Antropometrik Anak.pptx [Repaired]

8/11/2019 Antropometrik Anak.pptx [Repaired]

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ANTHROPOMETRIC MEASUREMENT AND GROWTH

MONITORING IN NORMAL CHILDREN


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Anthropometric Measurement

A part of well baby clinics

To detect growth faltering

To measure the prevalence of under nutritionand over nutrition

To identify groups with increased nutritionaland health need.

Growth chart application CDC Growth charts

WHO growth charts, 2005


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Is my child growing well ?

Is my child growing well ?

Is my child short ?

What should be done to make my childtaller ?

Is children growth in different manner

If the parents are short, will all mychildren became short ?


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Evaluation of growth

Anthropometry: reliability

training

equipment Plotting

Absolute height


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Evaluation of growth

Height velocity

Measurement at 6 mos interval

Deceleration / crossing centiles age 3-12 yrs: indicates

pathologic until proven otherwise Normal velocity indicates normal growth

Weight / height relationship

W/H ratio: suggestive endocrine causes

W/H ratio: suggestive systemic disease


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Growth Phase

Infants

Deceleration

50% during 1styear

25% of 1styear growthduring 2ndyear

Childhood

Constant 5-7 cm / year

Puberty

Acceleration

Deceleration

Halt

Interaction between GH andsex steroids


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Growth monitoring

Effective growth monitoring needs

Precise measurement

Accurate plotting on a chart Correct interpretation

Plan of investigation

School entry measurement best

opportunity to detect growth disorder


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Periodic assessment of child growth

Maintain or improve growth and health

Growth monitoring should not be a stand aloneactivity, but part of broader community basedprogramme to improve primary health care,education and sanitation.

Growth monitoring


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NORMAL GROWTH :

When weight and height/length track along similarpercentiles or growth channels

Canadian Pediatric Society, Dietitians of Canada and Health Canada. Nutritional for healthyinfants, Minister of Public Works and Government Services, 1998


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Hal-hal yang perlu dipantau dalam

pertumbuhan seorang anak

2 tahun pertama kehidupan:

Tinggi badan (TB/U), Berat badan (BB/U), BB/PB,body mass index (BMI/U), dan lingkar kepala(LK/U)

Usia 2-10 tahun:

TB/U, BB/U, dan BMI/U

Usia > 10 tahun: Hal-hal diatas (2-10 th)

Penilaian perkembangan status pubertas anak


13/52McGraw-Hill Copyright 2002

Measuring Body Weight

Electronic digital scales, calibratedin metric units are recommended.Chair scales are available for thosewho are not capable of standing.


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Weight Measurement


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Weight Measurement


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Measuring Growth in Length and

Stature Recumbent lengthis measured from birth until a

child is able to stand

Measured from the vertex (highest point on skull) to the

soles of the feet


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Length Measurement


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Height Measurement


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Measuring height

Measuring height is subject to error as aresult of

poor technique,

variations between instruments and observers,

diurnal variation

plotting mistakes


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Single height measurement

Will identify only stature

Very short/tall child

Will not identify process of growth

Children growing slowly (CHD)

Turner syndrome

Acquired disorder : hypothyroidism, coeliac disease

Children growth crossing centiles


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How many times height should be

measured ?

Consensus

Routinely up to 2 years 0.5, 1, 2, 4, 6, 9, 12, 18, 24 mos

Every 6 month up to 6 years

Every year up to 18 years


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Additional parameter for

evaluation of growth

Target height Boy = Fh+(Mh+13)

2

Girl= (Fh-13)+Mh

2

Mid parental height

Genetic height potential

Prediction of final height


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5 Directory of Growth

1. Catch-up growth

2. Normal growth

3. Growth faltering4. Flat growth

5. Loss of growth


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Algorithm of Growth Monitoring

Weighing

Plotting

Make curve

Interpretation

Increase

Not Increase

Identification of the problem

Solution

Evaluation

Not Increase

Catch-up Growth

Normal Growth

Growth Faltering

Flat GrowthLoss of Growth

Increase


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Indices derived from growth

measurement Constructed from two or more raw

anthropometric measurement and are simplenumerical ratio

Weight / Height 2 (BMI)

W for A : H for A : W for H

Essential part of the interpretation ofanthropometric measurement


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CDC GROWTH CHARTS

CDC G th Ch t


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CDC Growth Charts

Based on American population 1977

White

Hispanic

Black

Asian

First growth chartswithout BMI charts,

then in 2002 BMI is included


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WHO growth charts

Based on 18 cities in the world

First part2005

Only for 1

5 years boys and girls


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Nutricia workshop, 16 sept 2006 Malang


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IMT WHO dan CDC

Nutritional

Status

IMT WHO

2006

(0-5 th)

IMT WHO 2007

(5-19 th)

IMT CDC

2000

(2-20 th)

Obesitas > +3 > +2 SD > P 95Overweight +2 SD s/d +3

SD> +1 SD P 85 p 95

Normal -2 SD s/d +2

SD

-2 SD s/d +2 SD P 3 - < p 85


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Rekomendasi Klasifikasi Status Gizi

Status Gizi BB/TB

(% median)

BB/TB

WHO 2006

IMT CDC

2000

Obesitas > +3 > P 95

Overweight > +2 SD hingga +3 SD > P 85 P 95

Normal >90% -2SD hingga +2 SD

Gizi Kurang 70-90% -2 SD hingga -3 SD

Gizi buruk < 70% < - 3SD


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Indikator Pertumbuhan

Z-score TB/PB menurut

usia

BB menurut

usia

BB/PB atau BB/TB BMI menurut usia

>3

>2

>1

0 (median)

Di bawah

-1

Di bawah

-2

Di bawah

-3

Pendek(stunted)

Sangat pendek

(severely

stunted)

BB kurang(underweight)

BB sangat

kurang

(severely

underweight)

Sangat gemuk

(obese)

Gemuk

(overweight)

Kemungkinan

risiko overweight

Kurus (wasted)Sangat Kurus

(severely wasted)

Sangat gemuk

(obese)

Gemuk

(overweight)

Kemungkinan

risiko overweight

Kurus (wasted)Sangat Kurus

(severely wasted)

Interpretasi Indikator Pertumbuhan WHO

Child Growth Standards


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2014 03 01

2013 02 01

1 01

usia kronologis

01

Usia 1 th / 12 bln


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Antropometrik Anak.pptx [Repaired]