Lecture 11a - 20.7.10 - Paeds - GROWTH

8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH

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GROWTH

Dr. Vijaya Mohan05/02/2007



Implies a net increase in the sizeor mass of tissue and occurs due

to multiplication of cells and an

increase in the intracellular substance



Why monitor growth ?

Assessment of a child¶s growth is thebest marker of their well being- nutrition

and good health

The nor mal pattern of expected growth

is traditionally displayed on a growthchart

Ear ly detection of disease in children



PHASES OF GROWTH

4 PH ASES OF HUM AN GROWTH: Fetal

Infantile

Childhood

Pubertal



Fetal

Fastest period of growth 30% of eventual height

Deter mined by the size of the mother

and by placental nutrient supply

Insulin like growth factor 2 , Human

placental lactogen and insulin



Infantile phase

Growth during infancy to around 18months of age is largely due to

adequate nutrition

Good health, nor mal thyroid function

Accounts for about 15 % of final height



Childhood phase

Growth hor mone and IGH-1,thyroid hor mone acting at the

epiphysis

40 % of final height Psychosocial causes important



Pubertal growth spurt

Testosterone and oestradiol causethe back to lenghten and boost

GH secretion

Adds final 15% to height



Measurement

Height Supine length

Weight

Head circumference



Height

Most accurate height measuringequipment is the Har pendenStadiometer

Remove shoes, position the child withthe heels and back touching the

backboard,head straight, eyes andears level,gentle upward traction of themastoid process,knees straight for children above 2 years



Supine length

In children below 2 years ,supinelength is taken

Frankfurt plane

One person holds the head against the

headboard while the other straightens

the legs and moves the footboard up

against the heels fir mly.



Weight

Naked infant Child dressed in underclothes,

shoes removed

Electronic scales Uncooperative toddlers weighed

with adult



Head circumference

Maximum occipitofrontal circumference is taken

Mean of 3 measurements

Measure of head and brain growth



Growth parameters

Neonate nor mally loses up to12%of body weight in the first few

days of life but should regain birth

weight by 10 days of life Subsequent weight gain of 30

grams per day



Birth weight is doubled by 5months and tripled by at about 1

year.

Expected weight of a young childin kilograms age in years plus 4,

multiplied by 2.



Height

At birth approx. 50 cm,increasingto 75 cm at 1 year and 100 cm at

4 years

Subsequently annual gain of approx. 5 cm



Head circumference

At birth average 35 cm,40 cm at 3 months,47 cm at 1 year.

Subsequent annual increase is .5

cm from 2 to 7 years and .3 cm from 8 to 12 years

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Lecture 11a - 20.7.10 - Paeds - GROWTH