1.1 Years 0–2

The body grows more rapidly in the first six months of life after birth than at any other time. Healthy newborns will double their birthweight by the time they are 4–5 months old and triple it by their first birthday. The average weight gain throughout this period is 6.6 kg and the gain in length/height is 25 cm. By 2 years most healthy toddlers are approximately half their adult height. The average gain in height between 1–2 years is 12 cm and between 2–3 years it is 8 cm but there is no routine measurement taken during this time. In terms of weight gain, between 1–2 years it is around 2.4 kg (5 lbs) and between 2–3 years it is 2 kg. In the UK, children are routinely weighed at around 12 months and again during their review between 2–2.5 years.

You will now look at the role of health professionals in supporting the growth of babies and very young children.

The role of the midwife in ensuring good antenatal care and in monitoring the progress of mother and baby up to ten days after birth is important to recognise. If all is going well, the Health Visitor takes over the care of mother and baby at this time.

Listen to Audio 1 in which Julia, a Health Visitor, tells you why certain measurements are usually taken from babies at birth, during their 6–8-week check, then again at their 9–12-month review. She also explains the relevance of the Personal Child Health Record that in England is also known as the ‘red book’ or ‘e-redbook’.

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Transcript: Audio 1

JULIA:

Hello, I'm Julia. As a health visitor, I really believe in the importance of good antenatal preparation to make sure all parents feel supported and know how to access the relevant information to help them through the birth of their baby and into parenthood.

Before birth, the midwife monitors the baby's growth and measurements are taken of the growing baby during antenatal scans. And these let us know how the baby is developing and growing. The midwife then hands over care of the mother and the baby to the health visitor, who will arrange to visit the family between the tenth and fourteenth day after the birth.

Health visitors deliver the Healthy Child Programme from birth to 5 years. And every family is offered five contacts in the first three years, with the aim of ensuring every child reaches their full potential. The transition to parenthood can be challenging at times, as babies come with no instructions. Every family is given a parent held, child health record red book, which is an important source of information, as well as a way of recording your child's health and development in the first five years. It contains a range of information, including child health birth details and local information about services and support, also evidence-based information and advice on how to identify when your child is ill and advice on infant feeding and top tips for breastfeeding, also safer sleep, perinatal mental health of the parents, and advice on getting help for domestic abuse.

It covers immunisations and vaccinations and what to expect, how to care for your child after them, and screening and routine reviews, a newborn checklist for parents to notice if the child can see and hear, and details of the newborn hearing screening, which is usually in the first week of life. Also, the 6 to 8 week review, the 9 to 12 month review, and the 2 to 2 and a half year integrated review, and details about the school health service.

Reviews should include age appropriate advice on general development, including movement, speech, social skills, and behaviour, encouraging good sleeping habits, hearing and vision, growth, healthy eating, and portion sizes, care of teeth and going to the dentist, and keeping your child safe from accidents while keeping active. There's also a section for parents to record your child's firsts, as in their first smile, first word, first sat alone, fed themselves, crawled.

At the back of the book, you'll find the growth centile charts that can track the child's growth. The weight, length, and head circumference measurements are usually taken from all babies at birth. Premature babies born before 37 weeks of pregnancy or particularly large or small babies will be carefully monitored.

In relation to this course, why and how growth charts are used is an important issue to discuss with parents. They are developed from data from thousands of children to offer a guide to monitor growth. Whichever growth line a child is born on will indicate the expected progress throughout that first year and then up to 18 years. The weight, height, and head circumference measurements should roughly follow on a parallel to a printed centile line.

If a family are concerned about a child's growth, do talk to your health visitor or GP, or ring the health visitor helpline of your local team. Health visitors have a unique opportunity to encourage every parent to help their child from birth onwards to support healthy growth and development.

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