for the CHDP WellChild Exam Adapted by the State of California CHDP Nutrition Subcommittee from the online training module Accurately Weighing amp Measuring Infants Children and Adolescents Technique ID: 933755
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Slide1
How to AccuratelyWeigh and Measure Childrenfor 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”
U.S. Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health Bureau
http://depts.washington.edu/growth/
August 2012
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Slide3ObjectivesBy the end of this presentation
you will be able to:
Accurately weigh a child
Accurately measure a childManage common problems encountered
Slide4Overweight & Obese ChildrenCalifornia children ages 2 to < 5 years
2010 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM 160 reports
Slide5Overweight & Obese ChildrenCalifornia children ages 5 to < 20 years
2010 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM 160 reports
Slide6Measurements You TakeAre Important
Height, length, and weight alert providers to:
Growth problems
Feeding problems Emotional or social problems Illness
Slide7BMI for 5 year old boyWeight: 43.5 lb Height: 43.0 inBMI = 16.5
BMI-for-age =
75-84
th percentile
Normal range
If height is inaccurate:Weight: 43.5 lb Height:
42.5 in
BMI =
17.0
BMI-for-age =
85-94
th
percentile
Overweight range
Accurate Measuring Is Critical
Slide8Your MeasurementsGuide Providers
Take and Plot
Measurements
Weight Height Age BMI
BMI %
Growth
Chart
Obese
Overweight
Normal*
Underweight
In-depth
Medical
Assessment
Abnormal
Lab Tests
(cholesterol &
glucose
)
*Further tests may be warranted depending on family history
Normal
Note
in chart:
“Counsel & Follow-up”
Slide9Your MeasurementsGuide Many Others
BMI %
Growth
Chart
WIC
Schools
Parents
PedNSS
Data
Your
Measurements
Weight
Height
Age
BMI
HeadStart
Slide10What challenges do you face?
How do you handle them?
Slide11Respect PrivacyUse a private area or exam room for the following: Removal of clothing and
donning gown
Taking measurements
Discussing results
Slide12Before you begin:Determine equipment needed for infant and childMake sure equipment is clean, safe, and in good conditionUsing a balance scale? Set to zeroUsing a digital scale? Press the zero key to zero the indicator
Slide13Measure Lying or Standing? Length (Lying)Use Birth – 24 monthsWHO growth chart
Unable to stand
without assistance*
Stature (Standing)Able to stand without assistance
Use 2 – 20 yearsCDC growth chart
Slide14Measuring Infant’s Length Equipment Needed: Measuring boardMovable foot pieceRigid headboardMarked to 1/8”Need assistant
Slide15Measuring Infant’s Length
Slide16InappropriateMethods of MeasuringMeasuring tape or yardstick attached to table tops
Measuring between 2 pencil marks on exam table
Slide17Measuring Infant’s Length2 Measure infant wearing only clean, dry diaper. No shoes.Lay infant on back.Assistant or parent holdshead firmly against the headboard.With one hand, hold infant knees down, straightening the hips and knees.
Slide18Measuring Infant’s Length3 With the other hand,move the footboarduntil it is resting firmlyagainst infant heels.Toes point directly up.Measure length to nearest 1/8”.
On CHDP PM 160,
record measurement to nearest 1/4”.
Slide19Measuring Height (Stature) Equipment Needed: Vertical stadiometer (height rod): Movable horizontal headboard Marked to 1/8” Attached to a firm, vertical surface (without baseboard)
Slide20Measuring Height (Stature)
Slide21InappropriateMethods of Measuring2
Measuring tapes
Yardstick or poster attached to wall Height rod attached to scale
Slide22Measuring Height (Stature)2
Remove shoes and outer clothing
(jackets, hats). Child stands on a bare, flat surface with heels slightly apart; back as straight as possible.Heels, buttocks, head and shoulders blades touch thewall or measuring surface.
Eyes should be straightahead, arms at side,and shoulders relaxed.
Slide23Measuring Height (Stature)3
Ask child to stand as tall as possible, keeping heels on the ground.
Slowly lower headboard until it touches the crown of the head firmly.
Check the child’s position. Measurer’s eyes are parallel with the headpiece. Measure height to the nearest 1/8”.
On CHDP PM 160,record measurement to nearest 1/4”.
Slide24Weighing Infants & Toddlers
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
Slide25Weighing Infants & Toddlers Up to 36 months if unable to stand without assistance
Slide26Weighing Infants & Toddlers2
Weigh infant wearing only light underclothing
or a clean, dry diaper.
Place infant in the center of the scale tray.If using a beam scale, move lower weight from the zero until marker drops below the center point.Weigh infant to nearest 10 grams or ½ oz. Record weight right away.
If using beam balance, return upper and lower weights to zero.
Slide27Alternate Weighing MethodWeigh parent and child together= Total Weight
Weigh parent alone
Total Weight minus Parent’s Weight
= Child’s Weight
Slide28Weighing 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
Slide29Weighing Children & Adolescents2
Weigh in:
Undergarments Gown Lightweight clothing
Socks/bare feet
Slide30Weighing Children & Adolescents3Remove bulky outer clothing (jackets and sweaters) and shoes. Empty pockets of contents. Use clean dry diaper.Balance and zero the scale.Have the child stand in the center of the scale, feet slightly apart.Read the measurement to nearest 100 gram or ¼ lb.Record the measurement right away.
Slide31AdditionalGrowth Chart Training Modules
http://depts.washington.edu/growth/
U.S. Department of Health and Human Services
Health Resources and Services Administration (HRSA)
Maternal and Child Health Bureau
Slide32Growth Assessment ResourcesEssential clinical tools in training packetResource handout lists sources for:
Online tutorials
Online resources
Growth chartsPlotting aidsBMI calculators and wheelsCDC BMI Percentile Calculator for Child and TeenCHOP Body Mass Index and Z-score Calculation in Children
Shape Up America! Childhood Obesity Assessment CalculatorSoftware applications
Slide33ReferencesPedNSS data: http://www.dhcs.ca.gov/services/chdp/Pages/CountySurveillanceData.aspxHealth 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/
Photo Credit
Slide34Practice Time