Measurement of children's height and weight at regular intervals is important for identifying growth problems as well as for planning health promotion interventions for those at risk from under or over nutrition. Opportunistic measurement is recommended when children are seen by healthcare professionals for other reasons. Identification of variations in practice around measurement of height and weight in a children's unit led to the development of guidelines, purchase of new equipment, implementation of educational strategies and introduction of a growth link nurse role. Repeat audit revealed that these approaches did not bring about the desired changes in practice. Growth assessment is a quick, non invasive procedure that can provide valuable information about the general health and well being of the child but is perceived as a low priority by some healthcare professionals. Different approaches are needed to improve this important aspect of health care for children.