Newborn Measurement guide

Growth Measurements (Weight – Length – Head Circumference)

Purpose:
To assess the appropriateness of weight, length, and head circumference in relation to the neonate’s gestational age, as well as to monitor normal growth and detect any changes.

Work Procedures

First: Neonatal Weight Measurement

• Weight is measured upon admission to the Neonatal Intensive Care Unit (NICU), then measured daily at a fixed time, preferably before feeding.

Equipment:

• Neonatal scale
• Clean towel
• Clean sheet
• Large cotton piece
• 70% ethyl alcohol
• Waste bin with red bag

Steps:

• Perform routine hand hygiene.
• Clean the scale using cotton soaked with alcohol.
• Place a cotton towel on the scale to prevent the neonate from feeling cold.
• Zero the scale to eliminate the weight of the sheet.
• Remove the diaper and any clothing, wrap the neonate in a clean sheet, and carry the neonate toward the scale (if the scale is fixed), or move the scale next to the incubator or crib (if movable).
• Gently place the neonate on the scale.
• Keep the hand close to the neonate without touching.
• Record the accurate weight reading.
• Return the neonate to the crib and reapply the diaper or clothing worn prior to weighing.
• Clean the scale after use and return it to its place.
• Perform routine hand hygiene.
• Document the weight in the neonate’s chart and inform the physician of any significant weight changes.

Note:
The normal birth weight for full-term neonates ranges from 2700 to 3850 grams.

Important Points When Measuring Neonatal Weight:

• Ensure the scale is zeroed.
• Place the scale on a stable, horizontal surface.
• Ensure the neonate is calm, with feet not touching any surface.
• Weigh the neonate once daily at a fixed morning time before feeding.
• If the admission weight is less than 1000 g, weight is measured twice daily (morning and evening).
• Record the weight accurately in the neonate’s chart and growth chart.
• Never leave the neonate unattended on the scale; return immediately to the crib.
• Reweigh if there is a significant discrepancy from the previous measurement and notify the physician of any major changes.

Second: Head Circumference Measurement

• Measured upon admission to the NICU, then weekly on a fixed day (e.g., every Saturday).
• In cases of intracranial hemorrhage, hydrocephalus, or birth asphyxia, head circumference is measured daily.

Equipment:

• Measuring tape
• Cotton pieces moistened with 70% ethyl alcohol
• Waste bin with red bag

Steps:

• Perform routine hand hygiene.
• Disinfect the measuring tape using an alcohol swab.
• Measure the head circumference starting from the most prominent occipital point, passing above the auricles, to the midpoint of the forehead (1 cm above the eyebrows).
• Disinfect the measuring tape after use and return it to its place.
• Perform routine hand hygiene.
• Document the head circumference in the neonate’s chart and inform the physician of any significant changes.

Note:
Normal head circumference for a full-term neonate ranges from 33 to 37 cm.

Third: Length Measurement

• Measured upon admission to the NICU, then weekly on a fixed day (e.g., every Saturday).

Equipment:

• Measuring tape or graduated measuring board
• Cotton pieces moistened with 70% ethyl alcohol
• Clean towel
• Waste bin with red bag

Steps:

• Perform routine hand hygiene.
• Place a cotton towel on the measuring board to prevent cold exposure.
• Place the neonate supine with the body fully extended.
• Position the head straight and perpendicular to the fixed headboard, centered properly.
• Ensure the head, back, thighs, and heels are in contact with the measuring surface without bending.
• Ensure the feet are perpendicular and resting firmly against the movable footboard.
• If a measuring board is unavailable, measure length using a measuring tape following the same steps, after disinfecting the tape with alcohol.
• Disinfect the measuring tape after use and return it to its place.
• Perform routine hand hygiene.
• Document the length in the neonate’s chart.

Note:
Normal neonatal length generally ranges between 47.5 and 53.5 cm.

Responsible:

• Nursing staff.