Child growth and development

From WikiLectures

  • We describe physical development (height, proportionality, maturity of the system...) and neurological development (gross motor, fine motor, cognitive development, speech).

Length/height[edit | edit source]

  • up to two years we talk about length, from two years about height
  • from 3 years to puberty, the child should grow 5-7 cm per year

Mass[edit | edit source]

  • average birth weight (PH): 3500 g (then 10% weight loss); doubling of PH – in the 4th-5th months; tripling of PH – in 1 year (approx. 10.5 kg);
  • toddlers, preschoolers and school children should have 2kg annual gain.
age height/height weight head circumference
at birth 50 cm 3,5 kg (PH) 34 cm
6 months 43 cm
1 year 75 cm 10,5 kg (3×PH) 47 cm
2 years 87 cm (½ dospělé výšky) 13 kg (4×PH)
3 years 96 cm 50 cm
3,5 years 100 cm
5 years 110 cm 20 kg
10 years 140 cm 30 kg 53 cm
18 years 167,3 cm (girl), 180,2 cm (boy)[1] 56 cm

Proportionality of growth[edit | edit source]

  • Head/trunk ratio: newborn 1/4, adult 1/8.
  • proportion of muscle mass: 22% at 3 months, 35% at 3 years, 40% adult male
  • Power consumption:
    • infant: 40% energy for growth (110 kcal/kg per day);
    • toddler: 3% energy for growth (60-90 kcal/kg per day).

Periodization of child growth[edit | edit source]

  • The human growth pattern is referred to as„sandwich“ pattern, because between the period of rapid postnatal growth and the pubertal spurt there is a period of quiet growth (childhood; 2 to 11 years of life), unlike in other biological species.
  • ICP growth model according to Karlberg:
    • component I (infancy), infantile component of growth - from the 2nd half of intrauterine development to the 3rd to 4th year of life; mainly IGF-I is applied;
    • component C (childhood), the children's component of growth - begins before the end of the 1st year of life and lasts until the end of physical growth; dominant influence of growth hormone and persistent action of IGF-I;
    • component P (puberty), pubertal component of growth – phase of additional growth induced by puberty; it accelerates until the age of the highest growth rate, it slows down until the end of growth; influence of sex hormones. [2]
  • Humans grow relatively slowly (compared to other mammals) – in most mammals, a period of rapid postnatal growth is followed by a pubertal spurt and sexual maturity. In addition, a person has a period of quiet growth between these periods - childhood (specificity of a person).

Brain development[edit | edit source]

  • Replication of neuronsis completed before birth, but their organization continues long after birth.
  • White brain matter and synapses increase.
  • Gray matter develops relatively late – it grows from the 30th week of gestation and ends in the 1st year, therefore it is relatively sensitive to damage in late gestation and perinatally.
  • Myelination begins in the 4th month of gestation in the spinal cord, in the last trimester and in the brain;
    • at birth, myelination of autonomic nerves, cranial nerves (except optic and olfactory) is complete
    • the cortex and connections to the thalamus and BG are incompletely myelinated (here, myelination ends within 2 years).

Speech development[edit | edit source]

  • the first stage is nonverbal
  • from 2 months, communication begins to be vocalized – mutual vocal play;
  • 6-10 months - the child begins to better control the oral muscles, begins to babble and repeat syllables without a specific meaning;
  • at 12 months begins to have a need to use specific words to refer to objects and activities;
  • at 18 months can speak about 20-50 words;
  • attention – speech development can be delayed by frequent otitis media with conductive hearing impairment;
  • understanding develops faster than expressive ability;
    • the child understands the first words already at 9 months;
    • can understand 20-100 words at 13 months;
  • at the end of the 2nd year, the child begins to put words into sentences.

Assessment of body growth[edit | edit source]

  • The basic tool for assessment is the percentile chart of body height;
    • the basis for compiling percentile graphs is national reference studies;
    • we thus evaluate the degree of difference from the norm;
    • 94% of the population lies between the 3rd and 97th percentiles;
    • medium height – between 25-75 percentile (50% of the population);
    • great height – above 75th percentile;
    • very high height – over 97th percentile..
  • The assessment includesan assessment of the child's genetic growth potential ; dítěte;
    • we draw on the right edge of the percentile graph;
      • for boys – the body height of the father (point O), the body height of the mother increased by 13 cm (point M);
      • for girls – mother's body height (point M), father's height minus 13 cm (point O);
    • the middle between these values ​​is the average expected adult height, with a range of 8.5 cm;
  • With repeated measurements, we can calculate the growth rate in cm/year;
    • it changes depending on age and gender - we evaluate it from the percentile chart.
    • children from the age of two are correctly measure with a stadiometrattached to the wall - on the stadiometer scale there is a moving head that touches the vertex of the head (or have a giraffe there);
    • children under two years old are measured using the so-called body meter („trough“) – we determine length.

Development of teeth[edit | edit source]

  • Milk teeth
    • eeruption – on the mandible 5–7 month, on the maxilla 6–8 Moon;
    • exfoliation – mandible 6.–7. year, maxilla 7–8 year;
    • eruption of all milk teeth should be within 3 years of life;
    • we indicate a dental examination when not a single tooth has erupted within 13 months.
  • Permenant dentition
    • lower incisor – 6.–7. year (mandibula), 7.–8. year (maxilla);
    • second molar – 12.–13. year (mandibula).

Links[edit | edit source]

Related articles[edit | edit source]

External links[edit | edit source]

Sources[edit | edit source]

Literature[edit | edit source]

  • LEBL, Jan – PROVAZNÍK, Kamil – HEJCMANOVÁ, Ludmila. Preklinická pediatrie. 2. edition. Galén, 2007. ISBN 978-80-7262-438-6.