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Public Health Nutr. 2019 Jan;22(1):147-156. doi: 10.1017/S1368980018002549. Epub 2018 Oct 18.

Weight estimation among multi-racial/ethnic infants and children aged 0-5·9 years in the USA: simple tools for a critical measure.

Author information

1Kaiser Permanente Northern California Division of Research,2000Broadway,Oakland,CA94612,USA.
3Department of Nutritional Sciences,University of Texas at Austin,Austin,TX,USA.
4Division of Epidemiology and Community Health,School of Public Health,University of Minnesota,Minneapolis,MN,USA.
5Center for Human Nutrition,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
6Department of Epidemiology and Biostatistics,Michigan State University,East Lansing,MI,USA.
7David Geffen School of Medicine,University of California,Los Angeles,CA,USA.
8Department of Pediatrics, University of California,Irvine,CA,USA.
2Eunice Kennedy Shriver National Institute of Child Health and Human Development,Bethesda,MD,USA.



In resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).


Cross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).


National Children's Study-Formative Research in Anthropometry (2011-2012).


Multi-racial/ethnic infants and children aged <6 years (n 1473).


Developed Models 1-4 had high predictive precision (R 2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas (-1·7, 9·2 and -4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods.


Ulna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.


Anthropometric measure; Estimation; Forearm; Paediatric weight; Ulna

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