Holt International's Child Nutrition Program is designed to standardize child growth screening
protocols to ensure that children are growing to their full potential.
An important part of this process is anthropometric measurements, which refers to the way that
children are measured and includes measurements like height and weight.
This video will demonstrate the proper procedures for measuring the mid-upper arm circumference
of a child.
The routine assessment of a child's growth provides an important guide to a child's health,
development, nutritional status, and response to treatment or nutrition interventions.
Mid-upper arm circumference, or MUAC, is a fundamental measurement for tracking a child's
growth and malnutrition risk for children from six months to five years old.
Measurement Technique
The tools you will need to measure mid-upper arm circumference include a mid-upper arm
circumference tape, a pin, and a MUAC growth chart.
You will need a mid-upper arm circumference tape to measure a child's MUAC.
We measure mid-upper arm circumference for children ages six months to five years, and
children with disabilities of all ages.
It is very important to take this measurement quickly and accurately while using the appropriate
tools.
A cloth measuring tape is not appropriate.
It requires two caregivers to measure a child.
Before you begin, ensure that one caregiver is assigned to the role of assistant, and
the other caregiver is assigned to the role of lead.
The person measuring the child must first wash their hands.
Ensure the MUAC tape is sanitized to avoid the spread of illness.
Start by removing any bulky coats, long sleeves, or other clothing that covers the left arm.
If possible, the child should stand up straight or be held by a caregiver in an upright position.
Bend the child's left arm at a 90-degree angle to the body.
Place the MUAC tape window at the bump on the top of the shoulder and measure to the
elbow.
Divide the number in half to find the midpoint of the upper arm.
The midpoint is between the tip of the shoulder and the elbow.
Use a pin to mark the mid-upper arm point using your free hand.
Remember to keep the child's arm at 90 degrees.
Keep your top hand planted over the bump when marking the midpoint.
Some MUAC tapes have a viewing window and a slit.
Feed the tape through the small slit in the tape.
Read the measurement in the viewing window.
Ensure the MUAC tape window is placed over the midpoint pin mark and is not removed until
the MUAC measurement is recorded.
Always keep one hand gripping both the MUAC tape and the child's arm.
Pull the tape so it is snug against the child's arm, but not so tight that the skin around
the tape bulges.
Call the number out aloud and record immediately to the nearest decimal point.
Remember, always look for bends or kinks in the MUAC tape before every use.
A bent tape will not provide accurate results and should be replaced.
Always measure MUAC on the child's left arm.
Do not estimate the midpoint of the upper arm.
Measure the midpoint from the tip of the shoulder to the elbow bend.
Avoid pulling the MUAC tape so tight that the skin around the tape bulges.
Avoid not pulling the MUAC tape tight enough, which will create a falsely large reading.
Always ensure you read and record the tape accurately to the nearest millimeter.
Always use the same technique every time.
Sanitize the tape before measuring, between children, and after measuring.
Documentation
A single measurement does not reflect the rate of growth.
In order to establish a child's growth trends, the child's measurements must be routinely
made and plotted on a growth chart.
Measurements should be immediately recorded into the nutrition screening system.
The nutrition screening system form should be completed within the same day as the child's
measurements.
In order to complete the nutrition screening system action plan, growth charts must be
consistently plotted and interpreted.
This measurement must be recorded in the child's record in the nutrition screening system database,
and must include the date and name of the measurer, and plotted on a MUAC for age growth chart.
There is one growth chart that uses a child's MUAC.
Mid-upper arm circumference, or MUAC for age, reflects body fat stored relative to the
chronological age of the child, and can help identify acute malnutrition.
Each child should have their own set of growth charts that track their overall progress.
Refer to these charts when determining the child's overall health status.
Watch the growth chart training video to learn more about proper growth chart plotting and
chart interpretation.
You may also review the Child Nutrition Training Manual or corresponding Child Nutrition Training
Modules.
Tracking children's growth consistently and accurately is one of the best preventative
methods for combating malnutrition early in a child's life.
This is just one of five critical indicators of a child's growth and development.
Please review Holt's other Child Nutrition Training videos.
