Anthropometric Measurements

Measuring Recumbent Length (<2 Years)

• If a child is younger than 2 years, measure recumbent length. 
  • If a child younger than 2 will not lie down, measure the standing height and add 0.7 cm to convert to length.
• Accurate length measurement is particularly important for calculating growth velocity. 
  • Length measurements are best obtained when the child is relaxed and cooperative. 
  • If the child is agitated and both legs cannot be held in position, measure with 1 leg. 
  • Remove hats, hair adornments, hair buns, shoes, socks, etc.
  • Devices for measuring length should be calibrated and accurate to 0.1 cm.  
• Two people are required to measure length in infants.
  • Position infant on measuring board (that has a movable footboard and fixed headboard) with the body flat and the midline centered. 
  • One measurer holds the crown of the infant’s head against the headboard with the external auditory meatus and the lower margin of the eye orbit aligned perpendicular to the table. 
    • When measuring a preterm newborn or infant, gently untuck its chin from the chest to position the head properly.
  • A second measurer gently flattens the infant’s knees and grips both ankles so the feet are pointing upward and flat on the footboard. 
  • Record recumbent length to the last completed 0.1 cm. 

Measuring Height (≥2 Years)

• If a child is 2 years or older measure standing height. 
  • If they are unable to stand, measure recumbent length and subtract 0.7 cm to convert to height.
• Remove socks and hair ornaments.
• Help the child to stand on the baseboard with feet slightly apart. The back of the head, shoulder blades, buttocks, calves, and heels should all touch the vertical board.
• Position the child’s head so that a horizontal line from the ear canal to the lower border of the eye socket runs parallel to the base board. 
• Keeping the head in position, pull down the headboard to rest firmly on top of the head and compress the hair. 
• Read the measurement and record the child’s height to the last completed 0.1 cm. 
  • If the child is younger than 2 years, add 0.7 cm and record as length. 

Measuring Weight

• Various types of scales (infant scales, beam-balance scales, and digital scales) are available to measure body weight. 
  • Scales must be regularly calibrated to maintain accuracy. 

Infants 

• Remove infant clothing, including diaper. 
  • Infant may be weighed in a clean diaper if the scale is first zeroed with the weight of the clean diaper.
• Zero the scale. 
• Place infant supine in the center of the tray, making sure the infant is not touching anything but the tray.
• Read and record the measurement. 

Toddlers and children ≥2 years 

• If a child is 2 years old or older and will stand still, weigh the child alone. 
• Ask the mother to help the child remove shoes and outer clothing. 
• Talk with the child about the need to stand still.
• Ask the child to stand in the middle of the scale, feet slightly apart (on the footprints, if marked), and to remain still until the weight appears on the display. 
• Record the child’s weight to the nearest 0.1 kg. If the child jumps on the scale or will not stand still, you may use a tared weighing procedure instead with a parent’s weight tared to zero. 

Measuring Head Circumference (<2 Years)

Head circumference is a proxy measure for brain growth. 

• Measure head circumference at each visit until the 2-year visit.
• It is a useful screening tool for hydrocephalus in infants.
• Measure head circumference with a narrow and non-stretchable measuring tape.  
  • Remove interfering hair adornments. 
  • Position the tape on the forehead just above the supraorbital ridges and wrap around the occiput so that the maximum circumference is obtained, keeping the tape level on both sides.
  • Move the tape slightly up and down to ensure maximum circumference. 
  • The tape should have sufficient tension to press the hair against the skull.
• Record head circumference to the nearest 0.1 cm.