Parent perceptions of routine growth monitoring: A scoping review

Abstract

Background Despite being a well-accepted part of paediatric care, little is known about the benefits or potential harms of routine growth monitoring (RGM) from a parent’s perspective. Objective To explore parental experiences with RGM. Methods Literature searches were performed on Google Scholar, psycINFO, CINAHL, and PubMed. Included studies were published after 2000 and described parental comprehension, preferences, attitudes toward, and/or behaviour change related to RGM. Results Of 24 reviewed studies, four themes were identified: reliance on growth monitoring, understanding, influence on feeding and behaviour, and response to obesity-related classification. RGM was familiar but not strongly preferred to identify a child’s weight status. Parental understanding of RGM was poor, particularly among parents with low socioeconomic status. A common belief was that heavier babies were healthier, while smaller babies should prompt concern. Parents may be anxious and change behaviour in response to RGM, such as by halting breastfeeding, supplementing, or restricting their child’s diet. Parents frequently discounted RGM information when their child was identified as overweight, and expressed concerns about self-esteem and eating disorders. Conclusion This scoping review identifies that although RGM is familiar and sometimes reassuring to parents, increased consideration should be given to potential harms from parental perspectives when conducting growth monitoring.

Moving Toward Remote, Parent-Reported Measurements in Pediatric Anthropometrics for Research and Practice

“…Moreover, if a child or infant has a disease that impacts their motor function or attention span, measurement may be greatly hindered, especially for those parents who are not trained in the proper measurement procedures. Parents are deeply invested in their infant's growth, often citing actual numbers for weight and length to friends and family as a proxy for their child's health ( 14 , 15 ). Thus, it is expected that parental interest and participation in learning and utilizing remote methods will be high.…”

The care of infants with rapid weight gain: Should we be doing more?

“…Such interventions could possibly be considered inappropriate or stigmatising by some families. In at least one study, mothers have expressed the viewpoint that infancy is too early to intervene to prevent obesity 48 while other work has identified a ‘common belief’ among parents that heavier babies are healthier 49 . Thus, there is a need to consider whether structured interventions with a goal of reducing later childhood obesity are necessary for infants with RWG, or whether it would be more appropriate to provide them and their families with specific care which is aimed at supporting the infant's overall health and well‐being and which may or may not have a secondary effect of helping prevent later overweight or obesity.…”

Screening tools used in primary health care settings to identify health behaviours in children (birth–16 years); A systematic review of their effectiveness, feasibility and acceptability

“…[16][17][18] Further, practitioners have difficulty plotting and interpreting growth charts to inform practice, resulting in potentially inappropriate or ill-informed advice 19 while caregivers are often not receptive to weight-focussed conversations. [20][21][22] Growth monitoring also provides little guidance on what health behaviours the child and family might require support with. Given these limitations with current growth monitoring practice, there is opportunity to utilise measures of diet quality, physical activity, sedentary behaviours and sleep habits as modifiable health behaviours that influence child growth and key risk factors for non-communicable disease in later life.…”

“…However, several international systematic reviews have found a lack of high‐level evidence to support the effectiveness of routine growth monitoring as a screening tool in practice, and its benefit on child health 16–18 . Further, practitioners have difficulty plotting and interpreting growth charts to inform practice, resulting in potentially inappropriate or ill‐informed advice 19 while caregivers are often not receptive to weight‐focussed conversations 20–22 . Growth monitoring also provides little guidance on what health behaviours the child and family might require support with.…”