16. Assessment of Growth .pptx

Assessment of growth ANTHROPOMETRY GROWTH IS ASSESSED BY ANTHROPOMETRY, (MEASUREMENT OF BODY DIMENSIONS) Parameters to assess growth WEIGHT HEIGHT HEAD CIRCUMFERENCE BMI Other parameters of growth Bone age & Dentition WEIGHT: Minimum clothing Weight using beam scale Electronic weighing machi...

Assessment of growth ANTHROPOMETRY GROWTH IS ASSESSED BY ANTHROPOMETRY, (MEASUREMENT OF BODY DIMENSIONS) Parameters to assess growth WEIGHT HEIGHT HEAD CIRCUMFERENCE BMI Other parameters of growth Bone age & Dentition WEIGHT: Minimum clothing Weight using beam scale Electronic weighing machine Weighing a child using beam scale HEIGHT:  > 2 years---stadiometer to measure standing height  < 2 years: infantometer to measure recumbent length.  At birth: 50 cm  At 1 year: 75 cm  2-12 years: age(yrs)x6+77 = Ht in cm Using infantometer for length Using stadiometer for measuring height HEAD CIRCUMFERENCE (OFC):  Represents growth of the brain  Accuracy up to 1mm.  Microcephaly: HC <3SD for sex and age  Cranisynostosis: premature closure of sutures HEAD CIRCUMFERENCE (OFC) Measuring head circumference: Most prominent point on occiput and supraorbital ridge. Using non-stretchable tape BMI – Body Mass Index  With the metric system, the formula for BMI is weight in kilograms divided by height in meters squared.  Calculated BMI is plotted on BMI chart  Obesity / Overweight is diagnosed based on BMI centiles in children Growth Charts  Most important tool in assessment of growth of individual child  First designed by David Morley  It is a visual display of physical growth  Mainly for longitudinal follow up  Uses of growth charts:  Growth monitoring  Diagnostic tool  Planning and policy making  Educational tool Assessment of growth Mean & Standard deviation (S.D): Indicates where a given child is in relation to the so called normal group. 1 S.D – 66.6%, 2 S.D – 95%, 3 S.D – 99.7%  Concept of Percentile: – The no. of the percentile indicates the position which a measurement would hold in a typical series of 100. – 50th centile is the median value and is also termed standard value. – Usual accepted range of normal is Reference Population: Standard Normal Curve 50th Percentile 5th 95th CDC Growth Charts 2000 Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Nutrition and Physical Activity Maternal and Child Nutrition Branch CDC Growth Charts Are for All Racial and Ethnic Groups Combined  The effect of race and ethnicity on growth is controversial  Inadequate sample data for racial and ethnic specific charts  Environmental influences appear to contribute to variations in growth but more research is needed Available CDC Growth Charts  Birth to 36 months  Weight-for-length  Length-for-age  Weight-for-age  Head circumference-for-age Available CDC Growth Charts  2 to 20 years  BMI-for-age  Stature-for-age  Weight-for-age · Weight-for-height New in the CDC Growth Charts  Charts extend to 20 years  3rd and 97th percentiles available  Lower limits of length (45 vs. 49 cm) and height (77 vs. 90 cm) extended  BMI-for-age charts (2-20 years) added  85th percentile (at risk of overweight) added Parameters to assess growth Selective patients Upper segment : lower segment ratio First measure lower segment: distance from the upper border of pubic symphysis to heel. Height/ Length – lower segment = upper segment Use of US : LS ratio: Higher ratio suggests short limb dwarfism eg achondroplasia Parameters to assess growth Selective patients - Contd Arm span: (Marfan syndrome)  Distance between the tips of the middle fingers with both arms spread apart.  Below 10 yrs arm span < height  At 10 years arm span=height  Beyond 10 yrs arm span > height Mid-arm circumference: (Malnutrition) Skin fold thickness: (Malnutrition)