Gaining and Growing: Assuring Nutritional Care of Preterm Infants in the Community


Growth is a "predictable attribute of healthy children." (See AAP Pediatric Nutrition Handbook)

 Indicators of Growth Problems


Accurate and frequent assessment of growth is one of the most valuable tools in the care of preterm infants in the community. Inadequate growth indicates a need for further assessment and follow-up. Nevertheless, families report that health professionals do not always utilize growth assessment fully. Procedures for accurate measurement of height, weight, and head circumference have been established. If procedures are not carefully followed, the assessment will not be valid. Please see section on anthropometric measurements.

Growth is usually assessed by following the infant on a growth chart. Incremental growth velocity is also a useful tool, especially when assessment of growth is done very frequently and/or when the infant "falls off" standard growth charts.

Another potentially useful tool for infants with growth parameters that are below the growth charts is the calculation of z-scores. Sequential measurements and calculations of z-scores provide an indication of direction of growth parameters toward the norm as well as an indication of growth velocity. Free software for calculations of z-scores and other growth assessment parameters may be downloaded as part of the EpiInfo package from CDC and are often standard on EMR software.

Quick Check for the Health Professional

Indicators of Growth Problems

Further nutrition assessment is warranted when:

Criteria for referral for further evaluation (Adapted from Stice):

Up to 3 months

20 grams per day

3-6 months

15 grams per day

6-9 months

10 grams per day

9-12 months

6 grams per day

Up to 3 months

0.5 cm/week

3-6 months

0.25 cm/week

Nutrition Assessment: Growth Homepage
Gaining and Growing Homepage
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Page reviewed: March 24, 2015