Infant Toddler Development Training
Module 6, Lesson 2
Physical Signs and Anthropometric Assessment
Assessment of growth parameters such as weight, height, and the relationship of weight for height and monitoring for the rate of growth over time by plotting gains and/or losses on a growth chart is the most common physical evidence used in monitoring nutrition and growth. Additionally, the primary medical provider monitors head circumference and checks to see if there is enough subcutaneous fat under the skin to indicate nourishment status. Cutaneous factors such as thin dry hair, dry skin, oral lesions, or nail beds that are discolored, thin, or ragged can also be an indicator of nutritional problems. The importance of the head circumference is that the size of the head is often indicative of brain growth.
Accurate measurement of growth is extremely important. Infants and toddlers who have suspected growth risks or nutritional problems need to be followed closely. They should be weighed nude as clothes and shoes can contribute up to ½ pound for the infant and up to 2 pounds to the weight of an older child. A stadiometer should be used for checking the length and height. Plotting on the appropriate growth chart is very important. Length measured with the child lying down is plotted on a 0 – 3-year-old growth chart and height measured with the child standing flat is plotted on the 2 – 20 year old growth chart. The weight for height called the body mass index (BMI) should also be plotted as it provides a rough estimate of body bulk that includes muscles, fat, and bones. The nutritionist will routinely measure the triceps skin-fold for fat content and the mid-arm muscles to assess for muscle mass.
The Centers for Disease Control (CDC) in the United States provides growth charts standardized on the general population.
Print copies of the following male and female growth charts for the 0-3 year old and for the 2-20 year old if you have not already done so when you began this module.
CDC Growth Charts: United States
- Weight-for-age percentiles: Boys, birth to 36 months
- Weight-for-age percentiles: Girls, birth to 36 months
- Length-for-age percentiles: Boys, birth to 36 months
- Length-for-age percentiles: Girls, birth to 36 months
- Weight-for-length percentiles: Boys, birth to 36 months
- Weight-for-length percentiles: Girls, birth to 36 months
- Head circumference-for-age percentiles: Boys, birth to 36 months
- Head circumference-for-age percentiles: Girls, birth to 36 months
- Weight-for-age percentiles: Boys, 2 to 20 years
- Weight-for-age percentiles: Girls, 2 to 20 years
- Stature-for-age percentiles: Boys, 2 to 20 years
- Stature-for-age percentiles: Girls, 2 to 20 years
- Weight-for-stature percentiles: Boys
- Weight-for-stature percentiles: Girls
- Body mass index-for-age percentiles: Boys, 2 to 20 years
- Body mass index-for-age percentiles: Girls, 2 to 20 years
When the medical provider is following the growth of children with low incidence disabilities such as Cerebral Palsy, Down syndrome, William's syndrome, Achondroplasia or others they should plot the growth on specialized growth charts for a comparison to peers with the same condition. Specialized growth charts for Down syndrome, are available below.
Down Syndrome Growth Charts
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