What are the weight and height percentiles, and the BMI with corresponding BMI centile, for a 7-year-old female patient with a weight of 17.5 kg and a height of 105.1 cm, according to the UK World Health Organization (WHO) growth chart?

Growth Assessment for 7-Year-Old Girl: Weight 17.5 kg, Height 105.1 cm

Direct Answer

This 7-year-old girl has severely compromised growth parameters, with both weight and height falling well below the 2nd percentile on UK WHO growth charts, indicating potential severe malnutrition or underlying pathology requiring urgent pediatric evaluation. 1

Growth Percentile Calculations

Weight Percentile

• Weight: 17.5 kg at age 7 years = Below 2nd percentile (approximately <0.4th percentile) 1
• This weight is approximately 2-3 standard deviations below the median for age, meeting criteria for severe growth faltering 1, 2
• Normal weight range for a 7-year-old girl typically falls between 20-25 kg (25th-75th percentiles) 1

Height Percentile

• Height: 105.1 cm at age 7 years = Below 2nd percentile (approximately <0.4th percentile) 1
• This height is severely compromised, as typical 7-year-old girls measure 115-125 cm (25th-75th percentiles) 1
• The height deficit of approximately 10-15 cm below expected values suggests chronic growth impairment 1

BMI Calculation and Centile

• BMI = 17.5 kg ÷ (1.051 m)² = 15.8 kg/m²
• BMI Centile: Approximately 5th-10th percentile 1
• While the BMI percentile appears less severely affected than individual weight and height percentiles, this reflects proportionate growth failure rather than adequate nutritional status 1

Clinical Significance and Urgency

Critical Thresholds Exceeded

• Both measurements fall below the 2.3rd percentile (2 standard deviations below median), which is the WHO-recommended threshold for identifying children whose growth indicates adverse health conditions requiring immediate evaluation 1, 3
• The combination of severely low weight-for-age AND height-for-age suggests chronic rather than acute malnutrition or underlying systemic disease 1

Differential Considerations

• Chronic malnutrition: Inadequate caloric intake over prolonged period 1
• Malabsorption disorders: Celiac disease, inflammatory bowel disease, cystic fibrosis 1
• Endocrine disorders: Growth hormone deficiency, hypothyroidism 1
• Genetic syndromes: Turner syndrome, skeletal dysplasias 1
• Chronic systemic illness: Renal disease, cardiac disease, chronic infections 1

Recommended Clinical Actions

Immediate Evaluation Required

• Comprehensive pediatric referral is mandatory given measurements below 2nd percentile 1
• Detailed nutritional assessment including 3-day food record to quantify caloric intake 1
• Family growth pattern evaluation to assess genetic contribution versus pathology 1
• Screen for symptoms of malabsorption (diarrhea, steatorrhea), chronic disease, or feeding difficulties 1

Laboratory and Diagnostic Workup

• Complete blood count, comprehensive metabolic panel, thyroid function tests 1
• Celiac disease screening (tissue transglutaminase antibodies) 1
• Consider bone age assessment to evaluate growth potential 1
• Evaluate for endocrine disorders if clinically indicated 1

Monitoring Strategy

• Serial measurements every 3 months initially to track growth velocity and response to interventions 1
• Plot all measurements on appropriate UK WHO growth charts to visualize trajectory over time 1
• Growth velocity assessment is more informative than single measurements for determining true growth faltering 1

Critical Pitfalls to Avoid

• Do not assume this represents normal constitutional growth or familial short stature without thorough evaluation - measurements this severely compromised warrant investigation regardless of parental heights 1
• Do not delay referral waiting for "catch-up growth" - children with measurements below 2nd percentile require prompt evaluation to identify treatable causes 1
• Do not focus solely on BMI - while BMI appears relatively preserved, the severe deficits in both absolute weight and height indicate significant pathology 1
• Recognize that approximately one-third of children who are severely short or underweight at age 7 remain small as adults, making early intervention critical 4