Growth & Development Flashcards
When does average newborn regain birthweight?
3rd week
When does birthweight double?
5 months
When does birthweight triple?
1 year
Infant younger than 3 weeks who hasn’t regained birthweight…
Reassure and re-evaluate in 1 week
Average infant height (50%)?
50cm
Birth length goes up 50% by age…?
1
Birth length is doubled by…?
4
Birth length is tripled by…?
13
Growth rate first year of life?
20 cm/year
Birth size reflection of?
Maternal factors and in utero conditions (vs. genetic growth potential)
Infant can cross percentiles in 1st 12-18 months as genetic, hormonal, and environmental factors overcome maternal ones
When are you half your adult height?
2
When do you worry about abnormality of growth?
Shifts across 2+ percentile lines on growth curve after 2
What has significant effect on linear growth velocity?
Chronic diseases
Normal head circumference at birth for full term newborn?
35cm
Normal head growth for first 6 months?
~1 cm/month
Normal head growth from 6-12 months?
~1/2 cm/month
Head circumference above 98 percentile for age?
Macrocephaly
Infant with increasing head circumference, but normal development…?
Measure parents’ heads- Normal familial macrocephaly
Is hydrocephaly present at birth?
Can be, doesn’t have to be
Signs of hydrocephaly
Irritability, lethargy, poor appetite, persistent vomiting, bulging fontanelle, neurological findings in infant with rapidly enlarging head
Normal development, no signs increased ICP, parents with big heads
Macrocephaly
Irritability, vomiting, bulging fontanelle, impaired upward gaze
Hydrocephaly
Which is scary… Large anterior fontanelle v. Bulging fontanelle?
Bulging…associated with increased ICP
Is a bulging fontanelle associated with papilledema?
No ( it’s chronic, not acute)
No papilledema with bulging fontanelle
Weight drop first, then decreased length, spares head circumference
Inadequate calorie intake
Short stature with normal or elevated weight
Endocrine disorders
Microcephaly + Dysmorphic features
Chromosomal abnormalities
Weight and height decrease together
Chronic medical conditions
Head circumference below 5th percentile for age
Microcephaly
Acquired Microcephaly
Occurs in infants who had normal head circumference at birth
If head circumference decreases while weight and height stay the same, has to be a cause
A physical sign that a child is receiving inadequate nutrition for optimal growth and development.
FTT
Weight below 5th percentile for age
FTT
Weight that drops 2 major percentile channels
FTT
Weight less than 80% of ideal weight for age
FTT
Weight below 5th percentile on the weight-for-length curve
FTT
Which kids have specific growth charts?
Down, Turner, William’s
Don’t call growth abnormal unless comparing to the specific chart
When is it normal for kids to change % up to 2 channels up or down?
Between birth and 2
Consideration in FTT…?
New caretaker, improper mixing of formula
First thing to check with FTT?
Most cases from non-organic causes…evaluate diet first then look at mother/child interaction (feeding technique)
Labs/tests are not first step!
4 categories of organic causes of FTT?
- Chronic renal failure
- Thyroid and other metabolic disorders
- Disorders leading to inadequate absorption
- Disorders leading to inadequate utilization
*Something in history will suggest these causative factors
Throw ball while standing?
18 months
Throw overhand?
24 months
When can you stop factoring in prematurity for milestones?
2 years
28 week GA infant, now 2.5 months old… What aged milestones?
Full-term baby…corrected age is 38 weeks
Can follow mom around room through 180 degree arc
2 months (2 Sides)
Lift head and chest while prone
2 months (#2 rolling up)
Coo
2 months (two rhymes with coo)
Scratches/grabs clothes
4 months
Clutch/hold rattle
4 months (Looks like rattle)
Put objects deliberately in mouth
4 months
Sit up
6 months (6 looks like baby sitting, 6 month olds can sit)