Normal + Abnormal Growth Flashcards
What is Standard Deviation a measure of?
Variability
What percentage of people are within 1 SD from the median?
68%
What percentage of people are within 2 SD of the median?
95%
When is a child considered to show normal growth?
Measurements are within the normal range compared to children of their age
Rate of growth is within the normal range compared with children of their age
Up to what age should length be measured rather than height?
2 years
When should a child be described as being ‘on the X centile’ when referring to the growth chart?
If the point is exactly on the centile line or within 1/4 of a space of the centile line
If a child’s point on the growth chart is not within 1/4 of a centile line, how should it be described?
Between the Xth and Yth centile
What is the average age for a girl to enter puberty?
11
What is the average age for a boy to enter puberty?
12
What is precocious puberty?
Normal pubertal development occurring abnormally early
- -> less than 8 years for girls
- -> less than 9 years for boys
What is considered pubertal delay?
Absence of secondary sexual development in a girl aged 13 or a boy aged 14
What is the definition of faltering growth/failure to thrive?
Reduced growth in infancy, falling across 2 centile lines + manifesting in poor weight gain
When is weight loss in infancy normal?
Initial loss of up to 10% in first 3-4 days is normal
–> should be regained by 3 weeks
What are the causes of failure to thrive?
Non-organic/environmental (90%) - inadequate intake:
- feeding problems: unskilled feeding, insufficient breast milk, difficult to feed (low appetite, weak suck)
- maternal problems: neglect, postnatal depression
Organic:
- GI: IBD, Coeliac, cow milk protein allergy, GORD
- Swallowing: cleft palate, cerebral palsy
- Chronic disease: kidney, liver or heart failure
- Multi-system: Down’s, CF, hypothyroidism
- Chronic infection
What is the definition of short stature?
Height < 2nd centile
What are the causes of short stature?
Familial short stature (80%) - short parents (check mid parental height)
Constitutional delay in growth + puberty (benign)
IUGR
Neglect, poverty
Genetic: Down’s, Turner’s, CF, dwarfism
GI: Coeliac, IBD
Endocrine: steroids, hypothyroidism, growth hormone deficiency
How are overweight + obesity defined in children?
Overweight: BMI > 91st centile
Obesity: BMI > 98th centile
What are the possible causes of obesity in children?
Lifestyle (nearly always) Underlying conditions: (often accompanied by short stature) - hypothyroidism - Cushing's - Prader Willi
What are the features of Prader-Willi syndrome?
At birth: very floppy, ability to suck weak or absent, tube feeding common
Childhood: hyperphagia (food seeking and lacking satiety)
Learning difficulties
Hypogonadism
Short stature
What are the recommendations for vitamin supplements in babies?
By 2 weeks of age: breastfed babies should be given 8.5-10mg of vitamin D per day (formula has added vitamin D)
From 6 months:
- all children consuming < 500mls/d of infant formula should take vitamins A, C and D supplements
What are the recommendations for vitamin supplements in breastfeeding mothers?
Should take vitamin D
What are the recommended guidelines for exclusive breastfeeding?
Exclusive breastfeeding for the first 6 months of an infant’s life
What is the absolute minimum age for weaning (introducing solid foods)?
17 weeks (4 months) Recommended around 6 months
What are the benefits of breastfeeding?
Immunological features Anti-infective agents Growth factors Reduction in diarrhoea + respiratory infections Improved colonic function Reduction in atopic disease Greater likelihood of higher IQ Lower obesity risk Mower maternal breast cancer risk
What is gestational correction in regard to the growth chart?
Adjusting the plot of a measurement to account for the number of weeks a baby was born early
Number of weeks early = 40 minus gestational age
(should not be used of infants 37+ weeks)
How long should gestational correction be applied to a growth chart?
1 year for infants born 32-36 weeks
2 years for infants born before 32 weeks
