Do we need to measure everything?

Presenter’s Notes

“Do we need to measure everything?”

Purpose: “Do we need to measure everything?” • Provides an opportunity to talk about the worry that many parents have about their

baby’s growth. • Helps parents understand that growth is about more than weight gain and why growth

charts are used. • Provides information that normalizes variations in size and growth and how genetics and

environmental influences play a role in how baby grows.

Included in Kit: • “Do we need to measure everything?”presentation • Measuring Activity – (index cards included) This resource can be used as a nugget or mini topic within a Healthy Baby session.

Resources/handouts are available at the end of the Breastfeeding Activities binder.

Do we need to measure everything?

Ask participants:

How many of you have worried if your baby is gaining enough weight or worried that your baby is gaining too much?

• We humans do not trust our milk to provide for our young the way other mammals do.

• Our culture is very focused on being “the right size” and it starts right from when babies are born.

We all come in different sizes!

We all come in different sizes! Activity: To challenge our ideas about size and reinforce that there is no “perfect” or “ideal” size.

• Divide your participants into groups of 5-8 people.

• Each group will need: 3 index cards, a pen for writing, a paper measuring tape and an envelope.

• In their groups, have the participants guess who has the largest to smallest head without measuring. Each group will write their guess on the 1st index card and put it in the envelope.

• Now have groups measure their actual head size and list these from the largest to the smallest on the 2nd index card and place this in the envelope.

• Next, ask everyone in their groups to share what their shoe size is and list these on the 3rd index card from the largest to the smallest shoe size.

Ask groups to compare the estimated head size list to the actual measured head size list.

1. Are there any groups who listed all of them correctly on the estimate?

2. Are there any groups who listed the largest and the smallest correctly?

Ask groups to review the list of actual measured head size and shoe size.

1. Are there any groups for whom the lists are the same, the person with the largest head had the largest feet and the person with the smallest head had the smallest feet?

2. Ask the group if anyone had the largest head and smallest feet or the smallest head and largest feet?

Ask participants:

• What did this activity make you think about? Did anything surprise you?

• Did you expect that the tallest person would have the largest head and feet or the shortest person would have the smallest head and feet?

What’s average anyways?

Average Shoe Size (for Women)

Canada Size 6.5 (38.5)

United States Size 7 (39)

United Kingdom Size 7 (39)

China Size 5.5 (37.5)

What’s average anyways?

Did you know?

• In Canada, a female's average head size is 22 ½ inches and a female’s average shoe size is 6 ½.

Ask the groups:

• How many people on your group’s list, have the “average” sized head and feet?

Answer:

• It is unlikely than anyone will have both the average head and foot size as there is so much variation between individuals.

• Most of us, regardless of size and shape, fall within a range of normal. Our size does not affect our intelligence or our capabilities. Healthy people come in a range of sizes and shapes.

• Just like us, healthy babies come in all different sizes and will grow at different rates.

What affects our ideas about size ?

What affects our ideas about size? Ask Participants:

• How do you think we are affected by our culture’s obsession with body size and shape?

• Do we think that our babies need to be a certain weight and height to be healthy?

Did you know?

• Right after delivery it seems that everyone, especially parents, worry if their baby is gaining enough weight. Many parents want their baby to be on the upper end of weight gain and size.

• As babies grow, often this flips and then parents worry their baby is gaining too much.

Important:

• In most cases, we cannot control how our baby will grow, as babies are born with a preset growth pattern that is healthy for them.

• Altering feeding or other practices can interfere with baby’s natural growth patterns and may lead to health issues.

Consider this…

• Foot binding in Ancient China became popular as a means of displaying status. Women from wealthy families who did not need their feet to walk, as they had servants to carry them, could afford to have them bound in cloth at a young age. This binding changed their feet from what was a normal shape to the “ideal” foot length; 4 inches long regardless of the person’s size. This practice spread to all social classes as a symbol of beauty in Chinese culture.

• Loving, well meaning families would bind their daughter’s feet so they would be the “right size and shape” leaving their daughters with crippled painful feet.

Growth Charts

Growth Charts Over the years, height and weight measurements have been taken for a lot of children of different ages and different countries. These measurements have been put together in what is called a standard growth chart which tells doctors about how most babies/children grow. Why do we use growth charts?

• To track your child’s growth patterns because the way your baby grows provides information about their health.

What do the percentiles on the growth chart mean?

• If your baby’s weight or height is on the 50th percentile line, it means that out of 100 children the same age, 50 will be bigger and 50 will be smaller. Similarly, if your baby is in the 75th percentile, it means that out of 100 children the same age, your baby is bigger than 75 and smaller than 25.

• It is not realistic that all or most babies will fall on the 50th percentile line, which is considered the average. Remind participants from the earlier measuring activity, how few, if any, had both “average” head and feet.

• Percentiles are not like a test score. 97% is not better than 25%. Your baby’s growth pattern over time is more important than one single measurement.

• If your child is growing well, his head circumference, weight and length/height will follow (or “track”) along the same growth lines over time.

How often should your baby’s weight, length/height and head circumference be measured?

₋ Within 1-2 weeks of birth

₋ At 1, 2, 4, 6, 9, 12, 18 and 24 months

₋ Talk with your healthcare provider if you are having concerns about your baby’s growth.

Important:

• As long as your baby is growing at a steady rate, your baby is considered to have normal growth.

• Small fluctuations in growth are normal, so are growth spurts.

• Growth often reflects family growth patterns.

When is there a concern?

When is there a concern? In some instances, a baby’s growth pattern may move “far off” their percentile (steady growth pattern). Growing too fast or too slowly can be a sign of possible problems with health or nutrition.

Your health care provider will conduct a thorough assessment to look at possible causes:

• Hormones play a major role in growth but there may be other reasons that your baby/child may not grow normally.

• Failure to thrive. Some babies don't grow and gain weight normally after they're born. This is called failure to thrive (FTT). FTT may happen when a child simply doesn't get enough to eat. Some babies may have an illness that needs to be treated, but most will grow normally after they start eating enough food.

• Genetic conditions. Some genetic conditions can also cause children to not grow as they should. Some girls who are short may have Turner syndrome. This means they have one X chromosome instead of two, or that one of their X chromosomes is abnormal. Another genetic condition, Marfan syndrome, makes a person tall, with very long legs and arms.

• Chronic diseases. These include heart and kidney problems, cystic fibrosis, juvenile rheumatoid arthritis, and sickle cell anemia, which may slow growth in some cases.

Many of these growth disorders can be successfully treated.

I’m just right!

I’m just right!

• Being small or large at birth doesn't necessarily mean a baby will be small or large later in childhood or as an adult. Plenty of towering teenagers began life as small babies, and the biggest baby on the block can grow up to be a petite adult.

• By the time children are adults, children tend to resemble their parents in size. Many things affect a child’s growth: eating patterns, physical activity habits, environment and genetics.

• Whether your baby starts out large, small, or in between, you can expect your baby to keep growing fast, especially in the first few years.

• All children have a pattern of growth that is natural for them. Regular weight and length/height measurements over time will show your child’s own special growth pattern.

• Talk to your health care provider if you have concerns about your child’s growth.

“Do We Need to Measure Everything?”

has been developed and produced in partnership by

Healthy Child Manitoba Office and Youville Centre

For more information about your baby’s growth and development, contact your local health care provider or public health office.

The information in this presentation kit is not meant to replace physician advice.

Where Can I Get Help?

This kit was developed in February 2016 It is not intended as a handout for program participants

“Do We Need to Measure Everything?”

has been developed and produced in partnership by

Healthy Child Manitoba Office and Youville Centre

For more information about your baby’s growth and development, contact your local health care provider or public health office.

The information in this presentation kit is not meant to replace physician advice.

Where Can I Get Help?

This kit was developed in February 2016 It is not intended as a handout for program participants

References

• Promoting optimal monitoring of child growth in Canada: Using the new World Health Organization growth charts http://www.cps.ca/en/documents/position/child-growth-charts

• Is my child growing well? Questions and Answers for Parents

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865943/

• WHO Growth Charts – Dietitians of Canada, 2016

http://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspx

• "Your Source for Average Body Statistics“ - http://www.theaveragebody.com/

http://www.cps.ca/en/documents/position/child-growth-chartshttp://www.cps.ca/en/documents/position/child-growth-chartshttp://www.cps.ca/en/documents/position/child-growth-chartshttp://www.cps.ca/en/documents/position/child-growth-chartshttp://www.cps.ca/en/documents/position/child-growth-chartshttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865943/http://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts.aspxhttp://www.theaveragebody.com/