Paediatric growth charts: How do we use them and can we use them better?

Abstract

Aim: Measurement of growth parameters is a key aspect of paediatric care. The aim of this retrospective study was to ascertain rates of growth assessment in children in an acute paediatric setting and to define the frequency of placement of growth data on appropriate growth charts. The accuracy of plotting of growth data and role of potential factors were also examined. Methods: The charts of children attending the Children's Acute Assessment (CAA) unit at Christchurch Public Hospital, New Zealand, were reviewed. The frequency of documentation of height, weight and head circumference in the notes and on the appropriate growth chart was ascertained, along with review of the accuracy of the plotted data. Results: Weight was documented in the charts of 95% and height in 5% of 103 children. None of the children had measurement of their head circumference. A growth chart was present in the notes of 27% of children, but just 7% of the group had a growth chart with the current measurements plotted. Conclusions: This study identifies a missed opportunity for assessment of the nutritional status of children in the hospital setting in New Zealand. The results highlight a need for optimising child growth assessment, particularly at a time of growing awareness of health inequalities and childhood obesity. © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).