Plotting on Growth Chart

• A growth chart is a weight for age chart for children from birth to 5 years of age. It shows whether child’s growth is normal or not.

• X axis is for recording age from birth till 60 months of age. X axis is not shown as a straight line, but as 5 steps. Each step has 12 blocks,  each block representing one month. 

• Y axis is for recording  weight. It has markings from 0 to 21 kgs. The darker horizontal lines represent 500 gms interval while finer lines represent 100 gms interval.

• On top left corner the white rectangular box called information box is for recording the details of the child.

• There are three curved lines. From top to bottom they represent 

  • Median-50th percentile

  • Minus 2 SD

  • Minus 3 SD

• There are four color zones. 

  • White zone - Above the first line

  • Green zone - Between the first and second line (i.e.between Median and -2 SD)

  • Yellow zone - Between the second and third line (i.e. between -2 SD and -3 SD)

  • Orange – Below the third line (i.e. below -3 SD)

Step 1: Identify the appropriate growth chart.

Step 2: Fill up the details in the information box.

Step 3: Fill up the birth month in the first month box and date of birth on the leftside outside of the box

Step 4: Fill up the remaining month boxes.

Step 5: Plot the weight appropriate for the age

Step 6: Connect the plotted points to form the growth curve

Step 7: Interpret the plotted weight and growth chart

The growth chart for boys has a blue border while the growth chart for girls has a pink border.

Fill up the following details in the information box on the growth chart i.e. 

• name of child

• father’s name

• mother’s name

• family survey registration number and

• weight at the time of birth

Example, For a child, Isha born on 13th Mar 2019, the birth month is to be written in the first month box as 03/19 and the date of birth is written as 13th outside the box on the left side of the box. 

e.g. if child is born on 13th Mar 2019 the first box will be labelled as 03/19 and last box will be 02/24

Growth Chart with Birth months filled from first box to the last box

1. Plotting has to be made at the junction of vertical line (not between vertical lines) of the identified ‘month box’, and line corresponding to weight.  

   • First identify the horizontal line which indicates the present weight of the child to the nearest 0.1 kg. 

   • Then identify the month box indicating the present age of the child.

   • Put a dot where the two lines intersect. Draw a circle around the dot. You can put the date of weighing the child next to the circled dot

   • Write the weight below the ‘month box’, which indicates the present age of the child.

2. While determing the age of the child keep the following points in mind.

   • In the first month, age of the baby is taken in completed weeks and subsequently thereafter the completed months. 

   • To determine age in completed weeks, include the day of birth of the child and the day of weighing to count the number of days.  For e.g. child Isha born on 13th Mar 2019 and weighed on 23rd Mar 2019 is 11 days and thus completing a week. 

   • To determine completed month, child would complete a month one day before the date of birth.

   • A child born on 1st of any month would complete the month on the last day of respective month and so on during all the years.

   • A child born on 29,30,31st Jan would complete a month on the last day of Feb. and subsequently would complete the months a day before the date of birth.

3. While determining weight keep the following points in mind

   • Weight of the child is recorded to the nearest 0.1 kg. 

   • At birth child is weighed in baby pan type of weighing scale.

   • Subsequently the child is weighed using a salter’ weighing scale (can record weight upto 25 kgs).

   • The regular digital weighing scale or Tared weighing scale can be used.

   • A child is to be weighed monthly upto the age of 3 years and atleast once in 3 months, thereafter upto 5 years of age.

Isha’s born on 13th Mar 2019 had a birth weight of2.5 kg. On 11th day i.e. 23rd Mar 2019 (1 week), her weight was 2.4 kg. On 27th May 2019 (2 months), her weight was 3 kg, and 15th July (4 months) she weighed 4 kg. on 21st May 2020(1 yr 2 months), she weighed 7 kg.

A closer look at Isha's growth chart. Isha’s born on 13th Mar 2019 had a birth weight of2.5 kg. On 11th day i.e. 23rd Mar 2019 (1 week), her weight was 2.4 kg. On 27th May 2019 (2 months), her weight was 3 kg, and 15th July (4 months) she weighed 4 kg. on 21st May 2020(1 yr 2 months), she weighed 7 kg.

Connect the points plotted for two or more months/weight, with a straight line to form the Growth Curve and observe trends.

Whenever there is a gap in monthly weighing or no information available about weight then that gap in growth chart needs to be joined with a dotted line.

Growth curve of a female child, whose weight has been recorded monthly

Growth curve of a Isha, plotted with dotted lines. The weight has not been recorded on a monthly basis. As a result there is lot of gap between the plotted weights. In such cases dotted line is used instead of solid line while connecting the plotted points 

1. 1. When weight points plotted at different intervals are joined with a line, we get a Growth Curve.

   2. If plotted weight-for-age of a child falls in the 

      • White band – child is overweight

      • Green band – child’s weight is normal

      • Yellow band – child is moderately underweight

      • Orange band – child is severely underweight

   3. If plotted weight-for-age of a child falls exactly on the 1st or 2nd or 3rd printed growth curve line, then the child is in the less severe category of under weight.

      • Plotted point falls on 1st line – child’s growth is normal

      • Plotted point falls on 2nd line – child’s growth is normal

      • Plotted point falls on 3rd line – child is moderately underweight

   4. Depending on the pattern of monthly growth of a child, the direction of the growth curve may be upward, flat or downward. 

      • Upward growth curve - indicates that the child is healthy, gaining weight and is growing. 

      • Flat growth curve – Child is not gaining weight – it is considered as dangerous

      • Downward growth curve – Child is losing weight  – it is considered very dangerous.

Direction of Growth Curve