Does head size matter?
The most common charts used by paediatricians to measure head growth in toddlers may be inaccurate.
Head-circumference growth curves are used by paediatricians millions of times annually to identify children who may need extra follow-up or testing because of a large head, also called macrocephaly, or a rapidly growing head.

"The study was done because primary care doctors were concerned that the curves weren't working well for our patients," said study leader Carrie Daymont, a paediatric researcher formerly at The Children's Hospital of Philadelphia.

The researchers used the electronic health records of more than 75,000 infants in the Children's Hospital primary care network. They compared the most widely used charts with actual measurements and found that the most commonly used chart would lead to a diagnosis of macrocephaly, defined as a head circumference above the 95th percentile for age, in 2.5 times more one-year-olds than expected.

When using the CDC curves, the percentage of children diagnosed with macrocephaly changes with age. One-fifth of the expected number of one-month olds and 2.5 times the expected number of one-year-olds were classified as having macrocephaly. Many of these older infants may have received unnecessary follow-up tests and speciality referrals, and their parents may have been unnecessarily worried, the researchers said.

Using the CDC curves may cause a delay in diagnosis in babies under two months old with diseases causing large heads, and may cause children 6 months to 3 years to be labeled as having large or rapidly growing heads, when in fact they are healthy and have a typical head size, Daymont said. Use of the WHO curves would cause an excess of children to be labelled as having large heads at all ages. The researchers at Children's Hospital used the data from this study to develop a new growth curve.

"More research is also needed to determine how doctors can use head circumference growth curves to identify children with problems without causing unnecessary worry to parents of healthy children," said David Rubin, M.D. "We are currently working on research related to this question."

The team at Children's Hospital is currently evaluating other sources of data to see if the new head-circumference growth curves work in other populations.

Was your child misdiagnosed with any sort of "problem" as a baby? Share with us below.

Read Parent24’s Comments Policy publishes all comments posted on articles provided that they adhere to our Comments Policy. Should you wish to report a comment for editorial review, please do so by clicking the 'Report Comment' button to the right of each comment.

Comment on this story
Comments have been closed for this article.


Want to know what your baby looks like and what you can expect at this stage?




Play creatively

Don’t let your little one’s frustration with wanting to ‘get things just right’ stop them from playing creatively.

See more >


Everything from parties to pre-schools in your area.