lecture 16- envioromental Flashcards
Growth over time
Very rapid growth during first 2 years of life
Between 6-11 growth slows down
Pubertal growth spurt
Physiological growth
Skeletal growth
Soft cartilage in prenatal period, good for birth, gradually ossifies into bone
Ankles, feet, wrists and hands develop more bones as the child matures
muscle growth
Newborns are born with all the muscle fibres they will ever have
Maturation of fibres occurs very gradually in childhood and then accelerates in adolescence
World Health Organisation growth charts
The WHO has growth charts available from a sample of 8,500 children from widely different ethnic backgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman, USA).
This multicentre growth reference study was undertaken between 1997 and 2003.
The WHO growth charts represent a single international standard that represents the best description of physiological growth for all children from birth to 5 years.
They also include data for children aged 5 to 18.
Over 140 countries have adopted the WHO growth standards.
growth monitoring
Regular measuring of weight and length of child
Plotting information on a growth curve
Take action steps if required
Child’s health should then improve
Growth monitoring continued
-In developing nations, the United Nations Children’s Fund recommends monthly growth monitoring of all children up to 18 months of age.
-Growth monitoring often co-occurs with complex development programmes aimed at improving nutrition and it is perceived to mobilize communities. Monitoring in and of itself has the potential for making a significant impact on child mortality, even in the absence of nutrition supplementation or education.
In developed countries, growth monitoring is conducted far less frequently. The purpose is different and the outcomes that are anticipated are more modest.
Abnormal growth
Growth monitoring helps to detect:
Feeding difficulties
Chronic ill health
Social deprivation
Environmental influences
Three types of environmental influences on physical growth of children
Nutrition
Illness
Quality of care that child receives
nutrition
Diet is perhaps the most important environmental influence on human growth
Children who are inadequately nourished grow very slowly, if at all
If undernutrition is neither prolonged nor especially severe, children usually recover from any growth deficits by having a growth spurt once their diet becomes adequate.
Children are able to catch up with short term growth spurts in order to regain their genetically programmed growth trajectories
malnutrition
Prolonged malnutrition has a more serious impact especially in the first 5 years of life. Brain growth may be severely retarded and the child may remain short in stature
In many developing nations, as many as 85% of all children aged under 5 experience some form of malnutrition
It is estimated that every year undernutrition contributes to the deaths of about 5.6 million children under the age of five
One out of every four children aged under five (~146 million children) is underweight for his or her age, and at increased risk of an early death
There are two types of nutritional disease related to under-nutrition – Marasmus and Kwashiorkor
Marasmus
Marasmus affects babies who receive insufficient protein and too few calories.
This can happen if the mother is malnourished and does not have the resources to provide her child with a substitute for breast milk or if the child is separated from his/her mother
Babies with marasmus become very frail and wrinkled in appearance as growth stops and the body tissues begin to waste away.
If these children survive, they
may remain small in stuture and
often suffer from impaired social
and intellectual development
Kwashiokor
Kwashiorkor affects children who receive enough calories but not enough protein.
As the disease progresses, the child’s hair thins, the face, legs and adomen swell with water and severe skin lesions may develop.
In many poor nations, one of the few high-quality sources of protein readily available is breast milk.
So breast-fed infants do not ordinarily suffer from marasmus unless their mothers are severely malnourished. They may develop kwashiorkor when they are weaned from the breast but then have no other source of protein
Overnutrition
Dietary excess is another form of poor nutrition.
Increased risks of obesity, type 2 diabetes, high blood pressure, heart, liver and kidney disease.
Difficulties with friendships.
Habits.
Obesity epidemic
1 billion overweight adults in world
300 million are obese
Obesity and overweight pose major risks for chronic illness
Combination of increased consumption of energy-dense foods and reduced physical exercise
summary
Babies grow very rapidly in the first 2 years
From 2 to puberty, children gain 2-3 inches in height and 6-7 pounds in weight each year
Another growth spurt occurs at puberty
A number of different environmental factors will influence child growth (nutrition, illness, non-organic failure to thrive)
Nutrition and exercise levels will influence development of the brain and body
