Infant growth monitoring

The value of growth monitoring in infants is discussed at length in an important review by Ashworth et al (2008) Maternal & Child Nutrition vol 4 pp 86-117
The rationale for growth monitoring and promotion is almost self evident, but is it?. The concerns are based on low participation rates, poor health worker performance and inadequacies in health systems minimizing what can be done to alleviate the
The launch of the new World Health Organization growth standard and charts has reopened the debate. Growth monitoring programmes should improve nutritional status, increase utilization of health services and reductions in mortality.
There is evidence from small-scale studies in Nigeria, Jamaica, India, and from large programmes in Tanzania India , Madagascar and Senegal that children whose growth is monitored and whose mothers receive nutrition and health education and have access to basic child health services have a better nutritional status and/or survival than children who do not. There is evidence from India and Bangladesh that growth monitoring has little or no effect on nutritional status in large-scale programmes unless there is good nutrition counselling.
The programme should be
Where possible chart weights at birth, immunization (6, 10, 14 weeks and 9 months), vitamin A distribution and sick-child visits. Follow up and counsel any
Child whose weight is faltering and those with a weight-for-age Combine growth monitoring with other health intervention channels such as immunization for the convenience of caregivers, and ensure consistent message delivery. Target younger children and use the time gained to improve services. Monitor weight until 12 months of age. If there are ,episodes of growth faltering, continue to monitor until 18 months. ‘Training, supervision and support will need to be improved if health workers are .to be equipped with the necessary knowledge and communication skills to i promote healthy growth. Impact will be related to coverage, intensity of contact, -health worker performance, adequacy of resources and the ability and motivation of families to follow advice.
Ann Ashworth, Roger Shrimpton, Kazi Jamil (2008) Growth monitoring and i promotion: review of evidence of impact Maternal & Child Nutrition 4 (si) , 86-117

Martin Eastwood
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