WEL C0ME
ANTHROPOMETRY
By:
Dr. Akshay Gurav
1st year PG Scholar
Department of Kaumarbhritya
CONTENTS
• Introduction
• Definition
• Significance
• Anthropometric Measurements
• Clinical Importance
• Pramana Sharira
• Conclusion
Introduction:
Physical, Mental and
Social Growth & Development of a
child can be assessed under two
headings
I. Growth
II. Development
Assessment
Growth Development
i. Nutritional
i. Primitive Reflexes
Anthropometry
ii. Gross Motor Development
ii. Tissue Growth
iii. Fine Motor Development
iii. Dental Age
iv. Language Milestones
iv. Bone Age
v. Personal & Social Milestones
NUTRITIONAL
ANTHROPOMETRY
•Anthropos - "man"
and Metron "measurement”
•A branch of anthropology that involves the
quantitative measurement of the human body.
Nutritional Anthropometry
“Measurement of the variations of the physical
Dimensions & the gross composition of the
human body at different age levels and degrees
of nutrition”
•It is used to evaluate both under & over
nutrition.
Significance of Anthropometry
• Primary measures of past or current
nutritional status in children.
• Distinguish between stunting & wasting
• Identify PEM & obesity
• Monitor changes after nutrition intervention
• Public Health screening
ANTHROPOMETRIC
MEASUREMENTS
( For New Born & Young Children)
Weight
Recumbent length/ Height
Head Circumference
Chest Circumference
Mid Upper Arm Circumference (MUAC)
1. WEIGHT OR BODY MASS
• The measurement of weight is most
reliable criteria of assessment of
health and nutritional status of
children.
• The weight can be recorded using a
Beam type weighing balance
Electronic weighing scales for
infants and children
Bathroom type of mechanical
scale (very unreliable)
Salter spring machine (in field
conditions)
Other Methods
Other methods
Spring Balance Beam Balance
Growth Velocity
0-4 months 1.0kg/month(30g/day)
5-8 months 0.75kg/month(20gm/day)
9-12 months 0.50kg/month(15g/day)
1-3 years 2.25kg/yr
4-9 years 2.75 kg/yr
10-18 years 5.0-6.0kg/yr
(0.5kg/month)
Weight at birth – 3 kgs
Weight at 4-5 months 2 x birth weight
Weight at 1 year 3 x birth weight
Weight at 2 years 4 x birth weight
Weight at 3years 5 x birth weight
Weight at 5years 6 x birth weight
Weight at 7 years 7 x birth weight
Weight at 10 years 10 x birth weight
WEECH’S FORMULA
a) 3 – 12 months
Expected weight(kg) = age (mnts) + 9 / 2
b) 1- 6 years
Expected weight(kg) = age (yrs) x 2 + 8
c) 7 – 12 years
Expected weight(kg) = age (yrs) x 7 - 5 / 2
CLASSIFICATION OF
MALNUTRITION BY INDIAN
ACADEMY OF PEDIATRICS
Weight for age * Grade of
malnutrition
>80 % Normal
71-80% Grade 1 (Mild)
61-70% Grade 2
(Moderate)
51-60% Grade 3 (Severe)
<50% Grade 4 (very
severe)
CLINICAL IMPORTANCE
• Assess the feeding condition
• Fixation of dose
• Sensitive indicator of current nutritional
status.
• Deficit in weight indicates short term
under nutrition which can be easily
reversed.
• PEM is best indentified by weight
deficiency in all groups
• Low birth weight babies
• Over weight babies
2. HEIGHT OR LENGTH
• Height
vertical distance measured from crown of head to bottom of
feet (heels) for children 2 yr of age or older.
• Recumbent Length:
distance measured from crown of head to bottom of feet
(heels) while child(< 2 yr of age) is measured supine.
TECHNIQUE FOR HEIGHT
MEASUREMENT
• The infant is placed supine on the
infantometer.
• Assistant or mother is asked to keep
the vertex or top of the head snugly
touching the fixed vertically plank.
.
• The leg are fully extended by pressing
over the knee, and feet are kept vertical
at 90⁰ , the movable pedal plank of
infantometer is snuggly apposed against
soles and length is read from scale
• In older children who can stand , height
can be measured by the rod attached to
the lever type machine or by
stadiometer.
HEIGHT VELOCITY
Birth
AGEto 3 months 3.5cm/month
Approximate rate of
increase in stature
3 – 6 months 2.0cm/month
6 – 9 months 1.5cm/month
9 – 12 months 1.3cm/month
2 – 5 years 6 – 8cm/year
5 – 12 years 5cm/year
At birth 50cms
Gain during 1st year 25cms
Gain during 2nd year 12.5cms
Gain during 3rd year 7.5 to 10cms
Gain during 3 – 12 years 5 to 7.5cms
Adolescence 8cms/yr for girls during 12
to 16 years
10cms/yr for boys
during 14 to 18 years
B] Expected height 2-12 yrs
height (in cms) = age in years x 6 +77
( wheech’s formula )
C] Mid Parid Ht.
For Girls= [Link]+[Link]-13/2
For Boys= [Link]+[Link]+13/2
• Parental height , Tanner’s formula and
Weech’s formula are used.
Clinical Importance
• Deficit in height indicates chronic &
prolonged under nutrition resulting
often in permanently stunted physical
status
• Deficiency or Increase of Growth
Hormones
• Diagnosis of Gigantism and Dwarfism.
HEAD CIRCUMFERENCE
• Brain growth takes place 70%
during fetal life, 15% during infancy
and remaining 10% during pre-
school years.
• Head circumference are routinely
recorded until 5 years of age.
Measuring Tape and Fibre Glass Tape are
used for measurement of head circumference.
.
26
EXPECTED HEAD
CIRCUMFERENCE IN CHILDREN
Age Head circumference
(cm)
At birth 34 – 35
2 months 38
3 months 40
4 months 41
6 months 42 - 43
1 year 45 - 46
2 years 47 - 48
5 years 50 - 51
Head Circumference Growth
Velocity
Till 3 months 2 cm/month
3 months – 1 year 2cm/3 month
1 – 3 year 1cm/ 6 month
3 – 5 year 1cm/ year
• During first year there is 12 cm increase
in head circumference , while 1 – 5 year
age , only 5 cm gain occur in head size.
• Adult head size is achieved between 5 to
6 years .
• Bimonthly increase of head
circumference upto 1year
• 4cm+3cm+2cm+1cm+1cm+1cm per
month
CLINICAL IMPORTANCE
• Microcephaly
Down syndrome
Fetal alcohol syndrome (FAS)
Phenylketonuria (PKU)
• Macrocephaly
Hydrocephalus
Cranial Hyperostosis
Weaver syndrome
CHEST
CIRCUMFERENCE
• It is usually measured at
the level of nipples,
preferably in mid
inspiration.
• Xiphisternum
• In children
<= 5years - lying down
position
> 5 years - standing
position
Relationship between head size
with Chest Circumference:
• At birth: head circumference > chest
circumference by upto 3 cms.
• At around 9 months to 1 year of age:
head circumference = chest
circumference,
• but thereafter chest grows more rapidly
compared to the brain.
CLINICAL IMPORTANCE
• The head circumference is greater than chest
circumference by more than 3 cms in :
a) Preterms
b) Small-for-date , &
c) Hydrocephalic infants
• In malnourished children, chest size may be
significantly smaller than head circumference
because growth of brain is less affected by
undernutrition.
Therefore there will be considerable delay
before chest circumference overtakes head
circumference.
MID-UPPER ARM
CIRCUMFERENCE
• It is conventionally measured over the
left upper arm , at a point marked
midway between acromion (shoulder)
and olecranon (elbow) with arm bent
at right angle.
• During 1-5 Yrs of age it remains
reasonably static between 15-17cms
among healthy children .
• MUAC is measured with a fiber glass
or steel tape.
MUAC FOR CHILDREN
35
• Bangle test – quick assessment of arm
circumference. A fiber glass ring of
internal diameter of 4 cm is slipped up
the arm, if it passes above the elbow, it
suggests that upper arm is less than
12.5 cm and child is malnourished
• Shakir tape – is a fiber-glass tape with
red – less than 12.5 cm
yellow – 12.5- 13.5 cm
green – greater than 13.5 cm
shading so that paramedical workers
can assess nutritional status without
having to remember the normal limits
of mid arm circumference.
CLINICAL IMPORTANCE
• If it is less than 12.5 cm it is suggestive
of severe malnutrition.
• If it is between 12.5 -13.5 cm it is
indicative of moderate malnutrition..
• It is effectively used in diagnosis of
PEM.
PRAMANA
• Ayurvedic literature pertaining
to Human Anatomy furnishes detailed
description on measurements of body
and its elements.
• In our classics Praman Sharir is the
term given to this subdivision which
depicts the importance of measurements
or Anthropometry.
• Praman, the other way defines the
concept of measurements of various
biological entities. It bears an ample
importance in applied medical science.
Before starting with the treatment the
wise physician should go through these
Measurements thoroughly.
• Anguli Pramana(measurement of
different body parts of an individual by
his/her own fingure) is one of the
important concepts in Ayurveda which
has anatomical as well as anthropological
significance
• Ample references from
the Samhitas show Pramana as one of
the criteria used in the examination of
the patient .
• It plays a major role in determination
of the life span, physical and mental
strength and health of the person
• In Ayurveda different types
of Pramanas like Anjali pramana,
Anguli Pramanas are mentioned . Swa
Anguli is the unit for measurement of
body parts and structure.
• Angula Pramana of Anga Pratyanga of
human body is determined by the
measuring
Utshedha (height)
Aayam(length)
Vistar(breadth) of the Anga
pratyanga of an individual by taking his
own finger(Swa Angule) breadth as the
unit measurement .
• The concept Pramana should be
evaluated scientifically .
CONCLUSION
• Knowledge of Anthropometry is
important special for Pediatrician
• As it gives idea regarding normal
growth & development of child
• Knowledge of Anthropometry helps in
clinical diagnosis of many of the
diseases.
• Maintaining Anthropometry chart by
every Pediatrician is needed in order to
know the nutritional status of each child.
• THANK YOU
