Growth and Development Flashcards
1
Q
Avg Wt, Height and Head Circumference at Birth
A
3500 g
50 cm long
35 cm head
2
Q
Growth Rates After Birth
A
- Get back to birth weight by 7-10 days
- Dbl birth wt by 4 mo
- Triple birth wt by 1 yr
- Inc height by 50% by 1 yr
- Dbl height by 3-4 yrs
- Then height inc by about 5 cm / yr from 2-12 (acceleration in puberty)
- Head circumference inc by 1 cm per 2 wks in first 2 months; reaches 90% adult size by 3 yo
3
Q
Definition and Work-Up for Failure to Thrive
A
- deceleration in growth OR < 3-5th percentile
- CBC, electrolytes, BUN, creatinine, protein and albumin, UA, urine culture
- If suspect psychosocial cause then hospitalize, if child’s wt corrects on normal diet in hospital then confirms neglect or stressors as cause
4
Q
Causes of Short Stature
A
- 2 most common = familial (1 parent also short; puberty at normal age) or constitutional delay (delayed puberty and younger bone age)
- Endocrine
- GH def - if rapid may be tumor; test for insulin-like growth factor 1
- Hypothyroid
- Excess cortisol (Cushing, exogenous use)
- Systemic chronic illness - CF, DM, cyanotic heart disease, HIV
- Dec absorption - CF, IBD, celiac sprue
- Emotional or physical abuse –> functional GH deficiency (blunted GH response)
- Bizarre behavior - hoarding, pica, etc
- Meds - chronic use of steroids, Ritalin, dextroamphetamine
- Congenital anomalies - Down syndrome, Turner
5
Q
Definition of Obesity in Kids
A
- BMI once 2 yo (percentile)
- Obese >95th
- Overweight 85-95th
- Normal 5-85th
- Underweight < 5th
6
Q
General Nutrition Recommendations in Kids
A
- Limit juice (4-6 oz) and milk (24 oz)
- Do not promote grazing thru day- give a water in sippy cup; 3 meals + 2-3 snacks
- No TV during meals
- Look for signs of satiety
- Keep offering foods even if they refuse once
7
Q
Contraindications to Breast Feeding
A
- HIV, active untreated Tb
- Herpetic lesion on breast
- Mom using lithium, chemo, isoniazid, illegal drugs
- Galactosemia
