Ask

 

Routinely assessing the growth of children is an important part of good quality clinical care but raising the issue of a child’s growth and weight status can be challenging and sensitive.

Asking the child, parent/carer for consent before measuring their height and weight is an important first step.

​On thi​s page

Ask the child, parent or carer if you can measure their child’s height/length and weight ​

“Before we start today, would you mind if we checked how you are growing?”

It is important to explain to the child, parent or carer why growth assessments are being taken.

“Monitoring a child’s height and weight is really important. Just assessing them by looking at them is not enough.”

“I routinely measure height and weight and plot BMI on a growth chart for all children. It helps me to identify any health concerns early and determines the type of support I can provide my patients and their families.”

Once you have parental and child consent it is important to talk to the child throughout the measurements. You may like to use phrases like:

“Let’s see how you are growing today"

What to say if a parent refuses

If you sense strong resistance, stay positive, acknowledge this, and move onto their reason for presentation.

“It’s ok if you prefer we don’t record height and weight today. Perhaps next time. If you change your mind, your GP or any health professional is happy to talk to you about how you/your child is growing.”

“All NSW Health facilities are working towards routinely measuring children’s height and weight, so you might be asked again at your next appointment or by another health professional.”

Measure the child’s height and weight accurately​

​​​​​​​​Children aged over 2

    1. The child should stand barefoot, with heels together, legs straight and shoulders relaxed.
    2. Heels, buttocks and, if possible, scapulae should be against the wall.
    3. Position the headboard on the child’s head and check that the child is looking straight ahead, with the lower margins of their eyes in the same horizontal plane as their ear canal.
    4. Tell the child to ‘breathe in and stand tall’. Apply gentle but firm pressure to help the child stretch. Ensure the heels are not lifted from the ground. Tell the child to ‘breathe out and relax’ while the measurer maintains pressure on the head.
    5. Read the height to the last complete millimetre (do not round up!) Read from the same height as the top of the head.
    6. Plot the height measurement on the standard centile chart of height for age and sex and include in the child’s medical record.

    If required, ask another staff member or the parent for assistance to ensure the child stands in the correct position.

    1. Only light clothing should be worn. Remove shoes, socks and heavy clothing such as a coat, jacket, or jumper, and ensure pockets are empty.
    2. Turn the scale on and wait until it displays zero.
    3. Ask the child to stand on the middle of the scale, look straight ahead and stand still.
    4. Check the child is not holding onto a wall or table; and arms are at their side.
    5. Wait until the scale settles at a reading and record weight to the nearest 100g (0.1kg).
    6. If able, measure height and use both measurements to calculate BMI, plot on the relevant BMI-for-age chart and include in the child’s electronic medical record.

    Equipment

    • The scale should weigh up to 200kg in 100g (0.1kg) increments.
    • Scales should have a stable weighing platform, which is large enough to support the child.
    • Place the scale on a stable, non-carpeted surface.
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Children aged under 2

  • Length measurement is appropriate for most children under 2 years, and old if unable to stand.

    1. Lay child with their head against the headboard, and feet flat on the footboard, with their shoes and socks removed.
    2. Gently bring the top of the child’s head into contact with the fixed headboard. The child should be looking straight up.
    3. Hold the child’s knees and feet so they are together and flat against the board.
    4. Apply firm pressure to the child’s feet and knees. The child’s feet should be at right angles to the base of the board.
    5. Apply firm pressure to the child’s feet and knees. The child’s feet should be at right angles to the base of the board.
    6. Plot the length measurement on the relevant chart and include in the child’s medical record.

    Measuring may require two people to ensure correct measurement.

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    1. To collect bare weight, ensure the child is undressed with the nappy removed.
    2. Place a sheet/paper towel on the scale.
    3. Turn the scale on and wait until it displays zero.
    4. Place the child in the centre of the scale and ensure that weight is evenly distributed.
    5. Wait until the scale settles at a reading and record weight to the nearest 5g (0.005 kg).
    6. Plot the weight measurement on the relevant weight-for-age chart and enter into the child’s electronic medical record. If able, measure length and plot on the relevant chart and enter into the child’s record.
    ​

    Equipment

    • The scale should weigh up to 20kg, in 5g (0.005kg) increments.
    • Place the scale on a stable, non-carpeted surface.
    • If using a trolley, check the scale is not touching the edges of the trolley

​​​For children over 2 enter the child’s height and weight into the children’s BMI calculator

This calculator is a tool to help health professionals assess healthy growth and development in children. It is not a full assessment. All results need to be discussed with a health professional who knows the child and their family.

/heal/child/wellbeing/Pages/body-mass-index-calculator.aspx BMI calc​ulator

For children over 2 plot the child's height and weight on either the girl or boy growth chart

Growth charts are visual representations used to track the changes in a child's length or height, weight, and head circumference as they grow. Using growth chart, health professionals can assess healthy growth and development in children.

The growth chart will show which percentile the child sits in: 

  • Below a healthy weight (<5th percentile) 
  • A healthy weight (5th to <85th percentile) 
  • Above a healthy weight (85th to <95 percentile) 
  • Well above a healthy weight (95th percentile and above) 

 

For children aged under 2​​, height, weight and head circumference can be mapped via the growth charts in the Guideline’s appendices.

Assessing children's growth videos

Nurse's ​experience

 
Transcript: Nurse's ​experience
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Parent's experience

 
Transcript: Parent's experience
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​Allied health professional's experience

 
Transcript: All​ied health professional's experience
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Current as at: Monday 17 February 2025
Contact page owner: Centre for Population Health