Poor growth and abnormal puberty Flashcards
When concern about growth, when to reassess
Need two measurements 4-6 months apart
When is length measured
Until 2 years old
How old do you correct for prematurity until
Until child is one year old
Growth chart in celiac
Fall off in weight when weaning to wheat, fall off in length follows
IUGR growth chart
Low birthweight baby, may or may not show catch up.
If restriction occurred early in pregnancy, the HC and length will be affected
Hydrocephalus growth chart
HC crossing the percentiles upwards
Turner’s syndrome growth chart
Poor growth from infancy
Absence of pubertal growth spurt
Growth hormone deficiency growth chart
Fall off in height
GH deficiency is rare
Tanner staging boys
Boys - development of external genitalia
Stage 1: Prepubertal
Stage 2: Enlargement of scrotum and testes; scrotum skin reddens and changes in texture
Stage 3: Enlargement of penis (length at first); further growth of testes
Stage 4: Increased size of penis with growth in breadth and development of glans; testes and scrotum larger,
scrotum skin darker
Stage 5: Adult genitalia
Boys and girls - pubic hair
Stage 1: Prepubertal (can see velus hair similar to abdominal wall)
Stage 2: Sparse growth of long, slightly pigmented hair, straight or curled, at base of penis or along labia
Stage 3: Darker, coarser and more curled hair, spreading sparsely over junction of pubes
Stage 4: Hair adult in type, but covering smaller area than in adult; no spread to medial surface of thighs
Stage 5: Adult in type and quantity, with horizontal distribution (“feminine”)
Tanner staging girls- breast
Girls - breast development
Stage 1: Prepubertal
Stage 2: Breast bud stage with elevation of breast and papilla; enlargement of areola
Stage 3: Further enlargement of breast and areola; no separation of their contour
Stage 4: Areola and papilla form a secondary mound above level of breast
Stage 5: Mature stage: projection of papilla only, related to recession of areola
First signs of puberty in boys and girls
Testicular enlargement
Breast budding
Precocious puberty age definition
When
When is puberty considered delayed
When >13 in girls and >14 in boys
When does the growth spurt usually occur
Early in puberty for girls, late in puberty for boys
What is considered delayed menarche
When occurs >16 yo
Nutrition requirements of infants->milk and kcal/kg
Infants require 150ml/kg/24 hours
110kcal/kg/day
Bowel motions of breast fed
Non offensive
Porridge consistency
Yellow
Reduced bowel motion frequency without constipation
Ways to encourage successful breast-feeding
- Introduce concept of breastfeeding antenatally
- Baby to breast immediately after delivery
- Feeding on demand
- Avoid offering any formula feeds
- Ensure mother has good nutrition and rest
- Skilled advisors if any issues
- Ensure latching on and good position