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Tools & Calculators

Please let us know if you have any questions about these growth charts and calculators or any difficulties in using them.
WHO growth charts

WHO Growth Charts for Canada

In 2010, the WHO Growth Charts for Canada were released and were recommended as the standard growth charts for all Canadian children, to replace the CDC growths in use since 2000. The formatting of the 2010 charts was the result of a collaborative statement by the Dietitians of Canada, the Canadian Paediatric Society, the College of Family Physicians of Canada, and the Community Health Nurses of Canada.

A number of individuals and professional organizations, most notably the Canadian Pediatric Endocrine Group (CPEG), raised three concerns about the new WHO charts. In particular, CPEG felt that the loss of weight-for-age curves from ages 10–19 years in favor of a sole emphasis on the calculation of body-mass index (BMI) made the charts less useful for short-term clinical evaluation of weight gain or loss in growing children. Secondly, the inclusion of curves for the 0.1st and 99.9th centiles in the 2010 charts raised the possibility of some physicians considering these extremes as the “normal range”, possibly delaying referral of children until they reached one of these extremes. Finally, the loss of the number of intermediate-centile (10th, 25th, 75th and 90th) curves on the 2010 charts made it potentially more difficult for clinicians to identify children who were “crossing centiles”.

CPEG therefore undertook to recreate the weight-for-age curves for children 10–19 years of age, using a statistical method identical to that used by WHO, and including the majority of the data points in the WHO curves. Following discussions between the original collaborative group and CPEG, a consensus was achieved in March 2014, whereby two sets of growth charts would be released, both including the new weight-for-age curves developed by CPEG and differing only in the percentiles plotted:

  • Set 1 uses centiles 3/15/50/85/97 (roughly −2/−1/0/+1/+2 standard deviations) on all charts and in addition includes the 99.9th centile (+3 SD) on the weight-for-length (0–24 months) and BMI-for-age (2–19 years) charts.
  • Set 2 uses centiles 3/10/25/50/75/90/97 on all charts, substituting the 85th for the 90th centile and retaining the 99.9th centile on the weight-for-length (0–24 months) and BMI-for-age (2–19 years) charts. The 85th centile was used on the weight-for-length and BMI charts to correspond to the cut-off for obesity in adults.

English and French versions of both sets of growth charts are freely available for download at www.whogrowthcharts.ca, as well as instructions for how they should be printed. For those individuals and electronic health-records companies wishing access to the LMS data used to plot the charts, these are available on the CPEG website here.

BC Children’s Hospital has now printed and integrated the use of the Set 2 consensus charts. We encourage all clinicians and public-health clinics seeing children in BC to switch to the revised WHO Growth Charts for Canada, and measures are underway through the BC Ministry of Health to ensure that this occurs on the public-health side as well.

Links to the individual WHO Growth Charts for Canada, Set 2:

BOYS

GIRLS

Age Birth to 2 Years

Age Birth to 2 Years

Length-for-age and weight-for-age

Length-for-age and weight-for-age

Head circumference-for-age and weight-for-length

Head circumference-for-age and weight-for-length

Age 2 Years to 19 Years

Age 2 Years to 19 Years

Height-for-age and weight-for-age

Height-for-age and weight-for-age

BMI-for-age

BMI-for-age


ZIP files containing all of the Set 2 charts are available:

A number of additional resources for the WHO Growth Charts for Canada:

See also our Anthropometric Calculators (tab above) for determining percentiles and Z-scores for the WHO Growth Charts for Canada, in addition to the CDC Growth Charts and a number of common syndromes.

Also take a look at the browser-based Growth Chart Plotter App (tab above) for plotting heights and weights for boys and girls ages 2 to 19 years, ideal for making growth charts for PowerPoint presentations.‎

Anthro calculators

Anthropometric calculators

A number of resources are available on this website and that of the Canadian Pediatric Endocrine Group to assist clinicians in calculating Z-scores and centiles for anthropometric data for typically growing children, children with syndromes, and premature infants.


Microsoft® Office Excel® workbooks

The BCCH Anthropometric Calculators can calculate Z-scores and centiles for height/length, weight, head circumference, body-mass index, waist circumference, waist/height ratio, BMI, blood pressure (2004 NHBLI and 2017 AAP), skinfold thickness, arm circumference, height velocity, target (midparental) height, and predicted adult height for typically growing children and for children with selected syndromes, based on published norms.

These workbooks are free and do not contain macros. They may be used online or downloaded and saved to your hard drive or mobile device.

There are three calculator workbooks:

  • Anthropometric Calculator for children 0–19 years of age (current version: 2022/09/23), based on the World Health Organization (WHO) Growth Charts for Canada (2014 revision). Also contains calculators for blood pressure (using NIH 2004 or AAP 2017 references), waist circumference, arm circumference, triceps and subscapular skinfolds, target (midparental) height, predicted adult height, and height velocity for healthy children. The formulae for converting non-Gaussian physical measurements into Z-scores are strictly valid only for −3 < Z < +3, with more extreme values compressed as the conversion formulae plateau asymptotically. The WHO has addressed this issue by introducing the “SD23 correction method” for Z-scores outside this range. We apply this correction for WHO Z-scores for weight- and waist circumference–based measures (weight, body-mass index, weight-for-length, weight-for-height, waist circumference and waist-height ratio) with this calculator. Please also note that the WHO has also made available its free Anthro and AnthroPlus software to do these calculations in these two age groups, respectively.
  • Anthropometric Calculator for children 0–20 years of age (current version: 2022/09/23), based on the US Centers for Disease Control and Prevention (CDC) 2000 growth charts (available online at http://www.cdc.gov/growthcharts/). Also contains calculators for blood pressure (using NIH 2004 or AAP 2017 references), waist circumference, arm circumference, triceps and subscapular skinfolds, target (midparental) height, predicted adult height, and height velocity for healthy children. The formulae for converting non-Gaussian physical measurements into Z-scores are strictly valid only for −3 < Z < +3, with more extreme values compressed as the conversion formulae plateau asymptotically. The CDC has simply reported extreme values as “≤−3 SD” or “≥+3 SD”, for percentiles ≤0.1% or ≥99.9%. We report raw CDC Z-scores for weight- and waist circumference–based measures (weight, body-mass index, weight-for-length, weight-for-height, waist circumference and waist-height ratio) with this calculator. Please also note that the CDC has made available a nutrition module in its free Epi Info™ software to do these calculations.
  • Anthropometric Calculator for children with obesity (current version: 2022/01/17), based on WHO and CDC norms. This calculator provides extended measures of overweight and obesity, based on the median and upper-limit-of-normal (97th centile for WHO, 95th centile for CDC) BMI for age: age-corrected percent distance from the median [based on Freedman et al, Br J Nutr 2020;124(4):493–500], age-corrcted percent distance from the ULN, and percent of the ULN. The formulae for converting non-Gaussian physical measurements into Z-scores are strictly valid only for −3 < Z < +3, with more extreme values compressed as the conversion formulae plateau asymptotically. Historically, CDC has simply reported extreme values as “≤−3 SD” or “≥+3 SD”, for centiles ≤0.1% or ≥99.9%. With this calculator, we report raw Z-scores. For CDC BMI-Z ≥95%, we also calculate the “extended BMI-Z”, using the method of Wei et al [Ann Hum Biol 2020;47(6):514–521].
  • Anthropometric Calculator for children with Turner, Noonan, Russell–Silver, Prader–Willi, and Down syndromes (current version: 2022/01/17), based on various published norms (references in workbook).

We also have available a number of Microsoft® Excel workbook–based batch calculators, to be used in conjunction with the above calculator workbooks. Please note that these workbooks contains macros, which will have to be enabled for them to work. For each batch calculator, there is a worksheet in its workbook with instructions for use. Please also note that these workbook files and the associated anthropometric calculator files must be placed in the samer folder on your computer's hard drive or network drive. There are problems reported using this with Macs that we have been unable to resolve. Currently available:

  • Growth Z (current version 2022/01/11), to do batch calculations for WHO and CDC parameters, as well as 2004 NHLBI and 2017 AAP BP. Requires the WHO and/or CDC calculator above, as desired.
  • Head Circumference Z (current version 2022/01/02), to do batch calculations of head circumference for people 0–21 years of age, based on references from Rollins JD, Collins JS, Holden KR. J Pediatr 2010;156(6):907–913. Requires the WHO calculator above.
  • Height Velocity Z (current version 2022/01/02), to do batch calculations of growth velocity of children, based on references from Kelly A, Winer KK, Kalkwarf H, Oberfield SE, Lappe J, Gilsanz V, Zemel BS. J Clin Endocrinol Metab 2014;99(6):2104–2112. Requires the WHO calculator above.

AnthroCalc app for Android and iOS anthrocalc.png

Our AnthroCalc app is available on Google Play and on the App Store. The AnthroCalc app calculates centiles and Z-scores for height/length, weight, weight-for-length, body-mass index, waist circumference, head circumference, target (midparental) height, predicted adult height, and height velocity for typically growing children (using WHO or CDC references); for blood pressure (using NIH 2004 or AAP 2017 references); for children with a number of syndromes (Turner, Down, Prader–Willi, Russell–Silver and Noonan); and for preterm infants (Fenton, INTERGROWTH-21st).

Get it on Google Playappstore.en.svg

CPEG Shiny Calculators

There is also an option for those wanting to use these CPEG macros in either a clinical or research context, but who are uncomfortable with a statistical package. The Canadian Pediatric Endocrine Group has created on-line applications (Zapps™) running these macros on an R server (a/k/a Shiny), available here on their website.

Growth plotter apps

Growth chart plotter apps

Web browser—based plotter

Dr. Atul Sharma, MD, MSc, FRCPC, Assistant Professor, Department of Pediatrics and Child Health, University of Manitoba, has developed a web-based height-, weight- and BMI-plotting app for children from birth to age 19 years, using the WHO Growth Charts for Canada, 2014 revision. The app can be used to make images of plots for presentations (see screenshot below).

This app requires an HTLM5-compliant browser with JavaScript (e.g. Safari, Chrome, Firefox, or Opera), and it will not work with current versions of Microsoft Internet Explorer or Edge.

Set 2 plotters:

Plotters for Set 1 and French versions are also available here.


CPEG Shiny Plotters

For those who prefer to create growth charts by uploading anthropometric data in spreadsheet (csv) format, the Canadian Pediatric Endocrine Group has also created Shiny plotters for this purpose:

Or if you prefer to combine direct data entry with the versatility of Shiny:


GrowthCalc Android appgrowthplot.png

Our GrowthPlot app is available on Google Play. The GrowthPlot app plots length, weight, head circumference and weight-for-length for children from birth to 24 months of age; and it plots height, weight and body-mass index for children ages 2 to 19 years. Plots for WHO are made using the WHO Growth Charts for Canada, March 2014 revision. Plots for CDC are made using the 2000 CDC Growth Charts. Please note that the CDC now recommends the use of the WHO growth standards for infants 0–2 years of age. You can share the growth charts generated by this app as PNG image files via e-mail or text, suitable for use in publications or presentations.

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