Growth Charts and Their Uses Flashcards
Why do we monitor growth?
- For public health purposes - by screening + surveillance
- In clinical practice:
- Assessment of health + nutrition
- Diagnosis of disease
- Monitoring of disease
What do we monitor?
- Weight
- Height
- Head circumference
What is the criteria for measuring weight of children?
- Babies should be weighed without any clothes/nappy
- Children 2+ can be weighed in vest and pants, but no shoes, footwear and dolls/teddies in hand
- Only Class III clinical electronic scales in metro setting should be used
What is the criteria for measuring length of a child?
- Measure length before 2 years of age if concerned
- Use proper equipment (length board/mat) - requires 2 measurements
- Length should be measured without nappy or footwear
What is the criteria for measuring height of a child?
- Height should be measured from ages 2 years using a rigid rule with T piece, or stadiometer
- Ensure heels, bottom, back + head touching apparatus with eyes + ears at 90o
- Don’t try to stretch up, measure on expiration
- Always measure with shoes removed
What is the criteria for measuring head circumference?
- Head circumference should be measured using a narrow plastic or disposable paper tape
- Measurement should be taken where the head circumference is widest
What does a growth chart display?
- ‘Normal’ range of measurements for children of all ages
- Growth expressed in centiles
- Lines based on SDs from the mean
- Each line represents 2/3 SD + lines are evenly spaced
- Go from 0.4th to 99.6th centile
- Normal healthy children follow a line
Are growth chart values affected by ethnicity?
Ethnicity does affect growth, know that black babies are often heavier and have more muscle mass, South Asian babies are often smaller.
Do ‘normal’ values depend on social class as well?
Social class effects are likely to be nutritional - growth is not the same as nutrition eg. can weigh a lot but be malnourished.
How were the new (2009) UK-WHO growth charts formed?
Recognised that there were differences in weight gain between breast and formula fed babies and that healthy breast fed babies around the world showed very similar growth patterns. 15 years of data collection from breast fed babies of non-smoking mothers in 6 developed countries.
How are older children’s growth monitored?
Older children have a school age chart that goes from 2-18 and takes account of puberty (growth changes @ puberty). The principles are the same.
If Sheraz was on the 25th centile throughout for his head, length and weight, what would this mean?
There would be about 75 boys heavier than Sheraz and about 25 lighter than him. His weight is on the same line as at birth and matches his height and head size.
What factors affect normal growth?
- Nutrition - main influence perinatally
- Genetics - inc important as get older
- Hormones - inc important as get older
- Timing of puberty - can cause deviations from your line
- Disease
When is height velocity highest?
Early infancy + puberty
What are normal growth patterns?
- Rate of growth highest in first year of life
- Lowest around primary school age
- Rises again at puberty
- Falls right down when puberty ends (diff ages for girls + boys)
