The Normal Child

Question 1

What are the 4 main phases of growth?

Answer 1

1. Pre-natal / intrauterine (most rapid)
2. Infantile (up to 1yr)
   –Nutrition, good health and thyroid hormones impact this phase
3. Childhood
   –Growth hormone, thyroid hormones, good health + genetics
4. Pubertal
   –Testosterone / oestrogen, growth hormone

Question 2

What is the average birthweight and how should this weight increase?

Answer 2

-3.3kg
-Should increase by 30g/day up to 3 months
-Should x2 by 5 months
-Should x3 by 1 year
(expected weight for ages 1-10 = 2x(age + 4) )

Question 3

When should children start to develop teeth?

Answer 3

-Starts at 6 months - develop until 2 years
-Permanent teeth develop from 6-12yrs
-3rd molars by age 20

Question 4

What is the average head circumference at birth?

Answer 4

-35cm
-Adult = 50-60cm

Question 5

What is the normal feeding requirement?

Answer 5

-150ml/kg/day from day 7 –> weaning
(1 Oz = 30ml)

Question 6

What is the normal fluid requirement (when prescribing)?

Answer 6

-1st 10kg = 100ml/kg/day
-2nd 10kg = 50ml/kg/day
-3rd + subsequent = 20ml/kg/day

Question 7

What kind of vomiting does pyloric stenosis cause?

Answer 7

-Milky, projectile vomiting
-Hypochloraemic, hypokalaemic metabolic acidosis

Question 8

What is considered overweight + obese in children, and what is the recommended amount of physical activity they should get?

Answer 8

> 91st centile = overweight
98th centile = obese
-Should get 60mins/day (anything that increases HR

Question 9

What is development and what are its 4 key components?

Answer 9

= interaction of heredity + environment
1. Gross motor
2. Fine motor
3. Speech and language
4. Social

Question 10

What are the median ages for some key motor milestones?

Answer 10

6-8 weeks = raises head to 45 degrees
6-8 months = sits without support
8-9 months = crawling
12 months = walking unsteadily
18 months = running
2 years = jumping

Question 11

What are some warning signs for developmental delay?

Answer 11

-PERSISTING PRIMITIVE REFLEXES (should disappear by 4-6 months)
-Discordant development
-Regression
-FHx
-Maternal concern

Question 12

What screening procedures are done for infants?

Answer 12

-Birth neonatal exam
–Eyes (red reflex), heart, hips, hearing
-1 week Guthrie test (heel prick)
–PKU, hypothyroidism, CF, haemoglobinopathies
-8 week general examination
-4-5yrs orthoptist

Question 13

When should bladder control be established by?

Answer 13

-Dry during the day by 2-3yrs
-Dry at night by 3-4yrs
NB enuresis = inappropriate voiding after these ages
NB encopresis = inappropriate passage of faeces into clothes during day or night after the age of 4