|
 Physical
Examination: Assessment
of Physical Growth
Body Measurements
Body measurements
of infants and children help to identify significant conditions,
including growth retardation, malnutrition, obesity, and developmental
abnormalities.
Plot all measurements of head circumference, length/height, and weight on age-
and gender-specific CDC Growth Charts.
Head Circumference
- Measure
head circumference at each visit from newborn through 24 months.
- Use non-stretchable
measuring tape (metal, fiberglass, or disposable paper, not
cloth).
- Extend the
tape around the most prominent part of the occiput to the mid-forehead;
tighten the tape to compress the hair.
- Plot measurement
on appropriate CDC Growth Charts.
Height (or
Length)
- Measure height
(or length) at each visit for all ages.
- Plot measurement
on appropriate CDC Growth Charts.
 |
For
children less than 2 years (and those ages 2-3 who cannot
stand unassisted):
- Place
the infant or young child in a lying-down position.
- Use
a measuring board with stationary headboard and sliding
vertical foot piece.
For
children older than 2 years:
- Obtain
a standing height beginning at 2-3 years of age.
- Stand
the child (barefoot or in socks only) with head, shoulder
blades, buttocks, and heels touching the wall.
- Ask
the child to look straight ahead, with knees straight and
feet flat on the floor.
- Use
a graduated ruler or tape attached to a wall.
- Place
a flat surface horizontally on top of the child’s head.
- Lower
the flat surface horizontally until it touches the
crown of the head, compressing the hair.
|
Weight
- Measure weight
at each visit for all ages.
- Plot measurement
on appropriate CDC Growth Charts.
For infants
and small children:
- Use a balance-beam
table model or electronic scale (spring-type scales are not
sufficiently accurate).
- Be sure
the scale is zeroed before each use.
- Be sure
infant or child is unclothed (or wearing only a dry diaper
or light underpants).
For children
and youth older than 2-3 years:
- Weigh child
on a floor model beam scale.
- Check scales
regularly for accuracy.
- Be sure child
is unclothed and draped in a light gown.
Recording
Height and Weight Measurements
- Plot measurements
on age- and gender-specific CDC
Growth Charts.
- Interpret
measurements in the context of child’s family and growth
history.
- Document
measurements over time to provide an accurate record of growth.
- Recognize
that large or sustained deviations signal a potential problem.
If measurements
are between 10th and 25th percentiles, or between 75th and 90th percentiles:
Assess
past growth patterns and genetic and environmental factors
to determine whether in-depth follow-up is required.
If
measurements are less than 5th percentile or greater
than 95th percentile:
Recheck
measurements; if confirmed, consider a detailed medical
evaluation.
|
