Promoting breastfeeding and supporting introduction of healthy first foods

In all children, routine assessment of length/height, and weight should be completed at all health checks, child health nurse visits or GP consults.  Track these on growth charts and compare to previous assessments.  Identify rapid or inconsistent changes in growth patterns and changes in centile ranks (weight-for-length for age <2 years and BMI-for-age > 2 years).

Completing these assessment at every visit helps to normalise these as part of routine care, and provides an opportunitiy to discuss health growth with the family in a non-stigmatising way, regardless of where a child sits on a growth trajectory.

Using percentile charts to monitor change

Healthy growth in children (age 0-18 years old) can only be assessed properly using age- and sex- specific reference values, as the appropriate ratio of weight to height varies during development. Measuring growth should always be contextualised to a child’s clinical condition and be conducted in conjunction with clinical, developmental, psychosocial and behavioural assessment.

• For children 0-2 years, use WHO growth charts (calculate weight, length and weight for length for age) Using the BMI-for-age growth chart is not recommended for children younger than age 2 years.
• For children 2-18 years, use CDC growth charts** (calculate BMI-for-age, weight and height for age.^[5]
• Link to Growth Charts

**Queensland Health use WHO chart for children 0-2 years and CDC growth charts for children 2-18 years of age.

Advise, assist and empower families.

It is important to advise families of the importance of a healthy growth trajectory rather than a one-off assessment. Work with families to create SMART goals that they feel are achievable and sustainable, and which are more likely to become habits.

Healthy eating:

The Australian Breastfeeding Association resources provides support and education for families for breastfeeding from pregnancy through to 12 months and beyond.

Babies first food provides support for families in introducing their baby to food.

Physical Activity

The Australian 24-hour Movement Guidelines from birth to five years includes recommendations for incorporating physical activity and minimising sedentary behaviour in a 24-hour period as well as recommendations for sleep.

Further resources below can be used to educate and advise families to adopt healthy behaviour changes that will help them work towards achieving their health goals:

When supporting families with infant and early years growth, it is important to arrange follow-up appointments to continue to measure and monitor infant feeding and support.

Up-to-date information about the assessment and management of a range of conditions can be found on HealthPathways. HealthPathways is delivered across Queensland thanks to the support of Clinical Excellence Queensland, and you can find your local HealthPathways website here.

Programs and resources listed below may help facilitate health behaviour change for families, or provide additional support or management where appropriate:

Health professionals providing childhood services (e.g. health workers, medical, nursing, practice nurse and allied health professionals) can upskill in best-practice prevention, treatment and management of children with overweight or obesity and their families to provide specialist care, locally.

Our ECHO® Learning Series ‘Healthy Kids’ focuses on supporting professionals to deliver best-practice care to the families in their communities. The series provides mentoring, evidence-based advice, and support to professionals who consult with children and young people who may have overweight or obesity, so they can deliver care with empathy, confidence and success.

Healthy eating:

Queensland health Establishing Breastfeeding Clinical Guideline which provides information on supporting and encouraging breastfeeding.

The Infant Feeding Guidelines outlining breastfeeding, transition to solid food and nutrition guidelines from birth to two.

Physical Activity

The Australian Physical Activity and exercise guidelines from birth to five years includes recommendations for amount and type of activity.

Further clinical guidelines which may assist clinicians supporting the prevention, early intervention and management of overweight and obesity in early years are included below: