MEASUREMENT OF GROWTH ANTHROPOMETRY

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MEASUREMENT OF GROWTH ANTHROPOMETRY
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GROWTH

• An increase in size of all tissues in the body.
• Growth is affected by
• Genetic
• Hormonal
• Nutritional status
• Environmental factors

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GROWTH

• Parameters Anthropometric measurements
• 1. weight, height, head circumference
• 2. proportion
• - sitting height
• - Upper / lower segment ratio
• WEIGHT is determined especially by growing of 3
  tissues skeletal muscle, adipose tissue and bone
• HEIGHT is determined by growing of the bone

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GROWTH

• In acute protein and energy malnutrition, protein
  from skeletal muscle and fat from adipose tissue
  will be used. Weight will decrease, but not
  height.
• In chronic protein and energy malnutrition, bone
  metabolism will disturb and could cause linear
  growth disturbance

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GROWTH

• Three indices are commonly used in assessing the
  nutritional status of children Weight-for-age
  (W/A) Length-for-age or Height-for-age (H/A)
• Weight-for-length or Weight-for-height (W/H)
• There are 2 type of assessment
• One time assessment
• Growth monitoring (trend assessment)

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WEIGHING INFANT
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INTRODUCTION

• Greet the mother introduce yourself
• Explain the procedure to the mother
• Identify infants data
• name, address, sex, date of birth
• birth weight, birth length

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WEIGHING INFANT

• Infant is weighed nude or in a clean diaper
  oncalibrated beam or electronic scale
• Older infant is weighed wearing a clean,
  disposable diaper
• Remove infants clothing and be sure the diaper
  is clean and dry 
• Center the infant on the scale tray 
• Weigh infant to nearest 0.01 kg or 1/2 oz
• Write the weight on the infants chart

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WEIGHING INFANT

• Reposition and repeat weighing the infant (3 x)
• Compare weights
• Weight shoud agree within 0,1 kg or ¼ lb
• If infant is too active, postpone the measure
• Have parent stand on scale, tare, then read
  infant weight

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MEASURING INFANT LENGTH
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MEASURING INFANT LENGTH

• Length is measured with a suitable measuring
  board
• Use a calibrated length board with a fixed
  headpiece movable footpiece which is
  perpendicular to the table surface
• Measure infant without shoes wearing light
  underclothing/diaper

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MEASURING INFANT LENGTH

• His back in the centre of the length board? child
  is lying straight his shoulders buttocks are
  flat.
• The childs eyes should be looking straight up.
• Both legs should be fully extended the toes
  should be pointing upward with feet flat against
  the footpiece

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MEASURING INFANT LENGTH

• While the 2nd measurer hold the infants head,
  the measures aligns the infants trunk legs and
  bring the footpiece firmly against the heels.
• The measurer place one hand on infants knees to
  maintain full extension of the legs

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MEASURING INFANT LENGTH

• Frankfort horizontal plane is parallel to the
  fixed headpiece
• Frankfort horizontal plane is a line extending
  from the most inferior point of the orbital
  margin to the left tragion.
• The tragion is the deepest point in the notch
  superior to the tragus of the auricle

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MEASURING INFANT LENGTH

• Measure length to 0.1 cm
• Record measurement on chart
• Reposition remeasure
• Measurements should agree to 1 cm

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HEAD CIRCUMFERENCE
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HEAD CIRCUMFERENCE

• Head circumference is measured over the most
  prominent part of the occiput and just above
  supraorbital ridge
• Use a flexible, non stretchable tape
• Position the tape just above the eyebrows, above
  the ears around the biggest part on the back of
  the head
• Pull tape snugly to compress the hair

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HEAD CIRCUMFERENCE

• Read the measurement to the nearest 0.1 cm
• Write measurement on the chart
• Reposition tape remeasure
• Measures should agree within 0.2 cm

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WEIGHING CHILDREN ADOLESCENTS
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WEIGHING CHILDREN ADOLESCENTS

• A child gt36 months is weighted standing on a
  scale
• Use a calibrated beam balance/electronic scale
• Child must be able to stand without assisstance
• Child stands on center of scale platform
• Reposition repeat
• Measures should agree within 0.1 kg

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MEASUREMENT OF HEIGHT
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MEASUREMENT OF HEIGHT

• Use calibrated vertical stadiometer with right
  angle headpiece
• Ask the child to take off the shoes
• The child stands with heels, buttocks, shoulders
  head touching a flat upright surface
• Stand with heel together, legs straight, arms at
  sides, shoulders relaxed
• The head should be positioned in the Frankfurt
  plane

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MEASUREMENT OF HEIGHT

• Ask the child to take a deep breath, then let it
  out relax his shoulders
• Bring the perpendicular headpiece down to touch
  the crown of the head
• Measurers eye are parallel with the headpiece
• Read to nearest 0.1 cm
• Reposition remeasure
• Agree within 1 cm
• Record on the growth chart

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SITTING HEIGHT
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SITTING HEIGHT

• Use a calibrated vertical stadiometer with right
  angle headpiece
• Ask the child to sit on a stool
• The back of the head, thoracic spine buttock
  should rest against the wall
• The head should be positioned in Frankfurt plane
• Ask the child to take a deep breath, then let it
  out relax his shoulders
• Bring the perpendicular headpiece down to touch
  the crown of the head
• Read to nearest 0.1 cm

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SITTING HEIGHT

• Upper body segment
• height on scale- stool height
• Lower body segment
• standing height-upper body
• segment
• Calculate the upper to lower segment ratio
• Record the ratio on the appropriate curve

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• UPPER TO LOWER SEGMENT RATIO
• Indications
• Growth Assessment
• Differentiates collagen bone disease (skeletal
  dysplasia) from primary spine (e.g. Scoliosis)
• Technique Measurement
• See Sitting Height for an alternative method of
  calculating segment heights
• Lower segment Top of pubic symphysis to floor
• Upper segment Top of head to top of pubic
  symphysis
• Calculation TotalHeight - LowerSegmentHeight
• Interpretation Normal upper to lower ratio
• Birth ? upper to lower ratio 1.70 (Greatest
  ratio)
• Postpuberty ? upper to lower ratio 0.89 - 0.95

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Perawakan pendek
Idiopatik
Patologis
Variasi normal Familial short stature Constitution
al growth delay
Proporsional
Disproporsional

• Postnatal
• Malnutrisi
• Penyakit Kronis
• GIT, CP, ginjal, hematologi
• Infeksi
• Obat obatan
• Kelainan psikososial
• Kelainan endokrin

• Prenatal
• IUGR
• Faktor ibu
• Penyakit plasenta
• Infeksi
• Teratogen
• Sindrom dismorfik
• Kelainan kromosom

Displasia skeletal Riketsia
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ACHONDROPLASIA
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CALCULATION OF MIDPARENTAL HEIGHT

• Display fathers height and mothers height on
  the growth chart
• Boys mothers height12.5 cmfathers height
• 2
• Girls fathers height-12.5 cmmothers height
• 2
• Draw the range in the growth chart

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CALCULATION OF MIDPARENTAL HEIGHT
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PLOTTING MEASUREMENTS

• Select the appropriate chart for the age, sex
  measurements
• Calculate the childs age
• Plot the weight measurement on the growth chart
  appropriate for age sex
• Use a plotting aid such as a straightedge
• Use the information in the clinical assessment
  process
• Share the information with the family

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Grafik pertumbuhan perempuan 0-36 bulan PB/U
dan BB/U
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Grafik pertumbuhan laki-laki 0-36 bulan PB/U
dan BB/U
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STADIOMETER
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