Contd Growth and Developement Dr Shreedhar Paudel 1103009

Contd…. Growth and Developement Dr Shreedhar Paudel 11/03/009

Assessment of physical growth • Evaluated by – Body measurements – Velocity of physical growth

Technique of Measurement • • • Weight Length- for babies under 2 years Height- for children more than 2 years of age Chest circumference Head circumference

Normal Growth • Weight: average birth weight- 3 kg – The new born loses about 10% of the body wt which is regained by the age of 10 days – Wt gain- 25 to 30 gm/day- first 3 months of life, after that 400 gm of wt gain per month up to 1 yr – Simple formula- 5 months- 2* birth wt - 1 year- 3* birth wt - 2 years- 4* birth wt

Normal Growth…. • Length or height – 50 cm at birth – 60 cm at 3 months of age – 70 cm at 9 months – 75 cm at 1 year – 90 cm at 2 years – 100 cm at 4. 5 years

Normal Growth • Head circumference – 32 to 35 cm at birth – 40 cm at 3 months of age – 45 cm at 1 year – 48 cm at 2 years – 52 cm at 12 years (If the head circumference exceeds 1 cm in 2 weeks during the first 3 months of life, hydrocephalus should be suspected)

Normal Growth …. • Chest circumference - 3 cm less than that of head circumference at birth - Both are equal by the age of 1 year - Chest circumference exceeds head circumference after 1 year of age

Normal Growth…. • Velocity of growth – Increment in a unit time – Tool for early identification of factors affecting growth – Can also help in predicting the ultimate adult height

Growth Charts • Show progressive changes in the height and weight of a child as the age advances • A good epidemiological tool for early diagnosis of malnutrition, occult infections and other adverse environmental factors • Percentile curves are plotted in a proper way • Normal range is mean ± 2 SD i. e between 3 rd and 97 th percentile curves

Developmental milestones • Developmental milestones are physical or behavioral signs of development or maturation of infants and children. • Developmental milestones are tasks most children learn, or physical developments, that commonly appear in certain age ranges.

Developmental Milestones • Gross motor – 3 months – 5 months – 8 months – 9 months – 10 months – 11 months – 12 months – 13 months – 18 months – 24 months – 36 months Neck holding Sitting with support sitting without support Standing with support Walking with support Crawling Standing without support Walking without support Running Walking upstairs Riding tricycles

Developmental milestones • Fine motor – 4 months – 5 months – 7 months – 9 months Grasps a ring when placed in hand Reaches out to an object and holds it with both hands ( bidextrous grasp) Holds an object with palm ( palmar grasp) Holds small objects in between index finger and thumb ( pincer grasp)

Developmental Milestones • Language – 1 month – 3 months – 6 months – 9 months – 12 months – 18 months – 24 months – 36 months Turns head to sound Cooing Can say ‘ma’ ‘ba’(monosyllables) Can say ‘mama’ ‘baba’ (bisyllables) Two words with meaning Ten words with meaning Simple sentences Telling a story

Developmental Milestones • Social – 2 months – 3 months – 6 months – 9 months – 12 months – 36 months Social smile Recognizing mother Smiles at mirror images Waves ‘bye- bye’ Plays a simple ball games Knows gender