Anthropometric
measurements in children
- It is
almost impossible to provide a blanket rule or set of guidelines
for the use of anthropometric measurements in children, as
the particular measurement or technique to be used will depend
on what needs are to be assessed. However, no matter which
measurement is made, probably the most important aspect is
the accuracy and reproducibility of the measurement. Considerable
attention needs to be placed on ensuring the adequate training
of the persons carrying out the measurements and the accuracy
of the instruments being used.
- Further,
adequate norms or reference values need to be available. There
is still considerable debate about the use of NCHS growth
charts when comparing heights and weights of South African
children. Nevertheless, comparisons should be made using well
established reference values. Weights and heights/lengths
are the commonest assessments of nutritional status in children;
however, they are often poorly done with inadequate attention
being taken to ensure accuracy.
- In the
neonatal period, the common measurements are those of weight,
length (difficult to measure) and skull circumference. Weight
gain is often used as a proxy for linear growth, but this
is not reliable.
- In the
field, quick assessments of wasting in young children may
be made using mid-upper arm circumference, but a large number
of undernourished children will not be detected by this measurement.
- Assessment
of body fat can be made using skin-fold thickness measurements
at different sites. Further, the determination of body mass
index has gained in popularity. Other techniques include dual
energy X-ray measurements of body composition and electrical
impedance measurements.
- It must
be remembered that pubertal development plays an important
role in the growth and development of children, thus if children
in the adolescent years are to be assessed, a pubertal developmental
assessment or an assessment of bone age may be appropriate.
- Skull
circumference measurements are most frequently made in the
young child as the sutures are open and the size of the skull
may reflect changes in the intracranial contents.
Prof
John M Pettifor
Dept
of Paediatrics and Child Health, University of the Witwatersrand
and Director: MRC/WITS Mineral Metabolism Research Unit
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