How to Accurately Weigh and Measure Children for the CHDP Well-child Exam September 2007

1. How to Accurately Weigh and Measure Children for the CHDP Well-child ExamSeptember 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/

2. 9 Million Kids Are Overweight 2000 2005

3. Overweight & Obese ChildrenCalifornia children ages 2 to <5 years 2005 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM160 report

4. Overweight & Obese ChildrenCalifornia children ages 5 to <20 years 2005 CDC Pediatric Nutrition Surveillance System growth statistics from CHDP PM160 report

5. Agenda • Importance of accuracy • Challenges • Video: Standard technique • Practicing proper technique

6. Measurements You Take are Important • Height, length, and weight tell providers if a child has a: • Growth problem • Feeding problem • Emotional or social problem at home • Illness

7. Measurements You Take are Important 95% 90% 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 85% 75% 50%

8. Your Measurements Guide Providers In-depth Medical Assessment • Your • Measurements • Weight • Height • Age • Plot Obese Overweight BMI % Growth Chart + Extra tests Normal Underweight - Note in chart “No Therapeutic Action”

9. Your Measurements Guide Many Others HeadStart WIC • Your • Measurements • Weight • Height • Age • Plot Schools BMI % Growth Chart Parents PedNSS Data

10. It’s difficult to weigh and measure children… “What challenges do you face?”

11. Before you begin: 1. Determine equipment needed for patient 2. Check equipment: clean; safe; good repair 3. Balance scale to zero

12. Measure Lying or Standing? • Stature (Standing) • Able to stand without assistance • Use 2-20 years growth chart • Length (Lying) • Unable to stand without assistance • Use Birth - 36 months growth chart

13. Measuring Length

14. Measuring Stature (Height)

15. Weighing Infants and Toddlers Up to 36 months if unable to stand without assistance

16. Alternate Weighing Method 1. Weigh parent and child 2. Weigh parent alone 3. total weight - parent’s weight = child’s weight

17. Weighing Children and Adolescents • Weigh in: • Undergarments • Gown • Lightweight outer clothing • Socks/bare feet

18. Privacy Considerations • In a private area or exam room: • Remove clothes; offer gown • Take measurements • Discuss results

19. 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

20. Practice Time