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Monitoring head size and growth using the new UK-WHO growth standard
  1. Charlotte M Wright1,
  2. Hazel M Inskip2,
  3. Keith Godfrey2,3,
  4. Anthony F Williams4,
  5. Ken K Ong5,6
  1. 1Department of Child Health, Glasgow University, Glasgow, UK
  2. 2MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
  3. 3Southampton NIHR, Nutrition, Diet and Lifestyle Biomedical Research Unit, Southampton, UK
  4. 4St George's Hospital, University of London, London, UK
  5. 5MRC Epidemiology Unit, Cambridge, UK
  6. 6Department of Paediatrics, University of Cambridge, Cambridge, UK
  1. Correspondence to Professor Charlotte M Wright, PEACH Unit, QMH Tower, Yorkhill Hospitals, Glasgow G3 8SJ, UK; cmw7a{at}


In order to assess the extent to which children in the UK will follow the UK-WHO head circumference standard, the authors used head circumference data from the Southampton Women's Survey (n=3159) and the Avon Longitudinal Study of Parents and Children (n=15 208) in children aged 0–36 months, converted into z-scores using both the UK-WHO and UK1990 references. Rapid head growth was defined as crossing upwards through two major centile bands (1.33 SD). The UK-WHO standard identified many more infants with heads above the 98th centile than to the UK1990 reference (UK-WHO: 6–16% of infants at various ages; UK1990: 1–4%). Rapid head growth in the first 6–9 months was also much more common using the UK-WHO standard (UK-WHO: 14.6–15.3%; UK1990: 4.8–5.1%). Practitioners should be aware of these findings to avoid unnecessary referrals.

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  • Funding These components of the SWS were supported by the Medical Research Council, the University of Southampton, the British Heart Foundation and the Dunhill Medical Trust. Core support for ALSPAC was provided by the UK Medical Research Council, the Wellcome Trust and the University of Bristol.

  • Competing interests CW and AW are both member of the RCPCH growth chart design group and were closely involved in producing the new UK-WHO growth charts. CW also undertook a brief consultancy for WHO regarding the construction of their velocity standard. Otherwise, none of the authors have anything to declare.

  • Ethics approval This study was conducted with the approval of the Southampton and South West Hampshire Local Research Ethics Committee (SWS) and ALSPAC Law and Ethics Committee and Local Research Ethics Committees.

  • Provenance and peer review Not commissioned; externally peer reviewed.