3. 2009 Students Growth
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Transcript of 3. 2009 Students Growth
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ISSUES IN CHILDHEALTH-PART ONE FOCUS ON GROWTH
G.P-RHULE
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DIFFERENTIATION
DEVELOPMENT
GROWTH
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Because growth has an impact on diseasepresentation (FTT, effect of osteomyelitis ongrowth plates )
Because disease has an impact on growth andtherefore nutrition is a key component ofdisease management in children (Extra meal aday, timing of surgery for children with clefts)
Because growth deficiency impacts on adultfuture outcomes (intelligence, work capacity)
Interpreting Labs, X rays (alkaline
phospahtase, ossification centres)
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NUTRITION.
Hormonal influences
Disease states esp chronic.
Hereditary / Familial/Racial etc
Chromosomal /Genetic abnormalities
Social / Emotional
Often multifactorial.
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Weight for age
Height for age /weight
Head circumference Skin fold thickness Beads
Clothes
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Mid armcircumference
Other specialised
parameters eg. Armspan, , testicularvolume etc.
Special charts for
special conditions
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To pick up children who are faltering andintervene early. (Growth promotion)
To assess nutritional status. Aids in early diagnosis of illness other than
nutritional disorders.
Opportunity for other health interventions (e.g.
immunization, health education etc.)
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(AGE IN YRS X 3) + 4 (?? +2) =50thcentileof Havard standard in kids >1yr.
Up to 10% of birth weight lost after birth.
Regained by 2 weeks. 25g per day for first 5 mths. 15 g per day in the first year. 2.5kg in 2ndyr of life
2kg per year up to 5 yrs. Birth weight doubled by 5-6 months, tripled
by 1 year.
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Released in April 2006
Based on the breastfed child as the biological
norm for growth and development.
Initiated by WHO in 1997
Data collected over seven years (1997-2003).
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8440 children from six countries were involved(Brazil, Ghana, India, Norway, Oman andUSA).
The children were selected based on optimalenvironment for proper growth: recommendedinfant and young child feeding practices, goodhealthcare, mothers who did not smoke and
other factors associated with good healthoutcomes.
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Old charts based on data from late 1970s fromchildren in the USA. Most were artificially fed.
The old measurements were based on irregular
measurements, too far apart to identify trends. The old standards merely described how these
children grew whereas the new standards aimto describe how children should grow.
Old curves used centiles, new uses z-scores
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Clothes!
Money
Stigma
Staff attitudes esp when weight gain not good. Inconvenient timing.
Long distances
Infrequent visits
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GROWTH MONITORING AND PROMOTIONIS AN ESSENTIAL PART OF CHILDHEALTH. CHILDREN MUST ALWAYS BE
SEEN WITH WEIGHING CARDS! NUTRITION IS IMPORTANT BUT OTHER
REASONS FOR GROWTH FAILURE MUST BELOOKED FOR.
