• Elle

Preparing for a pediatric telehealth appointment

Updated: Dec 28, 2020

As we peek into 2021 most of us are becoming more comfortable with online meetings of all types and in the world of health care online clinic visits are becoming commonplace. In regards to appointments with a dietitian there is one big drawback to meeting virtually and that is having record of accurate height and weight measurements. Monitoring growth is a a big part of what both pediatricians and dietitians do as a part of preventative care; this monitoring in the pediatric world is dependent on height and weight measurements. So, if you haven't been asked yet it is likely you will be asked to take measurements of your kiddo at home in the near future.

There are so many benefits to seeing a provider via telehealth but when monitoring children tracking accurate weights/heights can be compromised with online appointments. Data showing how a child is growing is so important!

Here is why: It is preferable to make recommendations based on data trends rather than single points. For this reason it is important not to skip data tracking on a regular basis.

Read data tracking, interpret height and weight measurements. (wink, wink)

* the age and medical history of your child will help determine the appropriate frequency of tracking their height/weight, ask your provider what intervals they recommend for your child

Here are some tips and tricks to getting accurate measurements at home

General Guidelines:

- Your child should be weighed around the same time of day and in the same each time. Amount of time between each measurement should be determined by your pediatrician and/or dietitian.

- Especially with older children it is important we do not weigh them too much. While your provider having this information is important we want to encourage a culture of body positivity as to not perpetuate diet culture in children. We can be inadvertently sending the wrong message when the caregiver is weighing themselves frequently OR when a caregiver is asking a child to get on the scale frequently.

- If your child is being treated for an eating disorder please do not measure your child's height or weight at home nor have scales and tape measures accessible unless their treatment team has instructed you to do so.

For children up to 18 months

· Measure naked or in clean, dry diaper

· Record weight to nearest 0.01 kg or 0.02lbs

For children over 18 months

· Measure in minimal clothing (underclothes, pajamas, or other lightweight clothing; and no shoes)

· Record weight to nearest 0.1 kg or 0.2lbs

Measuring Height

Standing Method

1. Remove shoes, hat or hair accessories. Make sure their hairstyle does not interfere with the measurements (ex. a braid or a high ponytail)

2. Take the measurement on a flat surface, preferably one that is not carpeted. Use a wall with no baseboard, so they can get their heels as close to the wall as possible.

3. Have the child stand up against the wall on flat feet with feet positioned together. The child’s head, shoulders, buttocks, and heels should be making contact with the wall. (this may require you to correct their posture) Make sure legs are straight and shoulders are level. They should be looking straight ahead with their chin parallel to the floor.

4. Place a flat object (like a ruler, hardcover book, or cereal box) level on top of the child’s head to form a right angle with the wall. Lower the flat object it until it rests gently on top of your child’s head, keeping it at a right angle to the wall.

5. Lightly mark the wall with a pencil at the point where the flat object meets your child’s head. Placing a sticky note at that location is a great hack to keep from marking up your wall.

6. Have the child step away from the wall and use a tape measure to measure from the floor to the marked area on the wall.

7. Record the length in log to the nearest 0.1 centimeters or nearest 0.25 inches

Laying Down Method

When a child is laying measuring length often requires two people to get an accurate measurement.

1. Remove shoes, hat or hair accessories. Make sure their hairstyle does not interfere with the measurements (ex. a braid or a high ponytail)

2. Lay child down on a flat surface, like a changing table or on your bed.

3. Gently stretch out the baby’s legs to get a more accurate measurement. (bonus point if there is a wall they can rest their flexed feet on)

3. Use a flexible measuring tape to measure the child from the top of the head to the bottom of the heel.

4. Record the length in log to the nearest 0.1 centimeters or nearest 0.25 inches.

*If the baby moves around too much, you can also use a sheet of paper to help get a more accurate measurement. Place the baby on top of the paper and make a mark where the head is and at the bottom of the heel. Then move the baby and measure the length between the two markings you made.

*With a squirmy infant or one who will not straighten his or her leg completely, an accurate height may be difficult to measure. Consider taking the measurement twice and getting an average length between the two. (if you are unsure how to calculate an average just report both numbers to your provider)

I have found great success with the transition to telehealth and have been working with some wonderful parents well versed in using the above methods. Have any other questions about how to prepare for a telehealth nutrition appointment? Feel free to reach out anytime!

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