Childhood Growth And Development Flashcards
Red flag developmental milestones in children
No social smile in 8 weeks (suggests visual impairments - cataracts may be present. Reversible but need to be removed before visual pathways fully formed at 3 months)
Not walking alone by 18 months
Not saying words by 18 months (worried about deafness)
Reasons for developmental delay in children
Chronic illness e.g. Frequent trips to hospital
Lack of stimulation (no interaction with caregiver, children require personal interaction to learn)
Sensory impairment (vision and hearing affect walking and speech)
Developmental disorder (learning difficulties)
Speech delay in development
May be the only sign of a learning difficulty. Speech is one of the most complex aspects of development. Other functions may be normal
3 phases of childhood growth
Infant: Nutrition most important factor. Also Thyroxine and Insulin-like growth factor. Rapid growth.
Childhood: GH, Thyroxine, nutrition main determinant of adult height
Pubertal: Oestrogen/Testosterone, GH. Fusion of growth plates.
Measurements in children
Weight: babies weighed naked
Height: Infants <2 measure length. Needs 2 people. Over 2 measure height in metres.
Head circumference: measures brain growth. 80% brain growth before age 5.
Growth concerns in children
Drop in height or weight >2 centiles
Small thin children: under nutrition, chronic disease, genetic disease, neglect
Short fat children: GH deficiency, hypothyroidism
Tall fat children: Risk of early puberty and subsequent short stature
Tall thin: mostly normal. May be Marfan’s, excess GH.
4 key areas of child development
Gross motor
Speech and language
Social interaction
Fine motor
What is global developmental delay?
Delays occur in all 4 key areas of development
What information would you use to assess a child with suspected growth delay?
Previous height and weight measurements Parental height and weight Clinical history of previous illness Signs of muscle wasting Signs of abuse (neglect, emotional, physical) Social circumstances Material circumstances
What does 10th centile for weight mean?
10 % of children of that age and gender would weigh this amount or less
Why is important to assess the weight of a baby in the first 2 weeks?
Most babies lose and regain weight in the first 2 weeks of life. Weight within the first week is an assessment of feeding.
A baby below 10% of birth weight at/before 2 weeks needs careful assessment for feeding problems or unrecognised illness.
When do you stop correcting for height and weight of a pre-term baby
After the age of 1.
Before that plot height and weight using gestational age, not actual age.
How is the weight of a child affected by illness?
Drop of one centile is common. Weight normally returns within 2-3 weeks.
Drop in 2 centiles requires further assessment
What are the benefits of breast-feeding for the mother?
Post partum recovery
Psychological Benefits
Empowerment
Improved maternal health outcomes e.g. osteoporosis, ovarian and breast cancer
Benefits of breast feeding for the baby
Nutritional Benefits Improved Bonding Immunologic protection Reduced risk of cot Death Reduction of allergy risk
