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2.1
Measuring and Assessing Growth
Summary
●● Measuring growth is key to monitoring the ●● Infants and children normally grow parallel to
nutritional, endocrine, emotional and physical centile lines on growth charts although some
health of children. variation is normal due to illness in infancy,
cyclical growth and varying ages of the
●● Growth assessment requires training to take pubertal growth spurt.
accurate measurements using calibrated
equipment and to plot and interpret growth ●● Frequent measurements are not necessary in
and body mass index (BMI) charts. normal healthy infants and children and can
cause unnecessary stress and concern.
●● Growth charts describe how big or heavy
healthy children are expected to be at any age.
Measuring growth is a key tool in monitoring Additional measures can be used:
normal development and is used as part of a
nutritional assessment. When energy intake from ●● waist circumference – a measure of the amount
food and drinks is adequate, weight gain will be of fat stored centrally
within normal parameters. Normal growth
measurements can reassure health professionals ●● mid upper arm circumference (MUAC) – used
and parents while variations from expected growth to screen for malnutrition in under-fives in the
can be an important indicator in diagnosing developing world. A MUAC <11 cm in infants
obesity, growth faltering, endocrine disorders, 2–6 months and MUAC <11.5 cm in children
emotional neglect and other medical conditions. 6 months to 5 years is used as one indicator of
Growth rates vary throughout childhood and severe malnutrition
knowledge of how and why they vary is important
for interpreting growth measurements. ●● skinfold thicknesses – not regularly used but
can be a useful measure when weight is
Anthropometric Measures inaccurate because of fluid retention such as
oedema or ascites.
The most common measurements taken to assess
growth are: Growth Rates Throughout
Childhood
●● weight (Figure 2.1.1c)
Prenatal growth is the most rapid phase of growth in
●● length for children under 2 years and height for children. Growth rate slowly declines during infancy
children over 2 years (Figure 2.1.1a and 2.1.1d) and early childhood until during the primary school
years when children grow at a fairly steady rate of
●● head circumference measured around the about 5–6 cm/year. This declines to about 4–5 cm/
widest part of the head (Figure 2.1.1b). year just prior to the pubertal growth spurt, during
