Head and Chest circumference

Lesson 2 : Assessment of Nutritional Status- Nutritional anthropometry

Head and Chest circumference

Head circumference
Head size relates mainly to the size of brain, which increases quite rapidly during infancy. The chest in a normally nourished child grows faster than head during the second and third year of life. As a result, the chest circumference over takes head circumference by about one year of age. In protein energy malnutrition due to poor growth of chest, the head circumference may remain to be higher than the chest even at the age of 2½ to 3 years. Brain size vary with nutritional status. Head circumference is slightly affected in the second year of life. This helps as an additional guide in the age assessment.

Chest circumference
Use of this measurement is important in the second and perhaps third year of life. This is because the circumference of the head and the chest are about the same at six months of age. After this, the skull grows slowly and the chest more rapidly. Therefore between the ages of six months and five years, a chest/head circumference ratio of less than one may be due to failure to develop or to a wasting of the muscle and fat of the chest wall and can be used as community indicator of protein energy malnutrition of early childhood. The chest circumference is taken at the nipple level preferably in mid inspiration waist-Hip circumference ratio.

Equipment and Technique
A narrow flexible, non-stretch tape, made of steel or preferably fiber glass should be used. The child’s head should be steadied and the greatest circumference measured by placing the tape firmly round the frontal bones just superior to the supra-orbital ridges, passing it round the head at the same level on each side and laying it over the maximum occipital prominence at the back. Measurement should be made to the nearest 0.1cm. The chest circumference is taken at the nipple level preferably in mid inspiration.

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Last modified: Tuesday, 29 November 2011, 9:50 AM