Growth assessment in infants and toddlers using three different reference charts

Area of Science:

• Pediatric Nutrition
• Growth Monitoring
• Public Health

Background:

• Accurate assessment of nutritional status in children is crucial for early intervention.
• Different growth references may lead to varying classifications of nutritional risk.
• Tertiary care settings require reliable tools for identifying children at risk of undernutrition or overnutrition.

Purpose of the Study:

• To compare the proportion of children under 24 months identified as at risk of undernutrition or overnutrition using different growth references.
• To evaluate the impact of using Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), and Tanner-Whitehouse (Tanner) growth charts.

Main Methods:

• A cohort of 548 infants and toddlers (aged ≤24 months) in a tertiary care facility was assessed.
• Weight-for-age and length-for-age percentiles, and percent ideal body weight were calculated using CDC, NCHS, and Tanner growth charts.
• Electronic computation of growth parameters was performed.

Main Results:

• The CDC growth charts identified a higher proportion of children at risk of undernutrition (weight-for-age <3rd percentile) compared to NCHS and Tanner charts.
• Using CDC charts, more children were classified with percent ideal body weight <90 (risk of undernutrition).
• Conversely, fewer children were classified at risk of overnutrition (percent ideal body weight ≥110%) with CDC charts compared to NCHS and Tanner charts.

Conclusions:

• Implementation of CDC growth charts in tertiary care is likely to increase the number of children identified with undernutrition risk.
• A decrease in the identification of overnutrition risk is expected with the use of CDC charts.
• Growth charts serve as references for screening and should not be used in isolation for comprehensive nutritional status assessment.