Child Nutrition Assessment Scale

There is no "optimal scale" suitable for all scenarios, including the CHN method growth and development assessment scale adapted to the growth curve of Chinese children, the dietary intake frequency screening scale for children aged 0-6, and the micronutrient deficiency risk prediction scale. Different usage scenarios correspond to different tool selections.

Last week, I was outpatient at a community child care clinic. As soon as I sat down, I met a grandmother holding a 3-year-old boy. Her eyes were red as soon as she entered the door. She said that she saw a "Children's Nutrition Self-Assessment Scale" while browsing a short video the day before. After filling it out, it showed that the baby had "severe protein and energy deficiency." I was so scared that I didn't sleep all night, so I came to register with the baby in my arms. I measured the baby's height at 98cm and her weight at 15kg, both of which were at the 75th percentile for children of the same age. The standard couldn't be better. After careful questioning, I found out that the scale she used was the 2018 version of the European and American version. It used the growth benchmark for white children, which naturally does not match the values ​​of our Chinese babies.

To be honest, there are actually two different tendencies in the current academic circles' use of children's nutrition assessment scales. Some scholars insist on taking "hard growth data" as the only core, that is, only using scales such as the CHN method that only measure objective data such as height, weight, head circumference, and upper arm circumference, and completely exclude the content reported by parents. After all, if you ask parents "How many times did their children eat red meat last week?"

However, some doctors who are engaged in clinical child nutrition prefer multi-dimensional scales, and I am more accustomed to using this type of scale during my daily consultations. Last month, a 5-year-old girl came for a physical examination before entering the kindergarten. Her height and weight were all in the 50th percentile. There was no problem just by looking at the growth chart. However, when the parents filled out the dietary scale, they said that the child never eats dark green vegetables and cannot eat animal liver once a week. They also always say Her legs hurt and the corners of her mouth kept getting sore, so I asked her to get a blood test. Sure enough, her 25-hydroxyvitamin D was only 11ng/ml, her hemoglobin was just below the passing mark, and she was deficient in B vitamins. If we only looked at the growth data, these hidden nutritional problems would not be discovered at all.

Many parents think that the scale is a "standard answer" and the sky will fall if they get a low score after filling it out. In fact, it is not. I have encountered many parents who, when filling out the dietary scale, count the milk-containing drinks their children drink as pure milk and fruit-flavored drinks as fresh fruits. The filled-in values ​​look beautiful, but in fact the nutritional intake is quite different. If you fill it out like this, no matter how accurate the scale is, it will be useless. Just like when you test your baby's eyesight, and the baby secretly squints during the test, why do you still blame the eye chart for being inaccurate? The scale itself is an auxiliary tool. When filling it out, you must first understand the rules before it can be useful.

There is another controversial point that many people discuss: Can I use a scale to evaluate my baby at home? I think if you just want to get a rough idea of ​​the score, for example to see if your baby has eaten less vegetables recently and whether she has enough milk, filling it out for three to five days using the meal frequency scale officially released by the National Health Commission is much more reliable than guessing "Is my baby deficient in calcium" every day? ； But if you find that your child’s score is low after filling out the form, don’t just buy a bunch of supplements and give them to your child. I met a parent before who filled in the form and said that his child was iron deficient. After giving the child iron supplements for three months, the child was constipated and had anal fissures. When he came to the hospital, hemoglobin was found to be completely normal. However, when he filled in the form, he undercounted the amount of red meat the child ate by half, and he suffered for no reason.

After all, the Children's Nutrition Assessment Scale is neither a magic tool that can detect all kinds of diseases, nor is it a useless display. If you use it as a reference, combined with daily observation and professional judgment, it can help you avoid many parenting detours. ； If you treat it as a judgment and worry about the score, you might as well not use it. After all, raising a baby can only be done with a few gauges, right?