From the Guidelines
Pediatric weight measurements should be taken with the child wearing minimal clothing on a calibrated scale appropriate for their age and development, using the World Health Organization (WHO) growth charts for children under 2 years and the Centers for Disease Control and Prevention (CDC) growth charts for children 2 years and older, as recommended by the most recent guidelines 1.
Key Considerations
- For infants and children under 2 years, use a digital baby scale with the infant lying supine, recording weight to the nearest 10 grams.
- For children 2 years and older, use a standing scale with weight recorded to the nearest 0.1 kg.
- Measurements should be taken at every well-child visit and during illness, with consistent technique and equipment to ensure accuracy.
- When tracking growth, plot measurements on standardized growth charts to identify trends and potential concerns.
- For medication dosing, always use the most recent weight measurement, as pediatric medication doses are typically weight-based (mg/kg).
Importance of Accurate Measurements
- Regular calibration of scales and proper training of staff are essential for accurate measurements.
- Weight trends over time are more clinically significant than single measurements, helping to identify growth abnormalities or nutritional issues that may require intervention.
- In emergency situations where weighing is not possible, length-based estimation tools like the Broselow tape can provide approximate weight.
Growth Charts and Assessment
- The WHO growth charts are recommended for children under 2 years, as they are based on a healthy breastfed infant population 1.
- The CDC growth charts are recommended for children 2 years and older, as they are based on a larger and more diverse population 1.
- When using the WHO growth charts, use of the 2.3rd and 97.7th percentiles (or ±2 standard deviations) are recommended, rather than the 5th and 95th percentiles, to assess for possible abnormal or unhealthy growth 1.
From the Research
Weight Measurement in Pediatric Care
- The assessment of weight status in pediatric patients is crucial for identifying potential health issues, such as obesity or malnutrition 2.
- A study found that less than 50% of primary care physicians (PCPs) assessed BMI percentiles regularly in children, highlighting the need for improved weight measurement practices in pediatric care 2.
- The use of methods such as the Broselow-Luten Tape (BLT) can help obtain accurate patient weights, but errors can still occur, leading to dosing errors in prehospital pediatric care 3.
Importance of Accurate Weight Measurement
- Accurate weight measurement is essential for preventing drug dosing errors in pediatric patients, as incorrect weight estimations can lead to serious health consequences 3.
- A healthy relationship with food and regular nutrition counseling can help prevent nutritional disorders, including overweight, underweight, and nutrient deficiency, in adolescents 4.
- Nutrition counseling has been shown to have a positive impact on mental health and wellbeing in individuals affected by obesity, although more research is needed to fully understand its effects 5.
Guidelines for Weight Measurement and Nutrition Counseling
- Healthcare providers should proactively support early adolescents and their caregivers in developing a healthy relationship with food and their bodies to prevent maladaptive behaviors later on 4.
- Dietary counseling with or without oral nutrition supplementation (ONS) may have a positive impact on outcomes, such as reducing complications and improving nutrition status, in hospitalized patients who are malnourished or at risk of malnutrition 6.
- The effectiveness of dietary counseling can be improved by standardizing counseling methods and providing details on frequencies of counseling and ONS adherence 6.