GROWTH

Dr. Vijaya Mohan

05/02/2007
• Implies a net increase in the size
or mass of tissue and occurs due
to multiplication of cells and an
increase in the intracellular
substance
Why monitor growth ?
• Assessment of a child’s growth is the
best marker of their well being- nutrition
and good health
• The normal pattern of expected growth
is traditionally displayed on a growth
chart
• Early detection of disease in children
PHASES OF GROWTH
4 PHASES OF HUMAN GROWTH:
• Fetal
• Infantile
• Childhood
• Pubertal
Fetal
• Fastest period of growth
• 30% of eventual height
• Determined by the size of the mother
and by placental nutrient supply
• Insulin like growth factor 2 , Human
placental lactogen and insulin
Infantile phase
• Growth during infancy to around 18
months of age is largely due to
adequate nutrition
• Good health, normal thyroid function
• Accounts for about 15 % of final height
Childhood phase
• Growth hormone and IGH-1,
thyroid hormone acting at the
epiphysis
• 40 % of final height
• Psychosocial causes important
Pubertal growth spurt
• Testosterone and oestradiol cause
the back to lenghten and boost
GH secretion
• Adds final 15% to height
Measurement
• Height
• Supine length
• Weight
• Head circumference
Height
• Most accurate height measuring
equipment is the Harpenden
Stadiometer
• Remove shoes, position the child with
the heels and back touching the
backboard,head straight, eyes and
ears level,gentle upward traction of the
mastoid process,knees straight for
children above 2 years
Supine length
• In children below 2 years ,supine length
is taken
• Frankfurt plane
• One person holds the head against the
headboard while the other straightens
the legs and moves the footboard up
against the heels firmly.
Weight
• Naked infant
• Child dressed in underclothes,
shoes removed
• Electronic scales
• Uncooperative toddlers weighed
with adult
Head circumference
• Maximum occipitofrontal
circumference is taken
• Mean of 3 measurements
• Measure of head and brain growth
Growth parameters
• Neonate normally loses up to
12%of body weight in the first few
days of life but should regain birth
weight by 10 days of life
• Subsequent weight gain of 30
grams per day
• Birth weight is doubled by 5
months and tripled by at about 1
year.
• Expected weight of a young child
in kilograms age in years plus 4,
multiplied by 2.
Height
• At birth approx. 50 cm,increasing
to 75 cm at 1 year and 100 cm at
4 years
• Subsequently annual gain of
approx. 5 cm
Head circumference
• At birth average 35 cm,40 cm at 3
months,47 cm at 1 year.
• Subsequent annual increase is .5
cm from 2 to 7 years and .3 cm
from 8 to 12 years