Measuring Infant Growth Flashcards
What do you measure in infants?
1) Weight
2) Height/length
3) Head circumference (occipital frontal circumference)
How do you weight infants?
- Naked up to 2 years
- Nappy off
- Light clothes only after 2 years
- Can sit on mother’s lap and subtract mother’s weight
How do you measure length in infants?
- Children up to age 2 are measurement horizontally (need 2 people) bc children can’t stand
- Take nappy off
- Might need to do this for older children
How do you measure head circumference?
- For children up to 2 years bc brain development is mainly in the first 2 years
- Don’t continue to do this bc if it is normal in the first 2 years should continue normally
- Between midpoint and hairline
Describe the current use of growth charts
- 1990s chart
- WHO/UK Growth charts - based on term babies who stopped breastfeeding at 6 months, mothers are non-smokers
- RCPCH 2012 growth charts - combines date from the UK 1990 growth reference and WHO/UK growth charts to represent other ethnicities
- Based on relevant reference population - ethnic minorities
- Single or multiple measurements
What is the minimum age to use premature charts?
23 weeks
How do you correct gestational age for premature babies?
- For babies born < 37 weeks their measurements should be corrected up until at least 1 year old - when they should have caught up
- This is done by drawing a dot at their chronological age and then drawing an arrow back towards their corrected age
Why is there a gap between horizontal and vertical heigh on a growth chart?
Gravity
Why is there no information for 0-2 weeks on growth charts?
- Babies lose weight first and then regain it
- Initial birth weight more based on mother’s weight and placental health
Is it normal to cross centile lines for first 6 months?
Yes - have birth weight on chart
How is puberty indicated on a growth chart?
There is a marker for when puberty should have happened (13 breasts budding, 16 period)
What are additional parts to the growth chart?
1) Birth centiles length
2) Mid parental centile scale
3) Predicted adult height scale
What is the birth centiles length used for?
- Plot birth centile
- This can be used to see if the child was SGA and whether good catch up growth is achieved
Describe how you use an adult height predictor
1) Use an X to mark the child’s most recent height centile in the centre line
2) Read off the child’s estimated adult height from the right scale
- 80% of children will be within ±6cm of this value
- Scale also shown in feet and inches on left
Describe how you use a mid-parental centile comparator
1) Mark mothers height on the left hand scale and fathers height on the right scale using arrows
2) Draw a line between arrowheads and read off mid-parental centile where this crosses the central line
- Most children’s height centiles (9 out of 10) are within ± two centile spaces of the mid-parental centile - Quite generous so indicates for sure if someone is out
- If child is too tall/short for parents height something could be wrong
