Lecture 11a - 20.7.10 - Paeds - GROWTH
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Transcript of 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
8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH
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Implies a net increase in the sizeor mass of tissue and occurs due
to multiplication of cells and an
increase in the intracellular substance
8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH
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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
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PHASES OF GROWTH
4 PH ASES OF HUM AN GROWTH: Fetal
Infantile
Childhood
Pubertal
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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
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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
8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH
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Childhood phase
Growth hor mone and IGH-1,thyroid hor mone acting at the
epiphysis
40 % of final height Psychosocial causes important
8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH
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Pubertal growth spurt
Testosterone and oestradiol causethe back to lenghten and boost
GH secretion
Adds final 15% to height
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Measurement
Height Supine length
Weight
Head circumference
8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH
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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
8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH
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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.
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Weight
Naked infant Child dressed in underclothes,
shoes removed
Electronic scales Uncooperative toddlers weighed
with adult
8/8/2019 Lecture 11a - 20.7.10 - Paeds - GROWTH
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Head circumference
Maximum occipitofrontal circumference is taken
Mean of 3 measurements
Measure of head and brain growth
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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
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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.
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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
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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