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Updated: May 31, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Comparison of the World Health Organization growth velocity standards with existing US reference data
Mercedes de Onis1, Amani Siyam, Elaine Borghi
1Department of Nutrition, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. deonism@who.int
Insights
The World Health Organization (WHO) growth velocity standards differ from US child data, particularly for weight and length gains. WHO standards are recommended for assessing growth velocity and clinical decisions in US children.
Area of Science:
- Pediatrics
- Growth and Development
- Biostatistics
Background:
- Accurate growth assessment is crucial for child health.
- Existing growth velocity standards may not fully represent diverse populations.
- The World Health Organization (WHO) provides global growth standards.
Purpose of the Study:
- To compare World Health Organization (WHO) growth velocity standards with reference data derived from US children.
- To identify discrepancies in weight and length velocity between WHO standards and US-based data.
Main Methods:
- Compared serial weight and length gain data from US children against WHO child growth standards.
- Analyzed weight velocities for boys and girls across percentiles (5th-95th) at various intervals (1-3 months) up to 24 months.
- Compared length velocities at 2- and 3-month intervals up to 24 months.
Main Results:
- WHO and US weight increments showed similarity at the 5th percentile up to 3 months; other US percentiles were lower than WHO.
- US weight values converged to a narrower range than WHO standards from 3 months onward.
- Length medians were similar, but outer US percentiles for length also converged with age compared to WHO standards.
Conclusions:
- Significant differences exist between WHO growth velocity standards and US-based reference data.
- WHO growth velocity standards are suggested as a superior tool for growth assessment and clinical decision-making in US children.
Objective:
The goal of this study was to compare World Health Organization (WHO) growth velocity standards with reference data based on US children.
Methods:
Comparisons were made between reference values for weight and length gains based on serial data from US children and the WHO child growth standards. We compared weight velocities for boys and girls for selected percentiles (5th, 25th, 50th, 75th, and 95th) for 1-month intervals from birth to 6 months, 2-month intervals up to 12 months, and 3-month intervals up to 24 months. For length, we compared 2-month intervals from birth to 6 months and 3-month intervals up to 24 months.
Results:
WHO and US monthly weight increments were similar at the 5th percentile up to 3 months of age; values for other US percentiles were below the WHO percentiles ∼150 g on average. From 3 months onward, the US values converged to a narrow range of <100 g between estimated percentiles. Two- and 3-month weight gains showed similar variations. Differences between the WHO and US values were more pronounced at the lower end of the distribution. For length, medians were in closer agreement, but as occurred with weight, values at the outer US percentiles converged to a narrower range with increasing age compared with those of the WHO standards.
Conclusions:
There are important differences between the WHO standards and the reference values for growth velocity based on US data. The WHO values are a better tool for assessing growth velocity and making clinical decisions.
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