The IAP 2015 growth charts (Khadilkar et al.) are reference standards for height, weight and BMI of Indian children aged 5-18 years from middle/upper socio-economic backgrounds. They replace the older 2007 charts and align Indian standards with contemporary growth potential.

For children < 5 years, the IAP recommends WHO Multicentre Growth Reference Study (2006) Z-scores, since WHO standards represent growth under optimum conditions.

• Stunting: height-for-age < -2 SD (chronic undernutrition / chronic illness)
• Wasting: weight-for-height < -2 SD (acute undernutrition)
• Underweight: weight-for-age < -2 SD
• Severe Acute Malnutrition (SAM): WHZ < -3 SD OR MUAC < 11.5 cm (6-59 mo) OR bilateral pedal oedema
• Short stature: height < 3rd percentile or > 2 SD below mid-parental height

National Family Health Survey-5 (2019-21) data shows India's continuing growth crisis:

• 35.5% of under-5 children stunted
• 19.3% wasted
• 32.1% underweight
• 3.4% severely wasted (SAM)

Government programmes addressing this: ICDS, Anganwadi nutrition, POSHAN Abhiyaan, Mid-Day Meal, F-100/F-75 NRC therapeutic feeding for SAM, RBSK school health screening.

• Height < 3rd percentile or < -2 SD on IAP chart
• Growth velocity < 4 cm/year (after age 3 years)
• Crossing > 2 major centile lines
• Height > 2 SD below mid-parental height
• Disproportionate body segments (suspected skeletal dysplasia)
• Suspected pubertal disorder (precocious or delayed)