Techniques of anthropometric measurements in infants ppt medicine

Techniques of anthropometric measurements of the infants

1. TECHNIQUE OF ANTHROPOMETRIC MEASUREMENTS IN INFANTS ADITI SANTOSH JAIN GROUP 29

2. A n t hro pome tr y : Introduction A branch of anthropology that involves the quantitative measurement of the human body. Anthropos - "man" and Metron "measurement” It is the single most portable, universally applicable, inexpensive and non-invasive technique for assessing the size , proportions and composition of the human body. It is used to evaluate both under & over nutrition. The measured values reflects the current nutritional status & don’t differentiate between acute & chronic changes

3. Parameters of anthropometry A g e de p e n d e n t f ac t o r s :- Weight Height Head circumference Chest circumference Age independent factors:- Mid-arm circumference (1-5 years) Weight for height Skinfold thickness Mid upper arm/height ratio

4. THE AVERAGE ANTHROPOMETRIC PARAMETERS OF NEWBORNS Birth weight Boys 3200 – 3400 g Girls 3100 – 3300 g Birth length 50-52 cm Head circumference 34-36 cm Chest circumference 32-34 cm  Normal physical development Range of parameters: Body weight 15 – 85 centiles Body length 15 – 97 centiles Body weight to body length proportion 15 – 85 centiles Head circumference 10 – 95 centiles

5. Body weight The measurement of weight is most reliable criteria of assessment of health and nutritional status of children. Children up to 6 months of age are placed supinely on a special mechanical children's scale. If it is not contraindicated according to health conditions, the child should be nude and dressed with a preliminary weighed napkin, The napkin must cover all parts of the balance bowl. The head of the baby must be on the wide part of the balance. It is necessary to move Balances B and C from "0" till the time when mechanical pointer (A) will be on the same line. From the gotten total weight of balances B and C, the weight of the napkin (and other clothes if the child was dressed) must be deducted.

6. Birth weight estimation < 2500 g is low weight < 1500 g is very low weight < 1000 g is extremely low weight > 4500 g is macrosomia

7. The periodic recording of weight on a growth chart is essential for monitoring the growth of under-five children. G r o w t h V e l o c i t y : A. 0-4 months 5-8 months 9-12 months 1-3 years 4-9 years 10-18 years 1.0kg/month(30g/day) 0.75kg/month(20gm/day) 0.50kg/month(15g/day) 2.25kg/ yr 2.75 kg/ yr 5.0-6.0kg/yr (0 . 5 k g / m o n t h ) B. Weight at 4-5 months 2 x birth weight 3 x birth weight 4 x birth weight 7 x birth weight Weight at 1 year Weight at 2 years Weight at 7 years

8. WEECH’S FORMULA 3 – 12 months Expected weight(kg) = age (months) + 9 / 2 1- 6 years Expected weight(kg) = age (years) x 2 + 8 7 – 12 years Expected weight(kg) = age (years) x 7 - 5 / 2

9. Weight for age * Grade of malnutrition >80 % Normal 71-80% Grade 1 (Mild) 61-70% Grade 2 (Moderate) 51-60% Grade 3 (Severe) <50% Grade 4 (very severe) Classification of Malnutrition

10. Length or Height/Stature Measurement Technique • Upto 2 years of age Recumbent Length is measured with the help of an Infantometer . • In older children Standing Height or Stature is recorded. It is convenient to use an Inbuilt Stadiometer affixed on the wall which provides a direct read out of height with an accuracy of +/- 0.1cm. • Nutritional deprivation over a period of time affects the stature or linear growth of the child .

11. Technique of length measurement The infant is placed supine on the infantometer. Assistant or mother is asked to keep the vertex or top of the head snugly touching the fixed vertically plank. The leg are fully extended by pressing over the knee, and feet are kept vertical at 90 degree, the movable pedal plank of infantometer is snuggly apposed against soles and length is read from scale.

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13. AGE Approximate rate of increase in stature Birth to 3 months 3.5cm/month 3 – 6 months 2.0cm/month 6 – 9 months 1.5cm/month 9 – 12 months 1.2cm/month 1-3 years 1cm/month 4-6 years 3cm/year Height Velocity A At birth 50cms Gain during 1 st year 25cms Gain during 2 nd year 12.5cms Gain during 3 rd year 7.5 to 10cms Gain during 3 – 12 years 5 to 7.5cms dolescence 8cms/yr for girls during 12 to 16 years 10cms/yr for boys during 14 to 18 years 14

14. Head circumference • Brain growth takes place 70% during fetal life, 15% during infancy and remaining 10% during pre-school years. Head circumference are routinely recorded until 5 years of age. The head circumference is measured in supine position, with a measuring tape. The head circumference is measured by placing the tape over the occipital protuberance at the back and just over the supraorbital ridge and the glabella in front. It is placed behind on Maximal protrusion of occipital tuberance and iin front — on supraciliary arches

15. E x pe c t e d hea d c ir c um f ere n c e in children Age Head circumference (cm) At birth 34 – 35 2 months 38 3 months 40 4 months 41 6 months 42 - 43 1 year 45 - 46 2 years 47 - 48 5 years 50 - 51

16. Head Circumference Growth Velocity Till 3 months 2 cm/month 3 months – 1 year 2cm/3 month 1 – 3 year 1cm/ 6 month 3 – 5 year 1cm/ year During first year there is 12 cm increase in head circumference , while 1 – 5 year age , only 5 cm gain occur in head size. Adult head size is achieved between 5 to 6 years . the following formula (Dine’s formula) is used for estimating the head circumference in the first year of life : - (length in cm+ 9.5) ±2.59 2

17. Chest circumference The chest circumference at the age of breast-feeding is measured in supine position. The tape-measure is placed in the back below the angles of scapulae, in the front — above the nipples. With girls in the puberty period the tape in the front is placed above the mammary glands at a level of the fourth rib. <= 5years - lying down position 5 years - standing position

18. Relationship between head size with Chest Circumference: At birth : head circumference > chest circumference by upto 3 cms. At around 9 months to 1 year of age: head circumference = chest circumference, but thereafter chest grows more rapidly compared to the brain.

19. The head circumference is greater than chest circumference by more than 3 cms in : preterms small-for-date , & hydrocephalic infants In malnourished children, chest size may be significantly smaller than head circumference because growth of brain is less affected by undernutrition. Therefore there will be considerable delay before chest circumference overtakes head circumference.

20. Limb circumference Limbs circumference is important during disorders of physical development and some diseases. To measure the upper arm, thigh and shin centimetric tape is applied on the area of the most developed muscles, and such measurements are conducted in a horizontal position of the child.

21. Bangle test – quick assessment of arm circumference. A fiber glass ring of internal diameter of 4 cm is slipped up the arm, if it passes above the elbow, it suggests that upper arm is less than 12.5 cm and child is malnourished. Shakir tape – is a fiber-glass tape with red – less than 12.5 cm , yellow – 12.5- 13.5 cm , green – greater than 13.5 cm

22. MAC (cm) Ht. (cm) 16.5 133.0 13.5 103.5 12.5 70.0 QUAC stick – Quaker Upper Arm Circumference Stick It is developed on the principle that acute starvation severely affects mid-arm circumference while height is unaffected. • It is a height measuring rod, calibrated in MAC. Values of 80% MAC for Ht. are marked on stick at corresponding ht. levels The malnourishedchild would be taller than the anticipated height derived from the mid-arm circumference

23. Skinfold thickness • • Measured with Herpenden’s caliper Triceps or subscapular region • The skinfold with subcutaneous fat is picked up with thumb and index finger, and caliper is applied beyond the pinch. • Fat thickness >10mm - healthy children 1-6 years <6mm - is indicative of moderate to severe degree of malnutrition

24. Choose Appropriate Growth Chart – 36 months 2 – 20 years

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