Health
Weigh babies during immunisation visits to monitor growth, paediatricians tell parents
Parents should ensure their babies are weighed regularly, especially during every immunisation visit and other hospital appointments to detect growth problems early and prevent severe malnutrition, developmental delays and underlying illnesses, child health experts have asserted.
The child health experts said regular growth monitoring is one of the simplest and most effective ways of assessing a child’s health, noting that poor weight gain or weight loss could be the first sign of malnutrition, infections, chronic diseases, feeding problems or other serious medical conditions.
In interviews with PUNCH Healthwise, they explained that beyond checking a baby’s weight, healthcare workers should also routinely measure length or height and head circumference, plot the findings on standard growth charts and explain the results to parents to enable them to actively participate in monitoring their children’s health.
The specialists further urged health workers to educate mothers on the importance of growth monitoring at every opportunity, stressing that parents have a right to know their babies’ weight after every assessment and understand what it means for their child’s growth and development.
According to the World Health Organisation, growth monitoring is a key component of child survival strategies because it helps detect growth faltering early and allows timely interventions before malnutrition becomes severe.
UNICEF also recommends regular growth monitoring during routine child health services, noting that the first two years of life represent a critical window for growth and brain development.
Commenting on the matter, a Consultant Paediatrician at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Dr Olufemi Akodu, said every immunisation visit presents an opportunity to assess not only whether a child is receiving vaccines on schedule but also whether the child is growing appropriately.
The public health physician explained that babies experience rapid growth during their first two years of life, making regular weighing essential for identifying problems early.
He said, “Every immunisation visit provides an opportunity to check not only whether a child is receiving vaccines on schedule but also whether the child is growing well. Regular weighing helps healthcare workers monitor the baby’s growth over time, identify problems early, and provide timely advice to parents.
“Since babies grow rapidly in the first two years of life, even small changes in weight can provide important information about their health and nutrition.”
The paediatric epidemiologist further stated that parents should not wait until a child becomes visibly ill before monitoring growth.
He further noted that regular growth monitoring confirms whether a baby is growing normally, detects poor weight gain or weight loss early, identifies malnutrition before it becomes severe and reveals illnesses that may interfere with normal growth.
Akodu said, “Regular growth monitoring is one of the simplest and most effective ways to ensure a child is healthy.
“It helps to confirm that the baby is growing normally, detect poor weight gain or weight loss early, identify malnutrition before it becomes severe, detect illnesses that may affect growth, assess whether feeding practices, including breastfeeding and complementary feeding, are adequate, monitor the effectiveness of nutritional or medical treatment, and prevent complications such as severe malnutrition, developmental delays, and increased risk of infections.
“When growth problems are identified early, they can usually be corrected more easily.”
Explaining how growth is monitored, the child health expert said healthcare workers assess several parameters rather than weight alone.
He stated, “Healthcare workers monitor growth by measuring and recording weight using a calibrated infant or child weighing scale, length or height depending on the child’s age, head circumference, especially during the first two years to assess brain growth, and mid-upper arm circumference in older infants and children when assessing nutritional status.
“These measurements are plotted on a growth chart, usually based on the World Health Organisation Child Growth Standards. The trend over time is more important than a single measurement, as it shows whether the child is growing appropriately.”
The consultant paediatrician warned that poor weight gain should never be ignored because it could indicate inadequate feeding, infections or chronic illnesses.
He said, “Poor weight gain or weight loss is a warning sign that requires attention. It may indicate inadequate breastfeeding or feeding, poor complementary feeding practices, frequent infections such as diarrhoea or pneumonia, intestinal worm infestation in older infants and children, underlying medical conditions such as heart disease, kidney disease or other chronic illnesses, and difficulty feeding due to oral or neurological problems.
“It does not always mean a child is seriously ill, but it should never be ignored. Early assessment allows healthcare workers to identify the cause and provide appropriate treatment.”
Akodu advised parents whose babies are not gaining weight appropriately to seek prompt medical evaluation rather than rely on home remedies.
He said, “Parents should visit a healthcare facility promptly for assessment, continue exclusive breastfeeding for the first six months where appropriate, continue breastfeeding alongside complementary feeding until at least two years, ensure complementary foods after six months are nutritious, diverse and age-appropriate, feed the child more frequently if advised, ensure immunisations are up to date, maintain good hygiene to reduce infections, follow the healthcare worker’s recommendations and return for follow-up growth monitoring.
“Parents should avoid self-medication or relying solely on home remedies without medical advice.”
He added that health workers should use every interaction with mothers to educate them about growth monitoring.
Akodu said, “Every contact with a mother or caregiver—including antenatal clinics, delivery, postnatal care, immunisation clinics and sick-child visits—should include education on growth monitoring.
“Healthcare workers should explain why regular weighing is important, how to interpret growth charts, appropriate feeding practices, and warning signs that require medical attention.
“Well-informed parents are more likely to recognise problems early and seek care promptly.”
He also maintained that mothers should always be informed of their babies’ weight after every assessment.
Akodu said, “Parents have a right to know their child’s health status. Informing mothers of their baby’s weight and explaining its meaning helps them understand whether their child is growing well, appreciate the importance of good nutrition and appropriate feeding, recognise early signs of growth problems, participate actively in decisions about their child’s health, and feel motivated to attend future clinic appointments for continued growth monitoring.
“When mothers understand their child’s growth pattern, they become active partners in protecting their child’s health rather than passive recipients of healthcare.”
Also speaking, a Consultant Paediatrician and child health advocate, Dr Ayodele Renner, said monitoring a child’s weight serves as both a nutritional assessment tool and an early screening method for serious illnesses.
He explained that poor growth could sometimes be the first sign of diseases such as tuberculosis, HIV, cancer, or leukaemia.
Renner said, “Apart from the fact that it’s an indicator of how well nourished the child is, it could also point to growth failure.
“Growth failure is not just about assessing nutritional factors. It is also possible for growth failure to be the manifestation of other conditions like cancer, infections, leukaemia, tuberculosis, chronic diarrhoea, and HIV.
“Sometimes, the only feature that a child with HIV might present with is growth failure. So, it’s almost like a screening tool as well, apart from the fact that it’s a monitoring tool.
“It is also important because it’s an early warning sign that there might be danger ahead. If a child comes to us and we notice that they’ve lost a little bit of weight, it’s always easier to identify what might be going on and intervene early rather than when the child has lost significant weight or has fallen completely off their growth trajectory.”
He explained that healthcare workers monitor children by measuring weight, length or height and head circumference.
The Noisynaijapaediatrician said, “Weight can indicate acute malnutrition, while a faltering of length or height might be a better indicator of chronic malnutrition. We also indirectly monitor brain growth by monitoring the head circumference.
“For each of those measurements, we try to do it twice or thrice and then find the average of the readings for better accuracy before documenting them for future reference.”
Renner noted that babies should not only be weighed during immunisation visits but during every hospital encounter.
He said, “Babies should actually be weighed on every hospital encounter, not just at immunisation days.
“Well-baby checks should not just be limited to immunisations because sometimes children stop their vaccinations at nine months, and we know that even up to two years, a lot of growth is still taking place.
“So, children under five years should still have periodic well-baby checks that are not necessarily tied to immunisation. Anytime a child presents in the hospital, that constitutes an opportunity to institute weight monitoring.”
The child health advocate also urged healthcare workers to always inform parents of their children’s measurements.
He added, “It is the right of the parent to know the weight of the child because they come for intervention, and they should know what is being done.
“It also motivates parents. When the healthcare worker says, ‘Your baby has gained weight adequately,’ and follows it with, ‘Well done, you’re doing a fantastic job,’ it encourages parents and reinforces positive childcare practices.”
Renner further called for routine monitoring of children’s height beyond infancy.
He said, “Height should actually be monitored at every single child visit because height can falter at any age.
“There are some children whose weight is perfectly fine, but their height is not adequate for their age.
“So, even if you cannot do it during busy immunisation clinics, when the child comes in contact with the healthcare system for any complaint, both the weight and height should be done and charted so that we can determine if there are any deviations from what’s expected.”
He encouraged parents to ensure their children undergo growth monitoring during every hospital visit.
“At every visit, have the weight and height done. Discuss with the healthcare professional if they are on the right trajectory.
“This helps detect abnormalities early, institute prompt interventions, and prevent complications in the future,” Renner said.
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