Normal growth is a sign of good health and ill children often grow slowly, so growth must be assessed in any child presenting with, or monitored for, important health problems, whether in specialist or primary care practice. But what are the benefits of routine growth monitoring in apparently well children? The value of growth monitoring in developing countries has recently been questioned,1 but no systematic review has been published of growth monitoring in the industrialised world, and little guidance is available from formal trials. A multiprofessional group (see acknowledgements at end of paper) met in Coventry in 1998 to develop a consensus and agreed that the potential benefits of growth monitoring include: identification of chronic disorders; provision of reassurance to parents; monitoring the health of the nation's children; and supporting future research. This article aims to summarise the issues with regard to children over 2 years of age—growth monitoring in the under 2 year olds has been reviewed elsewhere.2

In some conditions (table 1), the child is abnormally short or tall from infancy onwards, whereas in others initial normal growth is followed by growth failure or acceleration. Individual measurements at a single point in time detect absolute short or tall stature but two or more measurements over a period of time are needed to detect a change in growth rate, irrespective of the starting height—hence the preferred term is “growth monitoring”, not “screening”. Nevertheless, growth monitoring is a form of screening—it involves offering a simple rapid test to apparently healthy people, to separate a group of subjects who are at high risk of having abnormal growth from a larger group who are at low risk. The classic requirements for screening programmes are well known (table 2). How well does growth monitoring perform?