Growth Monitoring

GROWTH MONITORING
Contents:
o Definition
o Purpose
o Equipment required
o Problems arises
o Methods of growth monitoring
o Summary
Growth monitoring is a screening tool to
diagnose nutritional , chronic systemic and
endocrine disease at an early stage .
Growth monitoring is the regular measurement
of a child’s size(weight ,height ,or length and
head circumference)in order to document
growth . this is extremely important as it can
detect early changes in a childs growth.
Purposes of growth monitoring
 provides a diagnostic tool for health and nutrition surveillance of individual
children and to instigate effective action in response to growth faltering
 Teach mothers ,families and health workers how diet and illness can affect child
growth and thereby stimulate individual initiative and improved practices.
 Provide regular contact with primary health care services, and so facilitate their
subsequent objectives of growth monitoring .
 Community mobilization :growth monitoring can serve as an entry point for
community mobilization.
 Target supplement feeding .
 Reporting prevalence of underweight.
Growth is the best general index of the health of an
individual child and regular measurements of growth permit
the early detection of malnutrition, frequently associated
with diarrhea ,and other illnesses ,when remedial action is
relatively easy.
although acute signs of malnutrition are easily noted
by health workers , it is often too late, and always more
expensive, to help the severely malnourished child.
“In 1982 growth monitoring ,i.e. regular weighing of children and
charting their weight on a chart was taken up by UNICEF as a part pf
the GOBI program i.e. G=growth promotion, O=ORT(oral rehydration
therapy),B=breast feeding , I=immunization . This programme was
later extended with the three Fs of Family planning ,Food and activities
for Females to GOBFFF.”
Important criteria for choosing
measuring equipment includes:
 Standard
 Reliability
 Ability to maintain accuracy
 Readability
 Portability
 Low cost
 Durability
 Local availability
 Ease of repair
 Cultural acceptability
Equipment required:
PROBLEMS !
 Lack of understanding on the part of health workers about the role
of growth monitoring ,many existing training methods only look at
teaching the skills of growth chart completion checking it for
errors.
 Lack of involvement of mother in monitoring the growth and
development of their children.
 Lack of commitment of senior health personal to the monitoring of
children’s growth and development.
 Lack of planning and facilities when children with growth faltering
are detected.
Methods of growth
monitoring ?
Weight –for-age
Weight for Age
1. Single best parameter for assessing

physical growth.
2. Carefully repeated measurement at
intervals.
3. Best done on road to health card.
Road to Health Card
Advantages of weight for age
1) Considered to be a useful indicator for growth monitoring in

general terms.
2) Sensitive to small changes in the child nutritional status as
reflected by weight and is a good indicator for defecting
growth faltering.
3) Only tools needed are weighing scales and charts-usually
easy to carry and relatively cheap.
Disadvantages
1) Weighting should be done regularly and this is not always

possible.
2) It is necessary to know a child’s age to the nearest month
and this information is not always available.
3) Malnourished children-aged over one year-who have
edema or ascites may not be classed as malnourished
when in fact they are.
Weight-for-length /height –for- age
Weight- for-length/height
oHeight should be taken in a standing position

without footwear with the help of height
machine or measuring scale fixed to the wall.
oSuitable for children 2 years or above.
oThe length of the baby at birth is about 50cm.
oLow height for age:- also known as nutritional
stunting or dwarfing reflects past or chronic
malnutrition.
o .
Advantages
o Identifies the very thin or wasted child with definite

malnutrition who requires immediate attention.
o Is a good indicator to distinguish children who are well-
proportioned from those who are thin for their height
o Does not require age data.
Disadvantages
o Stunted children with reasonable body proportions are

classified as not mal-nourished, but children who are
short(stunted) and also thin, will be classified as wasted
rather than stunted.
o Can be expensive and may have transportation problems.
o Measuring height or length require two people.
Height for Age
• Compare a child’s health with the expected height for a healthy reference
child of the same age.
• An index for long term nutritional deprivation.
• Suitable for children 2 years or above.
• Is a stable measurement of growth as opposed to body weight.
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Advantages of Height for Age
1) Indicate nutritional problem and illness.

2) Height measuring board can be made locally with low
cost and easy to transport.
3) Quick and easy method for child- mother are rarely
unhappy.
Disadvantages of Height for Age
1) Is not recommended as an independent

measure.
2) Need skilled personnel
3) Two people may required to measure
height.
Mid-upper arm circumference
M id - Up p er Arm Cir cu mf eren ce
 Measure the circumference of the left upper arm.

 Also used for the assessment of nutritional status.
 Recommended for use with children between six to fifty nine months.
 For assessing acute energy deficiency in adults during famine.
 Arm muscle and subcutaneous fat-major determinants.
Normal range of MUAC
S.N. Age Measurement (CM)
1. At Birth 10.5
2. 1 year 16.5
3. 1-5 years 17.5

Shakir Tape
-To detect malnourished children quickly.

Shakir Tape
S. Colour Measure indicate

n. code ment (cm)
1 Green 13.5-17.5 Adequately

Nourished.
2 Yellow 12.5-13.5 Undernourished
or at risk.
3 Red 12.5 Severe
Malnutrition
Advantages
 Useful indicator of severe current malnutrition.

 Quick to use and can be use by the most debilitated
individuals.
 Does not require age data.
 No known objection by community.
 Useful to indicate changes in nutritional status.
 The arm tape is inexpensive and easily portable.
Disadvantages
 Only identifies children with severe malnutrition.
 There is great variability in measurement.

“
”
Growth monitoring can be undertaken using a cycle process called triple a cycle .as the term indicates , there are three stages to the process.

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GROWTH MONITORING

1. Single best parameter for assessing

1) Considered to be a useful indicator for growth monitoring in

1) Weighting should be done regularly and this is not always

oHeight should be taken in a standing position

o Identifies the very thin or wasted child with definite

o Stunted children with reasonable body proportions are

1) Indicate nutritional problem and illness.

1) Is not recommended as an independent

 Measure the circumference of the left upper arm.

S.N. Age Measurement (CM)

3. 1-5 years 17.5

-To detect malnourished children quickly.

S. Colour Measure indicate

1 Green 13.5-17.5 Adequately

 Useful indicator of severe current malnutrition.

 Only identifies children with severe malnutrition.

 There is great variability in measurement.

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