Ant

hropomet
ry
―Dr
.Anki
tYadav
endr
a,
M.B.B.S.(
Dr.V.M.G.M.C.
,Sol
apur
),

M.D.Paedi
atr
icsr
esi
dent(
B.H.I
.M.S.
,Mumbai
)

0
 Ref
erencest
akenandadapt
edf
rom:

1.“Kl
eigman,Behrman,Jenson,Stant
on,Nel
son Text
book of
Paedi
atri
cs”
,1stSout
hAsi
aEditi
on,Saunder
sEl
sev
ier

2.“
K.Par
k,Park’
sText
bookofPr
event
iveandSoci
alMedi
cine”
,
23r
dEdi
ti
on,Bhanot

3.“
VinodK.Paul
,Ar
vindBagga,GhaiEssent
ialPedi
atr
ics”
,8t
h
Edi
ti
on,CBS

4.“
Kri
shnaM.Goel,Dev
endr
aK.Gupt
a,Hut
chi
son’
sPaedi
atr
ics”
,
2ndEdi
ti
on,
Jaypee

5.“MKC Nair
,PSN Menon,Rit
abr
ataKundu,I
AP Text
bookof
Pedi
atr
ics”
,6t
hEdi
ti
on,
Jaypee

6.“Dr
.May oorK.Chheda,Pr
act
icalaspect
sofPedi
atr
ics”
,7t
h
Edi
ti
on,Bhal
anibookdepot

7.“
Mehar
banSi
ngh,
Pedi
atr
icCl
i
nical
Met
hods”
,3r
dEdi
ti
on

8. “Nati
onal Healt
h and Nut ri
ti
on Examinat
ion Sur
vey
Ant
hropometr
yProcedur
esManual
,CDC”,
Jan2007

9.“ Ar
uchamy Lakshmanaswamy,Cl
ini
calPaedi
atri
cs hi
stor
y
taking and case discussi
on”
,3rd Edi
ti
on,Wolter
s Kluwer,
Lippincot
tWil
l
iams&Wi l
ki
ns

10.“
NCJoshi
,Cl
i
nical
Pedi
atr
ics”
,2ndEdi
ti
on,
Elsev
ier

1
Et
ymol
ogy
:

Greek wor d “
anthr
opo” = “
human”
;“met
ron” = “
measur
e”
(Ul
ajaszek,
1994)

Def
ini
ti
on:

St
udyofthemeasurementofthehumanbodyi nt
ermsoft
he
di
mensi
onsofbone,
muscle,
andadi
poset
issue.

I
mpor
tance:

1.I
tisakeycomponentofnut
ri
ti
onst
atusassessmenti
nchi
l
dren
andadul
ts.

2.I
tref
lect
sgener
alheal
thst
atusanddi
etar
yadequacy
.

3.Itcanbeusedt
otr
ackt
rendsi
ngr
owt
handdev
elopmentov
er
ti
me.

2
•Wei
ght

I
nst
rument
s:

1.Di
git
alwei
ghtscal
e

2.Por
tabl
escal
es

3.Beam t
ype(
Det
ect
o):
inf
ant
s

4.Spr
ingmachi
neorbat
hroom scal
e

Neonates:Theyarepl
aced on t
hescal
ewi
th al
lcl
othesand
di
apersremoved.

Smallchi
l
dren:Chil
drenwhocannotstandal oneonthescal
ewi l
l
beweighedwi t
ht heassist
anceofanadul t.Firstt
headul
twi l
l
standonthescaleandt henpressthetar
ebut tontoshow zer
o,
andthenwil
lcarr
yt hechi
ldt
orecordhisweight.

Ol
derchi
l
dren:Theyar
easkedt
oremov
etheshoesandt
hen
st
andonthescal
e.

3
4
•
Recumbentl
engt
h

I
nstrument:Inf
ant
ometer (
fi
xed head pi
ece and hor
izont
al
backboar
d,andanadj
ust
abl
efootpi
ece)

I
ti susedf orchil
dren<2y earsofage( becauseofexcessi ve
l
umbarl ordosisduri
ngt hi
sage) .Laythechil
dont heinfant omet er
witht hef eettowardthef ootpieceandt heheadagai nstt hef i
xed
head pi ece. Head shoul d be wi t
h t he Fr ankfort pl ane
per pendiculartothef l
oor .Ali
gnt hechil
d’slegsbypl acingone
handov ert heknees.Wi t
ht heot herhand,sli
det hefootpi ecet o
restf ir
ml yatt he chil
d’s heel s.The toes mustpoi ntdi r
ectly
upwar dwi t
hbot hsolesoft hef eetfl
exedper pendi
cularagai nst
thef ootpiece.Measur ebysi tti
ngdownwi they esatt hel evelof
i
nf antomet er.

5
•St
andi
nghei
ght(assessmentofmaxi
mum v
ert
icalsi
ze
ofaper
son)

I
nst
rument
:St
adi
omet
er(
Har
pendenSt
adi
omet
er)

I
ti sused in chil
dren ≥2 yearsage.Ther ei sa fixed vert
ical
backboardandanadj ust
ableheadpiece.Askt hechi l
dt ostand
withoutanyfootwearorcaps.Heshouldst andupstr
ai ghtagai
nst
thebackboardwi ththebody weightevenlydist
ri
butedandbot h
feetfl
atont heplatf
orm.Heel saretogetherandtoesapar t.The
toesshouldpointsli
ghtl
youtwar datanangl eof60°.Backoft he
head,shoulderblades,buttocks,heelsmakecont actwi t
ht he
backboard.

Lowert hest adiometerheadpiecesothati tr

estsfi
rmlyont opof
thepar ti
cipant’shead,withsuffi
ci
entpr essuretocompr esst he
hair.Inst
ructt hechil
dt ostandast allaspossi bl
e,takeadeep
breath,andhol dthisposit
ion.Theactoft akingadeepbr eath
helps straighten the spi
ne t oy i
eld a mor e consist
entand
reproduciblestatur
emeasur ement.

Fr
ankf
orthor
izont
alpl
ane:

Linefr
om theupperbor derofearcanal
stot hel
owerborderof
theorbi
toft heeyesisparal
lelt
othef l
oorandperpendi
cul
arto
thevert
ical
backboard.

6
7
8
•Uppersegment
:Lowersegment
Forl
owersegment
,measur
efr
om t
hepubi
csy
mphy
sist
il
lthe
fl
oor
.

Uppersegment=Hei
ght(
Lengt
h)–Lowersegment

9
•Si
tt
inghei
ght
Thechi l
dismadet ositonat ableorahardsurfacesot hathis
headl i
esinFrankfortplane.Thebackshouldbest r
aight,thi
ghs
hori
zontaland comf or
t abl
y posi
ti
oned.The feetshoul d be
supportedont hefootboar dandhandsshouldrestcomf ortabl
e
ont hechil
d’sl
ap.Theheadboar dshouldbel
oweredandmadet o
touchtheheadoft hesubj ectandreadi
ngshoul
dber ecordedto
thenearestcompleteduni t
.

•Knemometry:devi
ceformeasuri
ngt hedistancebetweenknee
andheelofasit
ti
ngchi
ldoradolescence;usedt oi
nvest
igat
ethe
eff
ect
sofster
oidsandgrowt
hhor moneonshor tstat
ure

10
•Headci
rcumf
erence

I
nst
rument
:non-
str
etchabl
emeasur
ingt
ape

Placethemeasur i
ngt apear oundt hechild’sheadsot hatthet ape
l
ies acr oss the f r
ont albones,sl i
ghtl
y abov et he eyebr ows,
perpendiculartot hel ongaxi soft hef ace,abovet heear s,and
overtheocci pit
alpr omi nenceatt hebackoft hehead.Mov et he
tapeupanddownov ert hebackoft heheadt olocatethemaxi mal
cir
cumf erence.Tightent het apesot hati tfi
tssnuglyaroundt he
headandcompr essest hehai randt heunder ly
ingsof ttissues.
Measur et hecircumf er encet ot henear est0.1cm.Repeatt he
measur ementt hri
ceandr ecordthelargestmeasur ement .

11
•Chestci
rcumf
erence

I
nst
rument
:non-
str
etchabl
emeasur
ingt
ape

Measur
e atthe l
evelofni
ppl
esdur
ing nor
malbr
eat
hing and
r
ecordt
othenearest0.
1cm.

12
•Mi
d-ar
m ci
rcumf
erence

I
nst
rument
:non-
str
etchabl
emeasur
ingt
ape

Chi l
d( 6-59mt hsage)shoul dstanduprightwi t
htheweightevenly
distri
but edonbot hfeet,theshouldersrelaxed,andtheleftarm
heldl ooselyatt heside.Holdthearmi n‘L’positi
onandmar kt he
mi dpointbet ween t he acromi on and ol ecr
anon process,by
extendi ngthet apedownt heposteri
orsurfaceoft hearm.Att he
mi dpoint,pullthet woendsoft heov erl
appingtape.Checkt hat
thet apef it
ssnugl yar oundthear m butdoesnotcompr esst he
skin.

-Bangl
etest:af i
bre-
glassri
ngofi nternaldiameterof4cm i s
sli
ppedupt hearm.Ifi
tpassesabov etheel bow,i
tsuggeststhat
upperarm i s <12.5 cm in ci
rcumf erence and the chi
ldi s
malnouri
shed.

-
Shaki
rtape:
afi
bre-
glasst
apedi
ff
erentcol
ourcodi
ng

Col
ourMid-ar
m Gr
adeof I
nter
vent
ion
ci
rcumfer
ence(
cm) mal
nut
ri
ti
on r
equir
ed

Red <12.
5 sev
ere admi
tandt
reat

Yel
l
ow 12.
5-13.
5 moder
ate di
etar
yadv
ise

Gr
een >13.
5 sev
ere noi
nter
vent
ion

13
-Quac st i
ck ( Quacker’
s arm ci r
cumf er
ence measur ing stick)
:
Principl
e: acut e st arvat
ion sev erel
y af fect
s mi d-
arm
circumferencewhi leheighti
sunaf f ect
ed.Iti
samet err odwith2
set sofmar kings.Theexpectedhei ghtofthechi
ldagai nstv ar
ious
sizesofmi d-arm ci
rcumference i sinscri
bed on the r od.The
mal nouri
shedchi l
dwoul dbet al
lert hantheant i
cipatedhei ght
der i
vedfrom t hemid-
arm cir
cumf erence.

-
Mid-
arm ci
rcumf
erence/
Hei
ghtr
ati
o:

nor
mal
-0.
32-
0.33;
mal
nut
ri
ti
oni
s<0.
29

14
15
•Ski
nfol
dthi
ckness

I
nst
rument
:Har
penden’
scal
l
iper
s

Tri
cepsski nfoldt hicknessi smeasur edposteriorl
y1cm abov e
themi dpoi
ntbet weent heacr omionprocessandt heol ecr
anon
process.Apr essur eof10g/ mm²i sappl
iedont hecaliperandt he
skinf
oldi sf reed f rom t he underl
yi
ng muscl e withl efthand,
between thet humb,i ndexand mi ddlefingerand hol ding the
cali
perwiththeot herhand.Ther eadingisrecordedtot henear est
0.1mm, maintaini
ngpr essureofcali
perasbef ore.

f
orchi
ldr
en1-6y
rsage:ski
nfol
dthi
ckness>10mm i
snor
mal
;<6
mm i
sabnor
mal

Bicepsski nfoldthicknessi smeasur ed byasking t

hechil
dt o
standerect ,faci
ngt heobser verwithar
m ononesi deandpal m
facingf
or ward.Theski nf
oldispicked-
upoverthebellyofbi
ceps
and1cm abov ethelinemar kedforthemi d-
arm ci
rcumfer
ence
onav er
tical l
inejoini
ngant ecubi
talf
ossatotheheadofhumer us.

Subscapul
arski
nfol
dthicknessismeasur
edbel
ow t
hei
nfer
ior
angl
eofscapul
aat45°tov er
ti
cal

Supr
a-i
li
acskinf
oldthi
cknessi
smeasuredabov
eil
i
accr
esti
nmi
d
-
axil
l
aryli
ne(about2cm abovethehi
pbone)

16
17
18
•Wai
stt
ohi
prat
io
Waisti
smeasuredoverthehighestpal
pablepoint
softheil
iac
cr
estsinthe mid-
axi
l
lar
ylines,bya fibre gl
ass t
ape.Hi
pi s
measur
edonthemaximum extensi
onofthebutt
ocks.

Waistt
ohi prat
io<0.7inwomeni ssuggesti
veofopti
mallevelsof
est
rogensandl esssuscept
ibi
l
itytomajordiseasesl
ikediabetes,
car
diovascul
ardisor
dersandovariancancer
s.

Waisttohiprat
io<0.9inmeni sassoci
atedwi
thl
esspr
eval
ence
ofprost
ateandtest
icul
arcancer
s.

•Wai
stt
ohei
ghtr
ati
o
val
ues>0.5indi
catecent
ralobesi
tyev
eni
nchi
l
drenwi
thnor
mal
weightandhei
ght.

19
•Sever
e acut
e mal
nut
ri
ti
on:sev
ere wast
ing and/
or bi
l
ater
al
edema.

A.Sev ere wasti

ng:ext
reme thi
nness di
agnosed by a weight-
for-
length( or hei
ght)<3 SD of t he WHO Chi l
d Gr owth
Standards. Inchil
dren ages 6-59 mths,a mi d-
upper ar m
cir
cumf erence<115mm al sodenotesextr
emet hi
nness

B.Bilater
aledemaisdiagnosedbygr aspi
ngbothf eet
,pl
aci
ng
at humbon t op ofeach,and pressi
ng gent
ly butfi
rml
yfor
10 secs.A pi t(
dent
)remaining undereach t
humb indi
cat
es
bi
lateraledema

Di
agnosti
ccr
it
eri
aforsev
ereacut
emal
nut
ri
ti
oni
nchi
l
drenofage
6-
60mt hs

I
ndi
cat
or Measur
e Cut
-of
f

Sev
erewast
ing Wei
ghtf
orhei
ght <–3SD

Sev
erest
unt
ing Hei
ghtf
orage <–3SD

Sev
ereunder
nut
ri
ti
on Wei
ghtf
orage <–3SD

Sev
erewast
ing Mi
d-ar
m ci
rcumf
erence <115mm

Bi
l
ater
aledema Cl
i
nical
signs

20
•Fai
lur
et ot
hri
ve:i
sasi gn,notadiagnosi
s.FTT i
sgener
all
y
usedtodescribechi
ldr
eny oungert
han2or3y rswhomeet
anyoft hefol
l
owingcri
teri
a:

A.Gr owth under t he thi

rd percent
il
e on Wor l
d Heal
th
Organizat
ion (WHO) weight f
or age growt
h char
ts(<3% =
l
esst han3st andar
ddev i
ati
onsbelow mean)

B.Weightforhei
ghtorbodymassi
ndex(
BMI
)lesst
hant
he
5thpercent
il
e

C.Growt
h pat
ter
ns t
hathave cr
ossed t
wo maj
orpercent
il
es
downwar
dont heweightf
oragechartswit
hin6mths

D.Gr
owt
hvel
oci
tyl
esst
hannor
malf
orage

•Under
wei
ght
:wei
ghtf
orage<–2SD ofWHO chi
l
dgr
owt
h
st
andar
dmedi
an

•Stunti
ng/Shortst
atur
e:hei
ghtf
orage<–2SD ofWHO chi
l
d
gr
owt hstandar
dmedian

•Tallstat
ure:hei
ghtf
orage >+2 SD ofWHO chi
l
d gr
owt
h
st
andardmedian

•Wasti
ng:wei
ghtf
orhei
ght< –2 SD ofWHO chi
l
d gr
owt
h
st
andar
dmedi
an

21
•Overwei
ght
:weightf
orhei
ght>+2SD ofWHO chi
l
dgr
owt
h
st
andardmedi
an

•Hei
ghtage:t
heagethatcor
respondstothechi
l
d’shei
ghtwhen
pl
ott
edatthe50t
hcent
il
eonagr owthchar
t

•Weightage:t
heagethatcor
respondstot
hechi
l
d’swei
ghtwhen
pl
ott
edatthe50thcent
il
eonagr owthchar
t

•Boneage:t
heaver
ageageatwhi
chchi
l
drenr
eacht
hisst
ageof
bonematur
ati
on

•Chr
onol
ogi
cal
age:
theagewhi
chaper
sonhasl
i
ved(
from bi
rt
h)

•Weightforage=wei
ghtoft
hechi
l
d(kg)÷wei
ghtofnor
mal
chi
l
dvofsameage×100

•Heightf
orage=lengt
h/hei
ghtoft
hechi
l
d(cm)÷l
engt
h/hei
ght
ofnormalchi
l
dofsameage×100

•Weightf
orhei
ght=wei
ghtofthechi
l
d(kg)÷wei
ghtofnor
mal
chi
l
dofsameheight(
cm)×100

22
•Wei
ghtv
eloci
ty:
rat
eofi
ncr
easei
nwei
ghtov
eraper
iodoft
ime

-
peaksbef
oret
he1sty
earofagef
orbot
hboy
sandgi
rl
s

-
ini
ti
all
ymalewei
ghtv
eloci
tyi
s>f
emal
e;r
eachesequi
l
ibr
ium at8
monthsofage

-
thenl
agsbehi
ndf
emal
esunt
iladol
escence

-
peakwei
ghtv
eloci
tydur
ingpuber
ty-

mal
esi
sat14.
3year
s,f
emal
esat12.
9year
s

Age Wei
ghtv
eloci
ty

0-
4mt
hs 30g/
day(
1kg/
mth)

5-
8mt
hs 20g/
day(
0.75kg/
mth)

9-
12mt
hs 10g/
day(
0.5kg/
mth)

1-
2yr
s 3kg/
yr

3-
12y
rs 2kg/
yr

12-
18y
rs 5-
6kg/
yr(
0.5kg/
mth)

23
•Hei
ghtv
eloci
ty:
rat
eofi
ncr
easei
nhei
ghtov
eraper
iodoft
ime

-
rapi
dlypr
ogr
essesf
rom bi
rt
hupt
otheendof1sty
earofl
i
fe

-
decr
easesi
n2ndy
ear

-
ini
ti
all
ymalehei
ghtv
eloci
tyi
s>f
emal
e;r
eachesequi
l
ibr
ium at7
monthsofage

-t
hen upt
o adol
escence,t
her
eis no si
gni
fi
cantdi
ff
erence i
n
growt
hrates

-Females:hei
ghtspur
tisat10.
5year
s,peakhei
ghtv
eloci
tyi
sat
12y ear
s

-
Mal
es:hei
ghtspur
tisat12.
5year
s,peakhei
ghtv
eloci
tyi
sat14
y
ear
s

Age Hei
ghtv
eloci
ty

atbi
rt
h 50cm

gai
ndur
ing1sty
ear 25cm

gai
ndur
ing2ndy
ear 12.
5cm

gai
ndur
ing3r
dyear 7.
5-10cm

gai
ndur
ing3-
12y
ear
s 5.
0-7.
5cm

adol
escence 8cm/
yearf
orgi
rl
s;10cm/
yearf
orboy
s

24
•Catch-upgr
owt
h:compensatorygr
owthafterper
iodsofgrowth
i
mpai r
mentdue toil
lness,star
vat
ion and ot
herunfavourabl
e
condi
tions

•Ape/Gor
ri
lai
ndex/
Apef
act
or:r
ati
oofani
ndi
vi
dual
’
sar
m spant
o
thehei
ght

-
boy
supt
o10y
ear
s:ar
m span<hei
ght

-
gir
lsupt
o11y
ear
s:ar
m span<hei
ght

-
inadul
ts:

males-ar
m spani
s>5cm byhei
ght
;femal
es-ar
m spani
s>1.
2
cm byhei
ght

Ponder
al/
Cor
pul
ence/
Rohr
er’
sindex=wei
ght(
g)÷hei
ght
³(cm)×
100

nor
mal
:>2.
5

bor
der
li
nemal
nut
ri
ti
on:
2-2.
5

sev
eremal
nut
ri
ti
on:
<2

I
nneonat
es

t
erm(
appr
opr
iat
eforgest
ati
onal
age)
:>2.
5

asy
mmet
ri
cIUGR:
<2

sy
mmet
ri
cIUGR:
>2

25
Quet
eleti
ndex=wei
ght(
kg)÷hei
ght
²(cm)×100

nor
mal
:0.
14-
0.16

mal
nut
ri
ti
on:
<0.
14

Bodymassi
ndex=wei
ght(
kg)÷hei
ght
²(
‌ m)

Dugdal
e’
sindex=wei
ght(
kg)÷hei
ght
^1.
6×100

nor
mal
:0.
88-
0.97

mal
nut
ri
ti
on:
<0.
79

KanawatiandMclar
enindex(f
or3mt hst
o4y rsage)
=mi
dar
m
ci
rcumference(
cm)÷headcir
cumfer
ence(cm)

nor
mal
:>0.
32

mi
l
dmal
nut
ri
ti
on:
0.28-
0.32

moder
atemal
nut
ri
ti
on:
0.25-
0.28

sev
eremal
nut
ri
ti
on:
<0.
25

Most
ell
er’
sfor
mul
aforbodysurfacear
ea:bodysur
facear
ea(
m²)
=[
hei
ght(cm)xwei
ght(
kg)/3600]^½

26
•Agedependentmeasur
ement
s

-
wei
ghtf
orage

-
hei
ghtf
orage

-
headci
rcumf
erence

-
chestci
rcumf
erence

•Agei
ndependentmeasur
ement
s

-
mid-
arm ci
rcumf
erence

-
mid-
arm ci
rcumf
erencet
oheadci
rcumf
erencer
ati
o

-
mid-
arm ci
rcumf
erencet
ohei
ghtr
ati
o

-
chestt
oheadci
rcumf
erencer
ati
o

-
wei
ghtf
orhei
ght

-
Quact
est

•Lawsofgr
owt
h

1.Gr
owt
hisacont
inuousandor
der
lypr
ocess

2.Gr
owt
hpat
ter
nofev
eryi
ndi
vi
dual
isuni
que

3.Di
ff
erentt
issuesgr
owatdi
ff
erentr
ates

27
•
Bir
th:
ter
m

-wei
ght~2.8kg(aver
agewei ghtinI
ndi
anbabies;loseweightby
10% i
n1stweekduet oexcr eti
onofexcessextravascul
arflui
d
andli
mit
ednutri
ti
onali
ntake;regai
norexceedbirthweightby2
weeksofage)

-
lengt
h~50cm

-
headci
rcumf
erence~35cm

Age wei
ght growt
hi nl
engt
h gr
owthinhead
gai
n(g/
d) (cm/mth) ci
rcumf
erence(
cm/
mth)

0-
3mt
h 30 3.
5 2

3-
6mt
h 20 2 1

6-
9mt
h 15 1.
5 0.
5

9-
12mt
h 12 1.
2 0.
5

1-
3yr 8 1 0.
25

4-
6yr 6 3cm/
yr 1cm/
yr

-
wei
ghtgai
n~30g/
dayaf
ter2weeksage,
dur
ingt
hef
ir
stmont
h

-
bir
thweightdoubl
esby4mont
hs;
tri
plesby1y
ear
;quadr
upl
esby
2½y ear
s

28
Age Weech’
sfor
mul
a

<1y
rage wei
ght(
kg)=[
9+age(
mths)
]÷2

1-
6yr
sage wei
ght(
kg)=[
2×age(
yrs)+8]

6-
12y
rsage wei
ght(
kg)=[
7×age(
yrs)–5]÷2

29
-hei
ght/l
engt
hi ncreases by50% duri
ng 1styear;bi
rt
hl engt
h
doublesby4y ear
s; ½oftheadul
thei
ghtisachei
vedby2years

-
Duri
ngadolescence,20%ofbodyst
atur
eand50%ofadul
tbone
massisl
aiddown

-
Haaser
ulet
ocal
cul
atet
hef
etal
age:

f
ir
st5l
unarmont
hs:
age(
mont
hs)=✓[
lengt
h(cm)
]

next5l
unarmont
hs:
age(
mont
hs)=✓[
lengt
h(cm)
]
Age(
year
s) Lengt
h/Hei
ght(
cm)

bi
rt
h 50

1 75

2 87

3 94

4 100

Tanner
’sf
ormul
a:

adul
thei
ght(
cm)=hei
ght(
cm)at2y
rs×2

adul
thei
ght(
cm)=hei
ght(
cm)at3y
rs×1.
37

Weech’
sfor
mul
a:hei
ght(
cm)=6×age(
year
s)+77

st
andi
nghei
ght(
cm)=r
ecumbentl
engt
h(cm)–0.
7

30
-
headci
rcumf
erence

Chr
onol
ogi
cal
age(
weeks) I
ncreaseinheadcir
cumf
erence
ofpret
erms(cm/wk)

1st2weeks 0.
5

3r
dweek 0.
75

fr
om 4th week t
o 40 weeks 1.
0
post
menst
rualage

Dynes’formula:headci
rcumf
erence(
cm)=l
engt
h(cm)÷2+9.
5
±2.5(ti
l
l 1yearofage)

-Tot
albrai
nv olumedoubl
esi nthe1sty roflifeandincr
eases
byanaddi t
ional15%overthe2ndyr.Totalbr
ainvolumeatage
1 mthisappr oxi
matel
y36% ofadultv olume butbyage 1 yr
i
sappr oxi
mat ely72% (
83% by2y r)

-
chestcir
cumference:equalst
heheadci
rcumf
erenceby1y
eari
n
t
erminfantsandby9mont hsi
npret
erms

31
-
uppersegment
:lowersegment

Age(
year
s) Uppersegment:
Lowersegment

bi
rt
h 1.
7:1

1 1.
6:1

2 1.
5:1

3 1.
3:1

9 1:
1

>9 1:
1.1

Sex Mi
dpar
ent
alhei
ght(
cm)

Mal
e [
mat
ernal
hei
ght(
cm)+pat
ernal
hei
ght(
cm)
]÷2+6.
5

Femal
e[mat
ernal
hei
ght(
cm)+pat
ernal
hei
ght(
cm)
]÷2–6.
5

Tar
getr
angef
orachi
l
d(cm)=mi
dpar
ent
alhei
ght(
cm)±6

32
•
Classi
fi
cat
onsf
ormal
nut
ri
ti
on

•Wel cometrustcl
assi
fi
cat
ion(1970)(basedonstandardweight
forage;95t
hcentil
eICMRvalueor50thcenti
leBost
onv al
ue)

Weight (
per
centage of80-
60% <60%
st
andardwei
ght)forage

wi
thedema kwashi
orkar marasmic
kwashi
orkar

wi
thoutedema under
wei
ght mar
asmus

•I
APcl
assi
fi
cat
ion

Gr
ades Per
cent
ageofst
andar
dwei
ghtf
orage

I 70-
80

I
I 60-
70

I
II 50-
60

I
V <50

33
•Gomez’
classi
fi
cat
ion(
1956)

Gr
ades Per
cent
ageofst
andar
dwei
ghtf
orage

Nor
mal 90-
110

I
,mi
l
dmal
nut
ri
ti
on 75-
89

I
I,
moder
atemal
nut
ri
ti
on 60-
74

I
II
,sev
eremal
nut
ri
ti
on <60

•Bengoa’
scl
assi
fi
cat
ion

Gr
ades Per
cent
ageofst
andar
dwei
ghtf
orage

I 76-
90

I
I 61-
75

I
II <60wi
thedema

•Jel
l
ife’
scl
assi
fi
cat
ion(
1965)

Gr
ades Per
cent
ageofst
andar
dwei
ghtf
orage

I 80-
90

I
I 70-
80

I
II 60-
70

I
V <60

34
•Udani
’
scl
assi
fi
cat
ion

Gr
ades Lossoff
atf
rom

I but
tocks

I
I but
tocks,
axi
l
la,
groi
n

I
II but
tocks,
axi
l
la,
groi
n,abdomen,
chest
,back

I
V but
tocks,
axi
l
la,
groi
n,abdomen,
chest
,back,
buccal
pad

•Wat
erl
ow’
scl
assi
fi
cat
ion(
1972)

•Col
e’
scl
assi
fi
cat
ion

Gr
ade Z-
scor
eforBMIf
orage

I <–1

I
I <–2

I
II <–3

35
•McLar
en’
scl
assi
fi
cat
ion

Cl
assi
fi
cat
ion Percent
ageofst
andar
dhei
ght
forage

Nor
mal 93-
105

Shor
t 80-
93

Dwar
f <80

•Ar
nol
d’scl
assi
fi
cat
ion

Gr
ade Mi
d-ar
m ci
rcumf
erence(
cm)

nor
mal >13.
5

mi
l
d-moder
ate 12.
5-13.
4

sev
ere <12.
5

I
deal
bodywei
ght[
IBW](
kg)=22.
5×hei
ght
²(m)

•Gr
adi
ngonnut
ri
ti
onal
stat
usaccor
dingt
oIBW

Bodywei
ght Condi
ti
on

Lesst
hanI
BW by18% Under
wei
ght

Mor
ethanI
BW by10% Ov
erwei
ght

Mor
ethanI
BW by20% Obesi
ty

36
•Cl
assi
fi
cat
ionofobesi
tydependi
ngupont
hewei
ghtf
orage

Cl
assi
fi
cat
ion Wei
ght(
%)

Mi
l
d 120-
130

Moder
ate 131-
140

Sev
ere 141-
150

Ver
ysev
ere >150

•Classi
fi
cati
onofnut
ri
ti
onalst
atusaccor
dingt
oBMIi
nchi
l
dren
andadolescent
s

Cl
assi
fi
cat
ion BMI(
kg/
m²)

Nor
mal 15-
22

Ov
erwei
ght 22-
25

Obesi
ty >25

37
•Cor
rel
ati
onbet
weenper
cent
il
esandZ-
scor
es

Zscor
e Exactper
cent
il
es Roundedper
cent
il
es

0 50 50

–1 15.
9 15

–2 2.
3 3

–3 0.
1 1

1 84.
1 85

2 97.
7 97

3 99.
9 99

38
 NOTE:

THI
SBOOKI
SONLYFORTHEPURPOSEOFGUIDANCEANDHELPTOPAEDI
ATRI
CSTUDENTS,
NOTFORCOMMERCIALOROTHERPURPOSES.

FORANYFEEDBACK/
QUERYPLEASECONTACTdr
.anki
tyadav
endr
a@gmai
l
.com

Speci
alThanks:

Dr
.ReshmaNev
gi

(
M.D.Paedi
atr
ics,
L.T.M.M.C.
,Si
on,
Mumbai
)

Dedi
cat
edt
oMadamj
i
!

39