Growth and development 2024 Lecture Notes PDF

Growth & Development Basma Abdelmoez Professor Of Pediatrics, Faculty of Medicine ,Minia University  Objectives Describe the difference between growth and development. Identify the stages of growth and development Demonstrate factors affecting growth...

Growth & Development Basma Abdelmoez Professor Of Pediatrics, Faculty of Medicine ,Minia University  Objectives Describe the difference between growth and development. Identify the stages of growth and development Demonstrate factors affecting growth and development. Describe different patterns of growth. Know how to assess the growth of a child  What is the difference between Growth and Development? Growth It is the increase in the size of the body as a whole or of its individual parts. Due to multiplication of the cells & ↑ in size of the cell. Development It is the maturation of organs and systems. With acquisition of skills. Adaptation to society and assuming responsibilities.  Periods in human life (Stages of growth & development) A) Intrauterine Stage Embryonic life→ 1st trimester Fetal life→ 2nd& 3rd trimester B) Extrauterine Stage 1. Neonatal period → the first 4 weeks of life (28 days). * Perinatal period → from 20th wk of fetal life to the end of the first 28 days. 2. Infancy (First 2 years of life) Early infancy → 1st year Late infancy → 2nd year  Periods in human life (Stages of growth & development) 3. Childhood (2-12yrs) Preschool age (early childhood)→ 2-6 years. School age (late childhood) → 6-10 yrs in females 6-12 yrs in males 4. Adolescence Females: 10 -15 yrs. Males: 12 -17 yrs. 5. Adulthood Females: >15 Males: > 17  Genetic Perinatal Factors affecting Growth & Development Chronic illness Environmental Sex Psychological differences & Emotional Endocrinal Socio-economic Nutritional Growth  Growth Patterns 1. General somatic pattern. 2. Neural pattern. 3. Genital pattern 4. Lymphatic pattern.  Assessment of Growth Body Teething Osseous Measures maturation  Assessment of Growth ⇩ Body Measures ⇣ Compare these measurements with growth standards Compare withAVERAGE for age & sex Plot on PERCENTILES Assessment of Growth Measuring Weight Head circumference Length/Height  Objectives Describe the average of growth measures of a normal child. Explain what a percentile is. Demonstrate plotting of a child measure against a percentile chart.  Assessment of Growth Body Teething Osseous Measures maturation  Assessment of Growth ⇩ Body Measures ⇣ Compare these measurements with growth standards Compare withAVERAGE for age & sex Plot on PERCENTILES Weight Compare with AVERAGE for age & sex  Compare with AVERAGE for age & sex 1. Weight ↓ 5-10% of weight in the first 3-4 days→ regained by age of 10 days. Average weight during the first year of life: - At birth → 3-3.5 kg (2.5-4 kg) - At 4mo → 6 kg (↑ by ¾ kg/mo) - At 8mo → 8 kg (↑ by ½ kg/mo) - At 12mo → 9-10 kg (↑ by ¼ kg/mo) Average weight after the first year of life Weight = Age in years x 2 + 8 (kg) Weight Compare with AVERAGE for age & sex Length/Height  Compare with AVERAGE for age & sex 2. Length/Height Average length during the first two years of life: - At birth → 50 cm - At 1 year → 75 cm (↑ by 25 cm = 50/2) - At 2 years → 87 cm (↑ by 12.5 cm = 25/2) - After that → ↑ by 6 cm/yr ⇒ At 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 size/length - At birth = 1/4 - In adult = 1/8  Body midpoint - At birth → just above umbilicus - At 2 yrs → just below umbilicus - At 6 yrs → midway between umbilicus and symphysis pubis - In adults → at symphysis pubis Adult Child Infant Baby  Arm span - Till 7 yrs → 3cm less than height -After that → span = height Weight Compare with AVERAGE for age & sex Length/Height Body Proportions  Compare with AVERAGE for age & sex 3. Body proportions Upper segment/lower segment ratio = crown to SP/ SP to heal ratio Variations in U/L ratio: - At birth = 1.7: 1 - At 3 yrs = 1.3: 1 - At 7yrs = 1:1 Significance→ short stature These ratios are normal → proportionate short stature These ratios are abnormal →disproportionate short stature (Causes???) Weight Compare with AVERAGE for age & sex Length/Height Body Head Proportions Circumference  Compare with AVERAGE for age & sex 4. Head Circumference Maximum growth during the first year: - At birth → 35 cm - At 3 mo → 41 cm (↑ by 2 cm/mo in the first 3 months) - At 12 mo → 45 cm (↑ by ½ cm/mo in the rest of the 9 mo) Reduced growth rate after that: - At 5 yrs → 50 cm - At 12 yrs → 55 cm (↑ by 5 cm/6 yrs)  Compare with AVERAGE for age & sex 4. Head Circumference Fontanelles Anterior Fontanelle - At birth → 4-5 cm (3 finger breadth in transverse diameter) - At 6 mo → 3 cm (2 finger breadth in transverse diameter) - At 12 mo → 1.5 cm (1 finger breadth in transverse diameter) - At 18 mo → closes Posterior Fontanelle → closed at birth or soon after (2mo). Q What are the causes of delayed closure of ant. and post. fontanelles? Weight Compare with AVERAGE for age & sex Length/Height Body Head Chest Proportions Circumference Circumference  Compare with AVERAGE for age & sex 5. Chest circumference Measured - At nipple line - Subject sitting - Midway between inspiration and expiration Relation between head and chest circumferences - At birth → HC > CC by 2 cm - At 1-2 yrs → HC=CC - After 2 yrs → HC