Routine growth measurements of infant and children in primary health care are important to monitor if young children are growing appropriately.  While concerns have typically been around inadequate growth, evidence shows that rapid or too much weight gain in the first two years of life increases the risks of developing overweight and metabolic diseases in later childhood.

Primary healthcare professionals are trusted clinicians that families go to make sure their infants and children are growing well. Hence it is important that they can confidently advise parents when unhealthy growth (under or over) or feeding practices are identified.  To understand current practices around growth monitoring in children under two years old in primary healthcare, and gaps in health professionals’ knowledge and skills, we scoped and reviewed the current evidence.

We found that infant height and weight were the most common measures of growth monitoring.  However, these measures were less frequently plotted on growth charts to monitor growth changes over time or to identify children who might be at risk of being affected by overweight or obesity.  Regular measurements of height and weight also decreased as infants became older.

Of concern were primary health care professionals who were reluctant to address unhealthy weight gain for infants under two years old, believing that excessive weight would self-resolve as infant height increased, or excessive weight not being an issue until a child was school-aged, or fearing that raising sensitive issues with parents would lead to service non-attendance.

The study findings suggest that there is a need to enhance primary healthcare professionals’ capabilities in identifying unhealthy weight gain and provide behaviour change counselling support to help parents implement strategies to promote healthy infant/child growth.

The full paper can be accessed here: Rossiter C, Cheng H, Denney-Wilson E. Primary healthcare professionals’ role in monitoring infant growth: A scoping review. Journal of Child Health Care. 2023;0(0). doi:10.1177/13674935231165897

What’s next?

Connecting the Dots for Healthy Beginnings is a partnership between our researchers in Sydney Local Health District and Karitane.  Together, they are looking to develop professional development resources for primary health clinicians to support parents with strategies to promote healthy growth in early life.  See here for past and upcoming webinars.   Researchers want to hear from primary healthcare professionals around Australia working with young children about your current practices, views, and training needs.  Please consider participating in this survey.

This work supports the work in CRE EPOCH-Translate Stream 3 to integrate early childhood obesity prevention interventions as part of routine services.