Growth Velocity and Charts in Childhood

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Questions and Answers

What age range is classified as early childhood?

12-18 years

6-12 years

0-2 years

2-6 years (correct)

Which of the following is NOT a method of assessing growth?

Anthropometric measures

Psychological testing (correct)

Fontanelles

Growth charts

What is the expected weight gain during the first 4 months of infancy?

250 g/month

750 g/month (correct)

500 g/month

1 kg/month

At what age does a child's weight triple approximately?

12 months Signup and view all the answers

Which of the following statements is true regarding weight increases in early childhood?

Weight increases by 2 kg/year. Signup and view all the answers

What is the body measurement expected at 4 months for an average infant?

6 kg Signup and view all the answers

What is the weight formula for children aged 1-6 years?

Weight in kg = (Age in years X 2) + 8 Signup and view all the answers

Which anthropometric measure is used to assess the growth of an infant's head?

Occipto-Frontal head circumference Signup and view all the answers

What is the primary purpose of using percentile measurements in assessing child growth?

To indicate normal growth range between the 3rd and 97th percentile Signup and view all the answers

What does a child's position in a percentile chart represent?

The child's growth parameters relative to others Signup and view all the answers

Which of the following statements about growth measurement deviations is correct?

A drop of two major percentiles suggests potential growth issues Signup and view all the answers

When should a child be investigated for abnormal growth based on percentile measurements?

If any single measurement is below the 3rd percentile or above the 97th percentile Signup and view all the answers

How is the normal growth range defined for a child in percentile terms?

Between 3rd and 97th percentiles Signup and view all the answers

What indicates malnutrition based on a child's weight curve?

A weight at the 50th percentile dropping to the 15th percentile Signup and view all the answers

What does plotting sequential measurements of a child's weight on a growth chart help evaluate?

The child's weight change over time in relation to growth patterns Signup and view all the answers

What is a common misconception regarding the percentile ranking system?

Higher percentiles indicate better overall health Signup and view all the answers

What is the maximum rate of brain growth reflected by the Occipto-Frontal Circumference (OFC) during the first year?

2 cm/month Signup and view all the answers

At what age should the OFC to chest circumference (CC) ratio equal 1?

At 6 months Signup and view all the answers

How is body surface area (BSA) calculated?

Square root of (Height (cm) x Weight (kg) ÷ 3600) Signup and view all the answers

At what age does teething typically start?

6-9 months Signup and view all the answers

What is the clinical significance of the OFC/CC ratio exceeding 1 beyond 6 months?

Suspect malnutrition Signup and view all the answers

Which of the following statements about OFC is true?

It reflects the rate of brain growth. Signup and view all the answers

What is the typical OFC at birth?

35 cm Signup and view all the answers

What measurement is taken at the level of the xiphoid process?

CC Signup and view all the answers

How should length be measured for a child under 2 years old?

In a supine position Signup and view all the answers

What is the expected height increase for a child during the second three months of life?

2 cm per month Signup and view all the answers

At what age is a child's height measured by the formula: Height = age in years x 5 + 80?

After the 2nd year Signup and view all the answers

If a child is 12 years old, how would you calculate their expected height based on their birth length?

Birth length x 3 Signup and view all the answers

Which of the following is NOT a step in measuring a child's length accurately?

Have the child look to the right Signup and view all the answers

For children older than 2 years, what is the correct position for measuring height?

Standing with back against the wall Signup and view all the answers

What is the role of the second person during the length measurement in children under 2 years?

To straighten the child's legs and hold the footboard Signup and view all the answers

Which growth measurement is affected by long-standing malnutrition for at least 6-12 months?

Length or height growth standards Signup and view all the answers

At what age does the first carpal bone typically start ossification?

2 months Signup and view all the answers

What is the significance of X-ray knee in newborns?

It assesses intrauterine skeletal maturation. Signup and view all the answers

How many carpal bones ossify by the age of 6?

7 Signup and view all the answers

What does a flattening of the weight curve in a growth chart indicate?

Early predictor of malnutrition Signup and view all the answers

At what age are 2 carpal centers typically present?

1 year Signup and view all the answers

Which percentile range is considered abnormal for a child's growth?

Between 3rd and 97th percentiles Signup and view all the answers

How often does one additional carpal center appear after the first year?

Annually each year until 6 years Signup and view all the answers

How many percentile curves are typically present in a growth chart?

7 Signup and view all the answers

What key component results in increased body size during growth?

Multiplication of cells Signup and view all the answers

Which of the following factors does NOT directly affect growth?

Psychological well-being Signup and view all the answers

During which stage of development does organogenesis occur?

Embryonic stage Signup and view all the answers

At what point does the most rapid physical growth and mental development typically occur postnatally?

Infancy Signup and view all the answers

Which hormone is primarily responsible for influencing growth rates?

Growth hormone Signup and view all the answers

Which period does NOT fall under the definition of postnatal growth?

Prenatal period Signup and view all the answers

What is one likely effect of being bedridden on growth?

Decreased growth Signup and view all the answers

What aspect of development does NOT directly relate to acquiring new skills?

Genetic factors Signup and view all the answers

What does a child's position in the percentile row represent?

The child's rank among peers based on growth parameters Signup and view all the answers

What should be investigated if a child's measurement falls below the 3rd percentile?

Possible genetic growth abnormalities Signup and view all the answers

What is indicated if a child's weight decreases from the 50th percentile at birth to the 15th percentile at 6 months?

A potential growth disorder Signup and view all the answers

What action is recommended if a child's growth curve deviates more than 2 major percentiles?

Examine for possible underlying health issues Signup and view all the answers

What are the normal percentile boundaries for measuring children's growth?

3rd to 97th percentile Signup and view all the answers

Which outcome is a purpose of plotting a child's weight on a growth chart?

To establish a consistent growth pattern Signup and view all the answers

What does the horizontal axis on a child's growth chart represent?

Age of the child Signup and view all the answers

Why is it important to use percentile measurements when assessing child growth?

To provide a baseline for average child development Signup and view all the answers

What is the primary rate of weight increase during the second four months of infancy?

500 g/month Signup and view all the answers

Which anthropometric measure is generally associated with assessing upper body growth in children?

Mid arm circumference Signup and view all the answers

What is a common weight gain expectation for a child during early childhood years after the age of 6?

2.5 kg/year Signup and view all the answers

What age is typically associated with the onset of adolescence?

12-18 years Signup and view all the answers

How is the weight of a child at 8 months expected to be compared to their birth weight?

It should be double the birth weight. Signup and view all the answers

Which growth measurement method requires the comparison of a single measurement with established averages?

Anthropometric Measures Signup and view all the answers

What is the approximate body measurement for a typical newborn's average weight?

3-3.5 kg Signup and view all the answers

What is a key indicator of abnormal growth based on a child's growth chart?

Crossing two percentile lines downward Signup and view all the answers

What is the expected increase in length per month for an infant during the first 3 months of life?

3 cm/month Signup and view all the answers

Which method is NOT appropriate for measuring a child's length under 2 years old?

Measuring in a standing position Signup and view all the answers

At what age should a child's height first be calculated using the formula: Height = age in years x 5 + 80?

12 years Signup and view all the answers

What should be done with a child's feet when measuring length accurately in the supine position?

Toes should be pointed upward Signup and view all the answers

How does a child's expected height at age 4 compare to their birth length?

It is twice the birth length Signup and view all the answers

What is the expected rate of height increase for a child from 1 to 2 years of age?

1 cm/month Signup and view all the answers

What does a child’s length measurement depend on if malnutrition persists for a prolonged period?

Long-standing malnutrition Signup and view all the answers

Which of the following statements is correct regarding the measuring of standing height?

The back should be straight against the wall Signup and view all the answers

What condition may cause the anterior fontanel to remain open beyond 6 months after birth?

Mongolism Signup and view all the answers

Which of the following is NOT a recognized cause of abnormal fontanel closure?

Osteogenesis imperfecta Signup and view all the answers

At what age does teething typically commence?

6 months Signup and view all the answers

Which of the following ossification centers is NOT typically present at birth?

Scapula Signup and view all the answers

What is the expected state of the posterior fontanel at birth?

Open but less than 0.5 cm Signup and view all the answers

Which of the following statements about secondary teeth is accurate?

Teething lasts from 6 years to 22 years Signup and view all the answers

What would indicate an abnormally large anterior fontanel at birth?

Open greater than 1 cm Signup and view all the answers

Which of the following conditions is associated with premature closure of the fontanel?

Hypopituitarism Signup and view all the answers

Study Notes

Growth Velocity Curves

Growth velocity is highest during infancy and puberty
Percentile: the relative position of a child's measurement compared to other children of the same age and sex
Normal range of measurements falls between 3rd and 97th percentile
Deviations outside this range may indicate abnormal growth and require further investigation

Using Growth Charts

Plot a child's weight measurements over time to create a weight curve
Deviations of greater than 2 major percentiles indicate abnormal growth
Example: if a child's weight was at the 50th percentile at birth and drops to the 15th percentile by 6 months, it indicates potential malnutrition

Value of Growth Charts

Follow up of growth
Early detection of deviations from normal growth (e.g. growth retardation)
Help in excluding organic problems as a cause of minor complaints (e.g. a mother complaining that her baby is not feeding "well" when the weight curve is not affected)

Stages of Childhood

Early childhood: 2-6 years (toddler or preschool age)
Late childhood (school age): 6-12 years
Adolescence: 12-18 years

Assessing Physical Growth

Anthropometric measures: physical measurements like weight, height, head circumference, etc.
Teething: the eruption of teeth
Fontanelles: soft spots on a baby's skull
Osseous Growth (Bone age): assessing bone development through X-rays
Growth Charts (Curves): graphical representations of growth measurements

Anthropometric Measures

Weight
- Average weight at birth: 3-3.5 kg
- First 4 months: weight increases by 750 g/month (3/4 kg)
- Second 4 months: weight increases by 500 g/month (1/2 kg)
- Third 4 months: weight increases by 250 g/month (1/4 kg)
- Early childhood (1-6 years): Weight increases by 2 kg/year (Weight in kg = (Age in years X 2) +8)
- Late childhood (7-12 years): Weight increases by 2.5 kg/year (Weight in kg = (Age in years X 7) - 5 / 2)
Length/Height
- Length is measured in supine position for children under 2 years
- Height is measured in standing position for children over 2 years
- At birth: 50 cm
- First 3 months: increases 3 cm/month
- Second 3 months: increases 2 cm/month
- From 7-12 months: increases 1.5 cm/month
- From 1-2 years: increases 1 cm/month
- After the 2nd year: Height = age in years x 5 + 80
- At 4 years: Birth length x 2
- At 12 years: Birth length x 3
Occipto-Frontal head circumference (OFC)
- Reflects brain growth
- At birth: 35 cm
- First 3 months: increases 2 cm/month
- Next 9 months: increases 0.5 cm/month
OFC and chest circumference (CC) ratio
- Measured at the level of the xiphiodprocess during mid-inspiration
- Suspect malnutrition if OFC/CC ratio > 1 beyond 6 months
- Age range and OFC/CC ratio: At birth > 1, at 6 months equal 1, at 1st year 95th centile
Mid arm circumference
Skin fold thickness
Arm span – Height relationship
Proportions of upper segment and lower segment

Teething

Primary (deciduous or milky) teeth start erupting at 6-9 months and are completed by 24 months

Osseous Growth

X-ray of the knee in newborns: helps assess intrauterine skeletal maturation and screen for congenital hypothyroidism
Carpal bones:
- First carpal bone ossifies at about 2 months of age
- Second carpal bone ossifies by the end of the first year
- One carpal bone ossifies approximately each year until the 6th year
- The 8th bone usually ossifies at the 12th year of age

Growth Charts (Curves)

Assess growth and normal growth variations among children
Early predictor of malnutrition (flattening of weight curve)
Monitor success of treatment for malnutrition
Each chart is composed of 7 curves representing percentiles: 97th, 90th, 75th, 50th, 25th, 10th and 3rd
Normal children should fall between the 3rd and 97th percentile curves
Deviations from a child's own percentile curve on serial measurements is abnormal

Growth Velocity Curves

Growth rate is most rapid during infancy and puberty.
While some variation is normal, children with measurements below the 3rd percentile or above the 97th percentile should be investigated.
Growth charts are used to track a child's growth over time, looking for deviations greater than 2 major percentiles.
A significant drop in percentile can indicate malnutrition.

Growth Chart Value

Growth charts are used to monitor a child's growth.
Growth charts help identify abnormal growth, such as growth retardation.
Growth charts can help rule out organic concerns when a child's weight curve is normal despite a parent's concern.

Growth Definitions

Growth is the natural increase in body size.
Growth results from cell multiplication and enlargement.
Measured by weight, height, head circumference, etc.
Development includes functional maturation of organs and systems, skill acquisition, adapting to new situations, and assuming responsibilities.
Development is measured by gross motor, fine motor, language, and social milestones.
Growth and development occur concurrently, not separately.

Factors Affecting Growth

Genetics
Endocrine System - Growth hormone and thyroid hormones are important.
Nutrition - Poor maternal and child nutrition during pregnancy and lactation can limit growth.
Chronic infections
Physical activity
Socioeconomic Status
Environment

Stages of Growth and Development

Prenatal:
- Embryonic stage (first 12 weeks of gestation) is marked by organogenesis.
- Fetal stage (12th to 40th week of gestation) is a period of rapid growth and development.
- The second trimester is characterized by length growth, while the third trimester is characterized by weight gain.
Perinatal: From the 20th week of fetal life to the 28th day after delivery.
Postnatal:
- Neonatal period: First 4 weeks after birth.
- Infancy (1-24 months): Rapid physical growth and mental development.
  - Early childhood (toddler age or preschool age): 2-6 years.
  - Late childhood (school age): 6-12 years.
- Adolescence: 12-18 years.

Assessing Growth

Anthropometric measures - including weight, height, head circumference, mid-arm circumference, skin-fold thickness, and arm span
Teething
Fontanelles
Osseous growth (bone age)
Growth charts

Weight

At birth: Average weight is 3-3.5 kg
Infancy:
- During the first 4 months, weight gains average 750 g/month.
- During the second 4 months, weight gains average 500 g/month.
- During the third 4 months, weight gains average 250 g/month.
Early childhood (1-6 years): Weight increases by approximately 2 kg/year.
Late childhood (7-12 years): Weight increases by approximately 2.5 kg/year.

Length or Height

Under 2 years: Length is measured in a supine position.
Over 2 years: Height is measured in a standing position.
At birth: Average length/height is 50 cm.
First three months: Increase in Length of 3 cm/month.
Second three months: Increase in Length of 2 cm/month.
From 7-12 months: Increase in Length of 1.5 cm/month.
From 1-2 years: Increase in Length of 1 cm/month.

Length or Height Calculation

After 2 years: Height = (Age in years x 5) + 80
4 years: Birth Length x 2
12 years: Birth Length x 3

Teething

Primary (deciduous teeth):
- Eruption starts at around 6-8 months and is usually complete by 2.5 years.
- The lower jaw incisors erupt before the upper jaw incisors.
Secondary (permanent teeth):
- Eruption starts at around 6 years and is usually complete by 22 years.
- Permanent teeth erupt immediately following exfoliation or may lag by 4-5 months.

Fontanelles

Posterior Fontanelle:
- Typically closed at birth or opened < 0.5 cm and closes within 2 months.
- If open > 1 cm or not closed within 4 months, it may indicate prematurity, increased intracranial tension, mongolism, cretinism, or other conditions.
Anterior Fontanelle:
- Closed at 18 months.
- Three fingerbreadths (3-4 cm) at birth.
- Two fingerbreadths at 6 months.
- One fingerbreadth at 12 months.
Large Fontanelle: (Delayed closure; before 6 months) May indicate Down syndrome, achondroplasia, congenital hypothyroidism, rickets, osteogenesis imperfecta, hypopituitarism, or increased intracranial tension.
Small Fontanelle: (Premature closure; before 6 months) May indicate craniosynostosis or congenital hyperthyroidism.

Osseous Growth

At birth, there are five secondary ossific centers:
- Lower end of femur.
- Upper end of tibia.
- Talus.
- Cuboid.

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Description

This quiz explores the importance of growth velocity curves and weight charts for monitoring a child's growth during infancy and puberty. Understand the significance of percentiles and how deviations may indicate potential health issues. Dive into the methods of plotting weight measurements and identifying abnormal growth patterns.