Definition

Percentile chats, now more commonly referred to as centile charts or growth charts, are used to show ‘how common characteristics are’ (Weller 2002), the 50th centile line thus showing the median or average of the population.

Background

The UK World Health Organization (WHO) growth charts are now used throughout the United Kingdom for the documentation on children’s weight, height/length, head circumference and body mass index (BMI). The centile measurements are based upon statistics from breastfed children from non-smoking parents. Furthermore, the charts are suitable for all ethnicities (NHS Choices 2011). The charts represent the normal growth that a healthy child should follow, providing professionals with a surveillance tool to monitor whether a child is growing (or developing through puberty) as expected. The newer charts (Childhood and Puberty Close Monitoring Charts), published in June 2013, allow for the closer monitoring of children who may be of concern due to growth, nutritional or puberty problems (RCPCH 2013).

Potential triggers

There are a multitude of reasons that a child may not be growing as anticipated. For instance, a greater than expected increase in head circumference may indicate hydrocephalus. There may also be safeguarding reasons why a child may not follow a centile, for instance in cases of neglect the child may not gain weight as expected. These triggers should not be ignored and a full assessment should be carried out by a qualified health care professional.

The following charts are available:

• Early years chart 0–4 years
  
• Neonatal and Infant Close Monitoring (NICM) chart
  
• Personal Child Health Record (PCHR) charts – otherwise known as the ‘Red Book’
  
• UK Down’s Syndrome chart (DS) 0–18 years
  
• School age charts 2–18
  
• Childhood and Puberty Close Monitoring (CPCM) Chart
  
• Body Mass Index (BMI) chart (RCPCH 2013)