1976; 89:225.

30.Mei Z, Grummer-Strawn LM, Thompson D, Dietz WH. Shifts in percentiles ofgrowth during early childhood: analysis of longitudinal data from the CaliforniaChild Health and Development Study. Pediatrics 2004; 113:e617.

31. Greulich WW, Pyle SI. Radiographic Atlas of Skeletal Development of the Handand Wrist, Stanford University Press, Stanford 1950.

32. Tanner JM, Whitehouse RH, Cameron N, et al. Assessment of Skeletal Maturityand Prediction of Adult Height (TW2 Method), Academic Press, London 1983.

33.Tanner JM, Goldstein H, Whitehouse RH. Standards for children's height at ages2-9 years allowing for heights of parents. Arch Dis Child 1970; 45:755.

34. Swaiman, KF. Neurologic examination of the term and preterm infant. In:Pediatric Neurology: Principles and Practice, 4th ed, Swaiman, KF, Ashwal, S,Ferriero, DM (Eds), Mosby, St. Louis 2006. p.48.

35.Fujimura M, Seryu JI. Velocity of head growth during the perinatal period. ArchDis Child 1977; 52:105.

36. Hall, JG, Froster-Iskenius, UG, Allanson, JE. Head circumference (occipitofrontalcircumference, OFC). In: Handbook of Physical Measurements. OxfordUniversity Press, New York 2007. p.72.

37.Recommendations for preventive pediatric health care. Pediatrics 2007;120:1376.

38.Hui LL, Schooling CM, Cowling BJ, et al. Are universal standards for optimalinfant growth appropriate? Evidence from a Hong Kong Chinese birth cohort.

Arch Dis Child 2008; 93:561.
http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm


15/15

39.Wright C, Lakshman R, Emmett P, Ong KK. Implications of adopting the WHO2006 Child Growth Standard in the UK: two prospective cohort studies. Arch DisChild 2008; 93:566.

40.Wright CM, Williams AF, Elliman D, et al. Using the new UK-WHO growth charts.BMJ 2010; 340:c1140.

41. Committee on Nutrition American Academy of Pediatrics. Failure to thrive. In:Pediatric Nutrition Handbook, 6th, Kleinman RE (Ed), American Academy ofPediatrics, Elk Grove Village, IL 2009. p.601.

42.Committee on Genetics. American Academy of Pediatrics: Health caresupervision for children with Williams syndrome. Pediatrics 2001; 107:1192.

43.Trotter TL, Hall JG, American Academy of Pediatrics Committee on Genetics.Health supervision for children with achondroplasia. Pediatrics 2005; 116:771.

44.Taveras EM, Rifas-Shiman SL, Belfort MB, et al. Weight status in the first 6months of life and obesity at 3 years of age. Pediatrics 2009; 123:1177.

45.Phillips S, Edlbeck A, Kirby M, Goday P. Ideal body weight in children. Nutr ClinPract 2007; 22:240.

46. Olsen, IE, Mascarenhas, MR, Stallings, VA. Clinical assessment of nutritionalstatus. In: Nutrition in Pediatrics Basic Science and Clinical Applications, 3rd ed,Walker, WA, Watkins, JB, Duggan, C (Eds), BC Decker Inc, Hamilton, Ontario2003. p.6.

47. Hall, JG, Froster-Iskenius, UG, Allanson, JE. Proportional growth and normalvariants. In: Handbook of Physical Measurements. Oxford University Press, NewYork 2007. p.13.

48. Hall, JG, Froster-Iskenius, UG, Allanson, JE. Limbs. In: Handbook of PhysicalMeasurements. Oxford University Press, New York 2007. p.240.

49. Dimeglio, A. Biometric measurements. In: Lovell and Winter's PediatricOrthopaedics, 6th ed, Morrissy, RT, Weinstein, SL (Eds), Lippincott Williams &Wilkins, Philadelphia 2006. p.35.

50.Jarzem PF, Gledhill RB. Predicting height from arm measurements. J PediatrOrthop 1993; 13:761.

51.Kanof ME, Lake AM, Bayless TM. Decreased height velocity in children andadolescents before the diagnosis of Crohn's disease. Gastroenterology 1988;95:1523.

52.Magiakou MA, Mastorakos G, Oldfield EH, et al. Cushing's syndrome in childrenand adolescents. Presentation, diagnosis, and therapy. N Engl J Med 1994;331:629.

53.Schlesinger S, MacGillivray MH, Munschauer RW. Acceleration of growth andbone maturation in childhood thyrotoxicosis. J Pediatr 1973; 83:233.

54.Ben-Joseph EP, Dowshen SA, Izenberg N. Public understanding of growthcharts: a review of the literature. Patient Educ Couns 2007; 65:288.

55.Ben-Joseph EP, Dowshen SA, Izenberg N. Do parents understand growthcharts? A national, Internet-based survey. Pediatrics 2009; 124:1100.

56.Laraway KA, Birch LL, Shaffer ML, Paul IM. Parent perception of healthy infantand toddler growth. Clin Pediatr (Phila) 2010; 49:343.
http://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htmhttp://c/Users/Eduardo%20Naranjo/Desktop/UpToDate.20.3-parsamed.ir/contents/mobipreview.htm

Documents

Normal Growth Patterns in Infants and Prepubertal Children