The annual conduct of Operation Timbang (OPT) Plus will not be complete without the “Plus”, which is the height or length taking. Fundamental steps and matters to consider in weight taking were already tackled in one of our published articles entitled OPT Plus 101: measurement using hanging type weighing scale. This time, the focus is on the know-hows of height and length taking.

Height is what we get when a child is measured in a standing position. This is usually done to children aged two years old and above. On the other hand, the length is the measurement we get when a child is measured while lying down. Length is taken among children below two years old and to those children who are not able to stand upright.

Height or length measurement is very important. This has been an integral part of the OPT Plus since 2012 by virtue of the NNC Governing Board Resolution No. 2, series of 2012. Height or length measurement has been included in the OPT Plus as the combination of the child’s height and weight measurements aid best in determining the child’s nutritional status. By taking height or length, one will know the child’s height or length for age status (stunted, normal, or tall) and weight for height or length status (wasted, normal, or overweight).

In taking the child’s height/length, appropriate measurement tools must be used. Suggested measuring tools for length and height taking are infantometer and vertical height board or stadiometer, respectively. 

It is just as important to follow appropriate procedures in measuring height or length. Get the accurate length and height data by reading the step by step procedure below:

Length Measurement

In doing length measurement, the child is measured while in a lying position. This should be accomplished by at least two people along with the child’s mother or caregiver to keep the child calm and relaxed while being measured. To make the child comfortable, a thin cloth can be placed attached to the board. Remove the child’s shoes, head or hair ornaments, and lower garments (including the diaper, if possible) as this can contribute to inaccurate measurement.

Measurement Procedures:

1. Inform the mother/caregiver about the conduct of length measurement and why it is conducted.

2. Put the measuring board on a flat and stable surface. 

3. Place the child lying in the middle of the measuring board.

4. The assistant and measurer should kneel on both ends of the measuring board.

5. The assistant must hold the sides of the child’s head, making sure that it firmly touches the fixed headboard with the child’s hair flattened.

6. Ensure that the child’s line of sight is at the right angle to the measuring board. (90 degrees). The child’s eyes should be looking straight up.

7. Measurer will hold the child’s legs and stretch them gently while keeping one hand on the knees to avoid bending.

8. After positioning the child’s legs, the measurer will push the sliding footplate until it touches firmly to the child’s soles.

9. Measurer will read the measurement at 90 degrees angle to the axis of the board vertically.

10. Child’s length is read and recorded to the nearest 0.1 centimeters or 1 millimeter.

Height Measurement

Measurer and another person to provide assistance while taking the child’s height can do this measurement. Remove the child’s socks or footwear and any head or hair ornaments that may result in an inaccurate measurement.

Measurement Procedures:

1. Explain to the mother/caregiver the conduct and purpose of height measurement.

2. Place the vertical height board on a level surface, and if possible, against a wall.

3. Let the child stand in an upright position. Make sure that the back of the head, shoulder blades, buttocks, calves, and heels touch the vertical board.

4. Keep the child’s legs and feet flat by holding his/her knees and ankles and prevent him/her from standing on his/her toes.

5. Position the head and instruct the child to look straight ahead to make sure that his/her sight is perpendicular to the ground.

6. Put thumb and forefinger over the child’s chin, keeping the head in an upright position.

7. Using the other hand, pull down the movable headpiece and ensure it firmly touches the child’s head, making sure it pushes through his/her hair. 

8. After securing that the child is in the right position, the child’s height is read at eye level and recorded to the nearest 0.1 centimeters or 1 millimeter. 

The Philippines is still in a pandemic situation. One way to increase the country’s resiliency is ensuring good health and proper nutrition. To prevent the spread of COVID-19 while conducting OPT Plus, health workers, mothers, caregivers, children and all that are involved in this activity must strictly follow the minimum health standards required by the Department of Health such as social distancing, wearing of face mask and face shield, frequent disinfection of the materials used, among others. This way, we can ensure both the health workers’ and the children’s safety while ensuring the quality of the height and length data being gathered through this annual activity. (PNC Stephanie C. Barrio)

References:

National Nutrition Council Governing Board (12 January 2012). NNC governing Board Resolution No. 2, Series of 2012 (File 2 of 2). National Nutrition Council. https://www.nnc.gov.ph/index.php/downloads/file/643-nnc-governing-board-resolution-no-2-series-of-2012-file-2-of-2.html

Inter-agency Technical Working Group on Child Growth Standards (2012 January 12). Implementing Guidelines on Operation Timbang Plus (OPT+). National Nutrition Council. https://www.nnc.gov.ph/phocadownloadpap/userupload/elavapie/OPT%20Plus%20Guidelines.pdf

World Health Organization Department of Nutrition for Health and Development (2008). Training Course on Child Growth Assessment WHO Child Growth Standards. https://www.who.int/childgrowth/training/module_b_measuring_growth.pdf