Growth Charts for International Adoptees
Growth charts for Boys, 0-36 months Growth chart for Boys, 2-20 years Growth charts for Girls, 0-36 months Growth chart for Girls, 2-20 years

 

 

 

 

 

 

Most international adoption doctors agree that the most reliable and useful growth charts to use for evaluating international adoptees are those provided by the Centers for Disease Control. These are the standard charts pediatricians use all over the United States. In addition, these charts have been accepted by the World Health Organization for international use. An in-depth description of these charts can be reviewed at http://www.cdc.gov/growthcharts/. Though there are racial and socioeconomic differences between countries that can affect growth curve norms, the charts of choice are still from the CDC.

Many children in orphanages have less than ideal growth. This is due to both less-than-adequate nutrition and poor psychosocial stimulation. Studies have documented over and over that for every three months that a child is in an orphanage he or she has a one month delay in height. Weight growth is often affected as well. Delays in weight and height, unless severe, are usually not concerning. Most adoptees show excellent catch-up growth in weight and height after they are in loving homes with good nutrition.

In contrast, head circumferences that are low are more concerning. Most studies suggest that children with head circumferences consistently below the 3rd percentile (the lowest line on the CDC curves) are at higher risk for lower I.Q. and behavior problems. This is because head circumference is a good measurement of brain growth. Thus, small head size (the medical term is microcephaly) suggests a brain that is not completely healthy and is growing poorly. This can relate to numerous things from maternal infections during pregnancy (like CMV) to genetic syndromes to Fetal Alcohol Syndrome. Head circumferences typically don't show much catch-up growth after adoption like weights and heights.

The following studies refer to head circumferences that are 2 standard deviations below the mean or average. This correlates with the 3rd percentile on the CDC charts.

For an in depth discussion of head circumference evaluation please see Dr. Dana Johnson's article on Dr. Jane Aronson's website: http://www.orphandoctor.com/medical/hc/.

A more succinct article by Dr. Johnson can be seen at his own website: http://www.med.umn.edu/peds/iac/preadoption/headgrowth.html.