Growth & Development
Prof. Mohammad Rashad
Faculty of Medicine
Benha University
1
Growth:
Is the increase in size du to
multiplication of cells or
enlargement of the present ones.
Development:
Is the maturation of organs and
acquisition of function.
2
Patterns of Growth
General growth: rapid in infancy & early
childhood, slower in late childhood and rapid
in adolescence.
Neural growth: rapid in the first few years.
Lymphoid growth: rapid in infancy and
accelerated in childhood.
Genital growth: minimal during infancy &
childhood and rapid during puberty.
3
Assessment of Growth
Weight:
At birth: 3-3.5 kg
First 4 months: increase 0.75 kg/m (24 gm /d).
Second 4 months: increase 0.5 kg/m (16 gm/d).
Third 4 months: increase 0.25 kg/m ( 8 gm/d).
So, birth wt. is doubled at 4-5 m’s, tippled at 1
y and quadripled at 2 y’s then,
[Weight = (age in years x 2) + 8]
4
Length & Height:
At birth: 50 cm.
1 year: 75 cm
2 years: 85 cm then,
[Height = (age in y’s x 5) + 80]
* Upper segment : lower segment
In infancy: 1.7 : 1
At puberty: 1 : 1
5
Head circumference:
At birth: 35 cm.
1 year : 45 cm. (about 1 cm/month)
2 years: 47 cm.
5 years: 50 cm.
12 years: 55 cm.
* It equals the chest circumference in infancy.
6
Mid-arm circumference:
* Not affected by oedema.
* Does not change much through 1-5 years.
So, > 13.5 cm (Normal).
12.5-13.5 cm (Mild to moderate PEM).
< 12.2 cm (Severe PEM).
7
Growth charts:
For a random sample of normal children of the
same sex and from the same locality, a
measure is plotted against age or another
measure for some time (months or years).
Choose 7 curves to be numbered 5, 10, 25, 50,
75, 90 & 95 where the number of each curve
equals the percentage of curves below it.
8
For a child following the height for age curve
no 25 (25th percentile), 25% of the children are
shorter than him and 75% are taller.
Children above the 95th percentile are above
normal and those below the 5th percentile are
below normal.
Deviation of a child from his own curve is
more indicative of a possible abnormality.
9
Body Mass Index (BMI):
[ BMI = Wt (kg) ÷ Ht² (meters) ]
* BMI for age: > 95th (overweight).
85th - 95th (risk of overweight).
< 5th ( underweight).
* Triceps & subscapular skinfold thickness are
better indicators of adeposity.
10
Developmental Milestones
Holds head for seconds & pays attention 1 month
to sounds & bright lights.
Smiles responsively. 2 months
Lifts head & shoulder for short time, rolls 3 months
to back from side, moves limbs
vigorously, moves eyes following objects
or sounds & watches his hands.
Rolls from side to side, sits with support, 6 months
leans forward to grasp objects, passes
objects from hand to hand & expresses
emotions as pleasure.
11
Sits up from lying position, crawls, picks 9 months
up things between finger & thumb, puts
things in his mouth, says one word,
rejects strangers & shouts for attention.
Pulls himself upright, walks with 12 months
support, obeys simple commands, holds
cup to drink & says 2-3 words.
Walks, climbs chairs & stairs, throws a 18 months
ball, spoon-feeds himself, turns pages,
knows several parts of his body & says
about 6 words (not in phrases).
12
Runs, opens doors, says 20-30 words, puts 2 years
2-3 words in sentences & indicates when
he wants to micturate or defecate.
Rides a tricycle, feed & undress himself, 3 years
knows his name & sex and makes
sentences.
Sings simple songs, counts a little & 4 years
recognizes some letters.
Counts to 10, knows many letters, sings 5 years
and makes friends outside the family.
13
Bone development:
The bony age is detected by the time of
appearance of ossific centers in X-rays.
* 1st 6 months: 1st carpal bone
* 2nd 6 months: 2nd carpal bone
* At 2 years: 3rd carpal bone….then,
[ Bony age = No of carpal bones – 1 ]
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