GROWING UP CHARTED
+PERSONAL
Contents
RECOLLECTIONS
Mothers share
personal stories
about their children
and their interactions
with growth charts
History Where did Growth
Charts come from?
Have they been
updated?
Inaccuracy
page
3
Is it ok to rely on
growth charts to
track health? How
accurate are they?
Reality
Real mothers share a
part of their story
with their children
and growth charts.
Feasibility/What is
Needed
How feasible is it to
create the charts
parents demand?
What are the real
needs?
References
Sources of stories,
quotes and pictures.
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The History of Growth Charts
“Children will
vary. Some
children are
faster, slower,
smaller or
larger.”
-Michelle Johnson
The CDC informs us that “Pediatric growth charts have been used by
pediatricians, nurses, and parents to track the growth of infants, children, and
adolescents
in the United States since 1977” (Growth 1). These charts developed
-Michelle Johnson
in 1977 were completed from the data obtained from National Health
Examination Surveys including ages six to seventeen and the first National Health
and Nutrition Examination Survey (NHANES), which included ages one to
seventeen. This means that there was no national data from birth to age one. To
compensate for the hole in data, information for birth to one year was taken solely
from a study in Ohio. Fortunately, these charts were updated the following year to
include a wider selection of data. Over the period of many years, these charts have
been updated with wider scopes, new technology, and with new recommendations
(Kuczmarski 2). The recent research indicates that our most recent growth charts
are based on more sufficient data than the international charts previously being
used. It can be asserted that these charts are a reliable reference when viewing a
child’s growth in comparison to an adequate data source.
more on
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Paige Hudson
Inaccuracy
Many parents have concerns
over the growth of their children. The
growth charts used by pediatricians
worldwide are a reference tool
developed from a sampling of data.
Yes, children are individuals and as
such cannot be held to one standard.
That is why growth charts have a
curve to show which percentage a
child may fall into. An article from
Parenting.com puts parents at ease:
“experts say there's rarely reason for
concern. For starters, healthy kids
come in a wide range of shapes and
sizes, and they don't grow at a steady
rate, either. Your child can look very
different from your fiends' kids -- or
from his own siblings at the same age
-- and still be completely normal”
(Renkl 1).
A growth chart may not have a
node for an outlier who is gaining
weight or getting taller at a rate than
other children, and that shows that not
everyone can fit on a standardized
chart. The CDC’s explains a few
exclusions from their updated charts:
“11 infants whose recumbent length
and stature differed by greater than or
equal to 5 cm were excluded from the
length-for-age, weight-for-length,
stature-for-age, weight-for-stature,
and BMI-for-age charts…two outlier
values, one for head circumference of
an infant girl, and one for recumbent
length of an infant boy, were
excluded because the measurement
values and the sampling weights were
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Vol. 1
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extreme” (Kuczmarski 5).
Though these charts cannot
represent the health of each and
every child, they are able to
provide averages to show how a
large sampling of an age group
are developing and whether or
not a child is developing at the
same rate.
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Paige Hudson
Eng 252
Vol. 1
Spencer and Kaytie
Michelle
I really like development
charts. They gave me
something to compare too.
They helped me, as first time
mother, know what to expect
and when. I do think people
/moms need to realize these
are averages. Children will
vary. Some children are
faster, slower, smaller or
larger.
Also, these charts can help
doctors and caseworkers
detect cases of neglect,
abuse, malnutrition and
presence of learning
disabilities.
With Spencer, he met all the
milestones until it came to verbal
and comprehension, which is about
a year, give or take. We knew
something was going on for a
couple years, but no one believed
us. Then at his four-year well child
check, we expressed it again and
our doctor agreed and sent us
finally for a mental evaluation. We
went to that appointment and in a
matter of minutes, we found
Spencer was mildly autistic.
Karen and Brooklyn
In Utah, they had programs offered
through the school system to help
children with delays. There were
ladies that would come to our house
and test Brooklyn to see where she fell
on the development charts. It was
determined that she was delayed and
she would benefit from their
program…She attended a regular
kindergarten class and had a fantastic
teacher that understood our situation.
By the end of the year, Brooklyn wasn't
where she needed to be. She struggled
with reading, writing, drawing...
everything. We decided to put her in
kindergarten a second time with the
same teacher. This time, she thrived.
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Paige Hudson
Eng 252
Feasibility
The CDC has made it clear that
high demands cannot always be
met. Parents often feel that the
reference charts should always
catch what is going on with their
child, as well as flag them when
they need help. The facts are, “it is
not feasible to conduct a study that
would obtain measures on the total
U.S. population of children”
(Kuczmarski 15). It is not realistic
for parents and healthcare
professionals to rely on these
reference charts for a diagnosis or
even to flag every child that should
be tested for more help. Just as the
argument stands with many that all
children develop differently, each
reference chart cannot be held
responsible for a child’s well being.
Suffice it to say that partnering
with observant parents, skilled
healthcare professionals, and the
reference charts results in children
getting the help that they need. No
these charts do not accurately
depict the health of an individual
child, that is not the purpose behind
them. Yes, the reference charts are
backed by sufficient research. They
are being re-evaluated and revised
from time to time to make sure they
are keeping up with modern health
trends. The final question posed,
how can we know that what our
doctors tell us is reality, is not so
easily answered. That is in the
judgment of a parent. If you feel that
your doctor or other healthcare
professional is not providing the care
you believe your child needs, you
should probably find a new
healthcare provider. These providers
are as unique and numbered as the
children that need them.
Vol. 1
Just as the argument
stands with many that
all children develop
differently, each
reference chart cannot
be held responsible for
a child’s well being.
What is Needed
Growth charts are being
viewed incorrectly: they are reference
charts. These are not to be used as a
final word of diagnosis or evaluation.
A chart that informs parents of their
child’s health is not what is needed.
The existing charts are a sufficient
reference to screen for children who
are not being taken care of or who are
in need of serious medical attention.
What is needed to know a child’s
health is attentive parents and skilled
healthcare professionals. To reiterate
what the CDC has stated, it is not
realistic to gather data on all the
children in the United States.
The services that are available
to parents regarding their child’s
health are numerous. Sometimes a
local pediatrician is not enough. This
puts the pressure on parents to be
present and proactive in the lives of
their children. It is suggested that
parents ask questions to help receive
the best care for your child. “Having
regular well-child visits with your
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child’s doctor and raising the
concerns that matter most to you
are key ingredients in helping the
doctor know you and your child,
and in forming a reliable and
trustworthy relationship” (WellChild 1). It can be difficult to
know what to ask your
pediatrician when at a well-child
check. The Academy of Pediatrics
recommends “jotting down three
to five questions and bringing
them to the visit” (Well-Child 1).
In sum, look to growth
reference charts for help knowing
if your child is in need of serious
medical attention. The charts are
sufficient and are not in need of
revision at this current time. It is
not a bad thing to grow up
charted. All health advice and
references available to every
person help to create a better
individual and in turn a better
world.
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Works Cited
Bouvier, Kaytie. Personal Interview. 11 February 2014.
“Growth Charts.” Centers for Disease Control and Prevention. 9 September 2010. Online. 10
February 2014.
JAMA Pediatrics Development of a Research Child Growth Reference and Its Comparison With
the Current International Growth Reference May 1998, Vol 152, No. 5. Online. 10 February
2014.
Johnson, Michelle. Personal Interview. 11 February 2014.
Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth charts for the United States:
Methods and development. National Center for Health Statistics. Vital Health Stat 11(246).
2002
Moorhead, Kimberly. Personal Interview. 11 February 2014.
Powell, Karen. Personal Interview. 12 February 2014
Renkl, Margaret. “What Kids’ Growth Charts Don’t Tell You.” Parenting.com. 27 December
2010: Online. http://www.cnn.com/2010/HEALTH/12/27/kids.growth.charts.parenting/
“Well-Child Care: A Check-Up for Success.” The American Academy of Pediatrics. 7 August
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2013. Online. 15 February 2014.
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