They said parents should ensure their children are weighed not only during immunisation appointments but also whenever they visit a healthcare facility, describing growth monitoring as one of the most effective tools for assessing a child's overall health and nutritional status.
According to the specialists, monitoring a child's growth goes beyond recording body weight. They explained that healthcare workers should also measure a child's length or height, head circumference and, where necessary, mid-upper arm circumference before plotting the results on standard growth charts to determine whether the child is developing appropriately.
They further emphasised that parents should always be informed of their children's measurements and understand what the results mean, noting that informed caregivers are more likely to identify potential health concerns early and seek timely medical attention.
The call aligns with recommendations by the World Health Organisation, which identifies growth monitoring as a critical component of child survival strategies because it enables health workers to detect growth faltering early and intervene before malnutrition becomes severe.
Similarly, UNICEF recommends routine growth monitoring during child health services, stressing that the first two years of life represent a crucial period for physical growth and brain development, making early identification of growth problems essential.
Immunisation Visits Offer More Than Vaccinations
Speaking with PUNCH Healthwise, Consultant Paediatrician at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Dr Olufemi Akodu, said every immunisation appointment provides healthcare workers with an opportunity to evaluate a child's overall development in addition to administering vaccines.
The public health physician explained that babies experience rapid growth during their first two years of life, making consistent weight monitoring an essential part of preventive healthcare.
He said, "Every immunisation visit provides an opportunity to check not only whether a child is receiving vaccines on schedule but also whether the child is growing well. Regular weighing helps healthcare workers monitor the baby’s growth over time, identify problems early, and provide timely advice to parents.
"Since babies grow rapidly in the first two years of life, even small changes in weight can provide important information about their health and nutrition."
Akodu cautioned parents against waiting until their children become visibly sick before paying attention to growth monitoring, noting that changes in weight often provide the earliest indication that something may be wrong.
He said regular monitoring helps healthcare professionals confirm healthy growth, detect poor weight gain or weight loss at an early stage, identify malnutrition before it becomes severe, assess whether feeding practices are appropriate and monitor the effectiveness of nutritional or medical interventions.
According to him, early detection significantly improves treatment outcomes and reduces the risk of long-term complications.
He said, "Regular growth monitoring is one of the simplest and most effective ways to ensure a child is healthy.
"It helps to confirm that the baby is growing normally, detect poor weight gain or weight loss early, identify malnutrition before it becomes severe, detect illnesses that may affect growth, assess whether feeding practices, including breastfeeding and complementary feeding, are adequate, monitor the effectiveness of nutritional or medical treatment, and prevent complications such as severe malnutrition, developmental delays, and increased risk of infections.
"When growth problems are identified early, they can usually be corrected more easily."
Growth Assessment Involves More Than Weight
Akodu explained that comprehensive growth monitoring requires multiple measurements rather than relying solely on weight.
He said healthcare workers routinely measure weight, length or height depending on the child's age, head circumference during the first two years to monitor brain development, and mid-upper arm circumference where nutritional assessment is required.
He said, "Healthcare workers monitor growth by measuring and recording weight using a calibrated infant or child weighing scale, length or height depending on the child’s age, head circumference, especially during the first two years to assess brain growth, and mid-upper arm circumference in older infants and children when assessing nutritional status.
"These measurements are plotted on a growth chart, usually based on the World Health Organisation Child Growth Standards. The trend over time is more important than a single measurement, as it shows whether the child is growing appropriately."
Poor Weight Gain Could Signal Serious Health Problems
The paediatric epidemiologist warned that poor weight gain should never be dismissed because it may indicate nutritional deficiencies, recurrent infections or more complex medical conditions.
He explained that inadequate breastfeeding, poor complementary feeding, diarrhoea, pneumonia, intestinal worm infestation and chronic illnesses affecting the heart or kidneys could all contribute to poor growth.
He said, "Poor weight gain or weight loss is a warning sign that requires attention. It may indicate inadequate breastfeeding or feeding, poor complementary feeding practices, frequent infections such as diarrhoea or pneumonia, intestinal worm infestation in older infants and children, underlying medical conditions such as heart disease, kidney disease or other chronic illnesses, and difficulty feeding due to oral or neurological problems.
"It does not always mean a child is seriously ill, but it should never be ignored. Early assessment allows healthcare workers to identify the cause and provide appropriate treatment."
Akodu advised parents whose children are not gaining weight appropriately to seek prompt medical care instead of relying on home remedies or self-medication.
He said, "Parents should visit a healthcare facility promptly for assessment, continue exclusive breastfeeding for the first six months where appropriate, continue breastfeeding alongside complementary feeding until at least two years, ensure complementary foods after six months are nutritious, diverse and age-appropriate, feed the child more frequently if advised, ensure immunisations are up to date, maintain good hygiene to reduce infections, follow the healthcare worker’s recommendations and return for follow-up growth monitoring.
"Parents should avoid self-medication or relying solely on home remedies without medical advice."
Parents Should Understand Every Measurement
Akodu also called on healthcare workers to educate mothers and caregivers during every contact with the health system, including antenatal clinics, delivery, postnatal care, immunisation appointments and sick-child visits.
He said, "Every contact with a mother or caregiver—including antenatal clinics, delivery, postnatal care, immunisation clinics and sick-child visits—should include education on growth monitoring.
"Healthcare workers should explain why regular weighing is important, how to interpret growth charts, appropriate feeding practices, and warning signs that require medical attention.
"Well-informed parents are more likely to recognise problems early and seek care promptly."
He further maintained that parents have the right to know their children's measurements after every assessment.
According to him, discussing the results empowers caregivers to become active participants in protecting their children's health.
He said, "Parents have a right to know their child’s health status. Informing mothers of their baby’s weight and explaining its meaning helps them understand whether their child is growing well, appreciate the importance of good nutrition and appropriate feeding, recognise early signs of growth problems, participate actively in decisions about their child’s health, and feel motivated to attend future clinic appointments for continued growth monitoring.
"When mothers understand their child’s growth pattern, they become active partners in protecting their child’s health rather than passive recipients of healthcare."
Growth Failure May Reveal Hidden Diseases
Also speaking, Consultant Paediatrician and child health advocate, Dr Ayodele Renner, described routine weight monitoring as both a nutritional assessment tool and an important screening method for potentially life-threatening illnesses.
He explained that growth failure may sometimes be the earliest or only sign of conditions such as tuberculosis, HIV, chronic diarrhoea, cancer and leukaemia.
He said, "Apart from the fact that it’s an indicator of how well nourished the child is, it could also point to growth failure.
"Growth failure is not just about assessing nutritional factors. It is also possible for growth failure to be the manifestation of other conditions like cancer, infections, leukaemia, tuberculosis, chronic diarrhoea, and HIV.
"Sometimes, the only feature that a child with HIV might present with is growth failure. So, it’s almost like a screening tool as well, apart from the fact that it’s a monitoring tool.
"It is also important because it’s an early warning sign that there might be danger ahead. If a child comes to us and we notice that they’ve lost a little bit of weight, it’s always easier to identify what might be going on and intervene early rather than when the child has lost significant weight or has fallen completely off their growth trajectory."
Renner explained that healthcare workers usually obtain multiple readings of a child's weight, height and head circumference to improve accuracy before documenting them for future comparison.
He said, "Weight can indicate acute malnutrition, while a faltering of length or height might be a better indicator of chronic malnutrition. We also indirectly monitor brain growth by monitoring the head circumference.
"For each of those measurements, we try to do it twice or thrice and then find the average of the readings for better accuracy before documenting them for future reference."
The child health advocate maintained that routine growth monitoring should not stop when immunisation schedules end.
He said children under five should continue attending periodic well-child assessments because significant growth continues well beyond infancy.
He said, "Babies should actually be weighed on every hospital encounter, not just at immunisation days.
"Well-baby checks should not just be limited to immunisations because sometimes children stop their vaccinations at nine months, and we know that even up to two years, a lot of growth is still taking place.
"So, children under five years should still have periodic well-baby checks that are not necessarily tied to immunisation. Anytime a child presents in the hospital, that constitutes an opportunity to institute weight monitoring."
Renner also insisted that healthcare workers should always communicate children's measurements to their parents.
He said, "It is the right of the parent to know the weight of the child because they come for intervention, and they should know what is being done.
"It also motivates parents. When the healthcare worker says, 'Your baby has gained weight adequately,' and follows it with, 'Well done, you're doing a fantastic job,' it encourages parents and reinforces positive childcare practices."
He further called for routine height measurements at every child health visit.
According to him, some children may maintain healthy body weight while experiencing poor height growth, making routine height assessment equally important.
He said, "Height should actually be monitored at every single child visit because height can falter at any age.
"There are some children whose weight is perfectly fine, but their height is not adequate for their age.
"So, even if you cannot do it during busy immunisation clinics, when the child comes in contact with the healthcare system for any complaint, both the weight and height should be done and charted so that we can determine if there are any deviations from what’s expected."
Encouraging parents to prioritise routine growth monitoring, Renner added:
"At every visit, have the weight and height done. Discuss with the healthcare professional if they are on the right trajectory.
"This helps detect abnormalities early, institute prompt interventions, and prevent complications in the future."