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Growth and Development

Growth refers to an increase in size of organs, while development is the acquisition of new functions. Growth is assessed by measurements of weight, height, head circumference, and other parameters. Development is assessed through history, exams, developmental screens, and tests. Important developmental milestones from ages 2-36 months include responsive smiling, sitting alone, walking independently, speaking first words, and drawing basic shapes. Monitoring both growth and development provides insights on a child's well-being, nutrition, and progress.

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55 views

Growth and Development

Growth refers to an increase in size of organs, while development is the acquisition of new functions. Growth is assessed by measurements of weight, height, head circumference, and other parameters. Development is assessed through history, exams, developmental screens, and tests. Important developmental milestones from ages 2-36 months include responsive smiling, sitting alone, walking independently, speaking first words, and drawing basic shapes. Monitoring both growth and development provides insights on a child's well-being, nutrition, and progress.

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‫بسم هللا الرحمن الرحيم‬

Internship Scientific Day


Feb 2019
Growth & Development
By Dr Bassam Y. Abu-Libdeh
What is the difference between G & D?

Growth of an organ: - Increase in the size of that organ.


Development of an organ: - Acquiring of new function by that organ

Growth
How do we assess growth?
By performing measurements of growth parameters including:- Weight,
Height/Length and Head Circumference. BMI is calculated by dividing Weight in
kilograms over (Height in meters) ² = Wt. (kg)
(Ht. m) ²
Other measurements: - Mid arm circumference, skin fold thickness and waist
circumference. Usually used by specialized centres to assess nutritional status.
What are the normal measurements at birth?
Weight = 3.25 kg (range:- 2.5 – 4.0 kg)
Length = 50 cm (range:- 47-56 cm)
HC = 35 cm (range:- 33-37 cm).

I. Weight:-
a. How do we assess weight?
By scale: - baby scale (usually up to 20 kg) and standing scale.

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b. Weight increment during the first year of life:-
 Immediately after birth, there is usually physiologic loss of weight
up to 10% of birth weight. Birth weight is usually regained up to 1
week of age (sometimes up to 2 weeks in breast fed babies)
 The most rapid increment in weight is during the first third of the
first year in life.
 During the first couple of months, babies usually add around 25-30
gm. daily (one egg a day except Sunday).
 The overall increment during the first year of life is around 6 kg and
divided as follows:-
750 gm. /month for the first 4 months (3 kg in 4 months)
500 gm./month for the second 4 months (2 kg in 4 months)
250 gm./months for the last 4 months (1 kg in 4 months).
 Babies usually double birth weight by the age of 4-5 months.
 Babies usually triple birth weight by the age of 1 year.

c. Weight increment during the second year of life:-


 Deceleration in increment.
 Weight usually increases by 3 kg during the second year of life.
 Weight by the age of 2 years is around 12 kg.
d. Weight increment during the ages of 3-7 years:-
 Further deceleration in increment.
 On average, weight increase by 2 kg each year between the ages of
3-7 years.
 The average weight between the ages of 2-7 years can be calculated
by the following formula:-
Average weight (kg) = [Age(years) x 2] + 8
e. Weight increment during the ages of 8-12 years:-
 Acceleration in increment (in preparation for puberty).
 On average, weight increase by 3.5 kg each year between the ages
of 8-12 years.

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 The average weight between the ages of 8-12 years can be
calculated by the following formula:-

Average weight (kg) = [Age (years) x 7] – 5

II. Height (length):-


a. How do we check height?
Lying (infantometer) or standing stadiometer.
b. Length increment during the first year of life:-
 Total increment by 25 cm.
 Average 2 cm/month.
 Average length at age of 1 year =75 cm.
c. Length increment during the second year of life:-
 Total increment by 12 cm.
 Average 1 cm/month.
 Average length at age of 2 years =87 cm
d. Length increment during the 3rd and 4th years of age:-
 Total increment of 6 cm each year.
 Average of 0.5 cm/month
 Average length at the age of 3 years = 93 cm
 Average length at the age of 4 years = 100 cm
 Babies double birth length by 4 years of age.
e. Length increment during the age of 5-12 years:-
 Average increment of 5 cm each year.
 The average height between the ages of 4-12 years can be
calculated by the following formula:-
Average height in cm = [Age (Years) X 5] +80

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III. Head Circumference (HC) or Occipitofrontal circumference
(OFC)
a. How to check HC?
By using a measuring tape from the most proximal point
anteriorly to the most distal point posteriorly. May take more
than one measure (¬ 3) and record the biggest reading.
b. Increment of HC during the first year of life:-
 Total increment by 12 cm
 Average HC at 1 year of age = 47 cm
 Increment as follows:-
6 cm during the first 3 months of life (0.5 cm/week)
6 cm during the last 9 months of the first year of life
(2/3 of cm / month)
 Importance of infant’ wellbeing during the first year of
life by:-
 Adequate nutrition & psychosocial support
 Prevention of accidents
 Vaccination
c. Increment during the second year:-
 Increment by 2 cm
 HC at 2 years of age=49 cm
d. Increment between the age of 3-18 years:-
 Average HC of an adult = 57 cm
 Increase of ¬ 8 cm in 16 years (¬ 0.5 cm/year)

Growth Charts
After performing measurements, always prepare growth charts.
CDC or WHO

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Development

a. How to assess development (tools to assess development)?


 History
 Physical exam
 Developmental screening tests (such as Denver
Development Chart)
 Specific tests for certain areas of development:-
Examples:- Hearing testing for delayed speech, CPK
for gross motor delay,…….
 Specific testing to determine the developmental age (DQ)
of the child.
b. What parameters we use to assess development?
 Gross motor
 Fine motor
 Language/Speech
 Personal/Social

c. Important developmental mile stones:-


Mile Stone Age (months)
1. Social/Interactive/Responsive smile 2
2. No head lag 4
3. Laughing 4
4. Rolls over 4-5
6. Sits with self-propping 6-7
7. Transfers object hand to hand 6
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8. Stranger anxiety 7
9. Double babble (baba mama none specific) 8-9
10. Sits alone 9
11. Immature pincer grasp 9
12. Waves bye-bye & plays Peek-a-boo 9
13. Stands holding furniture 10
14. Stands & walks with one hand held 12
15. Mature pincer grasp 12
16. Says 2-3 words (baba mama specific) 12
17. Walks independently 15
18. Drinks from cup 15
19. Runs 18
20. Scribbles with pencil 18
21. Says 10 words 18
22. Spoon-feeding self 18
23. Linking 2 words (2 words sentence) 24
24. Toilet trained Variable (~ 30)
25. Draws a circle 36
26. Drives tricycle 36
27. Full sentences 36
28. Draws cross 48
29. Draws a triangle 60
30. Adult speech 60

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