growth and development mean-2sd mean+2sd 2.5% 47.5%
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Growth Growth and and
DevelopmentDevelopment
Mean-2SD Mean+2SD
2.5%
47.5%
Neonatal PeriodNeonatal Period(1(1stst 4 Week of life): 4 Week of life):
Prone: FlexedSupine: FlexedVisual: Doll’s eye,Fixate in line of vision Reflex: Moro,Grasp,Stepping, Placing
At 4 Week of life:At 4 Week of life:
Prone: ExtendSupine: Tonic neckVisual: Follow Social: Begin to smile
At 8 Week of life:At 8 Week of life:
Visual: Follow 180 degree Social: Smile to social contact
At 12 Week of life:At 12 Week of life:
Prone: Lifts head and chestSitting: Early head controlSocial: Says aah,ngah
At 16 Week of life:At 16 Week of life:
Supine: Symmetric ,Grasp object , Bring to mouth
Sitting: No head lag Social: Laughs out loud
At 28 Week of life:At 28 Week of life:
Prone: Roles over , CrawlSitting: With support , TransferStanding: Support most of weight Language: Polysyllabic vowel Social: Prefer mother
At 40 Week of life:At 40 Week of life:
Prone: CrawlSitting: Sits up aloneStanding: Walks holding on furniture Social: Response to sound of name
At 52 Week of life:At 52 Week of life:
Walk: Take several steps
At 15 months of life:At 15 months of life:
Walk: aloneCrawl: UpstairsPlay: 3 cubes
At 18 months of life:At 18 months of life:
Walk: UpstairsLanguage: 10 words,1-2 part of bodyPlay: 4 cubes
At 24 months of life:At 24 months of life:
Walk: Runs well,downstairs, JumpsLanguage: 3 words togetherPlay: 7 cubesHandle spoon well , Listen to story
At 30 months of life:At 30 months of life:
Refers IFull name
At 36 months of life:At 36 months of life:
Ride tricycleStand on one footCopy circleWash handsAge and sex
At 48 months of life:At 48 months of life:
Copy cross and squareTell a storyPlay with childrenGo to toilet alone
At 60 months of life:At 60 months of life:
Draw triangleNames 4 colorsCount ten coinsDressing
Failure to Failure to ThriveThrive
(FTT)(FTT)
Failure to thrive(FTT):Failure to thrive(FTT):
Weight< 3%Drop of weight percentileWeight/Height < 5%Weight < 80% Median for Height
Kwashiorkor:Kwashiorkor:
Inadequate protein dietPitting edemaComplication of critical illnessWeight 60-80% for age Skin sign
Marasmus:Marasmus:The most common form of PEMSevere caloric depletionSecondary to diseasesWeight below 60% for ageInappropriate weaning
In most children with In most children with FTT, both FTT, both organicorganic and and inorganicinorganic risk risk factors are present.factors are present.
Early Infancy:Early Infancy: Feeding difficulties: 1)Lactation failure2)Inadequate feedings3)Formula mixing error4)Inadequate calories
Diagnosis:Diagnosis:History and Observation
Tests:1)CBC,ESR,U/A,Serum electrolytes2) S/E, S/C, Ph , Reducing substances,
Guiac test
Treatment:Treatment:HospitalizationAmbulatory
120 Kcal/24h X med weight/HeightVitamins & Minerals
RecoveryRecovery::
Positive mood changesWeight gain
Prognosis:Prognosis:Non organic FTT in first 2 yearAt 3-11 years:
Retardation(15-67%)
Learning Problems (37-67%)
Behavioral disturbances (28-48%)
Obesity:Obesity:
BMI:BMI:
Weight(Kg)/ Height2 (m)
Obesity Definition:Obesity Definition:
Overweight:Weight> 85th Percentile
BMI > 25
BMI > 85th percentile
Obesity: BMI > 30
BMI > 95th percentile
Obesity in adulthoodFamily historyTV watchingDietary intake
Treatment:Treatment:30% decrease in calories intakeStarting 1000-1500 Kcal/dayVery low calorie diet or protein
modified fastPharmacotherapySurgical therapy
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