childhood obesity
Open Book on Growth
Call for national strategy to chart child growth and combat obesity
A national strategy is needed to measurements and over 90 per cent aid designed to support the current
improve the monitoring of child
of those surveyed felt there should be Government and WHO strategy of
growth, because excessive weight
a national standard governing child monitoring early growth to ensure
gain in early life is an indicator of
measurement procedures. that every child’s health and nutri-
the risk of obesity in later life, spe-
Most worrying was the fact that tional needs are met, that every child
cialists urged In July at the launch
48 percent did not feel confident in is given the best possible start in life
of a new educational initiative on
calculating and assessing children’s and that early signs of disease such
charting child growth and devel-
BMI, the key diagnostic indicator for as faltering growth and obesity are
opment.
overweight and obesity. This concurs detected.
Speaking in London at the launch
with an online survey (3) of over 1,000 Issues covered include:
of Open Book on Growth, several
parents conducted by the Mumsnet • the importance of monitoring and
eminent specialists in child health and
website. Only six percent of the par- assessing post-natal growth
ents said their child’s BMI had been
nutrition called for a clearer under-
• what measurements to take
calculated between the ages of one
standing and more coherent strategy
• how to measure children of differ-
to three. In fact, parents seemed to
for monitoring the growth of toddlers
ent ages
be more anxious about their children
between the ages of one and three.
• when to seek medical advice
being underweight than overweight.
Together with guidelines on charting
• how to advise parents
‘Over 20 percent of two-to-three
child growth and development this
• the tools necessary to monitor and
year olds in the UK are currently
could help the Government achieve
assess child growth.
overweight,’ said Atul Singhal, deputy
its stated ambition to reduce child-

director at the MRC Childhood Nutri-
hood obesity and thereby become
Open Book on Growth is available
tion Research Centre at the Institute
‘the first major country to reverse the
free to all health and childcare pro-
of Child Health in London. ‘Over ten
rising tide of obesity and overweight
fessionals. Register at
percent are obese. Many of these
in the population’.(1)
www.infantandtoddlerforum.org
children will go on to become obese
Overweight and obesity in children
adults and suffer serious health
is diagnosed using body mass index

consequences such as heart disease
References:
(BMI) which can only be calculated
and diabetes. If we are serious about
1. Health weight, healthy lives: a cross-government strat-
after measurement of the child’s
egy for England. DoH January 2008.
halting the obesity epidemic then we 2. Survey of 160 health visitors and nurses in England and
weight and height. Growth measure-
must identify those at risk as early as
Scotland carried out by the Infant &Toddler Forum and
ments are therefore essential to iden-
www.healthvisitors.com. Results showed that:
possible and that means taking regu- • 94% routinely measured children’s weight
tify those children who are gaining
lar and accurate measurements of
• 71% routinely measured children’s height
weight too quickly.
• 62% used professional judgement to decide when
height, weight and BMI, right the way
to take measurements
Regular measurements of growth
through childhood.’
• 92% agreed there was a need for national standards
during the toddler years can also help
on child growth measurement
‘Regular measurements of child
• 19% had no formal training in child growth measure-
identify developmental problems
growth are absolutely essential,
ment
such as feeding problems, faltering
not only for the individual child but
• 46% said they were very confident in using growth
growth, food intolerance and aller-
charts
also for our overall understanding
• 50% said their confidence in using growth charts
gies. Yet there is currently little na-
of obesity and overweight,’ agreed
varied according to circumstances
tional guidance on when and how
• 48% said they were not confident in calculating a
Dr Pauline Emmett, senior research child’s BMI and assessing if they were overweight or
the growth of young children should
fellow at the University of Bristol. ‘The
obese
be measured. Children are routinely
3. Online survey of 1,091 parents carried out in April 2008
only reason we know that the BMI of by Mumsnet.com and the Infant &Toddler Forum. Key
weighed and measured during the
today’s children is higher than it was
findings were:
first year of life and then again when
• 63% didn’t have concerns about their child’s growth
30 years ago is that we have been
- of those with concerns, 51% were about the child
they go to school. However, this
taking those measurements. But it is
not gaining enough weight
leaves a two to three year window
• Child’s weight recorded 7.3 times under one; 3.4
high time there was a standardised
times when aged 1-3 years
when measurements may be con-
procedure.’
• Child’s height recorded 3.9 times under one; 2.3 times
ducted haphazardly or not at all.
‘Surveys of health visitors have
when aged 1-3 years
• 72% say checks done as part of routine assessment
Health and childcare professionals
shown there is an urgent need for
• 6% cent say BMI calculated between ages of 1-3
clearly need more guidance on mea-
information and training on the mea-
years
• 69% asked health professionals for advice on diet/
suring and charting growth during this
surement of child growth. Open Book growth (mainly health visitors); 40% asked friends; 33%
key period.
on Growth fills this need by providing
consulted parenting websites; 25% used specialist
publications. 13% had no advice.
A recent survey (2) of health visi-
evidence-based guidance and prac- The Infant & Toddler Forum
tors, school and community nurses
tical tools that health and childcare
• The Infant & Toddler Forum is a multi-disciplinary
who carry out growth measurements
team of experts and practitioners who share a com-
professionals can use to improve their
mon professional interest in infant and child health,
revealed that most use their profes-
day to day practice,’ said Dr Robert
growth and nutrition
sional judgement rather than follow
• Its aim is to improve the access of healthcare
Coombs, consultant neonatologist,
professionals to reliable, evidence-based information
any policy guidelines when decid-
Sheffield Teaching Hospitals.
relevant to their practice, which will equip them to
ing which children to measure, what
advise and support the parents of infants and young
children
measurements to take and how Produced by the Infant & Toddler • The Forum is supported by an educational grant from
often. One in five had had no for- Forum, the Open Book on Growth
Nutricia Ltd
• The views and outputs of the Forum are independent
mal training on taking child growth is an online and interactive training of Nutricia and its commercial interests.
28 NHDmag.com Aug/Sep ‘08 - issue 37
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