How to Accurately

Weigh and Measure

Children
for
the
CHDP
Well-Child
Adapted by the State of California CHDP Nutrition
Subcommittee
Exam
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/

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Objectives
By the end of this
presentation
you will be able to:
Accurately weigh a child
Accurately measure a

child
Manage common

problems encountered

Overweight & Obese

Children
California children ages 2 to < 5
years

DC Pediatric Nutrition Surveillance System growth statistics from CHDP PM 160

Overweight & Obese

Children
California children ages 5 to < 20
years

DC Pediatric Nutrition Surveillance System growth statistics from CHDP PM 160

Measurements You
Take
Are Important

Height, length, and

weight
alert
providers to:
Growth problems
Feeding problems
Emotional or social
problems
Illness

Accurate Measuring Is
BMI for 5 year old
Critical
boy
Weight: 43.5 lb
Height: 43.0 in
BMI = 16.5
BMI-for-age =
75-84th
percentile
Normal range
If height is
inaccurate:
Weight: 43.5 lb
Height: 42.5 in

= 17.0 =
BMI
BMI-for-age
85-94th percentile
Overweight
range

Your Measurements
Guide Providers In-depth
Take and Plot
MeasurementsBMI %

Weight
Height
Age
BMI

Growth
Chart

Medical
Assessment

Obese
Overweight

Lab Tests
(cholesterol &
glucose)

Normal*
Underweight

*Further tests may

be warranted
depending on
family history

Abnor
mal

Norm
al

Note in chart:
Counsel & Follow-up

Your Measurements
Guide Many Others
HeadStart
WIC
Your
Measurements

Weight
Height
Age
BMI

BMI %
Growth
Chart

Schools
Parents
PedNSS
Data

What challenges
do you face?
How do you handle them?

Respect Privacy
Use a private area or exam
room for the following:
Removal of clothing and
donning gown
Taking measurements
Discussing results

Before you
begin:
1.Determine equipment
needed for infant and child
2.Make sure equipment is
clean, safe, and in good
condition
3.Using a balance scale?
Set to zero
4.Using a digital scale?

Measure Lying or
Standing?

Length (Lying)
Use Birth 24
months
WHO growth chart
Unable to stand
without assistance*

Stature
(Standing)
Able to stand
without
assistance
Use 2 20 years

Measuring Infants
Equipment Length
Needed:
Measuring board
Movable foot piece
Rigid headboard
Marked to 1/8
Need assistant

Measuring Infants
Length

Inappropriate
Methods of Measuring
Measuring tape or yardstick attached to

table tops
Measuring between 2 pencil marks on

exam table

Measuring Infants
Length
1. Measure infant
wearing only clean,
dry diaper. No shoes.
2. Lay infant on back.
3. Assistant or parent holds
head firmly against
the headboard.
4. With one hand, hold infant knees
down, straightening the hips and
knees.

Measuring Infants
Length

5. With the other hand,

move the footboard
until it is resting firmly
against infant heels.
Toes point directly up.

6. Measure length to nearest 1/8.

7. On CHDP PM 160,
record measurement to nearest
1/4.

Measuring Height
Equipment(Stature)
Needed:
Vertical stadiometer (height
rod):
Movable horizontal
headboard
Marked to 1/8
Attached to a firm,
vertical surface
(without baseboard)

Measuring Height
(Stature)

Inappropriate
Methods of Measuring
Measuring tapes
Yardstick or poster attached to wall
Height rod attached to scale

Measuring Height
(Stature)
1. Remove shoes
and outer clothing
(jackets, hats).
2. Child stands on a bare, flat surface with
heels slightly apart; back as straight as
possible.
3. Heels, buttocks, head and
shoulders blades touch the
wall or measuring surface.
4. Eyes should be straight
ahead, arms at side,
and shoulders relaxed.

Measuring Height
(Stature)
5. Ask child to
stand as tall as
possible, keeping heels on the
ground.
6. Slowly lower headboard
until it touches the crown
of the head firmly.
7. Check the childs position.
Measurers eyes are parallel
with the headpiece.
8. Measure height to the nearest
1/8.

Weighing Infants &

Toddlers
Equipment needed:
Beam balance or

electronic scale
At least 35 lb capacity
Weigh in 10 g or oz
increments
Large tray to fully support
infant
Can be easily zeroed and

Weighing Infants &

Toddlers

Up to 36 months if unable to stand without

assistance

Weighing Infants &

Toddlers
1. Weigh infant
wearing only light
underclothing
or a clean, dry diaper.
2. Place infant in the center of the scale
tray.
3. If using a beam scale, move lower
weight from the zero until marker
drops below the center point.
4. Weigh infant to nearest 10 grams or
oz.
5. Record weight right away.

Alternate Weighing
Method
1. Weigh parent and child together
= Total Weight
2. Weigh parent alone
3. Total Weight minus
Parents Weight
= Childs Weight

Weighing Children &

Adolescents
Equipment Needed:
Beam or electronic scale

Weigh in 100 g or lb
increments
Large platform to support
the child
No length device attached
No remote display with
attachment cord

Weighing Children &

Adolescents
Weigh in:
Undergarments
Gown
Lightweight
clothing
Socks/bare feet

Weighing Children &

1.Adolescents
Remove bulky outer clothing (jackets
and sweaters) and shoes. Empty
pockets of contents. Use clean dry
diaper.

2. Balance and zero the scale.

3. Have the child stand in the center of
the scale, feet slightly apart.
4. Read the measurement to nearest 100
gram
or lb.
5. Record the measurement right away.

Additional
Growth Chart Training
Modules
http://depts.washington.edu/growt
h/
U.S. Department
of Health and
Human Services
Health Resources
and
Services
Administration
(HRSA)
Maternal and Child Health Bureau

Growth Assessment
Resources
Essential clinical tools in training packet
Resource handout lists sources for:
Online tutorials
Online resources
Growth charts
Plotting aids
BMI calculators and wheels

CDC BMI Percentile Calculator for Child and Te

en
CHOP Body Mass Index and Z-score Calculation
in Children
Shape Up America! Childhood Obesity Assessment

References
PedNSS data:

http://www.dhcs.ca.gov/services/chdp/Pages/CountySurveillan
ceData.aspx
Health 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

Photo Credit

Photos with permission. Ventura County CHDP Program and

Mandalay Bay Women and Children's Medical Group,

August19, 2011. Ventura County Health Care Agency.
http://www.vchca.org/

Practice Time