Please enable JavaScript.
Coggle requires JavaScript to display documents.
Growth in Infancy and Childhood - Coggle Diagram
Growth in Infancy and Childhood
Phases of Normal Growth
Infantile Growth
Rapid growth period from birth to 12-18mths
Rate
Healthy infants grow ~ 25cm/y
Most birth infants show 'catch up grow' during infantile growth period and achieve genetically appropriate centile by age 2
2 ys a child's height highly correlates with their fianl height
Monitored more frequently by weight rather than length / height measurements
Childhood Growth
Rate
6-4cm / year
Failure
Emotionaly depriving environment may result in temporary impaired hGH release
Bullying
Who do you sit with in school
What are your friend's names
What's your teachers name
Adolescent Growth
Puberty
The activation of the hypothalmic-pituitary-gonadal axis resulting in an increased production of sex steroids from ovaries and testes
Female
Change from no breast development to breast budding
Max height velocity #(mean 8.1cm/yr) early in puberty approx 1 yr after breast budding
Peak velocity at 13yrs
At menarch female growth almost complete with only 3-5cm post menarch
Males
Change from pre-pubertal penis, scrotum and testes to testicular enlargement, scrotal laxity, but pre-pubertal penis
Peak height velocity (mean 9.8cm/yr) occurs mid puberty (testicular volume 10-15ml)
Grow relatively slowly in early puberty and continue to grow even at full pubertal maturation
Growth stops shortly after male starts shaving
Orchidometer to assess testicular volume
Measurement of Growth
Supine length (Birth - approx 3 yrs)
Uses
Measurement of a child unable to stand
Equipment
Horizontal stadiometer
Key
2 ppl required
Child positioned on their back and head in contact with fixed headbaord
Feet upwarfs
Standing height (2yrs on)
Use
Measurement of child old enough to cooperate
Equipment
Fixed Stadiometer
Key
Remove footwear
Heels placed agaisnt bases
Encourage standing tall
Position head looking straight ahead with lower borders of the eye sockets in the same horizontal plane as the external auditory meati
Sitting height
Uses
To assess body proportions through deriving such-ischial leg length
Equipment
Sitting Stadiometer
Key
Use specific sitting height stadiometer
Use same head position
Feet are supported so that calves are relaxed
Subsichial leg length
Head Circumference
Most important in infancy and early childhood lfecting intracranial volume and brain growth
2/3 total head growth normally takes place between full term and 24 months
Boys heads bigger
..
Weight
Less than 2 nude
Over 2 in minimun clothing - empty pockets
Ensure scales is dalibrated monthly
Bone Age
Key
DEfines the amount of growth already taken pace and potential growth for the future
Method
X ray of non dominant hand
Systems
Greulich-Pyle
Series of x-rays to estimate the maturity of each epiphyseal centre in the hand and wrist
Tanner-Whitehouse
Each epiphyseal center is assigned a score, which when added together gives a bone maturity score
Software programmes
BoneXpert
Factors Influencing Growth
Genetics
Parental height indicate the target / mid - parental height for child
Girls ( Fathers height + mothers height ...
Mid Parental Height
Method
Boy
Plot fathers height on right side of growth chart
Ass 12.5 to mothers hgiht and plot on right side of chart
Girls
Plot mothers height on right side of chart
Gender
12.5cm height difference ...
Nutrition
Malnutrition
Deficienct intake
Malabsorption
Overfeeding
Ethnic Difference
Underlying chronic disease
Growth hormone deficienct
Renal insuffieciency
GI - coeliac , chronhs
...
Seasonal
Increased rate during summer months
Asses height velocity over 6mth-1yr period for allow for seasonal factor
Growth Disorders
Short stature children
70% of mothers realise their child is short
Any child whose height falls below 2rd centile
Causes
Endocrine
Hypothyroidism
Panhypopituitarism
Cushings
GHD insufficiency
Metabolic
Steroids
Idiopathic
Non-Endocrine
Familial
Constituitional
IUGR / SGA
Chronic disease
Malnutrition
Coeliac
Skeletal Dysplasia
Chromosomal - turners
Tall stature children
Any child whose height falls above the 99.6th centule
Less of a concern - considered advantageous
Causes
Endocrine
GH secreting tumours
Precoscious puberty
Hyperthyroidism
Simple obesity
Non-endocrine
Marfans
Constitutional growth delay
Growth Assessment
Accurate measurement of lenght height sitting height anf weght
Measurement of parents
Calculate decimal age
Plot the measurements on appropriate chart
Condition specific Growth Chart
Turner's
Down's syndrome
Growth
An Important indicators of a child's health and wellbeing
Vertical growth stops when the long bones stop lengthening as epiphyseal plates close
Influence
Good health
Adequate nourishment
Emotional security
Accuracy of Measurements - Auxology
Meta-term covering the study of all aspects of human physical growth
Key Points
Taken by the same person each time
Same technique
Same time of day
Everyone shrinks by 1-2cm during the day but mainly within 1st hour after rising
Taken using same equipment
Plotted carefully on centile chart
