measure height measure health

What can growth say about a child’s health?

Growth can be an indicator of overall health.1 Accurate measurement and regular plotting can help detect growth issues.2 Poor growth may indicate3 serious problems, such as:

  • A variety of medical conditions
  • Genetic syndromes
  • Nutritional deficiencies

As many of the conditions causing poor growth in a child can have a lasting impact on his or her physical development, it is crucial that any apparent issues are investigated to determine the underlying cause.

Because children have a limited time to grow, every visit is an opportunity to help your pediatric patients by recognizing health concerns as early as possible in their development.

Do you know all the facts about measuring correctly?

Know when to measure length vs height.

For children up to 2 years, measure length using an infantometer; for children 2 years and older, measure height using a stadiometer.

Get the facts with our free guide
In a study
of practices had an incorrect policy of when to measure length vs height.4,a

Use the proper equipment.

Common practices, such as marking exam table paper to measure length, are inaccurate.1 Length should be measured with an infantometer, which has a firm, flat horizontal surface with an immovable headpiece and movable footpiece both perpendicular to the measuring tape.5 Measure height with a stadiometer, which has a vertical board with attached metric ruler and movable horizontal headpiece.5

Learn more with our video training
In a study
of practices used inappropriate instruments for measuring height.4,a

Measure accurately.

To be considered accurate, height measurements must be within 0.5 cm,6 but many factors can lead to inaccuracy. For example, if a child is wearing socks, shoes, or a ponytail, or not standing correctly, measurements may not be accurate.

Download our Measurement Tips poster
In a study
of children were measured inaccurately.1,b

Plot the measurements.

To get an ongoing picture of a child’s growth, document the measurements on proper growth charts. Growth charts are age-based and gender- and condition-specific.

Download proper growth charts
According to a survey
of kids’ preventive visits lacked documentation of height, weight, or both.7,c

Do the math.

Growth assessment is about more than just accurate measurement and regular plotting. Determining growth velocity and calculating midparental height are also important steps to identify potential growth issues.

If the child’s height is below
-2 SD
from the mean and has a 1-year growth velocity of >1 SD below the mean (“falling off growth curve”), consider referring the child for further evaluation.8

Is it time to refer to a specialist?

Parents are counting on you as their child’s medical expert. Some of the causes of growth failure can have a lasting impact on a child’s physical development, so it’s critical that any apparent growth issues be investigated to determine the underlying cause. A “wait and see” approach could delay potential diagnosis and appropriate management.

Early recognition of growth failure and referral to a specialist may be key in helping to identify children who may need follow-up and monitoring. Our Referral Checklist can help you make a timely and appropriate referral.

Get the Checklist  
  1. Lipman TH, Hench KD, Delaune J, et al. A multicenter randomized controlled trial of an intervention to improve the accuracy of linear growth measurement. Arch Dis Child. 2004;89:342-346.
  2. Rogol AD, Hayden GF. Etiologies and early diagnosis of short stature and growth failure in children and adolescents. J Pediatr. 2014164(suppl 5):S1-S14.e6.
  3. Oostdijk W, Grote FK, de Muinck Keizer-Schrama SMPF, Wit JM. Diagnostic stature. Horm Res. 2009;72:206–217.
  4. Lipman TH, Hench K, Logan JD, DiFazio DA, Hale PM, Singer-Granick C. Assessment of growth by primary health care providers. J Pediatr. 2000;14:166-171.
  5. World Health Organization. Training course on child growth assessment. Geneva, Switzerland: WHO;2008.
  6. Voss LD, Bailey BJR, Cumming K, et al. The reliability of height measurement (the Wessex Growth Study). Arc Dis Child. 1990;65:1340-1344.
  7. Burman NJ, Cabana MD, Maselli JH, Hilton JF, Patel AI. Missing documentation of weight and height at preventive visits for children. Clin Pediatr. 2012;51(10):933-938.
  8. Gharib H, Cook DM, Saenger PH, et al; American Association of Clinical Endocrinologists Growth Hormone Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in adults and children—2003 update. Endocr Pract. 2003;9(1):64-76.