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WIC Anthropometrics and Laboratory Guidance 2

Procedures for Weighing and Measuring In order to be useful as an indicator of health, measurements must be accurately performed, recorded, plotted on appropriate growth charts, and appropriately interpreted. Measuring Length for Children Less than 24 months (2 years) of Age Equipment To measure length of children from birth until 24 months, you should use a tabletop measuring board or pediatric scale to measure length of the child while lying down. The length board should be on a stable smooth flat surface and have a stable headboard with movable foot piece. Length board or pediatric scale should be placed out of reach of dangerous objects, sink basins, or sharp edges. Technique Children from birth-24 months must be measured lying down (recumbent length). Two people are needed to measure length. Parents or caregivers should participate in the length measurement to provide reassurance and security to the infant. Measurements should be read to the nearest 1/8th inch. It is inappropriate to use improvised equipment for measuring length - such as measuring tapes or yardsticks attached to tabletops. Measuring between two pencil marks on an exam table does not provide an accurate measurement. Inappropriate equipment used for measuring has a tendency to measure ‘short.’ To measure length, follow these steps: 1. Remove shoes, hats, and hair accessories and flatten big hair styles (if possible). 2. Put clean paper cloth on measuring board or pediatric scale. 3. Lay child flat on his back in the center of the measuring board. 4. One person (could be the caregiver) cups her hands over the child’s ears while holding the child’s head firmly against the headboard (child’s eyes should be facing the ceiling and the top of his / her head should be against the headboard). The infant’s chin should not be tucked in against his chest or stretched too far back. 5. The second person brings the child’s knees together and gently pushes down on them so that both legs are extended; one of their hands should rest on the child’s knees or shins to prevent them from spreading apart or bending, while the other hand brings the movable footboard to rest firmly against the heels (toes should point upward and both feet need to be flat against the footboard). If only one of the infant’s legs is extended during the measurement, the measurement may be unreliable and inaccurate. Note: Attaining proper foot position may require multiple attempts if infants flex their feet or point their toes without relaxing. If initial attempts are unsuccessful, it is recommended to take a break and retry the measurement after infant becomes calm and relaxes. Caregivers may assist by soothing, and massaging infant’s legs or feet. Another measurement can be performed after the infant relaxes. For situations when an infant will not relax or allow positioning for an accurate length, record the best attempt and document on the sticky note the reasons that an accurate measurement could not be obtained.