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Understanding Pediatric Growth Metrics

This document discusses growth and development. It defines growth as an increase in size and weight through cell number and size, while development refers to functional maturation of organs. Both growth and development have limits. It is important to study growth patterns to identify deviations early and detect issues like undernutrition. Key growth parameters include weight, height, head circumference and arm circumference. Standards are set by organizations like WHO and growth is typically plotted on charts using percentiles. Factors like genetics, nutrition, emotional well-being and underlying medical conditions can influence growth.

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Debashish Rath
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52 views48 pages

Understanding Pediatric Growth Metrics

This document discusses growth and development. It defines growth as an increase in size and weight through cell number and size, while development refers to functional maturation of organs. Both growth and development have limits. It is important to study growth patterns to identify deviations early and detect issues like undernutrition. Key growth parameters include weight, height, head circumference and arm circumference. Standards are set by organizations like WHO and growth is typically plotted on charts using percentiles. Factors like genetics, nutrition, emotional well-being and underlying medical conditions can influence growth.

Uploaded by

Debashish Rath
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

GROWTH AND DEVELOPMENT

Dr B RATH
Professor & Head
Dept of Pediatrics

Growth & Development


Growth connotes Increase in size and weight
of tissue
Increase in number of cells
Increase in cell size

Development connotes functional maturation


of systems and organs
Note: both are usually closely related but not
always
Both have a limit

Importance of study of growth


To know the normal pattern of growth
To pick up deviations from normal so as to
pick up undernutrition, obesity, short stature,
micro and macrocepahly at the earliest

Growth parameters

Weight
Height
Head circumference
Mid arm circumference
Others : less commonly used

BMI
US:LS
Skin fold thickness
Leg length, etc

Assessment of parameters
Weight:
Prefer electronic scale; beam balance and spring
balance are also used, but less accurate
To be recorded with minimal clothing
In neonatal period: should be recorded before
feeding
For children who are uncooperative, substraction
method used

Height
Stadiometer after 2 years
Infantometer < 2 years, measures length

Head in Frankfurt plane


Heels, buttocks, back and occiput in the same
plane
Heels touching each other
What if: stadiometer and infantometer not
available?

PREPARATION OF STANDARD GRAPHS


Many standards; Harvard, NCHS, CDC, WHO,
ICMR, Dr K N Aggarwal etc
Current reference standard : WHO (which is
cross sectional study from 5 different
countries)
Percentiles calculated mathematically
1 SD corresponds to 84 / 16th percentile
2 SD corresponds to 97 / 3rd percentile

GROWTH CHARTS

Velocity of Growth

WHAT YOU MUST KNOW

FORMULA TO CALCULATE WEIGHT


3-12 nonths
[Age (m) +9] 2 kg

1-6 years
[Age (yrs) x 2 ] + 8 kg

7-12 years
{[Age (yrs) x 7 ] 5} 2 kg

More info on growth data


Average birth weight 2.8 2.9 kg
Weight gain during first 3 months 25-30 gms/day
Next 3 months 15-20 gms /day
Next 6 months 10-15 gms/day

Head circumference: at birth 33-34 cms


2 cms/ months in first 3 months
1 cm/ month x next 3 months
0.5 cm / month x next 6 months

PLOTTING AND INTERPRETING


GROWTH DATA

The Z score
[ Observed value mean ] SD

FACTORS AFFECTING GROWTH

Net result of genetic potential and


environmental factors
Genetic factors
Genetic diseases: trisomies, pygmies
Genetic bone disease: achondroplasia,
hypochondroplasia, chondrodysplasias, Morquio
disease

Environmental factors
NUTRITION
Depends on availability of food, socioeconomic status,
literacy of parents, food fad
Inability to swallow : CP

EMOTIONAL
Emotional deprivation

FACTORS AFFECTING GROWTH

Normal Body systems

Normal body homeostasis


pH, measured cations and anions and adequate O2 supply to
tissues

Normal endocrine function


Growth hormaone, thyroid hormone, sex hormones, insulin

Chronic Diseases

Chronic Malabsorption
CHD
C lung/ Liver D
ESRD
Chronic inflammtory disease ( TB/JRA/SLE)
Malignancy
Chronic Bowel Disease

FACTORS AFFECTING GROWTH


Intra uterine factors
Placental
TORCH infections
Gestational diabetes

More notes
Every child is expected to maintain his/her own
channel of growth
Growth may be uneven. Periods of growth arrest
may be followed by periods of catch up growth
Correction for immmaturity is done upto age of 2
years but not thereafter
Expected final height
Boys = mid parental height + 6.5 cm
Girls = mid parental height - 6.5 cm

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