GROWTH AND DEVELOPMENT Flashcards
DIFFERENTIATE BETWEEN GROWTH AND DEVELOPMENT
Growth denotes a net increase in the size or mass of tissue.
It is largely attributed to multiplication of cells and increase in the intracellular
substance.
Hypertrophy or expansion of cell size contributes to a lesser extent to the
process of growth.
Development specifies maturation of functions.
It is related to the maturation and myelination of the nervous system and
indicates acquisition of a variety of skills for optimal functioning of the
individual.
Growth and development usually proceed concurrently. They are closely related
and so factors affecting one also tend to have an impact on the other.
OUTLINE THE ORDER OF GROWTH
Order of growth is cephalocaudal and distal to proximal.
During fetal life, growth of head occurs before that of neck, and arms grow
before legs.
Distal parts of the body such as hands increase in size before upper arms.
In the postnatal life, growth of head slows down but limbs continue to grow
rapidly
LIST THE FACTORS YOU LOOK AT WHEN ASSESSING PHYSICAL GROWTH
Includes assessment of (Anthropometric measurements):
Weight
Height
Head circumference/ Occipital frontal circumference (OFC)
Chest circumference
Mid upper arm circumference (MUAC)
DESCRIBE WEIGHT AS A PHYSICAL GROWTH ASSESMENT FACTOR
The weight of a child in the nude or minimal light clothing is recorded accurately
on a lever or electronic type of weighing scale.
Spring balances are less accurate.
The weighing scale should have a minimum unit of 100g.
It is important that the child is placed in the middle of the weighing pan.
The weighing scale should be corrected for any zero error before measurement.
Serial measurements should be done on the same weighing scale
The average birthweight of neonates is about 3kg (2.5 – 3.5 kg).
During the first few days after birth, the newborn loses extracellular fluid
equivalent to about 10% of the body weight.
Most infants regain their birthweight by the age of 10 days.
Subsequently, they gain weight at a rate of approximately 30g per day for the
first 3 months of life.
Thereafter, they gain 20g per day between 3 and 6 months.
Between 6 and 12 months they gain 10g/day
DESCRIBE HEIGHT/LENGTH AS A PHYSICAL GROWTH ASSESMENT FACTOR
Length/height is recorded for children under 2 years of age.
Hairpins are removed and braids undone.
Bulky diapers should be removed.
The child is placed supine on a rigid measuring table or an infantometer.
The head is held firmly in position against a fixed upright head board by one
person.
Legs are straightened, keeping feet at right angles to legs, with toes pointing
upward.
The free foot board is brought into firm contact with the child’s heels.
Length of the baby is measured from a scale which is set in the measuring table.
Measurement of length of a child lying on a mattress and/or using cloth tapes is
inaccurate and not recommended
DESCRIBE HEAD CIRCUMFERENCE AS A PHYSICAL GROWTH ASSESMENT FACTOR
Hair ornaments are removed and braids undone.
Using a non-stretchable tape, the maximum circumference of the head from the
occipital protuberance to the supraorbital ridges on the forehead is recorded.
The crossed tape method, using firm pressure to compress the hair is the preferred
way to measure head circumference (as shown below)
Head growth is rapid, especially in the first half of infancy.
It reflects the brain growth during this period.
The head growth slows considerably thereafter.
At birth the head circumference is 35cm (34- 37cm).
DESCRIBE CHEST CIRCUMFERENCE AS A PHYSICAL GROWTH ASSESMENT FACTOR
The chest circumference is measured at the level of the nipples, midway between
inspiration and expiration.
The crossed tape method is recommended
The circumference of chest is about 3cm less than the head circumference at birth.
(32 cm)
The circumference of the head and chest are almost equal by the age of 1 year
(45cm).
Thereafter the chest circumference exceeds the head circumference
DESCRIBE MID UPPER ARM CIRCUMFERENCE AS A PHYSICAL GROWTH ASSESMENT FACTOR
To measure this first mark a point midway between the tip of acromial process
of scapula and the olecranon of ulna while the child holds the left arm by his side.
Thereafter, the crossed tape method is used for measuring the circumference.
It should be ensured that the tape is just tight enough to avoid any gap as well as
avoid compression of soft tissue.
HOW IS BIRTHWEIGHT CALCULATED?
The birthweight can be calculated using the following formulae:
For infants <12 month= (AGE IN MONTHS + 9)/2
For children >1 year= 8 + (2 x age in years)
So, at 4 years:
o Weight= 8 + (2 x 4)
o Weight= 8 + 8
o Weight= 16 kg
HOW IS STANDING HEIGHT MEASURED?
Standing height:
For the standing height, the child stands upright.
Heels are slightly separated and the weight is borne evenly on both feet.
Heels, buttocks, shoulder blades and back of the head are brought in contact
with a vertical surface as wall, height measuring rod or a stadiometer.
The head is so positioned that the child looks directly forwards with Frankfort
plane (the line joining floor of external auditory meatus to the lower margin
of orbit) and the biauricular plane being horizontal.
The head piece is kept firmly over the head to compress their hair
WHAT IS THE APPROX EXPECTED HEIGHT/LENGTH OF CHILDREN AT DIFFERENT STAGES?
The infant measures approximately 50 cm at birth.
At 3month= 60cm
At 6 months= 70cm
At 1 year= 76cm
At 2 years-10 years= (age x 6.5) + 76
After 4 years add about 5cm for each year until they are 12 years.
After this, increments in height vary according to the age at the onset of puberty.
There is a marked acceleration of the growth during puberty
WHAT IS THE HEAD CIRCUMFERENCE AT DIFFERENT STAGES OF A GROWING CHILD?
At birth the head circumference is 35cm (34- 37cm).
At the first year it increases by 10cm to about 45cm (44-47cm).
First 3 months it increases by 2cm per month
3-6 months it increases by 1cm
6-12 month it increases by 0.5cm per month
At 12 years it reaches about 55cm (10cm increase)
Note: the anterior fontanelle is diamond in shape while the posterior fontanelle is
deltoid.
The anterior fontanelle closes by 18 months.
The posterior fontanelle closes by 3 months
WHAT IS THE FORMULA FOR BMI?
The formula to calculate BMI is weight (kg)/ height (meter)2
WHAT IS BODY MASS INDEX?
BMI is primarily used to assess obesity.
BMI at or above the 95th centile for age or more than 30kg/m2 is obesity.
what is the importance of growth and development?
