length

D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/MD/MEDDD/M

head

weight

3 4 5 6

3 4 5 6

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

72cm

70

68

66

64

62

60

58

56

54

52

50

48

46

44

42cm

39cm

38

37

36

35

34

33

32

31

30cm

8.0kg

7.5

7.0

6.5

6.0

5.5

5.0

4.5

4.0

3.5

3.0

2.5

2.0

1.5kg

70cm

68

66

64

62

60

58

56cm

46cm

45

44

43

42

41

40

39

38

37

36cm

10.0kg

9.5

9.0

8.5

8.0

7.5

7.0

6.5

6.0

5.5

5.0

4.5

4.0

3.5

3.0

2.5

2.0kg

1 2 3 4

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

32 4 57 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

99.6th

Corrected age post-term in weeks (calendar months )

5

weight

head

length

56cm54525048464442403836343230282624

22cm

32cm

31

30

29

28

27

26

25

24

23

22

21

20

19

18

17

16cm

2000g

1800

1600

1400

1200

1000

800

600

400

200

0g

54cm5250484644cm

38cm

37

36

35

34

33

32

31cm

5.0kg

4.8

4.6

4.4

4.2

4.0

3.8

3.6

3.4

3.2

3.0

2.8

2.6

2.4

2.2

2.0

1.8

1.6

1.4

1.2

1.0

0.8

0.6

0.4

0.2

0.0kg

D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M

24 28 29 30 31 32 33 34 35 36 37 38 39 41

TERM

40

Gestational age in weeks

Gestational age in weeks

98th

91st

75th

50th

25th

9th

2nd

0.4th

-3SD

-4SD

0.4th

2nd9th25th50th75th91st98th99.6th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

-3 SD

-4 SD

-3SD

-4SD

99.6th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

-3 SD

-4 SD

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th-3 SD

-4 SD

Data Recording

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 1

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 2

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 4

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 6

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 8

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 10

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 3

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 5

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 7

Recording Date

Weight

Head Circumference

Length/Height

Location

Health worker name

Measurement 9

For preterm infants, before starting plottingfill in the date boxes for speedy and accuratecalculation of gestational and corrected age.Work backwards from EDD or forwards fromDOB and gestation using calendar on flap.

Date boxes on this page areonce per fortnight.

2 2 66

642

24 25 26

24 25 26

27 28 29 30 31 32 33 34 35 36 37 38 39 4140 4223

UK

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Corrected age post-term in weeks (calendar months )GIRLS23 to 42 weeksgestation

GIRLS2 weeks to6 months

length

head

GIRLS UK–WHONeonatal and InfantClose MonitoringGrowth Chart23 weeks gestation to 2 years corrected age

Please place sticker (if available) otherwise write in space provided.

Name: ____________________________________________

NHS / CHI No:

Hospital No:

Date of Birth:

EDD:

Gestation: __________weeks __________days

For preterm infants this chart is wholly gestationallycorrected, using the date box method. Unlike the UK-WHOA4 chart the arrow drawn back method should not beused. New users need to be taught how to use this chart.A fact sheet and powerpoint can be downloaded free fromwww.growthcharts.rcpch.ac.uk

Which children is this chart suitable for? This chart has been designed for plotting growth measurements ofpreterm infants from birth to the age of 2 years post-menstrual age.The chart is also suitable for term neonates or young infantsrequiring close monitoring. After this the UK-WHO 0-4 years chartscan be used. For healthy preterm babies born at or after 32 weeksgestation the UK-WHO 0-4 years charts can be used from birth,unless there is a need for detailed growth assessment.

A specialist growth chart for low birthweight The special features of this chart include:

• A ‘date box’ system to assist accurate calculation of gestational age

• Large scale for detailed monitoring

• Low reading (SD) lines to allow assessment of very small infants

The three charts display data from two sources:

1. 23-42 weeks gestation. This chart is based on reanalysedUK1990 data and illustrates the size at birth of UK infants bornat 23-42 weeks gestation around 1990 1. The 23-42 weeksgestation chart does not describe how preterm infants growafter birth because it shows only birth measurements of infantsborn at different gestational ages. The weight of many babiesborn before 32 weeks, particularly the sickest and mostimmature, may fall by more than two centile spaces in the earlydays.

2. 2 weeks to 6 months corrected age and 6 months to 2years corrected age charts. These charts are derived from theUK-WHO 0-4 years growth charts and use World HealthOrganization (WHO) data on healthy, non-deprived breastfedchildren of mothers who did not smoke 2. These charts do notreflect the usual growth of the preterm infant population.However individual infants who have remained well shouldfollow the trajectory indicated by the centile lines at theircorrected age.

MeasuringRemove all clothing, including caps or bonnets, footwear andnappy.

Weight: Use class III electronic scales.

Length: Use length board or mat. Do not use measuring tape.

Head circumference: Use non-stretchable tape.

Anyone who takes measurements should be suitably trained orsupervised by someone competent. For further information andtraining materials see www.growthcharts.rcpch.ac.uk

This is a new chart which is still being evaluated and anyfeedback will be appreciated, via the feedback form onwww.growthcharts.rcpch.ac.uk

References1. Cole TJ, Freeman JV, Preece MA. British 1990 growth reference centiles for weight, height,

body mass index and head circumference fitted by maximum penalized likelihood.Stat.Med. 1998;17:407-29.

2. WHO Child Growth Standards www.who.int/childgrowth/en3. Engle WA; American Academy Of Pediatrics. Age Terminology During The Perinatal Period:

Policy Statement Pediatrics 2004 114:1362-4.

© DH Copyright 2009

EDDD/MM D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D/M D

TER

Gestational age in weeks

9

DOB and gestation using calendar on flap.

G

27 28 29 30 31 32 33 34 35 36 37 38 39 4140

23/516/59/52/525/418/41 1/44/428/321/314/37/328/2

/birth

<

weight

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

-3 SD

-4 SD

-5 SD

16 17 181110

987

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

96cm

94

92

90

88

86

84

82

80

78

76

74

72

70

68

66

64

62

60

58

56cm

46cm

45

44

43

42

41

40

39

38

37

36

35

34cm

13.0kg

12.5

12.0

11.5

11.0

10.5

10.0

9.5

9.0

8.5

8.0

7.5

7.0

6.5

6.0

5.5

5.0

4.5

4.0kg

94cm

92

90

88

86

84

82

80

78

76

74

72

70cm

53cm

52

51

50

49

48

47

46

45

44

43

42

41

40cm

16.0kg

15.5

15.0

14.5

14.0

13.5

13.0

12.5

12.0

11.5

11.0

10.5

10.0

9.5

9.0

8.5

8.0

7.5

7.0

6.5

6.0

5.5

5.0

4.5

4.0kg

12 13 14 15 19 20 21 22 23

Corrected age post-term in calendar months

InstructionsFind the expected date of delivery (EDD) on thecalendar and work upwards in the same columnto find the weekly dates needed for the pretermdate boxes until birth gestation is reached. Forfortnightly dates on the 2 weeks to 6 monthschart, work downwards in the same column fromEDD (or DOB for term infants).

If DOB or EDD is 31st December use 30thDecember; in a leap year use 28th February for29th February. The date box date at 6 months maydiffer from the calendar months date by up to 2days, if the error exceeds 2 days then the boxesare dated wrongly.

When you get to the top of calendar (whenworking upwards from EDD) start again at thebottom in the same column.

Once you reach the end of the year start again atthe top, in the same column.

Week Month

Decem

ber

Novem

ber

Octo

ber

Septem

ber

August

July

June

May

April

March

February

January

Date boxes on this page are per calendar month.To complete, use the EDD day. e.g. If EDD = 23/1/10,enter 23/7/10 at 6m, 23/8 at 7m, 23/9 at 8m, etc.

Day

6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

24

Man

ufac

ture

4

S

ept.

12

UK

-WH

O N

ICM

A4G

Corrected age post-term in calendar months

D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y D/M/Y

1 2 3 4 5 6 7

8 9 10 11 12 13 14

15 16 17 18 19 20 21

22 23 24 25 26 27 28

29 30 31 1 2 3 4

5 6 7 8 9 10 11

12 13 14 15 16 17 18

19 20 21 22 23 24 25

26 27 28 1 2 3 4

5 6 7 8 9 10 11

12 13 14 15 16 17 18

19 20 21 22 23 24 25

26 27 28 29 30 31 1

2 3 4 5 6 7 8

9 10 11 12 13 14 15

16 17 18 19 20 21 22

23 24 25 26 27 28 29

30 1 2 3 4 5 6

7 8 9 10 11 12 13

14 15 16 17 18 19 20

21 22 23 24 25 26 27

28 29 30 31 1 2 3

4 5 6 7 8 9 10

11 12 13 14 15 16 17

18 19 20 21 22 23 24

25 26 27 28 29 30 1

2 3 4 5 6 7 8

9 10 11 12 13 14 15

16 17 18 19 20 21 22

23 24 25 26 27 28 29

30 31 1 2 3 4 5

6 7 8 9 10 11 12

13 14 15 16 17 18 19

20 21 22 23 24 25 26

27 28 29 30 31 1 2

3 4 5 6 7 8 9

10 11 12 13 14 15 16

17 18 19 20 21 22 23

24 25 26 27 28 29 30

1 2 3 4 5 6 7

8 9 10 11 12 13 14

15 16 17 18 19 20 21

22 23 24 25 26 27 28

29 30 31 1 2 3 4

5 6 7 8 9 10 11

12 13 14 15 16 17 18

19 20 21 22 23 24 25

26 27 28 29 30 1 2

3 4 5 6 7 8 9

10 11 12 13 14 15 16

17 18 19 20 21 22 23

24 25 26 27 28 29 30

Plotting instructionsFrom birth until 2 weeks after the expected date of delivery (EDD)plot measurements on the 23-42 weeks gestation chart. FromEDD plus 2 weeks (42 weeks gestation) plot measurements on the2 weeks to 6 months chart.

Gestational correction is always required when plotting babies bornpreterm (before 37 completed weeks of gestation). Do not applyany gestational correction for term babies (37-42 completed weeksof gestation). If desired the chart may also be used to look uprelative size for gestation but always plot birth data for babiesborn between 37-42 completed weeks at 40 weeks.

Calculating gestational, post-menstrual and corrected age fromdates is difficult and mistakes are common. Although the chart canbe plotted in the conventional way, this chart provides date boxeswhich will allow you to move directly from dates to gestational ageand reduce the risk of error. To do this effectively, when first usedthe chart needs to be prepared as below.

Before starting plotting use the calendar to fill in dateboxes. Then use the date boxes for speedy and accurate

calculation of age.

For preterm infants

1. If expected date of delivery (EDD) is not known, plot birthweightat the exact gestational age and then calculate the date of thenext completed week (e.g. for date of birth (DOB) 24/2/09 at 27weeks +3 days gestation, date at 28 weeks gestation will be28/2/09). Then write in the date (day and month only) at eachcompleted week of gestation, using the calendar (left) as aguide, until EDD is reached.

2. If EDD is known, write into the date box marked EDD then workbackwards on the 23-42 weeks chart, writing in the date (dayand month only) using the calendar (left) as a guide, for eachcompleted week of gestation until birth gestation is reached.

The date boxes are weekly on page 1 (23-42 weeks)Fortnightly on page 2 (2 weeks to 6 months)

Per Calendar month on page 3 (6-24 months)

For all infants

After 42 weeks post-menstrual age use the 2 weeks to 6 monthschart. Mark the expected date of each completed fortnight afterEDD (or DOB for term infants) in the boxes at the bottom of thechart, using the calendar (left) as a guide, and use these to identifythe gestationally corrected age.

On the 6 months to 2 years chart the date boxes are per calendarmonth (4.33 weeks). These dates can be calculated using the datein the EDD box. If a child’s EDD was 23/1/10 then mark 23/7/10 inthe 6 month box, 23/8 in the 7 month box, 23/9 in the 8 monthbox, etc. By age 6 months the data box date may be up to 2 daysdifferent from the calendar months date. This is not a problem, butthe calendar month date should be used from 6 months. If day erroris >2 days then a mistake has been made in dating the boxes.

GIRLS6 monthsto 2 years