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- WHO charts are recommended for children under 5; IAP charts are used for ages 5–18 in India.
- WHO charts are prescriptive (how children should grow); IAP charts are India-specific references.
- Plot weight, height, BMI and head circumference; act on the trend, not a single point.
- Crossing percentile bands downward is the early warning that matters most.
Growth monitoring is one of the most important things a pediatric clinic does, but the WHO-versus-IAP question trips up many doctors. Here is a clear, practical answer to which chart to use, when, and what to actually watch for.
WHO or IAP — which growth chart should you use?
Use WHO growth standards for children under 5 years and IAP growth charts for Indian children aged 5–18 years. The WHO charts describe how children should grow under optimal conditions, while the IAP charts are India-specific references better suited to older children in the Indian population.
What is the difference between WHO and IAP charts?
The key difference is that WHO charts are prescriptive growth standards based on a multi-country reference of breastfed children in optimal conditions, while IAP charts are descriptive references derived from Indian children. WHO answers "how should a child grow"; IAP answers "how do Indian children of this age typically grow".
| Aspect | WHO charts | IAP charts |
|---|---|---|
| Recommended age | Under 5 years | 5–18 years (India) |
| Type | Prescriptive standard | Descriptive reference |
| Population basis | Multi-country, optimal conditions | Indian children |
| Common use | Infancy / early childhood | School age to adolescence |
What measurements should you plot?
- Weight-for-age
- Height/length-for-age
- Weight-for-height and BMI-for-age
- Head circumference (especially under 2 years)
What is the most important thing to watch?
Watch the trend across visits, not a single measurement — a child consistently tracking along the 25th percentile is usually fine, but one crossing downward through percentile bands needs attention. A downward crossing is the earliest reliable signal of a feeding, illness, or growth problem.
In Aira Nexus Clinic, growth measurements auto-plot on the correct chart for the child's age (WHO under 5, IAP for older children), with automatic percentile flagging so a downward crossing is hard to miss.
See automatic WHO + IAP growth charting in action.
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