Determine whether the child has recently complained of abdominal pain or injury or is at risk for abdominal distention. Risk factors include gavage or enteral feeding, postoperative abdominal surgery, presence of enteral tubes for stomach or intestinal decompression, peritoneal dialysis, and prematurity (increased risk for necrotizing enterocolitis). There is little evidence to support that routine measurement of abdominal girth after suspected trauma is a reliable predictor of intraperitoneal bleeding.

In an age-appropriate manner, explain the procedure to the child and family, including the rationale for performing the procedure and particularly the frequency with which it is done. Explain to the child that small pen marks will be made on the abdomen. Assure the child that these marks are not permanent and will wash off. Visible marks made on the child’s body may be a threat to body image.

Determine whether one tape will be long enough to encircle the abdomen. Two paper tapes may be taped together for added length. For accuracy, ensure that the ending mark of one tape measure lines up with the beginning mark of the other tape measure.

Evaluate previous assessments and note any changes in abdomen, including girth, firmness, color, and bowel sounds.

Record abdominal girth, date and time of measurement, and factors pertinent to abdominal assessment (e.g., relation to meals, bowel movements).

Document any abdominal pain reported by child or assessed during girth measurement.

Inform healthcare prescriber of any significant changes (greater than 10% of the last measurement) in abdominal girth or abdominal examination.

If parents are measuring abdominal girth at home, instruct them to do the following: