Childhood growth Flashcards
What is used to document child growth?
The “Red Book” is the book that documents child growth.
What is a centile chart?
[axis, based in what]
Age (x-axis) against commulative height (y-axis)
o Based on surveys of large groups of children..
25th centile means what?
25% of children will be shorter than the 25th centile and 75% will be taller.
o Note – 50% of the population will be shorter than average (50th centile).
Attaining an accurate measurement for centile chart?
o Use well-maintained and accurate equipment.
o Position the child appropriately.
o Get rid of interfering items – i.e. shoes off.
o Calculate age and plot correctly on the chart
Centile charts we use are for cumulative height, what is that?
The total of all the growth they have done up until now.
Height velocity?
- height velocity in short children
Height velocity – how fast a child is growing in cm/year (many short children grow at a normal speed).
Causes of variations in growth in the population?
o Events before birth – i.e. poor foetal growth, LBW, etc.
o Medical issues in childhood – i.e. malnutrition, chronic disease.
o Genetic factors.
o Randomness – presence of multiple genes and the environment.
The fastest phase of growth?
Between the ages of 0-2 years old – children move up and down through the centiles around this time but will move to a centile position by about 2-3 years old.
Another phase of fast growth?
o There is another phase of fast growth at puberty.
o The skeleton matures as the child grows, the epiphyses fuse at the end of puberty and growth stops.
Monitoring height growth - when are concerns elicited? :
Concerns should invoke the use of the red book for at least a year.
How can Timing of puberty impact on height?
Late developers can fall behind in height.
Hormonal Control of Growth?
- most important hormone
- what stimulates secretion
- what inhibits it
- effects of the hormone
GH is the most important hormonal growth factor.
GH secretion:
o Stimulated by GnRH – pulsatile release mainly overnight.
o Inhibited by SS.
Effects of GH:
o Some direct effects.
o Secretion of IGF-1 from liver – then directly influences growth
Most common concern of abnormal growth?
Most common concern is short stature and very commonly, there is nothing wrong.
Short stature- commonly, there is nothing wrong when is something wrong?
If a child grows SLOWER than normal (not at a later state) then there may be something wrong
If a child grows SLOWER than normal (not at a later state) then there may be something wrong - such as?
o Poor nutrition.
o Chronic disease.
o Endocrine causes – GH deficiency, TSH/T4 deficiency.
o Genetic disorders affecting bone growth – achondroplasia, Turner’s & Down’s syndrome.
o Psychological distress and neglect.
