Parents’ Experience with Routine Infant Growth Monitoring

Abstract

Routine growth monitoring (RGM) is universally considered an integral part of pediatric primary care. While traditionally used to detect malnutrition, it is now primarily used to identify underlying causes of short stature and childhood obesity in developed countries.^1-3 Despite widespread use and assumptions that RGM is a safe, effective, low-cost screening intervention,² there is little evidence to support these beliefs. Several reviews have concluded that “there is insufficient reliable information to be confident about whether routine growth monitoring is of benefit to child health”^{1, 3-7} and others have raised concerns about the potential for associated harm.^{1, 2, 4-6, 8, 9} Studies have consistently shown that many parents and providers have difficulty interpreting growth charts which can lead to confusion, anxiety or inappropriate provider and parent responses.^9-11 Considerable time is dedicated to RGM for both parents and providers and it may displace other beneficial interventions. 

Most of the policy around RGM has been driven by providers, particularly specialist paediatric endocrinologists and dieticians, neither of whom generally perform RGM, with scarce attention paid to the important voices of parents. Although some studies on related issues (breastfeeding, obesity, comprehension of growth charts) have indirectly touched on the topic, a recent scoping review did not identify any previous qualitative studies that directly explored parents’ experiences of infant RGM9 in high-income settings. 

The objectives of this qualitative study were to better understand parents’ experiences with infant RGM with respect to: 1) potential benefits and harms, 2) comprehension and 3) self-reported behaviour change. 

Better understanding parents’ experiences may influence how front-line care providers perform RGM and communicate growth information. This could provide more evidence to evaluate the risks and benefits of RGM and lead to a more positive experience for parents.