COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX00044300 ■~> n- t Columbia (Bntoergttp mti)e(£ttptf:tog CHILD HEALTH ORGANIZATION ACTING WITH THE NATIONAL CHILD LABOR COMMITTEE, Inc. HEALTH IN EDUCATION EDUCATION IN HEALTH EXECUTIVE COMMITTEE Dr. L. EMMETT HOLT, Chairman Dr. VICTOR G. HEISER V. EVERIT MACY, Treasurer Mrs. FREDERICK PETERSON Dr. SAMUEL McC. HAMILL Dr. BERNARD SACHS Mrs. JOHN COLLIER Mrs. FRANK A. VANDERLIP Dr. GODFREY R. PISEK Dr. THOMAS D. WOOD STAFF OWEN R. LOVEJOY, Secretary EDWARD N. CLOPPER, Assistant Secretary SALLY LUCAS JEAN, Director of Field Work GENERAL COMMITTEE Dr. L. EMMETT LEO ARNSTEIN, New York Dr. S. JOSEPHINE BAKER, New York Mrs. CHARLES A. BEARD, New York Dr. HERMANN M. BIGGS, New York Mrs. ELMER BLAIR, New York Dh. HENRY DWIGHT CHAPIN, New York JOHN COLLIER, New York Mrs. JOHN COLLIER, New York Dr. JOHN DEWEY, New York Dr. CHARLES W. ELIOT, Cambridge Dr. WILLIAM R. P. EMERSON. Boston JOHN FARWELL, Chicago Dr. JOHN H. FINLEY, Albany Dr. SIMON FLEXNER, New York Mrs. BRYANT B. GLENNY, Buffalo Dr. ROYAL S. HAYNES, New York Dr. VICTOR G. HEISER, New York Dr. SAMUEL McCUNE LINDSAY, New York Judge ROBERT S. LOVETT, Washington Dr. SAMUEL McC. HAMILL. Philadelphia HENRY McDONALD, New York Mrs. P. V. PENNYBACKER, Austin, Texas. HOLT, Chairman Dr. FREDERICK PETERSON, New York Mrs. FREDERICK PETERSON. New York Dr. GODFREY R. PISEK, New York Mrs. WILLIAM A. READ, New York Dr. MARY SCHWARTZ ROSE, New York Rev. JOHN A. RYAN, Washington Dr. BERNARD SACHS, New York Dr. EDWARD F. SANDERSON, New York MORTIMER L. SCHIFF, New York Dr. ALBERT SHIELS, Los Angeles Dr. CHARLES HENDEE SMITH, New York Mrs. VICTOR SORCHAN, New York JOHN SPARGO. New York Mrs. WILLARD D. STRAIGHT, New York Mrs. LINA ROGERS STRUTHERS, New York Dr. M. CAREY THOMAS, Bryn Mawr Mrs. FRANK A. VANDERLIP, New York Dr. WILLIAM H. WELCH, Baltimore Dr. RAY L. WILBUR, San Francisco WILLIAM WIRT, Gary, Ind. Mrs. IRA COUCH WOOD, Chicago Dr. THOMAS D. WOOD. New York 289 FOURTH AVENUE NEW YORK o J* 1 iff .4 few cent fcrpe line tacked against the ivall, a book and a pair of scales are the only necessary equipment STANDARDS OF NUTRITION AND GROWTH THE chief standards by which nutrition and growth are estimated are three: 1. The relation of weight to height. 2. The annual gain in weight and height. 3. The general appearance of the child. Children should be weighed and measured without shoes and in only the usual indoor clothes; boys should remove their coats. All school children should be weighed at least every three months, at the beginning and end of the school year and twice between; Sep- tember, December, March and June are the best months. Those who are much below the normal should be weighed at least once every month; better, every week. The height should be taken twice a year, at six months' interval; September and March are the best months. The record of the child's weight and height should be kept through- out his school life. It should be made a part of his school record and should accompany him from one grade to another or when he is trans- ferred from one school to another. The weight for the age and the height for the age show such wide variations in different races, communities and families that neither of these can be taken as a guide to the state of the child's nutrition. The relation of weight to height is the only one which is of value in determining this condition. This relation is but little affected by race or country, it being nearly the same in the average American and the short Japanese boy. The averages for American school children are given in the follow- ing tables, prepared by Dr. Thomas D. Wood: COPYRIGHT, 1918, CHILD HEALTH OBGANIZATION , .,___ _ HEIGHT AND WEIGHT TABLE FOR BOYS The standard or normal weight for a boy is found where the hori- zontal column opposite his height crosses the vertical column under his age* . Illustration — The standard weight for a boy 57 inches high and 13 years old is 83 pounds. Height Inches 5 Yrs. 6 Yrs. 7 Yrs. 8 Yrs. 9 Yrs. 10 Yrs. n Yrs. 12 Yrs. 13 Yrs. 14 Yrs. 15 Yrs. 16 Yrs. 17 Yrs. 18 Yrs. 39 35 40 37 38 41 39 40 42 41 42 43 43 44 44 44 45 45 46 45 47 47 48 46 49 50 50 47 48 49 51 53 52 54 55 52 55 56 57 50 58 59 59 51 60 61 69, 69, 52 53 54 55 56 64 67 70 65 68 71 74 77 65 68 71 75 79 68 72 76 79 76 80 51 58 59 60 61 81 84 82 85 88 90 83 87 89 92 97 84 88 91 94 99 92 95 100 101 62 100 102 104 105 63 104 106 108 109 110 64 65 66 112 118 113 119 123 115 121 124 117 122 125 120 123 127 61 125 126 127 131 68 130 131 133 136 69 70 71 72 134 136 136 140 142 139 143 145 * Note — The age is taken at the nearest birthday. HEIGHT AND WEIGHT TABLE FOR GIRLS The standard or normal weight for a girl is found where the hori- zontal column opposite her height crosses the vertical column under her age. Illustration — The standard weight for a girl 50 inches high and 9 years old is 59 pounds. Height 5 6 7 8 9 10 n 12 13 14 15 16 17 18 Inches \rs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. Yrs. 39 34 40 35 37 41 39 39 42 41 42 42 43 43 44 44 44 45 46 46 45 47 47 47 46 48 49 50 47 50 51 53 48 52 53 55 57 54 5Q 59 57 60 49 50 51 61 62 63 59, 65 66 68 67 68 69 53 54 70 71 71 55 72 73 74 5Q 76 77 77 79 51 79 85 82 88 85 93 96 58 59 92 97 99 104 95 99 102 105 100 103 105 107 105 107 109 111 109 111 113 60 61 62 116 63 107 110 113 115 117 64 114 117 121 119 123 121 65 125 Only scales with bar and weights should be purchased for school use. Spring scales with dial face are not very durable and are likely to get out of order soon. Measurements for height should be taken with the child standing with feet close together and close against the measuring rod, or for school use a measuring tape may be tacked against a wall and a book placed on the child's head, edgewise, to mark his height. A special measuring rod is made by Hammacher, Schlemmer & Co., 133 Fourth Ave., New York ANNUAL GAIN IN WEIGHT AND HEIGHT While the relation of weight to height is significant as a starting point to determine a child's condition as regards nutrition, his rate of gain in weight and height is even more important as showing his progress. In health}'' children growth in height and gain in weight go on together and usually at the same rate. In neither of these is the increase uniform or continuous for long periods of time. There are seen with nearly all children periods of a few months in which growth and gain in weight are more rapid, followed by months in which both are slower. Gain in weight is usually more rapid in the fall and spring months; less rapid in winter and mid-summer. Chil- dren who are much below normal weight usually gain rapidly when the cause of the low weight can be removed. Average Annual Gain in Weight and Height Boys Girls Age Weight Height Age Weight Height 5— 6 4 It >s. 2 in. 5— 6 sy lbs. 2 in. 6— 7 4 2 " 6— 7 4 2 7— 8 4^ ' 2 " 7— 8 &A ' 2 ' 8— 9 5 2 " 8— 9 5 1% ' 9—10 6 2 " 9—10 &X ' 2K ' 10—11 5 i*A " 10—11 «H ' 2 ' 11—12 VA ' i% " 11—12 »M ' m ' 12—13 8 2 " 12—13 wy 2 ' 2 ' 13—14 10 2M " 13—14 W 2 ' 2 14—15 12 2M " 14—15 Wz ' iK ' 15—16 14 2K " 15—16 6 % ' 16—17 6K ' W2 " 16—17 sy 2 ' X ' 17—18 5 *A " 17—18 X " X " Approximate Monthly Gain in Weight Boys Girls Age Gain Age Gain 5 to 8 years 8 to 12 " 13 to 16 " 16 to 18 " 6 ounces 8 " 16 " 8 " 5 to 8 years 8 to 11 " 11 to 14 " 14 to 16 " 16 to 18 " 6 ounces 8 " 12 " 8 " 4 " Weight variations. — Variations in the annual rate of gain of a pound or a pound and a half on either side of the average, are common in healthy boys between the ages of five and twelve years; and varia- tions of three or four pounds on either side of the average are common from the thirteenth to the sixteenth year. Girls gain at the same rate as boys up to the age of ten years, during the next year they gain more rapidly and pass the boys, remaining ahead until about fifteen years old when the boys overtake and pass them permanently. Height variations. — Variations in the annual gain of healthy boys up to the fourteenth year are seldom more than half an inch above or below the average, and from the fourteenth to the seventeenth year seldom more than one inch over or below the average. Variations in girls are seldom more than half an inch above or below the average at any age, being greatest in the thirteenth and fourteenth years. Height is much less affected by undernourishment than is weight. Too rapid growth may in itself even be a cause of undernourishment. A child whose annual gain in weight is much below the average given in the tables is not in a normal condition as regards his nutri- tion and the cause of this should be carefully investigated. A child may be considered undernourished whose weight for his height is 10 per cent or more below the average given in the tables. There are some exceptions to this general rule. Certain children (this group is not a large one) may be stunted in growth by conditions which also affect weight, so that the relation of weight to height is normal, although the child is much below the standard in both. The general appearance of the child is much less significant than his weight and height in determining his nutrition; but when taken in connection with weight and height and when the observations are made by an experienced person, the general appearance gives valuable information. The child's face tells much; whether his expression shows keen interest, with bright eyes, red lips and plump and rosy cheeks; or whether his expression is dull and listless, with thin, pale cheeks and dark rings about the eyes. All the latter indicate under- nourishment, fatigue, exhaustion or actual illness. If the clothing is removed to the waist, not only can round shoulders and narrow chests be readily discovered but also the general nutrition of the body estimated by simple inspection. It is customary to record the nutrition as, I., excellent; II., fair; III., distinctly below par; IV., very bad. Children may very well be graded in this way, their rating changing from time to time with their progress . Observations made upon the child's general appearance as an indication of his nutrition are more valuable when made by a school doctor or a school nurse, but much information can be obtained from the observations of the teacher alone. The Story of the CHILD HEALTH ORGANIZATION told in Four Paragraphs I PURPOSE Health standards of American children are being lowered. Mulnutrition, tuber- culosis and lessened resistance to disease generally are a price of the world war. Disastrous results of our past neglect in matters of health education were revealed in the examinations of the selective draft. Our future guardians of democracy must be safeguarded in health. To do this is the purpose of the Child Health Organization. II PLAN TO TEACH health habits to children, and to secure adequate health examinations and health records for all children in the public schools of the country. TO CONSIDER the urgent jproblem of malnutrition among school children. TO SAFEGUARD the health of children in industry. TO COOPERATE with other bodies in securing an enlightened public opinion and legislation in these matters. Ill LITERATURE The following material has been prepared. Other publications are under way. 1. Weight Card — Showing proper rela- strong while eating Mr. Hoover's kind tion between weight and height for boys of lunches. Free. and girls from five to eighteen. $1.00 5 Tag _ VseA in we i g hing contests, to per 100. carry facts into the children's homes. 2. Class Room Record — A method of in- $1.00 per 100. c5 r 5 A 1 ° ftn re 6. Standards of Nutrition and Growth. $3.00 per 100. g centg a CQpy 3. Teachers' Service Booklet — Facts „ „ „ . . „. about malnutrition, and ways of com- 7 - How to Conduct a Nutrition Class. 10 bating it in the classroom. Free. cents per copy. 4. Demonstration Pamphlet — A report 8. The Diet of School Children. 10 cents about twenty-five Food Scouts who grew per copy. IV SERVICE The Child Health Organization will be glad, if expenses are paid, to furnish a speaker, look over the field in your community and make suggestions for local work, furnish literature at cost, and to help you in every way along the lines here indicated. A communication from you expressing your views and position will be welcome. CHILD HEALTH ORGANIZATION 289 FOURTH AVENUE, NEW YORK COLUMBIA UNIVERSITY LIBRARIES This book is due on the date indicated below, or at the expiration of a definite period after the date of borrowing, as provided by the library rules or by special arrangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED Cifc 747; MIOO Child health organization of Amer- ica . Standards of nutrition and growth