Growth in Children
Growth is an essential feature of life of a child that distinguishes him or her from an adult. The terms growth and development are often used as synonyms, but strictly speaking they are different in the sense that growth refers to a net increase in the size or mass of tissues, while development refers to the maturation of functions of the tissues, for e.g. myelination of nervous system. Development has already been discussed in the article on the milestones. This article will deal with the fines aspects of growth of a child and how to monitor growth.
The process of growth begins at conception and continues till the child becomes a mature adult. There are many factors which influence the growth of a child. Some are related to genetic factors, while others are environmental. Genetic factors include characteristics of parents like height, weight, intelligence, race, sex and genetic abnormalities.
Amongst the environmental factors, a different set of factors are at work in the intra uterine and extra uterine environment. In the intrauterine life, maternal under nutrition and anaemia are an important cause of small babies. Other than this many common diseases of pregnancy like high blood pressure and excess vomiting of pregnancy is also associated low birth weight baby. Alcohol and tobacco consumption is a further cause of low birth babies. On the contrary, women with diabetes generally have high birth weight babies.
In the extra uterine life, many factors influence growth. The two major factors that influence growth are nutrition and infectious episodes. Ensuring adequate nutrition and prevention from infectious episodes is the most reliable and cost effective method to ensure healthy children.
The role of nutrition in growth is obvious. The child needs energy, protein and fats in adequate quantities for him/her to grow. If the child does not get the adequate calories then he/she is not going to go well. The commonest form of under nutrition is Protein-Energy malnutrition. This is a combined deficiency of protein and calories in the diet.
There are certain other facets of growth that lead to the different growth patterns observed in children. Growth and development is a continuous and orderly process. The sequence of growth is comparable in all most all children; however the growth is not always uniform. If growth of a child is plotted on a graph then it would assume a sigma shaped curve. There are specific periods in a child life when they will grow fast and at other times, the growth velocity slows down or may even decelerate. During the early half of foetal life, early few months after birth and adolescence, growth proceeds at a fast velocity. During the mid childhood, children grow at a steady pace.
Now that we have discussed a few details about growth, we will now examine how growth is measured and monitored.
There are two primary variables to measure growth-height and weight. Both these parameters are important but do not provide conclusive evidence of growth retardation unless cross referenced against another variable like age or between them. Thus we now have various ratios like height against age, height against weight, weight against age and so on. Plotting weight of a child against age will determine any recent under nutrition while comparing height against age will diagnose chronic under nutrition.
Another way to monitor growth is by use of growth charts and normograms. These charts provide a comparison between the child whose growth is monitored and the general weight and height of the children in that particular community or nation. Since the growth characteristics vary from race to race, different charts are needed for different races and countries. You can download the latest growth charts from here
It is very easy to use these charts. All that is needed is to plot the weight or height of the child against age in the chart. The chart will usually have 3-4 horizontal lines across them. If the child falls below the bottommost line then the child is undernourished and requires intervention. Using this cart, one can easily keep track of the growth of children, even at home.
There are many other methods of estimating growth, but height, weight and general level of activity are the most commonly used and most reliable indicators of growth. By monitoring growth diligently one can ensure the right remedial steps and enhance the health of your children.