growth monitoring Flashcards
what are the 3 key parameters we monitor
weight (g/kg)
length (cm) or height (if >2y)
head circumference (up till 2y, OFC, cm)
other measurements that aren’t routine but may be done
weight for age length/height for age BMI weight for length rate of weight gain (infants only)
how are growth charts developed
population derived references
followed children through early years in different countries to see differences in growth and normal range
weight, length and OFC at birth
3.3kg
50cm
35cm
weight and length at 4mths
6.6kg
60cm
weight, length and OFC at 12 mths
10kg
75cm
35cm
weight and length at 3y
15kg
95cm
centiles and normal development
no single measurement is abnormal
pattern, progress and hx are crucial
what is failure to thrive
child growing too slowly in form and usually in function at the expected rate for their age
significantly low rate of weight gain - crossing centile spaces
not a diagnosis but a description of a pattern
supply of energy/nutrients < demand
maternal causes of failure to thrive in early life - deficient intake
poor lactation
incorrectly prepared feeds
unusual milk/other feeds
inadequate care
infant causes of FTT in early life - deficient intake
prematurity
small for dates
oro palatal abnormalities (e.g. cleft palate)
neuromuscular disease (e.g. cerebral palsy)
genetic disorders
causes of FTT in early life - increased metabolic demands
congenital lung disease heart/liver/renal disease infection anaemia inborn errors of metabolism CF thyroid disease crohn's/IBD malignancy
causes of FTT in early life - XS nutrient loss
gastro-oesophageal reflux
pyloric stenosis
gastroenteritis - post infectious phase
malabsorption - food allergy, persistent diarrhoea, coeliac, pancreatic insufficiency, short bowel syndrome
causes of FTT in early life - non-medical causes
- poverty/socio-economic status
- dysfunctional family interactions - esp maternal depression/drug use
- difficult parent-child interactions
- lack of parental support - no friends/extended family
- lack of preparation for parenting/education
- child neglect
- emotional deprivation
- poor feeding/feeding skills disorder
process for assessing FTT