Nutrition Interventions for Children with Special Health Care Needs

Chapter 2 - Anthropometricss
Stature (Length and Height)
Stature is measured in two ways: recumbent length for the child younger than 36
months of age and standing height for children older than 24 months (4). Alternative
measurements (e.g., crown-rump length, sitting height, and arm span) can also
provide information about a child’s stature.
Contractures about the hips, knees, and ankles can interfere with an accurate
stature measurement. Crown-rump length or sitting height measurements are
often useful estimates of stature for children with contractures of the lower body.
These measurements will not correlate directly with height or length, but can
indicate a child’s rate of growth when plotted on CDC growth charts. Although the
measurements will be below the 5th percentile for age, they will show whether or
not the child is following a consistent growth curve. The stature of children with
involvement of the lower body only (e.g., some children with myelomeningocele)
can be estimated by using arm-span measurements. However, for children with
contractures of the upper extremities such as in cerebral palsy, accurate arm span
measurements are also difficult (6). For those children who have contractures of
the arm, tibia length, though less accurate, is sometimes used with a formula to
estimate stature (7).
Length
For children who are younger than 24 months of age and children 24 to 36 months
of age who are unable to stand independently, measure recumbent length. Older
children who are unable to stand may also be measured in the recumbent position;
however, it should be noted on the growth chart that the measurement is length, not
height.
Equipment for Length Measurement
In order to have accurate recumbent length measurements, it is important to have
a good quality length-measuring device. The infant length board should have a fixed
headboard and a movable footboard that are perpendicular to the surface on which
the child is lying. A measuring tape, marked in millimeters or 1/8 inch segments,
is needed along one or both sides of the table, with the zero end at the end of the
headboard (3,4). The required features of an infant length board are shown in Figure
2. The proper technique for measuring length is shown in Figure 3.
16 Nutrition Interventions for Children With Special Health Care Needs