Assessing children’s health and development

Refugee children may be well nourished. However some children may suffer from chronic under nutrition with stunting of growth; others may have nutritional deficits such as rickets and anaemia, or have intestinal infestations. In guidance published by the Royal College of Paediatrics and Child Health (RCPCH), The Health of Refugee Children - Guidelines for Paediatricians, a series of useful questions is provided for assessing health and development, including:

• Does the child and/or carer know how and where to buy and prepare a nutritionally balanced diet?
• Is the child/family eating a balanced diet?
• Is nutritional advice to the child and family delivered in a way that is sensitive to religious requirements and cultural preferences?
• Is the child thriving?
• Is the child suffering from nutritional deficiencies?
• Is the child the correct weight/height for the age and gaining weight/height normally?

The RCPCH guidance recommends that children be referred for further assessment where there is more than a two centile discrepancy between height and weight or where serial measurements of growth fail to show adequate weight or height gain.

Practitioners should be aware that UK centile charts might not be standardised for all ethnic groups.

Unaccompanied refugee children may be particularly vulnerable to poor nutrition. The refugee children and young people area of this website provides further guidance on supporting their health needs.