Gateway Gazette

Researcher Creates Preterm Growth Charts that are Used Globally

Two new apps give clinicians and parents an easy way to monitor the health of premature babies

By Laura Herperger

Tanis Fenton, researcher and registered dietitian, developed global preterm growth charts which are now available in app form. Calgary mother Maheny Lopez says the app allowed for easy monitoring of the health of her infant Melina in the neonatal intensive-care unit at the Foothills Medical Centre. Photo by Riley Brandt, University of Calgary
Tanis Fenton, researcher and registered dietitian, developed global preterm growth charts which are now available in app form. Calgary mother Maheny Lopez says the app allowed for easy monitoring of the health of her infant Melina in the neonatal intensive-care unit at the Foothills Medical Centre. Photo by Riley Brandt, University of Calgary

When you weigh less than five pounds, as preterm infants do, every growth spurt counts. So knowing what normal growth (weight, length, and head circumference) is for a preterm infant is really important.

Tanis Fenton is the researcher who is giving clinicians that reliable reference — a validated growth chart used in manuals and electronic medical records globally and now also available in app form.

“Of all hospital patients, preterm infants have the highest nutritional needs and the fastest growth rates. They can double their weight in just six weeks. That’s why validated measurement charts are so important in their health care,” says Tanis Fenton PhD, a registered dietitian and epidemiologist who has been working with pre-term infants much of her career.

Alberta has the most preemies in Canada

Alberta has a higher rate of preterm births than any other province, equal to 4,700 babies born every year. Fenton, an associate professor at the Cumming School of Medicine and a member of Alberta Children’s Hospital Research, the O’Brien Institute for Public Health and the Department of Community Health Sciences, became aware of how difficult it was to evaluate infants while working in the neonatal intensive-care unit at the Foothills Medical Centre.

“A growth chart, as a reference, can provide the assessment of whether an infant is getting the necessary nutrition or indicate if an infant has needs that differ from the expected,” says Fenton. “A reliable reference can help in early detection of problems and to ensure infants thrive.”

Calgary mom grateful for app’s role in her infant’s health

Melina weighed only 620 grams when she was born at 23 weeks in April. She is now five times that weight and is being discharged from the Foothills Medical Centre
Melina weighed only 620 grams when she was born at 23 weeks in April. She is now five times that weight and is being discharged from the Foothills Medical Centre

Maheny Lopez is a parent who is using the chart information. She feels more confident about the health of her preterm infant because of Fenton’s data and research. Melina weighed only 620 grams when she was born at 23 weeks in April; she is now five times that weight and ready to be discharged from the hospital.

“It was so awesome to verify the growth of our daughter on a daily basis on the app to see how she was doing,” says Lopez. “It allowed me to stay on top of her health and gave me some control.”

Fenton’s charts are available in two apps: one for parents to plot their babies’ growth onto the growth chart and the other one for health professionals to calculate exact percentiles and z-scores.

Fenton charts are standard worldwide

For many years, the only existing preterm growth charts were more than 25 years old and had their limitations. The World Health Organization only publishes charts for term infants, but not preterm ones. In 2003, Fenton created the first Fenton Preterm Growth Chart based on the need she saw in Calgary. She and a colleague updated the charts in 2013 after studying the growth of preterm infants in Calgary, Regina and San Diego; the charts are now widely used locally and internationally.

Dietitians and healthcare professionals in 141 countries use Fenton's preterm growth charts. They are now available on two apps.
Dietitians and healthcare professionals in 141 countries use Fenton’s preterm growth charts. They are now available on two apps.

Fenton has been invited around the world to speak on this topic. The Fenton Preterm Growth Charts are used across Canada and have been included in 21 textbooks. The charts are in the Merck Manual and have been cited in 368 papers. The American Academy of Pediatrics 2014 Handbook on Nutrition notes the charts are “commonly used in NICUs.”  The website is also accessed by dietitians and healthcare professionals in 141 countries.

“I’m really pleased that this tool is used by so many clinicians to improve health outcomes for this vulnerable population,” she says. “I honestly never expected that it would lead to such a high-user rate, which is absolutely fantastic.”

Fenton is doing more assessments and validations through another follow-up project beginning this year. Her work is funded by the Canadian Foundation for Dietetic Research.

Engagement in the community is actively driven through the strategic Knowledge Translation Research Platform identified in the University of Calgary’s Strategic Research Plan. This platform aims to address community priorities and develop close partnerships with various stakeholders.

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