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Y2 LCRS 1 - RDA Aryan > Child Growth > Flashcards

Flashcards in Child Growth Deck (18)
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Why measure growth

- Poor growth in infancy is associated with high childhood morbidity and mortality.
- Growth is best indicator of health
- Demonstration of normality of growth by age and stage of puberty
- Identify disorders of growth
- Assess obesity


What is a centile chart

Way of expressing variation in the population


Are centiles a normal range

Centiles are not a “normal range”
- you can be taller or shorter than the centile lines and still be completely normal and healthy. E.g is you have very tall parents, you would have genes for tall height.


At what age do most children set out on a centile

Most children set out on a centile by about 2 years and grow on the same centile during childhood - see diagram of the centile graph


What do you look at when looking at centile charts

Pattern of growth is more important than position on the centiles.
- Most very tall or very short people are healthy and grow in a normal pattern.

A child who falls significantly in their centile position is not growing normally, whatever their height.


When does growth stop

At the end of puberty


What is height velocity

[Height velocity calculation:
height now - height last visit]/[age now - age last visit]
Interval approx 6 months
Expressed in cm/year


Describe the speed of growth of a child after birth

Very fast growth at the beginning post-natal, falls off until puberty. At puberty you get the puberty growth spurt


Describe the endocrinology of growth

GH is stimulated to be released from the anterior pituitary by GHRH. Somatostatin inhibits the secretion of GH. GH then acts on GH receptors which stimulates the production of IGF-1.

Both GH and IGF-1 have their own actions. IGF-1 binds to IGF-1 receptors on growth plates causing you to grow.

Note: Somatotroph cells of AP secrete GH and GH is a single chain polypeptide so as treatment has to be given IV. Growth is influenced by nutrition, sleep, exercise, stress


What are the phases of growth



Describe antenatal growth

The most rapid phase and crucial for achieving potential
Maternal health and the placenta are important factor for antenatal growth
Epigenetic changes due to poor antenatal environment


List some chronic paediatric diseases which can affect growth?

Sickle cell
Juvenile chronic arthritis
Inflammatory bowel disease
Crohns disease
Coeliac disease
Cystic fibrosis
Renal failure
Congenital heart disease


What are the causes of tall stature?

Tall parents
Early puberty
Syndromes e.g. Marfans
Growth hormone excess - gigantism


Why is getting fat bad?

With increasing weight there is increasing risk of death


Describe the growth of bone in children?

The bones mature and epiphyses fuse at the end of puberty.

The final part of growth occurs in the spine and the final epiphyses to fuse are in the pelvis.


What are the causes of short stature?

- Genetic
- Pubertal and growth delay
- IUGR (intrauterine growth restriction - when you're born tiny and never really grow and catch up to the normal)/SGA
- Dysmorphic syndromes (Downs)
- Endocrine disorders (hypothyroidism)
- Chronic paediatric disease (If you have lots of inflammatory cytokines this triggers a pathway that blocks the effect of GH)
- Psychosocial depravation (neglect = causes changes in GH pulsitility)


What is the cause of most short children?

Normal growth pattern
Most short children have a normal growth pattern and do not have any medical problem.
They are usually the children of short parents


Describe children with intrauterine growth restriction?

Not all children with intrauterine growth restriction catch up completely. Growth will be normal in childhood but they have “lost” some height in the antenatal period.