Techniques of anthropometric measurements of the infants

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

2. Anthropometry:
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
Age dependent factors:-
a) Weight
b) Height
c) Head circumference
d) Chest circumference
Age independent factors:-
a)Mid-arm circumference (1-5 years)
b) Weight for height
c) Skinfold thickness
d) 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.
•GrowthVelocity :
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
(0.5kg/month)
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
a) 3 – 12 months
Expected weight(kg) = age (months) + 9 / 2
b) 1- 6 years
Expected weight(kg) = age (years) x 2 + 8
c) 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.

12. 12

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 1st year 25cms
Gain during 2nd year 12.5cms
Gain during 3rd 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

15. 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

17. Expected head circumference 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

18. 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

19. 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

20. 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.

21. • The head circumference is greater than chest
circumference by more than 3 cms in :
a) preterms
b) small-for-date , &
c) 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.

22. 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.

23. • 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

24. 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

25. 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

26. Choose Appropriate
Growth Chart
0 – 36 months 2 – 20 years

27. THANK YOU