Anthropometry Skills

1. Place the weighing scale on a flat hard surface.

2. Check and adjust the reading on the scale to zero.

3. Instruct the patient to remove footwear and any extra clothing like a shawl, jacket etc.

4. Instruct the patient to put one foot on each side of the scale.

5. Ask the patient to stand still, look straight ahead and place arms on the side.

6. Read the measurement to the nearest 0.1 Kg by kneeling down on the side of the patient.

1. Place the baby pan weighing scale on a flat hard surface.

2. Check and adjust the reading on the scale to zero.

3. Instruct the mother to remove any extra clothing like a shawl, jacket etc. of the baby.

4. Place a sterile towel or paper on the pan to reduce the chances of hypothermia and cross infection.

5. Ask the mother to place the baby on the centre of the pan.

6. Record the weight to the nearest 100 gms after the baby tray is settled with the child and the weight indicator reading is stable.

1. Place the weighing scale on a flat hard surface.

2. Check and adjust the reading on the scale to zero.

3. Instruct the mother to remove her footwear and any extra clothing like a shawl, jacket etc.

4. Instruct the mother to put one foot on each side of the scale.

5. Ask the mother to stand still, look straight ahead and place arms on the side.

6. Record the weight of the mother to the nearest measurement by kneeling down on the side of the mother

7. Ask the mother to step down.

8. Check and adjust the reading on the scale to zero.

9. Instruct the mother to remove any extra clothing like a shawl, jacket etc. of the baby.

10. Instruct the mother to stand on the weighing scale carrying the baby in her arms by putting one foot on each side of the scale.

11. Ask the mother to stand still, look straight ahead.

12. Record the weight of the mother and baby, once the baby becomes still, to the nearest measurement by kneeling down on the side of the patient.

13. Now subtract the first reading ( mother’s weight) from the second reading (mother-baby weight) to get the baby’s weight.

1. Identify a correct spot for the adult to stand on (exactly below the point where stadiometer has been fixed on the wall).

2. Instruct the adult to remove footwear and cap/hat.

3. Help the person to stand on the floor with feet slightly apart. The back of the head, shoulder blades, buttocks, calves, and heels should all touch the wall.

4. Position the person’s head so that a horizontal line from the ear canal to the lower border of the eye socket runs parallel to the baseboard.

5. Keep the head in position with one hand by holding the bridge between thumb and forefinger over the chin.

6. Use other hand to pull down the headboard of stadiometer to rest firmly on top of the head and compress the hair.

7. Read the measurement in centimetres to the last completed 0.1 cm.

1. Identify a correct spot for the child to stand on (exactly below the point where stadiometer has been fixed on the wall).

2. Instruct the mother to remove footwear and cap/hat of the child.

3. Help the child to stand on the floor with feet slightly apart.

4. Kneel down to position the child’s head so that a horizontal line from the ear canal to the lower border of the eye socket runs parallel to the baseboard.

5. Ask the mother to kneel down to apply gentle pressure on the knees so as to straighten them.

6. Ensure that the back of the head, shoulder blades, buttocks, calves, and heels all touch the wall.

7. Keep the head in position with one hand by holding the bridge between thumb and forefinger over the chin.

8. Ask assistant to pull down the headboard to rest firmly on top of the head and compress the hair.

9. Read the measurement in centimetres to the last completed 0.1 cm. 

1. Infantometer is placed on a flat, hard, even surface. 

2. Instruct the mother/informant to remove extra outer clothes like shawl, jacket etc. and footwear like booties and socks and any head covering.

3. Push the foot end of the board outwards, so as to make enough space for the child to be accommodated.

4. Ask the mother to place the child on the infantometer board.

5. Check that the head touches the base of the board.

6. Position the child’s head so that an imaginary vertical line from the ear canal to the lower border of the eye socket is perpendicular to the board. (The child’s eyes should be looking straight up).

7. Apply gentle pressure to the knees to straighten the legs as far as they can go without causing injury.

8. Move the foot end of the infantometer board so as to touch the child's feet.

9. Check that the soles of the feet are flat against the footboard, toes pointing upwards and the knees are straightened and head in position before noting down the reading.

10. Record the reading to the nearest millimeter from the markings/calibration on the board. 

1. Ask the mother to remove any clothing that may cover the child’s left arm.

2. Instruct the mother to ensure that the child stands erect with feet together and the left arm flexed 90 degrees at the elbow with the palm facing up.

3. Stand behind the child being examined.

4. Locate and mark the uppermost edge of the posterior border of the acromion process of the scapula.

5. Hold the zero end of the measuring tape at this mark and extend the tape down the posterior surface of the arm to the tip of the olecranon process (the bony part of the mid-elbow)

6. Keep the tape in position, and locate half the distance from the acromion to the olecranon processes, i.e., the midpoint of the upper arm. With the cosmetic pencil, mark (+) at the midpoint on the posterior of the arm.

7. Instruct the mother to ensure that the child stands erect with feet together and the left hand extended at the elbow and hanging freely at the sides.

8. Stand behind the child’s left side and bend/mould the MUAC tape with numbers upright into a circular shape by inserting the green end of the tip of the tape from the last distal opening present at the other end, from down to up direction. This tip is again reinserted into the middle opening and again inserted into first proximal opening to form a bangle.

9. Place this bangle shaped measuring tape correctly around the left upper arm at the marked point perpendicular to the long axis of the upper arm.

10. Inspect the tension of the tape on the child’s arm. Make sure the tape has the proper tension and is not too tight or too loose.

11. Record the MUAC to the nearest 0.1 cm. 

1. Ask the person to remove footwear.

2. Ask the person to stand with both feet together and arms slightly apart at the sides.

3. Stand behind the right side of the person and palpates the hip area for the right iliac crest.

4. Mark a horizontal line at the highest point of the iliac crest. Ask the patient to place his index finger at this point in case marking is not done on the body.

5. Stand behind the person and palpate for the lower margin of the last palpable rib at midaxillary line. Ask the patient to place his thumb at this point in case marking is not done on the body.

6. Mark an approximate midpoint between lower margin of the palpable rib and the highest point of iliac crest. Place your finger at this point in case marking is not done on the body.

7. Stand on the person’s right side and place the zero end of the measuring tape around the trunk in a horizontal plane at this level marked on the right side of the trunk.

8. Ensure that both feet are together and arms are by the side of patient with the weight evenly distributed.

9. Walk around and encircle the person to make sure that the tape is parallel to the floor and that the tape is snug, but does not compress the skin.

10. Read the waist circumference to the nearest centimetre, with the zero end of the tape being held below the measurement value

1. Ask the person to remove footwear.

2. Ask the person to stand straight with feet together, arms by the side and weight evenly distributed on both feet.

3. Stand on the right side of the patient and place the measuring tape around the buttocks at the maximum extension of the buttocks.

4. Adjust the sides of the tape and check the front and sides so that the plane of the tape is horizontal and exactly parallel to the floor.

5. Ensure that tape is held snug but not tight.

6. The measurement is taken with the zero end of the tape being held below the measurement value.

7. Take the measurement from the right side and record it to the nearest centimeter. 

Body Mass Index = Weight in kg  divided by (height in metres square)

Body Mass Index can be used to classify nutritional status into categories - underweight, normal, overweight and obesity.

As per WHO Standards

1. Underweight - BMI <18.5

2. Normal -  BMI 18.5 – 24.9

3. Overweight - BMI 25 to 29.9

4. Obese - BMI  30 and above

As per Indian Standards

1. Underweight - BMI <18.5

2. Normal -  BMI 18.5 – 22.9

3. Overweight - BMI 23 to 24.9

4. Obese - BMI  25 and above

As per WHO Standards, the following cut-off is used to identify individuals at high risk

Males  - More than 101 cm (40 inches)  

Females - More than 89 cms (35 inches) 

As per Indian Standards, the following cut-off is used to identify individuals at high risk

Males  - More than 90 cm (36 inches)   

Females - More than 80 cms (32 inches) 

The following cut-off is used to identify MALES at risk

Low risk - 0.95 or less 

Moderate risk - 0.96 to 1.0

High risk - >1

The following cut-off is used to identify FEMALES at risk

Low risk - 0.80 or less 

Moderate risk - 0.81 to 0.85 

High risk - >0.85