How to Accurately Weigh How to Accurately Weigh and Measure Children and Measure Children

for the CHDP for the CHDP Well-child ExamWell-child Exam

September 2007September 2007

Developed by the Statewide CHDP Nutrition Subcommittee from the on-line training module:

“Accurately Weighing & Measuring Infants, Children and Adolescents: Technique”

U.S. Dept. of Health and Human Services; Health Resources and Services Administration;

Maternal and Child Health Bureau http://depts.washington.edu/growth/

20002000 20052005

9 Million Kids Are 9 Million Kids Are OverweightOverweight

Overweight & Obese ChildrenOverweight & Obese Children California children ages 2 to <5 yearsCalifornia children ages 2 to <5 years

2005

16.7 15.5 13.8 14.8 16.3

18.813.4 12.5 13.2

17.4

05

10152025303540

Hispanic White Asian Black All Groups

Per

cent

age

Overweight: 85 - <95%BMI Obese: > or = 95% BMI

2005 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM160 report

Overweight & Obese ChildrenOverweight & Obese Children California childrenCalifornia children ages 5 to <20 years ages 5 to <20 years

2005

19 17.2 13.3 17.7 18.3

24.119.4

13.4

20.7 22.7

0

10

20

30

40

50

Hispanic White Asian Black All Groups

Per

cent

age

Overweight: 85 - <95%BMI Obese: > or = 95% BMI

2005 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM160 report

AgendaAgenda

Importance of accuracyImportance of accuracy

Challenges Challenges

Video: Standard Video: Standard techniquetechnique

Practicing proper Practicing proper techniquetechnique

Height, length, and weight tell providers if a child has a:

Growth problem

Feeding problem

Emotional or social problem at home

Illness

Measurements You Measurements You Take are ImportantTake are Important

5 year old boy

Weight: 43.5 lb

Height: 43 in

BMI= 16.5

BMI-for-age = 75-84th %tile

Inaccurate height measurement: 42.5 in

BMI=17

BMI-for-age = 85-94th %tile

Measurements You Take are Measurements You Take are ImportantImportant

75%

85%

90%95%

50%

BMI % Growth Chart

Obese

Overweight

Normal

Underweight

Extra tests

In-depthMedical

Assessment

Note in chart“No Therapeutic

Action”

Your Measurements

• Weight• Height• Age• Plot

Your Measurements Guide ProvidersYour Measurements Guide Providers

+

-

Your Measurements Guide Many OthersYour Measurements Guide Many Others

BMI % Growth Chart

WIC

Schools

Parents

PedNSSData

Your Measurements

• Weight• Height• Age• Plot

HeadStart

It’s difficult to weigh and measure children…

“What challenges do you face?”

Before you begin:

1. Determine equipment needed for patient

2. Check equipment: clean; safe; good repair

3. Balance scale to zero

Measure Lying or Standing?

Length (Lying)Length (Lying)

Unable to stand without assistance

Use Birth - 36 months growth chart

Stature (Standing)Stature (Standing)

Able to stand without assistance

Use 2-20 years growth chart

Measuring Length

Measuring Stature (Height)

Weighing Infants and ToddlersWeighing Infants and Toddlers

Up to 36 months if unable to stand without assistance

Alternate Weighing MethodAlternate Weighing Method

1. Weigh parent and child1. Weigh parent and child

2. Weigh parent alone2. Weigh parent alone 3.3. total weight total weight

-- parent’s weightparent’s weight= child’s weight= child’s weight

Weighing Children and Adolescents

Weigh in: Undergarments Gown Lightweight outer clothing Socks/bare feet

Privacy ConsiderationsPrivacy Considerations

In a private area or exam room:

Remove clothes; offer gown

Take measurements

Discuss results

Please visit:Please visit:http://depts.washington.edu/growth/

For training modules: “Accurately Weighing & Measuring

Infants, Children and Adolescents: Equipment & Technique”

U.S. Dept. of Health and Human Services

Health Resources and Services Administration (HRSA)

Maternal and Child Health Bureau

Practice TimePractice Time