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WIC Anthropometrics and Laboratory Guidance 6

NOTE: Document any situations when measurement accuracy may be affected. A statement documenting any important information (e.g., dirty diaper, weighed with shoes on, etc.) on the sticky note on the Anthro/Lab screen. This information may also be included in the Nutrition Assessment when interpreting growth.

Plotting and Interpreting Growth Charts A growth chart is a valuable tool for assessing a child’s growth over time and can be used as an educational tool for parents and caregivers. Several measurements plotted at different ages give information on how the child’s growth is progressing. Most children grow along the same percentile curve, although “spurts” are normal. When assessing growth, review risk definitions for risks 101 and 111 for women and 103, 113, and 114 for infants and children. BMI (wt/ht2) is calculated from weight and height measurements and is used to judge whether an individual's weight is appropriate for their height. BMI is the most commonly used approach to screen adults for overweight or obesity and BMI percentiles are the recommended measure to be used with children. Infant growth is assessed using weight for length percentiles. During pregnancy, weight gain is assessed rather than BMI to evaluate weight. Recommended Weight Gain Infants Birth – 6 months ¾ to 1 ounce per day 6-12 months

½ to ¾ ounce per day

General Guideline: Full-term infants double their birth weight by 6 months and triple their birth weight by 12 months.

Children “Between ages 1 and 2, toddler will gain only about 5 pounds. Weight gain will remain at about 5 pounds per year between ages 2-5.” (Kaneshiro, 2014) Kaneshiro, N.M. (2014, February 14). Normal Growth and Development. Retrieved September 3, 2015, from Medline Plus: https://www.nlm.nih.gov/medlineplus/ency/article/002456.htm.

Pregnancy Single Pregnancy Weight Gain based on Prepregnancy BMI Underweight <18.5

28-40 lbs Normal 18.5-24.9

25-35 lbs Overweight 25.0-29.9

15-25 lbs Obese >30.0

11-20 lbs

Twin Pregnancy Weight Gain based on Prepregnancy BMI Normal 18.5-24.9

37-54 lbs Overweight 25.0-29.9

31-50 lbs Obese >30.0

25-42 lbs * A gain of 1.5 pounds per week during the 2nd and 3rd trimesters has been associated with a reduced risk of preterm and low birth weight delivery in twin pregnancy.

Triplet pregnancy Overall weight gain should be around 50 lbs with a steady rate of gain of approximately 1.5 lbs per week throughout pregnancy.