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Boy’s Growth Record
For use by parents and other care providers to monitor and
promote his health, growth, and development

This is the main record of your son’s health, growth and development.

This booklet contains recommendations for feeding and caring for your son
at different ages: as a child grows, his needs change.

The record is to be used jointly by you and others who care for him. Therefore, keep
it in a safe place and carry it with you whenever you bring him to:
x a health centre (whether it is for a well-baby visit or because he is sick)
x a doctor or other health care provider
x a hospital outpatient department or emergency department
x any other health appointment
Personal Data

Child’s name _____________________________________ ‰Boy If a girl,


must use a
Identification/Record number ___________________ Girl’s Growth
Parents’ names ______________________________________________ Record

_____________________________________________________
Address ___________________________________________________
_____________________________________________________
Birth information:
Date of birth _______________________
Gestational age at birth ____________ Single/multiple birth? ________
Measurements at birth:
Weight _________ Length __________ Head circumference _________
Birth rank _________
Date of birth of next younger sibling (born to mother)________
Feeding:
Age at introduction of any foods or fluids ____________ More details of feeding history
Age at termination of breastfeeding ___________ may be recorded in Visit Notes
Adverse events (dates):
(such as death of parent, death of sibling age <5 years) ________________________
________________________________________________________________

1
Table of Contents
Page
Personal data ..........................................................................................................................1
Table of contents...................................................................................................................2
Recommended immunization schedule ............................................................................4
Other national programme recommendations...............................................................5
Visit notes.........................................................................................................................6–11
When special care or advice may be needed............................................................... 12

Recommendations for feeding


Up to 6 months of age ........................................................................................ 14
Recommended foods for babies and children age 6 months to 5 years .. 15
Age 6 months to 1 year....................................................................................... 16
Age 1 to 2 years .................................................................................................... 18
Age 2 to 5 years .................................................................................................... 19
Recommendations for food safety and hygiene ............................................. 20
Care for development messages
Key messages about care for all times ............................................................. 21
Age 0 to 4 months................................................................................................ 22
Age 4 to 6 months................................................................................................ 23
Age 6 months to 1 year....................................................................................... 24
Age 1 to 2 years .................................................................................................... 25
Age 2 years and older .......................................................................................... 26

2
Growth charts for boys .....................................................................................................27
Understanding growth charts ....................................................................................................28

Birth to 6 months BOYS


Length-for-age ........................................................................................................29
Weight-for-age .......................................................................................................30
Weight-for-length .................................................................................................31
BMI-for-age .............................................................................................................32

Age 6 months to 2 years BOYS


Length-for-age ........................................................................................................33
Weight-for-age ......................................................................................................34
Weight-for-length .................................................................................................35
BMI-for-age .............................................................................................................36

Age 2 to 5 years BOYS


Height-for-age ........................................................................................................37
Weight-for-age .......................................................................................................38
Weight-for-height..................................................................................................39
BMI-for-age .............................................................................................................40
Gross motor milestones....................................................................................................41

Annex: Immunization schedule for infants recommended by the


WHO Expanded Programme on Immunization............................................42

3
Sample Immunization Schedule (EPI)
Date
Age Vaccine Place received
received
DPT-1
2–3 Hib
months Hepatitis B
OPV-1
DPT-2
4–5 Hib
months Hepatitis B
OPV-2
DPT-3
6–7 Hib
months Hepatitis B
OPV-3
12–15 MMR
months Yellow fever
DPT
18 months
OPV
DPT
5 years OPV
MMR

Bring your child back for the next immunizations on:


________________ ________________ _____________ ______________
________________ ________________ _____________ ______________
4
Other National Programme Recommendations
for Children under Age 5 Years

(Recommendations to be inserted with space to record supplements given, etc))

Micronutrient supplementation given, such as iron, Vitamin A:


(note date, supplement, amount given)

Deworming:

Developmental assessment:

5
Date of birth:
Visit Notes
Age Measurements
(Record below; then plot on
today Reason for visit, observations,
Date of charts)
(Completed
visit Length/ recommendations
years/months Weight
Height BMI*
or weeks) (kg)
(cm)

* BMI (body mass index) = weight in kilograms divided by length or height in meters squared (kg/m2)

6
Visit Notes

Feeding: Notes on history, any problems, counselling given

Other information (such as drug or food allergies, chronic conditions):

7
Date of birth:
Visit Notes
Age Measurements
(Record below; then plot on
today Reason for visit, observations,
charts)
(Completed
Date of Length/ recommendations
years/months Weight
visit Height BMI*
or weeks) (kg)
(cm)

* BMI (body mass index) = weight in kilograms divided by length or height in meters squared (kg/m2)

8
Visit Notes

Feeding: Notes on history, any problems, counselling given

Other information (such as drug or food allergies, chronic conditions):

9
Date of birth:
Visit Notes
Age Measurements
(Record below; then plot on
today Reason for visit, observations,
charts)
(Completed
Date of Length/ recommendations
years/months Weight
visit Height BMI*
or weeks) (kg)
(cm)

* BMI (body mass index) = weight in kilograms divided by length or height in meters squared (kg/m2)

10
Visit Notes

Feeding: Notes on history, any problems, counselling given

Other information (such as drug or food allergies, chronic conditions):

11
When Special Care or Advice May be Needed

Any time that you have concerns about your child’s growth or development, seek the
advice of a health care provider. He or she can assess your child and advise you.
Other times that special care or advice may be needed include:
j If the child’s growth curve is too far from the centre line (labelled '0'), it may be
a sign that he is undernourished or overweight. If he is not within the normal
range, a health care provider can help you find ways to help him grow normally.
For example, changes may be needed in the type of foods he is given, or the
frequency or quantity of feeding. Or he may need more emotional support, or
stimulation, or physical activity that will help him become healthy.
j If the child is severely undernourished, he needs urgent specialized care.
j If the child is obese, he needs medical assessment and specialized management.
Discuss this with the health care provider.
j If a mother suspects that she may be HIV positive, she should be encouraged to
go for counselling and testing.
j If a pregnant woman or the mother of an infant knows that she is HIV positive,
she needs specialized counselling about her options for feeding the baby.

12
Recommendations for feeding
and care of
infants and children

Recommendations for Feeding and Care


j If your child is sick, feed him according to the recommendations for his age group provided in
this section. Also give more fluids (breastfeed more for a breastfed child) and encourage him to
eat soft, varied, appetizing, favourite foods. After illness, give food more often than usual and
encourage the child to eat more.

13
Recommendations for feeding
an infant up to 6 months of age

x Feed your baby only breast milk until he is 6 months of age (180 days).
x Breastfeed as often as your baby wants, day and night, at least 8 times in 24 hours.
x Breastfeed when your baby shows signs of hunger: beginning to fuss, sucking fingers, or
moving his lips.
x At each feeding, encourage your baby to empty the breast and then offer the other breast.
x Do not give him other foods or fluids. Breast milk quenches your baby’s thirst and satisfies
his hunger.

14
Recommended foods for babies and children
age 6 months to 5 years
Breast milk continues to be an important source of nutrients up to age 2 years or beyond. Your
baby needs other foods and liquids in addition to breast milk once he reaches 6 months of age
(180 days). This page lists examples of recommended foods. The following pages recommend
how much, how often and how to feed your child at different ages.
x Staple foods give your child energy. These foods include cereals (rice, wheat, maize, millet,
quinoa), roots (cassava, yam, potato), and starchy fruits (plantain, breadfruit).
x Staple foods do not contain enough nutrients by themselves. You also need to give animal-
source and other nutritious foods. Your child should eat a variety of these foods:
¾ Animal-source foods: Liver, meat, chicken, fish, eggs
¾ Milk products: Cheese, yoghurt, curds (and milk, for non-breastfed children)
¾ Pulses: Chickpeas, lentils, cow peas, black-eyed peas, kidney beans, lima beans (For
vegetarians, these are important alternatives to animal-source foods.)

Feeding recommendations
¾ Green leafy and yellow-coloured vegetables: Spinach, broccoli, chard, sweet potatoes,
carrots, pumpkin
¾ Fruits: Banana, orange, guava, mango, peach, kiwi, papaya
¾ Oils and fats: Vegetable oils, butter
¾ Groundnut paste, other nut pastes; soaked or germinated seeds such as sesame,
pumpkin, sunflower, melon seeds
x Feed your child different foods from the groups above, together with the staple food.

15
Recommendations for feeding
an infant age 6 months to 1 year

x Breastfeed as often as your baby wants.


x To initiate complementary feeding, begin offering him small amounts of other foods at age 6
months (180 days). Introduce new foods one at a time. Wait a few days to be sure that he
can tolerate a new food before introducing another food.
x Give him staple foods and a variety of animal-source and other nutritious foods (listed on
page 15).
x Increase the quantity of food as he grows older while continuing to breastfeed frequently.
¾ At 6–8 months of age, start by offering 2–3 tablespoons of thick porridge or well-
mashed foods 2–3 times per day. Increase the amount gradually to 1/2 cup.* By 8 months,
give him small chewable items to eat with his fingers. Let him try to feed himself, but
provide help. Avoid foods that can cause choking (such as nuts, grapes, raw carrots). Give
1–2 snacks between meals depending on his appetite.
¾ At 9–11 months of age, offer finely chopped or mashed foods and foods that baby can
pick up, about 1/2 cup, at 3–4 meals per day plus 1–2 snacks depending on his appetite.

16
x Feed him from his own plate or bowl.
x Patiently help your baby eat. Talk to him lovingly, look into his eyes and actively
encourage him to eat, but do not force him.
x If he loses interest while eating, remove any distractions and try to keep him interested in
the meal.
x After 6 months of age, babies may need more water even when they drink the
recommended amounts of milk. To find out if your baby is still thirsty after eating, offer
him some water (that has been boiled and cooled).

Feeding recommendations
* In these recommendations, a cup refers to 250 ml or an 8 ounce cup and a tablespoon refers to a 15 ml
tablespoon. Each country should specify customary measures that mothers will understand.
The suggested amounts assume an energy density of 0.8–1.0 Kcal/g. If the foods given are thin and lower in
nutritional content (i.e. about 0.6 Kcal/g), meals should increase to 2/3 cup at 6–8 months and to 3/4 cup at 9–
11 months.

17
Recommendations for feeding
a child age 1 to 2 years

x Breastfeed as often as your child wants up to age 2 years or


beyond.
x Continue to give 3–4 meals of nutritious foods, chopped or
mashed if necessary, 3/4–1 cup* at each meal. Also give 1–2
snacks per day between meals depending on his appetite.
x At each meal, feed your child a staple food along with different nutritious foods from
the groups listed on page 15.
x Feed him from his own plate or bowl. Continue to actively help him to eat.

* The suggested amount assumes an energy density of 0.8–1.0 Kcal/g. If the foods given are thin and lower
in nutritional content, the child should receive a full cup at each meal.

18
Recommendations for feeding
a child age 2 to 5 years

x Give family foods at 3 meals each day. Also, twice daily between meals, give nutritious
snacks such as:
________________________________________________________________
________________________________________________________________
________________________________________________________________

x Offer a variety of foods such as those on page 15. If he refuses a new food, offer him
“tastes” of it several times. Show that you like the food.
Do not force him to eat. Give realistic portions depending on his age, size and activity level.

Feeding recommendations
x
Increase the quantity of food as he grows older.

19
Recommendations for Safe Food Preparation and Hygiene
Practise good hygiene to prevent illness:
x Wash your hands with soap before preparing food, before feeding a baby, and after using
the latrine or toilet.
x Obtain clean water for drinking, treat it properly,* store it in clean covered containers,
and use a clean scoop to draw it.
x Wash your child's cup or bowl thoroughly with soap and clean water or boil it.
x Avoid using feeding bottles which are difficult to clean.
x Prepare food using clean utensils. Feed a baby with a clean spoon.
x Keep food preparation surfaces clean by using water and soap or detergent to clean them
after each use.
x Cook foods thoroughly, especially meat, poultry, eggs and seafood. Reheat cooked food
thoroughly, for example, bring soups and stews to boiling point.
x Cover food that is left over, and refrigerate it if possible. Discard cooked food that is left
at room temperature for longer than two hours.
x Avoid contact between raw and cooked foods and store them in separate containers.
x Have a clean, functioning latrine that is used by all family members old enough to do so.
Quickly collect the stool of a young child or baby and put it into a latrine. Promptly clean
a child who has passed stool. Then wash your hands and his.
* Boil water vigorously for a few seconds. Cover and let it cool down on its own without adding ice. This water
is safe for the baby to drink.

20
Key Messages about Care for All Times

Care Messages
j Brain development is most rapid in the first two years of life, so young children need to be
stimulated by playing with others, moving around, hearing sounds, and having things to see, touch,
and explore.

j Daily routines regarding eating, sleeping, hygiene, etc. help children to develop regular patterns and
to feel secure.

j Teach your child to communicate by speaking to him, listening to him, and playing with him.

j Play is children's work. It gives them many chances to learn and develop the ability to solve
problems. They learn by trying things out and by observing and copying others.

j Fancy toys are not needed for development. Toys to stimulate development can be made at home.

j Illness interferes with normal growth and development. To prevent illness, have your child
immunized and feed him as described in the Growth Record. When he is ill, take him to a health
care provider.

j Children learn most rapidly when they are in nurturing and stimulating relationships with their
caregivers. The mother, father, and siblings can all contribute to the child's development by caring
for and playing with him.

j Protecting children from physical harm and emotional distress (due to violence or strong anger)
helps them gain confidence to explore and learn.

21
Care for development messages
Age 0 to 4 months
Emotional development
x A healthy child can see, hear, and smell at birth. He recognizes his mother from her voice, scent, and
face.
x His father plays an important role in the child's development and should be involved in caring for him.
x He can learn a lot from older siblings, and they from him, so they too should play with and help care
for him.
x Soothing him when he is distressed will help him learn to trust and communicate with you.
x Breastfeeding is a good time for cuddling, nurturing, and emotional bonding.
Communication
x Look into your child’s eyes and smile at him (for example, when feeding). Talking face to face with
him, repeating his sounds and gestures, and singing to him will teach him to communicate.
x He will respond to his mother's touch, looks, smiles and sounds. He will try to communicate his needs
through movements, cooing sounds, and cries.
Movement
x He will soon discover his hands and feet. Letting him move his arms and legs freely will help him grow
strong.
x He will begin to reach for objects and put them in his mouth because he learns by taste and touch.
x He will try to raise his head to see around. Help by carrying him, raising his head and back so he can
see. Letting him roll on a safe surface will help him develop his muscles.

22
Care for development messages
Age 4 to 6 months

Care Messages
Emotional development
x Children love to see people and faces, so family members should hold and carry the baby, smile,
laugh, and talk with him.
x He is now attaching to his mother and may feel uncomfortable with strangers. Leaving him with
people he knows will help him feel secure.
Communication
x He enjoys making new sounds like squeals and laughs. He will respond
to someone's voice with more sounds, copy the sounds he hears, and
start learning about making a conversation with another person.
x To prepare him for talking, repeat his sounds and talk to him about
what he feels, sees and wants.
Movement
x As he sees his world, he will want to touch, taste, and explore. Giving him safe clean colourful
household objects that he can touch, bang, throw, and put into his mouth will help him learn and
develop hand skills. Keep away small objects that can go into the mouth and be swallowed.
x Letting him sit with support and roll around safely will help his muscles develop.

23
Care for development messages
Age 6 months to 1 year
Emotional development
x He may not want to separate from you. Help him cope with separation by gently telling him when
you will need to leave him and by leaving him with people he is familiar with. Peek-a-boo and hide-
and-seek are well-known games to teach him that you are not gone forever when he cannot see
you.
x He will notice when people express strong anger and may be upset by it. Avoid exposing him to
such emotional distress and reassure him if it does happen.
x The love and time you give him, your interest in what he is doing, and your support for his curiosity
will help his self-confidence.
Communication
x Respond to his sounds and interests. Talk to him, sing for him, give meaning to his babbling, take
notice, and respond when he tries to tell you something. Telling him stories, reading to him, and
telling him the names of things and people will help him learn to speak and communicate.
Movement
x Playing with safe clean household items like non-breakable plates,
cups and spoons, banging pots and pans, opening and closing lids,
stacking and sorting objects, and feeding himself with his fingers
will help his learning and hand skills.
x Letting him move freely and play in a safe environment will help his
muscles develop.

24
Care for development messages

Care Messages
Age 1 to 2 years
Emotional development
x Give him opportunities to do things for himself, and rejoice in what he does to help him develop
self-esteem.
x He may be angry and frustrated when he cannot have all that he wants. Tell him about his feelings.
He will learn rules quicker if there are not many of them and if they are clear and consistent.
x He may want to do everything on his own and appear stubborn. He may want to stay an infant and
also be grown up at the same time. Understanding this phase of his childhood, holding him when he
wants to be a baby, and giving him some independence when he wants to be grown up will help him.
Communication
x This age is important for him to learn to speak and understand words. Encourage his learning by
watching what he does and naming it. Use every chance to make conversation with him (for
example, when feeding, bathing, or working near him).
x Ask him simple questions and respond to his attempts to talk. Encourage him to repeat words.
Listening when he uses gestures or words will increase his efforts to talk. Imaginary play, books,
songs, rhymes, stories, and taking turns in games will enrich his development.
Movement
x He will begin to use one hand more frequently and skilfully. Let him use whichever
hand the brain has selected. He can practice hand skills while he is feeding and
dressing himself, drawing, scribbling, playing with water, playing with things he can
stack or combine, and putting things in and out of containers.
x Take him outside so that he can run, jump, climb, and grow strong.

25
Care for development messages
Age 2 years and older
Emotional development
x The love and time you give him, your interest in what he is doing, your belief that he will succeed,
and your support for his curiosity will help his self-confidence and desire to learn.
x At this age he can understand what is right and wrong. He can be taught how people should behave
through stories, songs, and games. He will learn better if he is told what is correct first, and he
should be corrected gently so that he does not feel ashamed.
x Cooking and doing errands together, sorting clothes, and doing other household chores will boost
his self-confidence and improve his learning.
Communication
x Listen to what he is telling you, encourage him to ask questions, and try to answer them. Let him
talk about whatever he has experienced or wants to tell you. Encourage him to tell stories. Teach
him to name things, to count, and to compare and match sizes, shapes and colours of things around
him.
Movement
x Drawing, writing, colouring, stacking, sorting, and helping prepare
food will improve his hand skills.
x Playing out of doors and with other children will enrich all of his
development.
x Encourage his active play and movement. Provide opportunities
for activities such as marching, jumping, kicking and hopping.

26
Boy’s Growth Charts
Boy’s Growth Charts

27
Understanding Growth Charts
Normal growth in individual children can vary a great deal. Plotting a child’s measurements over
time on growth charts can show whether a child is growing normally or not.
A health care provider weighs and measures your child and records these measurements. Then
the child’s measurements are plotted as dots on the charts. Measurements taken at later visits are
also plotted, and the dots are joined by a line. This line is your child’s growth curve or trend.

Interpreting Growth Curves


x The line labelled 0 on the growth chart is the median which is, generally speaking, the average.
The other lines, called z-score lines, indicate distance from the average. A point or trend
which is far from the median, such as 3 or –3, indicates a growth problem.
x The growth curve of a normally growing child will usually follow a track that is roughly parallel
to the median. The track may be above or below the median.
x Any quick change in trend (the child’s curve veers upward or downward from its normal
track) should be investigated to determine its cause and remedy any problem.
x A flat line indicates that the child is not growing. This is called stagnation and may also need to
be investigated.
x A growth curve that crosses a z-score line may indicate risk. A health care provider can
interpret risk based on where (relative to the median) the change in trend began and the rate
of change.

28
Length-for-age BOYS

Birth to 6 months
Birth to 6 months (z-scores)
3
2 This Length-
70 1 70 for-age chart
shows
0 attained
length
-1 relative to
65 65 age in
-2 comparison
to the median
Length (cm)

-3 (0 line).
60 60
x A child
whose
length-for-
age is
55 55 below the
line –2 is
stunted.
x Below –3
50 50 is
severely
stunted.

45 45

Weeks 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Months 3 4 5 6
Age (Completed weeks or months)

29
Weight-for-age BOYS
Birth to 6 months (z-scores)
11 3 11 This Weight-
for-age chart
shows body
10 10 weight relative
2 to age in
comparison to
9 9 the median (0
1 line).

8 0 8 x A child whose
weight-for-
Weight (kg)

age is below
7 -1 7 the line –2 is
underweight.
-2 x Below –3 is
6 6
severely
-3 underweight.
5 5 Clinical
signs of
marasmus
4 4 or
kwashiorkor
may be
3 3 observed.

2 2

Weeks 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Months 3 4 5 6
Age (Completed weeks or months)

30
This Weight-
Weight-for-length BOYS

Birth to 6 months
for-length
chart shows
Birth to 6 months (z-scores) body weight
14 14 relative to
3 length in
13 13 comparison to
the median (0
2 line).
12 12
1 x A child
11 11
whose
0 weight-for-
10 10 length is
-1 above the
9 9 line 3 is
-2
Weight (kg)

obese.
8 -3 8 x Above 2 is
overweight.
x Above 1
7 7
shows
possible
6 6 risk of
overweight.
5 5
x Below the
4 4 line –2 is
wasted.
x Below –3 is
3 3
severely
wasted.
2 2 Refer for
urgent
45 50 55 60 65 70 75 80 specialized
care.
Length (cm)

31
BMI-for-age BOYS
Birth to 6 months (z-scores) This BMI-for-
age chart

22
3 22
shows Body
Mass Index
(BMI, a ratio of
21 21 body weight to
2 length) for the
20 20 child’s age in
comparison to
19 19 the median (0
1 line). BMI-for-
18 18 age is
especially
0 useful for
BMI (kg/m²)

17 17
screening for
overweight.
16 -1 16

15 15
x A child
-2 whose BMI-
for-age is
14 14
above the
-3 line 3 is
13 13 obese.
x Above 2 is
12 12 overweight.
x Above 1
11 11 shows
possible
10 10 risk of
overweight.
Weeks 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Months 3 4 5 6
Age (Completed weeks or months)

32
Length-for-age BOYS
6 months to 2 years (z-scores)
3 This
95 95 Length-for-
2 age chart
shows
90
1 90
attained
length
0 relative to
age in
85 85 comparison
-1 to the

6 months to 2 years
median (0
Length (cm)

-2 line).
80 80
-3 x A child
whose
length-
75 75 for-age is
below the
line –2 is
70 70 stunted.
x Below –3
is
severely
65 65 stunted.

60 60
Months 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
1 year 2 years
Age (Completed months and years)

33
Weight-for-age BOYS
6 months to 2 years (z-scores)
17 3 17
This Weight-for-
16 16 age chart shows
body weight
15
2 15
relative to age in
comparison to
the median (0
14 14 line).
1
13 13 x A child whose
weight-for-age
Weight (kg)

12 0 12 is below the
line –2 is
underweight.
11 11
-1 x Below –3 is
severely
10 10 underweight.
-2 Clinical
9 9 signs of
-3 marasmus
8 8 or
kwashiorkor
may be
7 7
observed.
6 6

Months 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
1 year 2 years
Age (Completed months and years)

34
This Weight-
Weight-for-length BOYS for-length
Birth to 2 years (z-scores) chart shows
body weight
relative to
24 3 24
length in
comparison to
22 2 22 the median (0
line).
20 1 20
x A child
0 whose
18 18
weight-for-
-1 length is
16 16 above the
-2

6 months to 2 years
line 3 is
Weight (kg)

-3 obese.
14 14
x Above 2 is
overweight.
12 12
x Above 1
shows
10 10 possible
risk of
overweight.
8 8

x Below the
6 6 line –2 is
wasted.
4 4 x Below –3 is
severely
wasted.
2 2
Refer for
urgent
45 50 55 60 65 70 75 80 85 90 95 100 105 110 specialized
care.
Length (cm)

35
BMI-for-age BOYS
6 months to 2 years (z-scores) This BMI-for-
age chart
shows Body
22 22 Mass Index
(BMI, a ratio of
body weight to
21 21 length) for the
child’s age in
20
3 20
comparison to
the median (0
line). BMI-for-
19 19 age is
especially
2 useful for
BMI (kg/m²)

18 18 screening for
overweight.

17 1 17 x A child
whose BMI-
for-age is
16 16
above the
0 line 3 is
15 15 obese.
-1 x Above 2 is
overweight.
14 14 x Above 1
-2 shows
possible
13 13
risk of
-3 overweight.
Months 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
1 year 2 years
Age (Completed months and years)

36
Height-for-age BOYS
2 to 5 years (z-scores)
3
This Height-
120 120
2 for-age
chart shows
growth in
115 115
1 height
relative to
age in
110 0 110
comparison
to the
median (0
105 -1 105
Height (cm)

line).

100 -2 100 x A child


whose
height-for-
95
-3 95 age is
below the
line –2 is
90 90 stunted.
x Below –3
is
85 85 severely
stunted.

80 80

2 to 5 years
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
2 years 3 years 4 years 5 years
Age (Completed months and years)

37
Weight-for-age BOYS
2 to 5 years (z-scores)
28 3 28
This Weight-
27 27 for-age chart
26 26 shows body
25 25 weight relative
to age in
24 2 24 comparison to
23 23 the median (0
line).
22 22
21 1 21 x A child whose
weight-for-
Weight (Kg)

20 20
19 19 age is below
the line –2 is
18 0 18 underweight.
17 17 x Below –3 is
severely
16 -1 16
underweight.
15 15 Clinical
14 -2 14 signs of
13 13 marasmus
or
12 -3 12 kwashiorkor
11 11 may be
observed.
10 10
9 9
8 8
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
2 years 3 years 4 years 5 years
Age (Completed months and years)

38
Weight-for-height BOYS This Weight-
for-height chart
2 to 5 years (z-scores) shows body
weight relative
30 3 30 to height in
comparison to
28 28 the median (0
2 line).
26 26 x A child
whose
24
1 24 weight-for-
height is
22 0 22 above the
line 3 is
-1 obese.
Weight (Kg)

20 20
x Above 2 is
18
-2 18 overweight.
-3 x Above 1
16 16 shows
possible
risk of
14 14
overweight.
12 12
x Below the
line –2 is
10 10 wasted.
x Below –3 is
8 8 severely
wasted.
6 6 Refer for
urgent

2 to 5 years
65 70 75 80 85 90 95 100 105 110 115 120 specialized
care.
Height (cm)

39
BMI-for-age BOYS
2 to 5 years (z-scores) This BMI-for-
age chart
shows Body
Mass Index
20
3 20 (BMI, a ratio of
body weight to
length) for the
19 19 child’s age in
comparison to
the median (0
2 line). BMI-for-
18 18
age is
especially
useful for
BMI (kg/m²)

17 17
screening for
1 overweight.
16 16
x A child
whose BMI-
15 0 15 for-age is
above the
line 3 is
14 -1 14 obese.
x Above 2 is
overweight.
13 13
-2 x Above 1
shows
possible
12 -3 12 risk of
overweight.
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
2 years 3 years 4 years 5 years
Age (Completed months and years)

40
Gross Motor Milestones
Windows of Achievement
Walking alone

Standing alone
Motor Milestone

Walking with assistance

Hands-&-knees crawling

Standing with assistance

Sitting without support

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Age in months

These windows show when the population for the WHO Child Growth Standards achieved these motor milestones.

41
Annex: Immunization schedule for infants recommended by
the WHO Expanded Programme on Immunization
This chart would be used when developing the immunization schedule for a country,
such as on page 4 of this booklet. (This page is not for mothers.)

Age
Vaccine Birth 6 weeks 10 weeks 14 weeks 9 months
BCG x

Oral polio x* x x x

DTP x x x

Hepatitis B Scheme Aa x x x

Scheme Ba x x x
Haemophilius
x x x
influenzae type b
Yellow fever xb

Measles xc
*
In polio-endemic countries
a
Scheme A is recommended in countries where perinatal transmission of hepatitis B virus is frequent (e.g.
in South-East Asia). Scheme B may be used in countries where perinatal transmission is less frequent
(e.g. in sub-Saharan Africa).
b
In countries where yellow fever poses a risk.
c
A second opportunity to receive a dose of measles vaccine should be provided for all children. This may
be done either as part of the routine schedule or in a campaign.

42

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