Maternal and Child Health Bureau HomeModule IntroTable of ContentsGlossary
Training Module: Poor Growth

Anthropometrics: Weight, length, and weight-for-length
Choose a sectionSection 1Section 2Section 3Section 4Section 5

1. Anthropometrics: Weight, length, and weight-for-length

With all these measures, monitoring a child's measurements over time provides the best information. Growth faltering, or slowed growth velocity, often indicates a problem. Cutoff values are also used to classify children's growth as normal or questionable. See Overview of Growth Charts for more information about guidelines for growth assessment.

Several guidelines have been established to identify poor growth. The most common cutoff point for concern is the fifth percentile, though other cutoffs are also used. The table below summarizes recommendations of several agencies and organizations. Criteria refer not only to weight but also to length and weight-for-length.

Cutoff point
Institute of Medicine

Length-for-age, height-for-age, weight-for-length or weight-for-height 5th percentile

Institute of Medicine, 1996


Length-for-age, height-for-age, weight-for-length, body-mass-index-for-age 10th percentile

US Department of Agriculture


Body-mass-index-for-age 5th percentile

BMI Module

Height (or length)-for-age, weight-for-height, weight-for-age 2.3 percentile (-2 SD)*

WHO, 1995

Medical practice

Weight-for-age, weight-for-length, length-for-age

5th percentile

Kessler and Dawson, 1999

Medical Practice Weight-for-age, length-for-age or height-for-age Dropping downward across percentiles Kessler and Dawson, 1999, page 22
* For more information about the use of standard deviations, click here

The Institute of Medicine made recommendations for the identification of children needing special nutrition services through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC, with its preventive emphasis, recommends the tenth percentile weight-for-length as a point for intervention. The fifth percentile of weight-for-age is commonly used in medical settings. The World Health Organization (WHO) takes a worldwide perspective and emphasizes the needs of developing countries. The WHO cutoff, 2 standard deviations below the mean, is slightly lower than the 5th percentile used in the US.


Back Next