Preparing for a telephone appointment

Part One: Keeping track of growth

The way the world works has changed so rapidly in recent months. Remote working has become a reality and even the NHS is starting to embrace this. Many Doctors appointments are now taking place by telephone, or video consultation. This presents some challenges, especially for children and young people and we are going to do a series of blogs looking at how to make the best of this.

If you have ever had to take a child to hospital, you will know that we always weigh and measure your child – this is so that we can track his or her growth. A child who is not growing as they should is a worry to us, but a happily growing child can be very reassuring. We cannot do this over the phone, so we are relying increasingly on parents to weigh and measure their own children. Here is our guide on obtaining accurate measurements at home for your child:

Weighing – you can use normal ‘bathroom’ scales for any age of child. If they can stand, you just weigh them as you would an adult. For younger children, who cannot stand, we use the ‘subtraction method’. An adult holds the child as they stand on the scale, note the weight, and then re-weigh themselves without the child. Just subtract the smaller number from the bigger one and you have the child’s weight. Try to weigh the child in lightweight clothes or just underwear for the most accurate measurement. Weight should be in kilograms, if possible to save us having to convert it! You can buy smaller ‘baby scales’ where the baby can lie in the scale – this may be more accurate for little ones under a year of age, but don’t invest unless you think you will get some good use out of it as this phase passes so quickly!

Height – this is only really accurate for children who are standing independently. Below this age, it is so tricky for anyone to get an accurate length measurement! Find a bit of spare wall in your house with a level floor – our kitchen doorpost serves well for us. Ask the child to stand, with their feet flat on the floor, back to the wall, and look straight ahead. Use a hardback book, balanced on their heads to mark the height on the wall or doorpost. The child can then step away and you use a measure (ours comes from the DIY drawer!) to measure the height. Please do this in centimetres!

Head circumference – we sometimes ask parents to measure this. It is notoriously tricky to do, and often takes a few attempts to get right. We need to know the widest part of the head. Use a piece of non-stretchy string or ribbon, and measure around the head. The string or ribbon needs to sit just above the ears, just above the eyebrows and around the widest bit at the back of the head, called the occiput. I often tell children that this is where their crown will sit! You then place the string along a ruler or tape measure to find out the measurement. Again, this should be in centimetres, ideally to one decimal place eg: 49.1cm…. this is a really difficult measurement to get right and often, a second pair of hands is needed!

It is so helpful to do this in advance of a telephone or video consultation and really helps us to track your child’s progress and discuss ongoing decisions about their health with you. We are all learning how to make this work as well as possible.

What have you found helps with remote medical appointments?

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