Baby Sign Language Chart - PowerPoint

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					 Growth and
Development
 DR. REKHA DUTT
   GROWTH- It is increase in physical size.

   Development – It is increase in skills and
    functions.

Normal growth and development occur
 if there is optimum nutrition,

 freedom of recurrent infections

 and freedom from adverse genetic and
  environmental influences.
Determinants of growth and
development
   Genetic inheritance
   Nutrition
   Age – more in fetal life, infancy and puberty
   Sex
   Physical surroundings
   Psychological factors
   Infection and parasitosis
   Economic factors
   Birth order, education of parents
Normal growth

   A normal child is that whose characteristics
    fall with in the range of measurements
    accepted as normal for majority of children in
    same age group.
   Normal variations are assumed to include 2
    Standard Deviation above and below the
    mean i.e.3rd and 97th centiles.
Surveillance of growth and
development
   It is done to identify those children who are not
    growing normally.
   Weight for age – A single weight record only
    indicates size at the moment but does not give any
    information whether a child’s weight is increasing or
    decreasing. Repeated measurements at intervals
    ideally monthly from birth to 1 year,2 monthly during
    2nd year and 3 monthly should be taken upto 5 years
    of age.
   A baby should gain 500gm/month for first 3 months,
    doubles the birth weight by 5 months ,trebles by 1
    year and quadruples by 2 years.
   Height for age – Birth length is approx. 50 cm.It
    increases by 25 cm at first year and another 12 cm
    during second year.
    Low height for age – also called as stunting. It
    reflects past and chronic malnutrition.

   Weight for height – Low weight for height is
    nutritional wasting or emaciation( acute
    malnutrition).

   Head and chest circumference – At birth head
    circumference is approx. 34 cm.It is about 2 cm
    more than chest circumference. By 6-9 months the
    two measurements become equal after which chest
    circumference takes over head circumference.
Behavioral development
   Motor development
   Head holding – 3 months
   Sits without support – 6-8 months
   Crawling- 9 months
   Stands with support – 10-11 months
   Walks – 12-14 months
   Language development
   Experimenting with noises – 6-8 months
   First words – 10-11 months
   Short sentences – 24 months
   Sociopersonal development
   Looks at mother and smile – 6-8 weeks
   Recognizes mother – 4-5 months
   Suspicious of strangers – 9-10 months
Growth Chart


   Definition: It is a visible display of a child’s
    physical growth and development.
    First designed by David Morley .
   Growth chart offers a simple and inexpensive
    way of monitoring weight gain.
   Any deviation from “normal” detected by
    comparison with reference curves.
The WHO growth chart

   It has two reference curves.
   Upper reference curve -the median (50th
    percentile) for boys.
    Lower reference curve – 3rd percentile for
    girls
   Space between two growth curves called
    weight channel or road to health – zone
    of normality for most population.
Interpretation

   Normal - growth line above 3rd percentile and
    will run parallel to reference curves

 Abnormal- flattening or falling of child’s
  weight curves signals
 growth failure
   Earliest sign of PEM
   Precede clinical signs by weeks or even
  months
   Such child needs special care
Objective- keep child above 3rd percentile
Growth Chart Used In India

   It has four reference curves.
   Top most curve – 80 %of the median (50th
    percentile) of the WHO reference standard.
    Lower lines represent 70% ,60% and 50% of the
    standard.
   80% median weight is approximately equal to 2 SD
    below the median which is the conventional lower
    limit of “normal range”.
   Purpose of reference curve – It indicates degree of
    malnutrition.
INTERPRETATION

   1st degree (grade 1)malnutrition- child’s
    weight between 80% and 70% lines.
   2nd degree (grade 2 or moderate)
    malnutrition –child’s weight between 70% and
    60% lines.
   3rd degree (grade 3 severe) malnutrition -
    weight below 60% line.
   Grade 4-weight below 50% line.
   Weight b/w top 2 lines – is considered
    satisfactory.
Management

   Weight b/w curves 1 & 3-
    undernourished,require supplementary
    feeding at home

   Weight below curve 3-consult the doctor and
    follow his advice.

   Weight below curve 4-hospitalized for
    treatment
Uses of growth chart

   Growth monitoring
   Diagnostic tool
   Planning and policy making
   Educational tool
   Tool for action
   Evaluation
   Tool for teaching
   Reference:www.commedutm.org/pics/ug-
    presentations/growth%chart.

				
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