Race and ethnicity-specific growth charts for children
An alternative to the CDC clinical growth charts
In an earlier post, I discussed what growth charts mean and ways that you can use growth charts to monitor your child’s development. The CDC growth and BMI charts are the standard in doing this. They are age- and gender-specific and incorporate data from all races and ethnicities.
To provide an alternative what they consider to be a “lumping together” of all children, Halls.MD offers a collection of alternative growth charts that not only break children’s growth data down by age and gender, but also race and ethnicity.
What are the differences?
Let me start off by saying that the data used by both the CDC and Halls.MD are from the National Health and Nutrition Examination Survey (NHANES) conducted by the CDC. The key difference between the growth charts, then, are in how that data is used to create the chart and how it affects the percentiles.
The CDC combines data for children of all races and ethnicities; Halls.MD breaks it out by the race-ethnicity categories that CDC used when conducting the survey, creating 4 separate charts for each gender and body dimension.
- White
- Black
- Hispanic
- Other (which includes all Hispanics, regardless of race, who were not Mexican-American and also includes all non-Hispanics from racial groups other than white or black, including Aleut, Eskimo, American Indian, Asian and Pacific Islander)
The CDC data includes some historical measurement data; Halls.MD uses only the most recent survey results. This matters because children have grown taller and heavier since previous surveys were administered, and the average child is now bigger. You can look at this in one of two ways. First, by including past data, the CDC’s charts arguably inflate the growth percentile associated with a given height or weight. The second point of view, though, is that Halls.MD charts, which include recent data only, may actually be shifting the percentiles downward to accommodate changes in the population. This difference in philosophy means that the CDC weight charts, for example, show the 95th percentile line at a lower weight than the Halls.MD weight charts do. Who’s right? I’m not really sure.
The final difference between the growth charts is that Halls.MD breaks height and weight out into separate tables, making it somewhat easier to read.
CDC Growth Chart - Girls 0-36 months
Halls.md Growth Chart - Girls weight only
Which growth chart type should you rely on?
Absolutely, there are differences between the CDC and Halls.MD charts, but the question is: are the differences big enough to make a difference? Doctors do not use height and growth percentiles on their own, but instead track them over time. So whether your child is at the 35th percentile on the CDC chart and 45th percentile on the Halls.MD chart, is not as important as whether they stay around that same percentile over time (on the same chart).
………
In the end, which chart you use may be a matter of personal preference. If any of you has used the Halls.MD chart system, I’d appreciate your thoughts on how you think it compares to the CDC growth charts.
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The World Health Organization is launching global Child Growth Standards for infants and children up to the age of five.