Growth and development monitoring in children

What it is

The comprehensive early-childhood assessment is done by doctors and nurses under the Health Promotion and Maintenance Pathway (Resolution 3280 of 2018). Growth is measured by weight, length or height and head circumference, and classified with the WHO standards adopted in Colombia by Resolution 2465 of 2016. Development is assessed through the family's observations and the Escala Abreviada de Desarrollo-3 (a short developmental scale). The trend on the chart tells you more than a single measurement.

Reference values

• Weight-for-height from -1 to +1: adequate; from -2 to below -1: risk of acute malnutrition.
• Weight-for-height above +1 to +2: risk of overweight; above +2 to +3: overweight; above +3: obesity.
• Height-for-age from -2 to below -1: risk of short stature.
• The WHO growth standards cover birth to 5 years (60 completed months).
• M-CHAT screening for autism between 18 and 30 months.

What you need

• Calibrated baby and standing scales.
• An infantometer for children under 2 (lying down) and a stadiometer for older children.
• A non-stretch tape measure for head circumference.
• WHO charts, the child health card and the Escala Abreviada de Desarrollo-3.

How to measure it (and why)

1. Review the health card and earlier measurements — the trend is worth more than a single value.
2. Weigh the child undressed or in light clothing, with the scale at zero, and repeat — clothing and reading error change the weight.
3. Measure children under 2 lying down on an infantometer and older children standing on a stadiometer — technique changes with age.
4. Measure head circumference above the eyebrows and ears, around the back of the head — it reflects brain growth.
5. Plot each measurement on the WHO chart by sex and age, and classify it — allows comparison with the standard.
6. Apply the developmental scale and ask the family what they notice — detects delays early.
7. Record in the chart and the health card, and explain the curve to the family — the family follows growth at home.

How to read it

• A curve that flattens or falls deserves attention even if the value is still «in range».
• In infants under 6 months, assess breastfeeding: position, latch, suck and frequency.
• The indicators are not used to classify children with conditions that alter their measurements; specific charts are used.
• Vaccination is reviewed with the health card at the same visit.

Next step: when to call for help

• Call or refer if weight-for-height is below -2 standard deviations or the curve is falling.
• Refer to paediatrics if the developmental scale or the M-CHAT shows a problem.
• Call if head circumference is outside ±2 standard deviations or changes abruptly.
• Activate the child protection pathway if there are signs of abuse or neglect.

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Elsewhere in DurgiPedia

• Vital signs in children: how they change with age

Connections

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: WHO child growth standards (World Health Organization, 2006); Resolución 2465 de 2016: indicadores antropométricos, patrones de referencia y puntos de corte para la clasificación antropométrica del estado nutricional (Ministerio de Salud y Protección Social de Colombia, 2016); Resolución 3280 de 2018: lineamientos técnicos y operativos de la Ruta Integral de Atención para la Promoción y Mantenimiento de la Salud y de la Ruta Integral de Atención en Salud para la Población Materno Perinatal (Ministerio de Salud y Protección Social de Colombia, 2018).

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