Background
Measurement of growth and nutrition in the pediatric population
In clinical practice, an essential component of pediatric preventative care is the accurate measurement of growth in this population. Pediatric growth patterns are influenced by multiple factors, such as genetics, overall health, and proper nutrition. The pediatric provider must measure and follow these growth patterns over time to ensure the overall health and well-being of their pediatric patients.
Normal growth patterns are the criterion standard for clinicians to assess the general health of a child, and pediatricians must be well-versed in the normal and abnormal growth patterns for children. An infant or child’s deviation from a previously stable growth pattern is often the first sign of an underlying issue that requires close follow-up. Pediatricians need to be aware of risk factors for failure to thrive and obesity and the potential morbidity and mortality associated with these issues for the child. For these reasons, growth charts are a critical part of every pediatric health maintenance visit and play an important role in the nutritional assessment of the child. [1]
Technical Considerations
Obtaining accurate measurements of growth in pediatrics
The measurements of growth in pediatrics must be as accurate as possible. Those members of the office staff who are responsible for growth measurements should be trained in these skills in order to keep errors to a minimum. Ways to limit errors are as follows:
Taking multiple measurements (3 is ideal) with the mean measurement being plotted on a standardized growth chart (This helps to decrease observer variation.)
Using the same equipment each time
Note that measurement errors associated with child variation can exist. For example, a mean height variation of approximately 1.5 cm can exist between a measurement taken in a child upon wakening and then again in the late afternoon. Body weight variation from morning to evening is generally negligible. [2]
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Length and weight percentiles for boys birth to 24 months.
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Head circumference percentiles for boys 0-24 months.
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Length and weight percentiles for girls age 0-24 months.
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Head circumference percentiles for girls age 0-24 months.
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Weight and height for age percentiles for boys 2-20 years.
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BMI for age percentiles for boys 2-20 years.
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Weight and height for age percentiles for girls 2-20 years.
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BMI percentiles for age for girls 2-20 years.
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Measurement of height in children.
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Measurement of length in infants.
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Measurement of head circumference.
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Measurement of subscapular skin fold.
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Measurement of triceps skin fold.
Tables
Age |
Approximate Daily Weight Gain (g) |
Approximate Monthly Weight Gain |
Growth in Length (cm/mo) |
Growth in Head Circumference (cm/mo) |
Recommended Daily Allowance (Kcal/kg/day) |
0-3 mos |
30 |
2 lb |
3.5 |
2.00 |
115 |
3-6 mos |
20 |
1.25 lb |
2.0 |
1.00 |
110 |
6-9 mos |
15 |
1 lb |
1.5 |
0.50 |
100 |
9-12 mos |
12 |
13 oz |
1.2 |
0.50 |
100 |
1-3 yrs |
8 |
8 oz |
1.0 |
0.25 |
100 |
4-6 yrs |
6 |
6 oz |
3 cm/yr |
1 cm/yr |
90-110 |
