Lecture 11 - Infant and Child Growth

Question 1

how does muscle control and coordination develop in children

Answer 1

top down and centrally to peripherally

Question 2

Critical or sensitive time periods or windows of development occur where

Answer 2

certain skills must be learned in order for subsequent learning to occur

Question 3

all infants progress on …

Answer 3

their own timeline of development

Question 4

the world health organisation recommends that infants should sit alone by what age

Answer 4

7 months

Question 5

the world health organisation recommends that infants should stand holding furniture by what age

Answer 5

9 months

Question 6

the world health organisation recommends that infants should stand alone by what age

Answer 6

14 months

Question 7

the world health organisation recommends that infants should walk alone by what age

Answer 7

15 months

Question 8

child growth assessment is important to determine whether a child is

Answer 8

growing “normally” or has a trend towards a growth concern that should be addressed

Question 9

in child growth assessment weight is a good indicator of what

Answer 9

of acute changes in dietary intake

Question 10

in child growth assessment height reflects

Answer 10

long term nutrition (better nutrition they will grow better standing height)

Question 11

in child growth assessment head circumference reflects

Answer 11

brain growth

Question 12

in child growth assessment BMI screens for

Answer 12

overnutrition or growth faltering

Question 13

what are the two components of child growth assessment

Answer 13

1. measure = weight, length / height, head circumference and BMI
2. plot measurements of a childs body size on growth charts

Question 14

clinical electronic scales are calibrated how often

Answer 14

every 6 months

Question 15

what must be done when measuring children’s weight up to 2 years

Answer 15

remove clothing and nappy

Question 16

what are the guidelines of measuring weight for children 2 years and above

Answer 16

minimal clothing, remove shoes, empty bladder and before a meal

Question 17

weight in children is recorded to the nearest what

Answer 17

nearest 10g

Question 18

what is an alternate method of measuring a childs weight when they are younger than 2 years

Answer 18

weigh mother and infant together and subtract the weight of the mother

Question 19

what is used to measure length in children

Answer 19

a calibrated length board with fixed headpiece and moveable footpiece which is perpendicular to the surface of the table

Question 20

how many people are needed to get an accurate length measurement of a child

Answer 20

two people

Question 21

when measuring an infants length what must they be wearing

Answer 21

without shoes, and wearing light underclothing or diaper

Question 22

how should an infant be positioned to have their length measured

Answer 22

• should be placed on their back in the centre of the board, lying flat against the surface.
• eyes should be looking up
• both legs should be fully extended and toes should be pointing upwards with feet flat against the foot piece

Question 23

length in infants should be measured to the nearest (it is good practice to take how many measurements)

Answer 23

nearest 0.1cm

good practice to take 3 measurements

Question 24

what is the change in terms of measuring a childs height at 2 years

Answer 24

at 2 years we measure their height standing up rather than their length

Question 25

when should weight and length be measured in children

Answer 25

- in the first weeks of lide - at routine cheeks - when there is a concern about weight gain, growth or general health

Question 26

how often should we measure weight and height in infants and why should we not doo this too often

Answer 26

- measuring too often can be misleading - should be measured > 2 weeks apart after 6 months of age

Question 27

how to measure head circumference

Answer 27

position the tape just above the eyebrow, above the ears and around the biggest part on the back of the head

Question 28

what should be used to measure head circumference

Answer 28

use a flexible, non stretchable tape

Question 29

head circumference should be measured to the nearest

Answer 29

0.1cm

Question 30

head circumference is measured up until what age

Answer 30

1 year of age

Question 31

what is a growth reference

Answer 31

describes how certain children grew in a particular time and place

Question 32

what is a growth standard

Answer 32

describes how healthy children should grow under optimal environmental and health conditions

Question 33

why are we unable to use growth standards after the age of 5 years

Answer 33

after 5 years we are unable to control for the same factors that could when younger so we use references not standards

Question 34

what was the criteria used for the WHO multi centre growth reference study

Answer 34

- mothers willing to exclusively breastfeed for at least 4 months - introduction of complementary feeding by the age of 6 months and continued partial breastfeeding up to at least 2 months - no maternal smoking before and after delivery

Question 35

how many home visits were included in the WHO multi centre growth reference study (and how often were these)

Answer 35

20 home visits - once fortnightly until 2 months old - once monthly until 13 months old - thereafter every 2 months until second birthday

Question 36

what was recorded in the WHO multi centre growth reference study

Answer 36

anthropometrics (from birth) and developmental milestone age (from 4 months of age)

Question 37

what was found about the variance in the WHO multi centre growth reference study

Answer 37

variance in growth was due to differences among individuals and only minimally to difference among site (country)

Question 38

what is the growth reference data for children aged 5-19 WHO

Answer 38

- weight for age (5-10 years) - height for age (5-19 years) - BMI for age (5-19 years)

Question 39

what is the growth reference data for children aged 2-20 years CDC

Answer 39

- stature for age (2-20 years) - weight for age (2-20 years) - BMI for age (2-20 years)

Question 40

how to calculate z-scores

Answer 40

1. mean (find the avereages) 2. standard deviation (calculate how spread out the values are from the mean) 3. z score

Question 41

what does a z score tell you

Answer 41

tells you how many standard deviations away a specific value is from the mean

Question 42

if the z score is 0 it means

Answer 42

the value is exactly the average

Question 43

if the z score is positive it indicates

Answer 43

the value is above the average

Question 44

if the z score is negative it indicates

Answer 44

the value is below the average

Question 45

the higher the z score ( in the positive or negative direction), the ...

Answer 45

the more unusual or less typical the value is compared to the average

Question 46

what is the z score equal to

Answer 46

measured value - average in the reference population / standard deviation of the reference population

Question 47

why plot on a growth chart ?

Answer 47

- to compare a childs weight, height or head circumference against other healthy children of their age - to track how a child grows over time - normal growth is an important indicator of health

Question 48

what are the New Zealand Growth Charts for children aged 0-5 years

Answer 48

New Zealand - World Health Organisation Growth Charts (0-5 years)

Question 49

what are the New Zealand Growth Charts for children aged 5-18 years

Answer 49

either WHO reference 2007 or the Centres for Disease Control (CDC) Growth Charts

Question 50

on a growth chart, if a child is growing normally growth will

Answer 50

'track' parallel to one of the centile lines on the growth chart

Question 51

if a childs growth on a growth chart starts to track up or down significantly, further investigation is necessary (how many centiles for weight and height would this be a concern)

Answer 51

there is a consistent change in centile position by two or more intercentile spaces for weight or by one or more inter-centile spaces for height

Question 52

if there is a difference of ........ or more inter-centile spaces between the weight and heigh values of a child this also requires investigation

Answer 52

a difference of two or more inter-centile spaces

Question 53

what does each percentile (centile line) mark

Answer 53

the weight or height below which the percent of children of that age and gender fall

Question 54

how many centiles are there on growth charts and where do they extend from

Answer 54

9 centiles that extend from 0.4th to the 99.6th

Question 55

what does the 50th centile represent

Answer 55

the mean

Question 56

a child is described as being .... or .... on a growth chart

Answer 56

on a centile or between two centiles

Question 57

a centile describes

Answer 57

the number of children expected to below that line ( e.g 50% below the 50th centile)

Question 58

head circumferences taken within the first 24hrs of life are

Answer 58

unreliable because the head may be subjected to molding

Question 59

babies often lose weight in the first 3-5 days, what % regain by 2 weeks

Answer 59

80%

Question 60

is weight loss in babies after birth normal

Answer 60

yes

Question 61

baby weight loss is expressed as a

Answer 61

percentage of birthweight

Question 62

a baby weight loss greater than .... may indicate a feeding problem or illness

Answer 62

>10%

Question 63

why do the centiles shift slightly when length is changed to height measure at 2 years of age

Answer 63

because when a child is standing up their spine is compressed / squashed slightly compared to lying down

Question 64

head circumference usually tracks within

Answer 64

a range of one centile space

Question 65

rapid head growth can be a sign of

Answer 65

hydrocephalus

Question 66

slowing head growth may be a sign of

Answer 66

underlying problems of brain or skull growth and development

Question 67

why is head growth no longer useful after 2 years of age

Answer 67

because it is slow

Question 68

BMI reflects

Answer 68

how heavy a child is relative to their height

Question 69

BMI is for .... not

Answer 69

BMI for screening tool not a diagnostic tool

Question 70

how often should infants and toddlers be measured

Answer 70

- in the first week of life - at 1, 2, 4, 6, 9, 12, 18 and 24 months - between 4 - 6 years - older children and adolescents should be measured once each year

Question 71

what are the NZ recommendations of measuring weight and height and head circumference up until what age

Answer 71

weight and height = up to 5 years head circumference = up to 1 year