Physiological growth dynamics
A child's growth is a complex process influenced by growth hormone (somatotropin), as well as numerous exogenous and endogenous factors. The rate of elongation is uneven:
- First year of life: the period of most rapid growth (gain of 20–30 cm/year).
- Second year of life: the rate physiologically decreases to 10–15 cm/year.
- Childhood period: slow and stable growth (4–6 cm/year).
- Pubertal period: growth spurt, rate increases to 10 cm/year and more.
General measurement rules
All anthropometric data are recorded in the outpatient medical record. A height meter (stadiometer) with 0.1 cm increments is used for measurement accuracy.
It is best to take measurements in the morning. By evening, height may falsely decrease due to spinal disc compression from daily loads.
Results are evaluated taking into account the exact age and sex of the child according to uniform WHO standards, using centile charts (where the median is the 50th centile) or standard deviation scores (SDS).
Measurement technique in children under 2 years
Young children are measured strictly in a horizontal position on an infantometer. The procedure requires two people:
- The assistant holds the child's head so that the parietal region is firmly pressed against the fixed board. The head must lie straight.
- The examiner holds the legs, pressing slightly on the knees to straighten the limbs.
- The feet are flexed at a 90-degree angle, after which the movable board is slid up to the heels.
Standing and sitting height measurement (over 2 years)
Children who can stand steadily are measured using a vertical height meter (stadiometer). The patient stands barefoot, arms at the sides, heels together, toes apart.
Points of contact with the vertical stand (standing position):
- Heels
- Buttocks
- Interscapular region (sometimes the back of the head)
An important reference point is the Frankfurt horizontal plane. This is an imaginary line from the lower orbital margin to the upper margin of the external acoustic meatus. It must be strictly parallel to the floor. The headboard is lowered onto the crown of the head.
To assess body proportions (length of the upper segment), sitting height measurement is used. The child sits on a folding bench, straightens the back, pressing the buttocks and interscapular region against the stand. The head is also aligned along the Frankfurt horizontal plane. The value is read from the seat level.
Class and exam questions
Why should height be measured in the morning?
Readings are most accurate in the morning. In the evening, height may be lower due to physiological compression of the interscapular discs under the influence of static loads during the day.
How to properly position a child's head when measuring standing height?
The head must be positioned so that the Frankfurt horizontal plane (the line from the lower orbital margin to the tragus of the ear) is strictly parallel to the floor.
Why is sitting height measured?
This is necessary to assess the proportionality of development, in particular, to determine the length of the upper body segment (trunk and head).
What else to study on this topic
- The influence of somatotropin and other factors on growth
- Detailed algorithm for working with WHO centile charts and graphs
- Calculation and interpretation of the SDS (Standard Deviation Score)
- Pathological growth deviations (growth retardation, gigantism)
Master the entire topic in the Pediatrics course
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Other topics in "Chapter 1. General Issues"
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