Determining the best use of WHO growth standards and growth references within the Canadian context : Determining the best use of World Health Organization growth standards and growth references within the Canadian context

Recommendation 6………………………………………………………………………………………………………28 To ensure knowledge translation and uptake by key organizations, training on the use and interpretation of the 2006 WHO growth charts, including the normal differences between these standards and the CDC growth references, should be provided to all health care professionals involved in measuring and assessing the growth of Canadian children [...] To address the question regarding how the WHO standards compare with the CDC and NCHS/WHO charts and how the WHO Standards apply to infants and children aged 0-5 years in Canada, we compared the observed differences between the WHO, CDC and NCHS/WHO charts reported in the literature (11,12). [...] The literature reports that the main differences in growth plotted on the WHO charts compared with the CDC and the NCHS/WHO are observed in the first 2 years and particularly the first few months, especially for weight. [...] Direct comparison of the CDC and WHO curves for infants 0-2 years of age indicates that fewer US infants would be below the 5th percentile for weight-for-age using the WHO curves and more US infants would be above the 95th percentile (13), with the exception of the first 6 months of life (Figure 1). [...] For each of the 3 regional data sets, the proportion of children below the 3rd percentile and above the 97th percentile for weight and length/height, and BMI-for-age and weight-for- height below the 5th, between the 85th and 95th percentiles, and above the 95th percentile were determined and are reported in Appendix 1. The following 9 scatter plot graphs show at what ages the differences between t