Pediatrics (Growth, Common Conditions, Safety)

A single measurement is a data point. Serial measurements show whether a child is following a pattern, accelerating, or falling away from one. For children in Canada, use the WHO Growth Standards from birth to 5 years and the WHO Growth Reference from 5 to 19 years. Plot weight, length or standing height, and—particularly in infants and young children—head circumference using accurate, age-appropriate technique. Corrected age may be needed when interpreting the early growth of a child born prematurely. A percentile is not a grade. A healthy child may consistently track near the 3rd or 90th percentile, especially when that pattern fits family stature and the child’s development and examination are reassuring. Concern rises when weight, length or height, and head circumference move in different directions, or when the child crosses downward through major centile lines. Weight often changes before length does when intake is inadequate. A decline in weight followed later by slowed length gain suggests a longer-standing problem. Head growth that slows disproportionately raises concern for impaired brain growth and needs prompt assessment in context. Growth is produced...