Studying a method of weight estimation for infants <3 months old to guide dosing decisions when use of a scale is impractical.

Summary

Weight is the foremost marker of health and health outcomes in infants. A weighing scale remains the universal gold standard for obtaining weight in children and is highlighted by the World Health Organization as one of four essential pieces of equipment needed when caring for newborns. However, the vast majority of healthcare providers in remote, resource-constrained settings simply do not have access to functional, calibrated scales with the precision necessary to accurately determine weight. Many critically ill newborns in the U.S. suffer similar challenges when it comes to weight assessment. For infants receiving care in a neonatal intensive care unit, it can be nearly impossible to remove or account for the weight of life-sustaining medical equipment prior to obtaining a scale-based weight. The relative error introduced by such equipment can significantly affect the safety profile of the medicines these infants receive.

Importantly, there is no other patient population for whom more calculation and manipulation of drug doses occurs than in the newborn—from prescribing and transcribing the dose to diluting, compounding, dispensing, and administering the final formulation. As a result, dosing errors represent the most common type of medication errors. For example, if the infant’s weight is captured incorrectly, improvements in the drug delivery process become irrelevant. If the child’s weight is unavailable, the process, as a whole, is rendered useless.

In response to similar issues for older children, the PTN, under the leadership of Dr. Susan Abdel-Rahman at Children’s Mercy Hospital in Kansas City, recently validated the Mercy TAPE—an anthropometric-based device developed by Dr. Abdel-Rahman that predicts weight in children 2 months through 16 years of age. The critical gap that remains unaddressed by the Mercy TAPE and other weight estimation strategies, is the newborn period. The Baby TAPE study intends to collect the necessary anthropometric data on children under the age of 3 months with the eventual goal of developing, designing, and validating a similar weight estimation tool for newborns and young infants. Anthropometric data on length and girth surrogates was collected in approximately 2000 infants at 8 study sites.

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