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HUNT 243 > Lecture 11 - Infant and Child Growth > Flashcards

Lecture 11 - Infant and Child Growth Flashcards

1
Q

how does muscle control and coordination develop in children

A

top down and centrally to peripherally

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2
Q

Critical or sensitive time periods or windows of development occur where

A

certain skills must be learned in order for subsequent learning to occur

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3
Q

all infants progress on …

A

their own timeline of development

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4
Q

the world health organisation recommends that infants should sit alone by what age

A

7 months

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5
Q

the world health organisation recommends that infants should stand holding furniture by what age

A

9 months

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6
Q

the world health organisation recommends that infants should stand alone by what age

A

14 months

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7
Q

the world health organisation recommends that infants should walk alone by what age

A

15 months

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8
Q

child growth assessment is important to determine whether a child is

A

growing “normally” or has a trend towards a growth concern that should be addressed

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9
Q

in child growth assessment weight is a good indicator of what

A

of acute changes in dietary intake

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10
Q

in child growth assessment height reflects

A

long term nutrition (better nutrition they will grow better standing height)

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11
Q

in child growth assessment head circumference reflects

A

brain growth

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12
Q

in child growth assessment BMI screens for

A

overnutrition or growth faltering

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13
Q

what are the two components of child growth assessment

A
  1. measure = weight, length / height, head circumference and BMI
  2. plot measurements of a childs body size on growth charts
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14
Q

clinical electronic scales are calibrated how often

A

every 6 months

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15
Q

what must be done when measuring children’s weight up to 2 years

A

remove clothing and nappy

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16
Q

what are the guidelines of measuring weight for children 2 years and above

A

minimal clothing, remove shoes, empty bladder and before a meal

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17
Q

weight in children is recorded to the nearest what

A

nearest 10g

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18
Q

what is an alternate method of measuring a childs weight when they are younger than 2 years

A

weigh mother and infant together and subtract the weight of the mother

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19
Q

what is used to measure length in children

A

a calibrated length board with fixed headpiece and moveable footpiece which is perpendicular to the surface of the table

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20
Q

how many people are needed to get an accurate length measurement of a child

A

two people

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21
Q

when measuring an infants length what must they be wearing

A

without shoes, and wearing light underclothing or diaper

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22
Q

how should an infant be positioned to have their length measured

A
  • should be placed on their back in the centre of the board, lying flat against the surface.
  • eyes should be looking up
  • both legs should be fully extended and toes should be pointing upwards with feet flat against the foot piece
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23
Q

length in infants should be measured to the nearest (it is good practice to take how many measurements)

A

nearest 0.1cm

good practice to take 3 measurements

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24
Q

what is the change in terms of measuring a childs height at 2 years

A

at 2 years we measure their height standing up rather than their length

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25
Q

when should weight and length be measured in children

A
  • in the first weeks of lide
  • at routine cheeks
  • when there is a concern about weight gain, growth or general health
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26
Q

how often should we measure weight and height in infants and why should we not doo this too often

A
  • measuring too often can be misleading
  • should be measured > 2 weeks apart after 6 months of age
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27
Q

how to measure head circumference

A

position the tape just above the eyebrow, above the ears and around the biggest part on the back of the head

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28
Q

what should be used to measure head circumference

A

use a flexible, non stretchable tape

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29
Q

head circumference should be measured to the nearest

A

0.1cm

30
Q

head circumference is measured up until what age

A

1 year of age

31
Q

what is a growth reference

A

describes how certain children grew in a particular time and place

32
Q

what is a growth standard

A

describes how healthy children should grow under optimal environmental and health conditions

33
Q

why are we unable to use growth standards after the age of 5 years

A

after 5 years we are unable to control for the same factors that could when younger so we use references not standards

34
Q

what was the criteria used for the WHO multi centre growth reference study

A
  • mothers willing to exclusively breastfeed for at least 4 months
  • introduction of complementary feeding by the age of 6 months and continued partial breastfeeding up to at least 2 months
  • no maternal smoking before and after delivery
35
Q

how many home visits were included in the WHO multi centre growth reference study (and how often were these)

A

20 home visits

  • once fortnightly until 2 months old
  • once monthly until 13 months old
  • thereafter every 2 months until second birthday
36
Q

what was recorded in the WHO multi centre growth reference study

A

anthropometrics (from birth) and developmental milestone age (from 4 months of age)

37
Q

what was found about the variance in the WHO multi centre growth reference study

A

variance in growth was due to differences among individuals and only minimally to difference among site (country)

38
Q

what is the growth reference data for children aged 5-19 WHO

A
  • weight for age (5-10 years)
  • height for age (5-19 years)
  • BMI for age (5-19 years)
39
Q

what is the growth reference data for children aged 2-20 years CDC

A
  • stature for age (2-20 years)
  • weight for age (2-20 years)
  • BMI for age (2-20 years)
40
Q

how to calculate z-scores

A
  1. mean (find the avereages)
  2. standard deviation (calculate how spread out the values are from the mean)
  3. z score
41
Q

what does a z score tell you

A

tells you how many standard deviations away a specific value is from the mean

42
Q

if the z score is 0 it means

A

the value is exactly the average

43
Q

if the z score is positive it indicates

A

the value is above the average

44
Q

if the z score is negative it indicates

A

the value is below the average

45
Q

the higher the z score ( in the positive or negative direction), the …

A

the more unusual or less typical the value is compared to the average

46
Q

what is the z score equal to

A

measured value - average in the reference population / standard deviation of the reference population

47
Q

why plot on a growth chart ?

A
  • to compare a childs weight, height or head circumference against other healthy children of their age
  • to track how a child grows over time
  • normal growth is an important indicator of health
48
Q

what are the New Zealand Growth Charts for children aged 0-5 years

A

New Zealand - World Health Organisation Growth Charts (0-5 years)

49
Q

what are the New Zealand Growth Charts for children aged 5-18 years

A

either WHO reference 2007 or the Centres for Disease Control (CDC) Growth Charts

50
Q

on a growth chart, if a child is growing normally growth will

A

‘track’ parallel to one of the centile lines on the growth chart

51
Q

if a childs growth on a growth chart starts to track up or down significantly, further investigation is necessary (how many centiles for weight and height would this be a concern)

A

there is a consistent change in centile position by two or more intercentile spaces for weight

or by one or more inter-centile spaces for height

52
Q

if there is a difference of …….. or more inter-centile spaces between the weight and heigh values of a child this also requires investigation

A

a difference of two or more inter-centile spaces

53
Q

what does each percentile (centile line) mark

A

the weight or height below which the percent of children of that age and gender fall

54
Q

how many centiles are there on growth charts and where do they extend from

A

9 centiles that extend from 0.4th to the 99.6th

55
Q

what does the 50th centile represent

A

the mean

56
Q

a child is described as being …. or …. on a growth chart

A

on a centile or between two centiles

57
Q

a centile describes

A

the number of children expected to below that line ( e.g 50% below the 50th centile)

58
Q

head circumferences taken within the first 24hrs of life are

A

unreliable because the head may be subjected to molding

59
Q

babies often lose weight in the first 3-5 days, what % regain by 2 weeks

A

80%

60
Q

is weight loss in babies after birth normal

A

yes

61
Q

baby weight loss is expressed as a

A

percentage of birthweight

62
Q

a baby weight loss greater than …. may indicate a feeding problem or illness

A

> 10%

63
Q

why do the centiles shift slightly when length is changed to height measure at 2 years of age

A

because when a child is standing up their spine is compressed / squashed slightly compared to lying down

64
Q

head circumference usually tracks within

A

a range of one centile space

65
Q

rapid head growth can be a sign of

A

hydrocephalus

66
Q

slowing head growth may be a sign of

A

underlying problems of brain or skull growth and development

67
Q

why is head growth no longer useful after 2 years of age

A

because it is slow

68
Q

BMI reflects

A

how heavy a child is relative to their height

69
Q

BMI is for …. not

A

BMI for screening tool not a diagnostic tool

70
Q

how often should infants and toddlers be measured

A
  • in the first week of life
  • at 1, 2, 4, 6, 9, 12, 18 and 24 months
  • between 4 - 6 years
  • older children and adolescents should be measured once each year
71
Q

what are the NZ recommendations of measuring weight and height and head circumference up until what age

A

weight and height = up to 5 years

head circumference = up to 1 year

HUNT 243 (30 decks)

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