adapted by the state of california chdp nutrition subcommittee from the online training module:
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How to Accurately Weigh and Measure Children for the CHDP Well-Child Exam. Adapted by the State of California CHDP Nutrition Subcommittee from the online training module: “Accurately Weighing & Measuring Infants, Children and Adolescents: Technique” - PowerPoint PPT PresentationTRANSCRIPT
Adapted by the State of California CHDP Nutrition Subcommittee from the online training module:
“Accurately Weighing & Measuring Infants,Children and Adolescents: Technique”
U.S. Department of Health and Human ServicesHealth Resources and Services Administration
Maternal and Child Health Bureau
http://depts.washington.edu/growth/
August 2012
How to AccuratelyWeigh and Measure Children
for the CHDP Well-Child Exam
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By the end of this presentation you will be able to:
Accurately weigh a child Accurately measure a child Manage common problems
encountered
Objectives
2010 Prevalence Rates
16.6 15.6 12.9 14.8 16.1
18.813.8
11.913.2
17.3
05
10152025303540
Hispanic White Asian Black All Groups
Per
cent
age
Overweight: 85 - < 95 % BMI Obese: ≥ 95 % BMI
2010 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM 160 reports
Overweight & Obese ChildrenCalifornia children ages 2 to < 5 years
2010 Prevalence Rates
19.4 17.6 13.9 17.8 18.7
24.720.3
12.6
21.1 23.3
0
10
20
30
40
50
Hispanic White Asian Black All Groups
Per
cent
age
Overweight: 85 - < 95 % BMI Obese: ≥ 95 % BMI
2010 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM 160 reports
Overweight & Obese ChildrenCalifornia children ages 5 to < 20 years
Height, length, and weight alert providers to:
• Growth problems• Feeding problems• Emotional or social problems• Illness
Measurements You TakeAre Important
BMI for 5 year old boy•Weight: 43.5 lb •Height: 43.0 in•BMI = 16.5
• BMI-for-age =75-84th percentile
• Normal range
If height is inaccurate:•Weight: 43.5 lb •Height: 42.5 in•BMI = 17.0
• BMI-for-age = 85-94th percentile
• Overweight range
Accurate Measuring Is Critical
BMI % Growth Chart
Obese
Overweight
Normal*
Underweight
Lab Tests(cholesterol &
glucose)
In-depthMedical
Assessment
Note in chart:“Counsel & Follow-up”
Take and PlotMeasurements
• Weight• Height• Age• BMI
Your MeasurementsGuide Providers
*Further tests may be warranted depending on
family history
Normal
Abnormal
Your MeasurementsGuide Many Others
BMI % Growth
Chart
WIC
Schools
Parents
PedNSSData
Your Measurements
• Weight• Height• Age• BMI
HeadStart
Use a private area or exam room for the following:
Removal of clothing and donning gown Taking measurements Discussing results
Respect Privacy
Before you begin:1.Determine equipment needed for
infant and child
2.Make sure equipment is clean, safe, and in good condition
3.Using a balance scale? Set to zero
4.Using a digital scale? Press the zero key to zero the indicator
Measure Lying or Standing?
Length (Lying)Use Birth – 24 monthsWHO growth chart Unable to standwithout assistance*
Stature (Standing)Able to stand without assistanceUse 2 – 20 yearsCDC growth chart
Measuring Infant’s Length Equipment Needed: Measuring boardMovable foot pieceRigid headboardMarked to 1/8”
Need assistant
Measuring tape or yardstick attached to table tops
Measuring between 2 pencil marks on exam table
InappropriateMethods of Measuring
Measuring Infant’s Length 1. Measure infant wearing only clean, dry
diaper. No shoes.
2. Lay infant on back.
3. Assistant or parent holdshead firmly against the headboard.
4. With one hand, hold infant knees down, straightening the hips and knees.
Measuring Infant’s Length
5. With the other hand,move the footboarduntil it is resting firmlyagainst infant heels.Toes point directly up.
6. Measure length to nearest 1/8”.
7. On CHDP PM 160,record measurement to nearest 1/4”.
Measuring Height (Stature) Equipment Needed:
Vertical stadiometer (height rod): Movable horizontal headboard Marked to 1/8” Attached to a firm, vertical surface (without baseboard)
Measuring tapes
Yardstick or poster attached to wall
Height rod attached to scale
InappropriateMethods of Measuring
Measuring Height (Stature) 1. Remove shoes and outer clothing
(jackets, hats).
2. Child stands on a bare, flat surface with heels slightly apart; back as straight as possible.
3. Heels, buttocks, head and shoulders blades touch thewall or measuring surface.
4. Eyes should be straightahead, arms at side,and shoulders relaxed.
Measuring Height (Stature) 5. Ask child to stand as tall as possible,
keeping heels on the ground.6. Slowly lower headboard
until it touches the crown of the head firmly.
7. Check the child’s position. Measurer’s eyes are parallel with the headpiece.
8. Measure height to the nearest 1/8”.9. On CHDP PM 160,
record measurement to nearest 1/4”.
Equipment needed:
Beam balance or electronic scale At least 35 lb capacity Weigh in 10 g or ½ oz increments Large tray to fully support infant Can be easily “zeroed” and calibrated
Weighing Infants & Toddlers
Weighing Infants & Toddlers1. Weigh infant wearing only light underclothing
or a clean, dry diaper.2. Place infant in the center of the scale tray.3. If using a beam scale, move lower weight from
the zero until marker drops below the center point.
4. Weigh infant to nearest 10 grams or ½ oz. 5. Record weight right away.6. If using beam balance, return upper and lower
weights to zero.
1. Weigh parent and child together= Total Weight
2. Weigh parent alone
3. Total Weight minus Parent’s Weight= Child’s Weight
Alternate Weighing Method
Weighing Children & AdolescentsEquipment Needed:
Beam or electronic scale Weigh in 100 g or ¼ lb increments Large platform to support the child No length device attached No remote display with attachment cord
Weighing Children & Adolescents1. Remove bulky outer clothing (jackets and
sweaters) and shoes. Empty pockets of contents. Use clean dry diaper.
2. Balance and zero the scale.
3. Have the child stand in the center of the scale, feet slightly apart.
4. Read the measurement to nearest 100 gram or ¼ lb.
5. Record the measurement right away.
http://depts.washington.edu/growth/
U.S. Department of Health and Human Services
Health Resources and Services Administration (HRSA)
Maternal and Child Health Bureau
AdditionalGrowth Chart Training Modules
Essential clinical tools in training packet Resource handout lists sources for:• Online tutorials• Online resources• Growth charts• Plotting aids• BMI calculators and wheels
CDC BMI Percentile Calculator for Child and TeenCHOP Body Mass Index and Z-score Calculation in ChildrenShape Up America! Childhood Obesity Assessment Calculator
• Software applications
Growth Assessment Resources
PedNSS data: http://www.dhcs.ca.gov/services/chdp/Pages/CountySurveillanceData.aspx
Health Resources and Services Administration (HRSA) is part of the U.S. Department of Health and Human Services and helps provide health resources for medically underserved populations. http://www.hrsa.gov/index.html
Health Assessment Guidelines: http://www.dhcs.ca.gov/services/chdp/Pages/Pub156.aspx
Photos with permission. Ventura County CHDP Program and Mandalay Bay
Women and Children's Medical Group, August 19, 2011. Ventura County Health Care Agency. http://www.vchca.org/
References
Photo Credit