ANTHROPOMETRIC MEASUREMENT TRAINING Michigan WIC 201920 - PDF document

7/17/2020 ANTHROPOMETRIC MEASUREMENT TRAINING Michigan WIC 2019‐20 Anthropometric PRINT PRINT Measurement Training ATTACHMENTS Worksheet 1 Worksheet 2 Worksheet 3 LINKS LINKS Worksheet 4 Worksheet 5 Agenda PowerPoint Pgs. 1 ‐ 36 Manual Pgs. 1 ‐ 43 1

7/17/2020 To record measurements and round accurately for data entry in MI‐WIC Develop consistency in measuring techniques and data entry methods Use measuring equipment correctly, read measurement values accurately, observe client privacy Provide basic measuring equipment care Objectives Training will be able to Evaluate plotting values on age and sex Specific growth charts Prenatal Weight Gain WHO/CDC Growth Charts Measurement Procedures Recording Values Risk Codes Preterm Infants Evaluations MI‐WIC Data Entry Anthropometric Measurement Training Overview 2

7/17/2020 POLICY 1.02 STATE OF MICHIGAN WIC MISSION AND VISION This Photo by Unknown Author is licensed under CC BY‐NC‐ND  Infants 1 Measure  Children Physical Growth  Women Anthropometric  Record Form Record 2 Measurement Measurement  MI‐WIC Values  Gain Grid Activities  NCHS/CDC Growth Charts (B < 24 Months Evaluate Values 3 or 2‐5 Years) on Growth  Prenatal Weight Chart 3

7/17/2020 Anthropometric Training Why do we need Anthropometric training ?  Person Off Street  15 Minutes! Anthropometric Measurements Required for a WIC Nutrition Assessment Head Circumference Weight Height Stature (Standing Height) Length (lying down) Common Human Body Measurements 4

7/17/2020 CLUES 1 Health and Nutritional Well‐being GROWTH 2 Normal or Delayed Accurate Body Measurements WEIGHT 3 Normal, Overweight or Underweight PREGNANCY/POSTPARTUM 4 Weight Gain or Loss DETERMINATION OF RISK FACTORS 5 For Care Plan Development Inaccurate Body OVERMEASUREMENT 1 Measurements Impression of excessive leanness of fatness A half (1/2) inch measurement error can change a child’s ranking UNDER MEASUREMENT 2 from the 10th percentile to below Impression of shortness or thinness the 5th percentile length‐for‐age. 5

7/17/2020 Anthropometric Training Key Point #1 The major focus of Anthropometric Training is to learn procedures and techniques that will result in… Consistent Measurement Techniques Improved Accuracy Reduced Errors Over Time Anthropometric Risk Determination Policy 2.15 Infants (Birth to 12 Months)* Children (12 to 24 Months)* Length, Weight and Head Circumference at Length, weight and head circumference at certification and mid‐cert evaluation (I‐Eval) Certification, mid‐cert evaluation (C‐Eval) and recertification *Use Recumbent (lying down) Length Board Cont… 6

7/17/2020 Anthropometric Risk Determination Policy 2.15 Children: 2 to 5 Years Women Stature and weight at certification, mid‐ Stature and weight at certification cert evaluation (C‐Eval) and recertification and recertification  Use Stadiometer (Standing)  If child must be measured recumbently (laying down), record measurement, check “?” box, make entry in ‘Comments’. Measurement will plot as red asterisk but risk code will not be assigned Exhibit of Growth Charts Boys (Birth <24 Months of Age): Girls (Birth < 24 Months of Age): WHO GROWTH CHART WHO GROWTH CHART Form DCH ‐ 0313c Form DCH ‐ 0313a Boys (2 to 5 Years of Age): Girls (2 to 5 Years of Age): CDC GROWTH CHART CDC GROWTH CHART Form DCH ‐ 0313c Form DCH ‐ 0313b 7

7/17/2020 8

7/17/2020 Anthropometric Training Key Point #2 Check ‘UNK’ if a measurement is not known and enter a comment Check ‘?’ if measurement could not be taken according to procedure and enter a comment For example , if a child is uncooperative and must be measured recumbently (laying down), record the measurement, check “?” box, make entry in ‘Comments’. Measurement will plot as red asterisk but risk code will not be assigned 9

7/17/2020 Entering Weeks Gestation Weeks Gestation must be recorded Before saving Anthropometric in weeks of completed gestation Measurement for the Cert (ie, 39 weeks, 6 days recorded as visit, enter Weeks Gestation. 39 weeks gestation). Agencies must have consistent Accurate Weeks Gestation is method of determining weeks essential – determines way growth gestation (Anthropometric percentiles are calculated. Cannot be Measurement Procedures changed in MI‐WIC after day of entry! Manual). Anthropometric Training Key Point #3 Weeks of Gestation must be entered accurately in order for growth chart percentiles to be correctly calculated in MI‐WIC. WIC Policy: Clinics must have consistent procedure for determining Gestation Age. 10

7/17/2020 WHO (Boys & Girls) Growth Charts * Longitudinal study * Hypothesis ‐ breastfed infants grow differently than formula‐fed infants * Studied Breastfed infants in 6 countries throughout the world * Families followed study protocol for the duration of the study * Data collected provided the information needed to construct new growth grids * Breastfed infants and children do grow differently than formula‐fed infants. WHO Growth Charts: Birth < 24 Months (Boys & Girls) Head circumference‐for‐age Length‐for‐age Data Sheet Included On Charts Graphs For Plotting Weight‐for‐age Weight‐for‐length 11

7/17/2020 WHO Charts CDC Growth Charts 2‐5 Years (Boys & Girls) Graphs for plotting: Graphs for plotting: Stature‐for‐age Stature‐for‐age Weight‐for‐age Weight‐for‐age BMI‐for‐age BMI‐for‐age Data sheet included on charts Data sheet included on charts 12

7/17/2020 13

7/17/2020 14

7/17/2020 CDC GROWTH CHARTS VLBW (Boys & Girls) Infants that were born < 1500 grams (VLBW) may also be assessed for growth using the IHDP VLBW charts in addition to the CDC growth charts. The VLBW charts are now optional for educational purposes. Same Plot Graphs as Birth < 24 Months: Data Sheet Included on Charts Length‐for‐age Gestation‐Adjusted Age (GAA) is bottom axis on 3 Head Circumference‐for‐age charts plotted for age. Weight‐for‐age Chart may be printed Weight‐for‐length 15

7/17/2020 VLBW Charts 16

7/17/2020 17

7/17/2020 18

7/17/2020 37 Gestational Age Adjustment If an infant is born at 32 weeks, subtract that number from 40 40 weeks – 32 = 8 Weeks Gestational –adjusted age is 4 months when the chronological age is 6 months 19

7/17/2020 20

7/17/2020 Adjustment for Preterm Growth will not begin plotting on WHO Growth Charts until infant reaches 40 weeks gestation adjusted age. Percentiles are shown in pink in MI‐WIC if adjusted for prematurity. VLBW charts will plot growth for infants up to 2 months preterm Note: Adjustments for gestational age are Not used when using the 2‐5 years charts 21

7/17/2020 22

7/17/2020 CHAT MI‐WIC Input Boxes 23

7/17/2020 Anthropometric Training Key Point #4 The measurements of infants born The VLBW chart does not assign less than or equal to 1500 grams (3 risks but does give parents an idea lbs. 5 oz.) are plotted on the VLBW of how well their child is growing in chart in MI‐WIC. This chart uses relation to other VLBW babies metric values only. 24

7/17/2020 Anthropometric Training Key Point #5 Adjustments for Preterm are Measurements in MI‐WIC are made in MI‐WIC through 23 not adjusted for preterm after 24 months of age months of age. The WHO Birth <24 Month and Measurements of any child over VLBW charts (if < 1500 grams) the chronological age of 2 are are the default growth charts. plotted on the 2‐5 year old chart. Converting Metric to English 25

7/17/2020 Understanding BMI‐For‐Age BMI means Simple formula that The formula is: the Body Mass Index combines weight weight divided by the and height square of the height x 703 26

7/17/2020 The BMI‐for‐Age Chart Bottom Axis: Age (heavy 1 yr., faint ½ yr., 3 mo. Hatch mark – nearest month) Side Axis: BMI (Faint lines = 0.2 – nearest 0.1 BMI) Case Study of Sam for BMI‐for‐Age Mother’s Height _______ Gestational Father’s Height________ Age__________ Weeks Date Age Weight Height BMI Comment 4/4/20 3 yrs 7 mos 37 lb 4 oz 41.5 in 15.2 27

7/17/2020 BMI BMI Sam’s BMI Plotted on Boy’s Boys: 2 to 20 years BMI‐for‐Age Chart Interpretation Sam’s BMI‐for‐age is at the 29th %tile so it falls within the normal range. This chart shows that Sam is heavier for his height than 29 % of other boys his own age. Or, 71 % of boys his age are heavier for their height than Sam. BMI BMI BMI‐for‐age charts are the default option when the 2‐5 yr. charts are displayed. Choose this option to display weight‐ for‐length charts by BMI in MI‐WIC selecting the “Prev. Graph” BMI is automatically calculated in MI‐WIC if stature measurement is used (C2‐C5). 28