Growth Assessment Year 4 Paediatrics Notes OmpathStudy

Growth Assessment Year 4 · Paediatrics Collection: 4TH YEAR ALL NOTES / PAEDS / PAEDS 4.3 / Munge / NUTRITION -- Slide 1 Growth Assessment Dr Rose Munge Slide 2 OBJECTIVES. Definition of growth. Importance of studying growth. Outline determinants of growth. Describe the measures of growth\nEvaluation and interpretation of an individual child’s growth. Summary Slide 3 INTRODUCTION Definition: Growth is the progressive increase in size of the whole body Normal growth is progression of change in the size of the body that is compatible with established standards for a given population Normal growth is the best indicator of general health and nutritional status of an individual child. Understanding the normal patterns of growth enables the early detection of pathologic deviations i.e. chronic disease,inter-personal and psychologic stress. Slide 4 DETERMINANTS OF NORMAL GROWTH Factors which influence postnatal growth include: Environmental factors\n-Nutrition\n-Intrauterine environment\n-Postnatal illnesses 2. Genetic factors Hormonal factors Psychosocial Gender. Slide 5 MEASURES OF GROWTH Measures of normal growth include:\n- height/length\n- weight\n- head circumference\n-Mid upper arm circumference.\n These measurements are the mainstay of the nutritional assessment of the child and are useful only if the clinician is able to correctly interpret them. Slide 6 MEASURES OF GROWTH CONT Height for age..assess linear growth. its a measure of chronic undernutrition (stunting) Weight for height..its used to distinguish\nacute from chronic malnutrition (wasting and stunting) Weight for age..widely used and most sensitive index but cant be used to distinguish acute from chronic malnutrition. Slide 7 -Standard procedure -Reliable equipment(Regularly calibrated)\nWeight Weight measurements should be obtained on a scale that has been calibrated properly. The infant should be weighed without clothes/ diapers. Best done with a beam balance scale. The older child should be measured without shoes, in little or no outer clothing. Taking the Measurements Slide 8 WEIGHT MEASUREMENT Slide 9 Height/length Length/height measurements require a firm, flat, horizontal or vertical surface with perpendicular surfaces at each end.\nLength is most accurately measured by two examiners (one to position the child), with the child supine on a measuring board.\nFor older children, the measure is stature or height, taken using a stadiometer Ideally, the measurement should be performed three times to improve accuracy. Slide 10 HEIGHT MEASUREMENT Slide 11 LENGTH MEASUREMENT Slide 12 Head Circumference The head circumference is measured at the maximum diameter through the supra-orbital ridge and is extended circumferentially to include the most prominent portion of the occiput so that the greatest volume of the cranium is measured. A non-stretch measuring tape should be used and The recorded value should be the mean of three measurements\nIts important in follow-up of low birth weight infants and in children with CNS abnormalities like post meningitic hydrocephalus. Slide 13 HEAD CIRCUMFERENCE Slide 14 HEAD CIRCUMFERENCE Head circumference is measured in children from birth to 3 years of age because this is the period of rapid brain growth. Errors in the accurate measurement of a newborn skull are frequent and result from \n-scalp edema\n-overriding of the sutures\n-intravenous fluid infiltration - -presence of a cephalohematoma. Slide 15 Mid upper arm circumference The patient should be standing or sitting. The non-dominant arm should be used if possible, and the patient asked to remove clothing so the arm is bare.\nThe circumference of arm is measured at the mid-point between the acromion and the olecranon process.\nA non stretch-tape measure is used and should not be pulled tight; it should just fit comfortably round the arm. Slide 16 Mid upper arm circumference Slide 17 NORMAL GROWTH PATTERNS . A few days after birth weight drops by 10% as a result of lose of excess fluid. This should however be regained in 10 – 14 days after birth. Breast fed infant tents to regain birth weight a little later than bottle fed infants. On average infants 0-3 months gain ~ 1kg/month,3-6 month gain 0.5kg/month,6-9months gain 0.33kg/month and 9-12 months gain 0.25kg/month Infant double their weight by 4-5 months and triple it by 1 year of age. children gain~ 2kg/year between 2 years and puberty Slide 18 General guidelines regarding length or height gain (during infancy and childhood include the following ): Term Infants grow 25 cm during the first year of life \n- 0 to 6 months — 2.5 cm/month \n- 7 to 12 months — 1.25 cm /month Then 12.5 cm in the second year of life and then 5-6cm\nbetween 4 years and onset of puberty At puberty they grow by ~ 1cm/ year HEIGHT/ LENGTH Slide 19 Note; There is a normal deceleration of height velocity before the pubertal growth spurt. Prepubertal growth is a nonlinear process, comprised of growth spurts lasting an average of eight w