Growth & Development Stages

Growth & Development

• Growth refers to an increase in the size of the body or its individual parts. This occurs through cell multiplication and an increase in cell size.
• Development refers to the maturation of organs and systems. It includes the acquisition of skills, adaptation to society, and assuming responsibilities.

Stages of Growth & Development

• Intrauterine Stage:
  • Embryonic life: First trimester of pregnancy
  • Fetal life: Second and third trimesters of pregnancy
• Extrauterine Stage:
  • Neonatal Period: The first 4 weeks of life (28 days).
    • Perinatal period: From the 20th week of fetal life to the end of the first 28 days
  • Infancy: (First 2 years of life)
    • Early infancy: First year
    • Late infancy: Second year
  • Childhood: (2-12 years)
    • Preschool age (early childhood): 2-6 years
    • School age (late childhood): 6-10 years for females, 6-12 years for males
  • Adolescence:
    • Females: 10-15 years
    • Males: 12-17 years
  • Adulthood:
    • Females: > 15 years
    • Males: > 17 years

Factors Affecting Growth & Development

• Genetics: The most important factor.
• Perinatal: Events during and around birth.
• Environmental: Social, cultural, and economic factors.
• Chronic Illness: Can significantly impact growth and development.
• Sex Differences: Physiological variations between genders.
• Psychological & Emotional: Mental health and emotional well-being play a role.
• Endocrine: Hormonal influences on growth.
• Nutritional: Adequate nutrition is essential for proper growth.
• Socio-economic: Economic status and living conditions can influence growth.

Growth Patterns

• General Somatic: Refers to overall body growth.
• Neural: Growth of the brain and nervous system.
• Genital: Growth of the reproductive organs.
• Lymphatic: Growth of the lymphatic system.

Assessing Child Growth

• Body Measures: Includes weight, head circumference, and height/length (measuring growth).
• Teething: Tracking the timeline of teeth eruption.
• Osseous Maturation: Evaluating the development of bones.

Body Measures

• Compare measurements with growth standards:
  • Comparison with AVERAGE for age and sex: Determine if the child is within the typical range for their age and gender
  • Plotting on PERCENTILES: Create a visual representation of the child's growth trajectory using percentile charts

Assessing Child Growth: Body Measure Details

• Weight:
  • First 3-4 days of life: Weight typically decreases by 5-10% and is regained by 10 days of age.
  • Average weight during the first year of life:
    • Birth: 3-3.5 kg (2.5-4 kg)
    • 4 months: 6 kg (increase by ¾ kg/month)
    • 8 months: 8 kg (increase by ½ kg/month)
    • 12 months: 9-10 kg (increase by ¼ kg/month)
  • Average weight after the first year of life: Weight = Age in years x 2 + 8 (kg)
• Length/Height:
  • Average length during the first two years of life:
    • Birth: 50 cm
    • 1 year: 75 cm (increase by 25 cm)
    • 2 years: 87 cm (increase by 12.5 cm)
  • After the second year: Increase by 6 cm/year.
    • 4 years: 100 cm (double birth length)
  • Average length after the first two years of life: Length = Age in years x 5 + 80 (cm)
• Head Circumference:
  • Maximum growth during the first year:
    • Birth: 35 cm
    • 3 months: 41 cm (increase by 2 cm/month)
    • 12 months: 45 cm (increase by ½ cm/month)
  • Reduced growth rate after the first year:
    • 5 years: 50 cm
    • 12 years: 55 cm (increase by 5 cm/6 years)
  • Fontanelles:
    • Anterior Fontanelle:
      • Birth: 4-5 cm (3 finger breadth)
      • 6 months: 3 cm (2 finger breadth)
      • 12 months: 1.5 cm (1 finger breadth)
      • 18 months: Closes
    • Posterior Fontanelle: Closed at birth or shortly afterward (within 2 months).
• Chest Circumference:
  • In infants, chest circumference is approximately 1 cm less than head circumference.
  • As the child grows, the chest circumference becomes greater than head circumference.
  • By the time the child reaches 5 years of age, the chest circumference is usually equal to the head circumference.

Body Proportions

• Upper segment/lower segment ratio: Crown to pubic symphysis (SP) / SP to heel ratio.
  • Birth: 1.7:1
  • 3 years: 1.3:1
  • 7 years: 1:1
• Short Stature:
  • Proportionate short stature: Normal upper segment/lower segment ratio.
  • Disproportionate short stature: Abnormal upper segment/lower segment ratio (investigate the cause).

Other Growth Assessment Factors

• Body Midpoint:
  • Birth: Just above the umbilicus.
  • 2 years: Just below the umbilicus.
  • 6 years: Midway between the umbilicus and symphysis pubis.
  • Adults: At symphysis pubis.
• Arm Span:
  • Up to 7 years: 3 cm less than height.
  • After 7 years: Span = height.