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HUNT243 Exam > Lecture 11: Infant and Child Growth > Flashcards

Lecture 11: Infant and Child Growth Flashcards

1
Q

What direction does muscle control and coordination develop from?

A
  • Top down
  • Centrally to peripherally
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2
Q

What direction is top down?

A

Head control to lower leg coordination and walking

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3
Q

What direction is centrally to peripherally?

A

Shoulders and arms before hands and fingers

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4
Q

At what age should head control be achieved? (Plunket)

A

6 months

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5
Q

At what age should infants be able to sit and pivot? (Plunket)

A

10 months

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6
Q

At what age should infants be able to pull self to standing? (Plunket)

A

12 months

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7
Q

At what age should infants be walking independently? (Plunket)

A

18 months

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8
Q

What is the WHO window of achievement for walking alone?

A

8-18 months

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9
Q

What is the WHO window of achievement for standing alone?

A

7-17 months

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10
Q

What is the WHO window of achievement for walking with assistance?

A

6-14 months

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11
Q

What is the WHO window of achievement for hands and knees crawling?

A

5-14 months

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12
Q

What is the WHO window of achievement for standing with assistance?

A

5-12 months

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13
Q

What is the WHO window of achievement for sitting without support?

A

4-9 months

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14
Q

It 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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15
Q

What are the two stages of a child growth assessment?

A
  1. Measure: weight, length/height, head circumference and BMI
  2. Plot measurements of a child’s body size on growth charts
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16
Q

What is weight a good indicator of?

A

Acute changes in dietary intake

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17
Q

What does height reflect?

A

Long-term nutrition

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18
Q

What does head circumference reflect?

A

Brain growth

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19
Q

What is BMI used to screen for?

A

Over nutrition or growth faltering

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20
Q

How often are clinical electronic scales calibrated?

A

Every 6 months

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21
Q

When weighing children up to 2 years, remove..

A

Clothing and nappy

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22
Q

When weighing children over 2 years…

A

Minimal clothing, remove shows, empty bladder and before a meal

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23
Q

Measured weight is recorded to the nearest…

A

10g

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24
Q

What do you do when baby doesn’t want to sit or lie to be weighed?

A

Get mother to hold them, weigh both, subtract mothers weight

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25
Q

At what age should children be able to sit or stand independently to be weighed?

A

Beyond 2 years

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26
Q

At what age is length used rather than height?

A

For under 2’s

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27
Q

What is length measured using?

A

A calibrated length board with fixed headpiece and movable footpiece

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28
Q

How should the infant be placed on a length board?

A

On back in centre, lying flat, eyes looking up, both legs fully extended, toes pointing upwards, feet flat against food piece

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29
Q

Length is measured to the nearest….

A

0.1cm - good practice to take 3 measurements

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30
Q

When should weight and length be measured?

A
  • Often by LMC/GP/Well Child Provider
  • In the first week of life
  • At routine checks
  • When there is concern about weight, growth or health
31
Q

How often should weight and length be measured?

A
  • Measuring too often can be misleading
  • Should be measured >2 weeks apart after 6 months of age
32
Q

What should be used to measure head circumference?

A

Flexible, non-stretchable tape

33
Q

How is head circumference measured?

A

Position the tape just above eyebrows, above the ears - around the biggest part on the back of the head

34
Q

How accurately should head circumference be measured?

A

To the nearest 0.1cm - three measurements and take average

35
Q

What age is head circumference measured?

A

Up to 1 year of age

36
Q

What is a growth reference?

A

Describes how certain children grew in a particular place and time

37
Q

What is a growth standard?

A

Describes how healthy children should grow under optimal environmental and health conditions
- used during the early periods of life

38
Q

A reference is NOT a…

A

Standard

39
Q

What does the WHO Child Growth Standards (0-5 years) provide?

A

A single international standard that represents the best description of physiological growth for children from birth to 5 years

40
Q

What do WHO Child growth standards (0-5 years) establish as the normative model for growth and development?

A

Breastfed infants

41
Q

WHO Child Growth Standards represent the best….

A

Description of physiological growth and should be applied to all children everywhere regardless of ethnicity, socio-economic status and type of feeding

42
Q

What are the main attained growth measures?

A
  • Weight for age
  • Length/height for age
  • Weight for length/height
  • BMI for age
43
Q

Why is it a lot more challenging to develop the same standards for infants compared to children…..

A

Because we can’t control as much of diet and exercise

44
Q

What WHO growth reference data is used for children aged 5-19 years? (3)

A
  • Weight for age (5-10 years)
  • Height for age (5-19 years)
  • BMI for age (5-19 years)
45
Q

Z-scores are more used in ?? rather than ?? setting

A

More used in research rather than clinical setting

46
Q

What are z-scores a measure of?

A

The deviation of the anthropometric measurement from the reference mean or median in terms of SD

47
Q

How do you calculate z-scores?

A
  1. Find Mean
  2. Calculate SD
  3. Get Z-score
48
Q

What is the equation for z-scores?

A

z-score = (measured value - average value in the reference population) / standard deviation of the reference population

49
Q

Severe poor growth would be referred to a…

A

Pediatrician

50
Q

Why plot on a growth chart?

A

To compare children’s measurements against healthy children of the same age
- To track how a child grows over time

51
Q

Normal growth is an important indicator of….

A

Heath
- So growth should be assessed regularly

52
Q

For children aged 0-5 years what should be used to monitor growth?

A

The NZ WHO growth charts (0-5 years)

53
Q

For children and young people aged 5-18 years what should be used to monitor growth?

A

Use either:
- WHO reference 2007 growth charts
- Centers for disease control (CDC) growth charts

54
Q

If a child is growing normally, growth will usually ‘track’ parallel to…

A

one of the centile lines on the chart

55
Q

If a childs growth starts to track up or down significantly (two or more inter-centile spaces)…..

A

Further investigation is necessary to identify the cause

56
Q

To plot growth you need data on…

A
  • Sex
  • Age
  • Weight/length/head circumference
57
Q

Each percentile line marks….

A

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

58
Q

Which centile represents the median?

A

50th Centile

59
Q

What does each centile show?

A

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

60
Q

Half of children will fall between…

A

the 25th and 75th centiles

61
Q

If a point is within 1/4 space of a line we say it is…

A

On the centile (e.g. on the 91st centile)

62
Q

Why is the 50th centile de-emphasized?

A

50th percentile now looks the same as all of the others, as it brings fear and worry if they are not at this

63
Q

Why is head circumference taken in the first 24 hours unreliable?

A

The head may be subject to molding

64
Q

Why do growth charts have a gap in the first 2 weeks of life?

A

Because babies lose weight in the first 3-5 days and 80% have regained it by 2 weeks
- Weight loss is normal after birth

65
Q

When is weight loss not normal after birth?

A

> 10% weight loss
- may indicate a feeding problem or illness

66
Q

When do we switch from measuring length to measuring height?

A

At 2 years of age

67
Q

What happens to the centiles when we switch from measuring length to height?

A

Centiles shift down slightly
- This is because when a child is standing up their spine is compressed slightly compared to when lying down

68
Q

Head circumference usually tracks within a range of…

A

One centile space

69
Q

Rapid head growth can be a sign of…

A

Hydrocephalus (fluid in the brain)

70
Q

Slowing head growth may be a sign of…

A

Underlying problems of brain or skull growth and development

71
Q

Why do we stop measuring head growth after 2 years?

A

Growth in HC is slow and measurement is no longer useful

72
Q

BMI is for screening and is not a ?? tool

A

Diagnostic

73
Q

How often should infants and toddlers be measured?

A
  • In first week of life
  • At 1, 2, 4, 6, 9, 12, 18 and 24 mo
  • Between 4 to 6 years
74
Q

How often should older children and adolescents be measured?

A

Once a year

HUNT243 Exam (19 decks)

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