Problems of child growth development and health

Complaints of deficiency, syndromic features, features of intrauterine infection, and metabolic abnormalities.

All parameters should be increasing with age in parallel to the reference curves.

Fallot’s, Transposition of the Great Vessels (TGV), complex congenital heart disease (CHD), Eisenmenger's syndrome, and respiratory disease.

6 months of age

Growth retardation, overgrowth, developmental delay, manifestations of system abnormalities, fever, and symptoms related to specific systems.

All parameters should be increasing with age in parallel to the reference curves.

A chart that outlines the predicted manner in which children achieve developmental milestones.

Neurological abnormalities and developmental delay.

Pain on movement, tenderness, weakness, abnormal gait, arthritis, bony tenderness, neurological features, abnormal appearance, postural abnormalities.

Look for systemic features.

Physical growth

Overfeeding, tall for age, generalized fat distribution, no dysmorphic features, normal systems, and normal development.

Growth and developmental delay, abnormal sexual maturity, metabolic derangements, obesity

Cough, difficulty in breathing, rhinorrhoea, dyspnoea, laboured breathing, cyanosis, chest recessions, abnormal respiratory rate, abnormal breath sounds, added sounds

Bleeding, bruising, rashes, infection and fever (bone marrow dysfunction), jaundice (haemolytic conditions), pallor, rashes, bleeding tendency, lymphadenopathy, bony tenderness, arthritis, hepatosplenomegaly.

Abnormal vital signs, evidence of sepsis, systemic illness, evidence of metabolic derangement, dehydration, malnutrition, signs related to systems, features of organ failure, and signs of abuse.

Spinal anomalies and incontinence.

Look for other groups of lymph nodes and evidence of a local cause if it is localized. If generalized, look for evidence of hematological disease, infections, other malignancies, or connective tissue disease.

Development

Being underweight, overweight or obese, constipation or changes in bowel habits, being pale or lethargic, tooth decay, poor physical growth.

Nausea, vomiting, loss of appetite (LOA), diarrhoea, constipation

Signs of hyperthyroidism can include feeling jumpy, fast heartbeat, enlarged thyroid, sweat and sleep problems, big appetite with weight loss, wide-eyed stare, and other problems like fainting and looser stool.

Look for rashes elsewhere, joint swellings, evidence of haemolytic anaemia, cardiac and pulmonary features, hepatosplenomegaly, and renal involvement.

SLE

Environmental pollution negatively impacts human growth and development. For example, lead exposure from deteriorated lead-based paint in older housing can harm children by affecting the normal development of the brain and other organs and systems.

The most common cause of hyperthyroidism in children and adolescents is an autoimmune condition called Grave’s disease.

Oliguria, haematuria, and hypertension.

CHDR contains reference charts for normal growth, normal development, immunization schedule, feeding instructions, and stimulatory activities to improve skills.

diarrhoea, TB, and parasitic diseases, which cause growth retardation.

To confirm diagnosis, find aetiology, determine extent, identify complications, monitor disease, and monitor treatment.

Respiratory failure and methaemoglobinaemia (rare; unlikely).

Hydrocephalus

Generalized gross oedema.

Shunt, spinal anomalies, neurological abnormalities, developmental delay, evidence of intrauterine infections, features of raised intracranial pressure

Malnutrition and hepato renal failure.

Parents and caregivers must have good knowledge in preparing clean, tasty, balanced, inexpensive, culturally acceptable, and locally available food.

Decreased energy, appearing swollen or puffy, weight gain without increased appetite, decreased growth rate, muscle soreness, constipation or harder stool less often, brittle hair, and dry skin.

Malnutrition and dehydration, syndromic features, evidence of chronic illnesses, evidence of neglect/abuse.

They are often smaller and have lower birth weights compared to their gestational age.

The most common cause is an autoimmune condition called Hashimoto’s thyroiditis.

Coarse facial features, growth retardation, and developmental delays.

It causes the body to produce antibodies that attack and destroy the thyroid gland, leading to reduced production of thyroid hormone.

Through ultrasound measurements of the fetus's size and growth rate.

At birth, the upper segment (US) is greater than the lower segment (LS).

Headache, neurological signs, developmental delay, syndromic features, macrocephaly or microcephaly, sensory and motor deficits, abnormal reflexes, and abnormalities in higher functions.

Intrauterine factors include maternal diseases, infections, toxins (alcohol, tobacco smoke), pregnancy-related issues such as gestational diabetes, pregnancy-induced hypertension, and maternal psychological effects.

Thyroxin.

Oedema, dyspnoea on exertion, cyanosis, pallor, associated congenital anomalies or syndromic features.

At 10 years of age, the upper segment (US) equals the lower segment (LS).

Abnormal pulse, BP, heart sounds, murmurs, basal crepitations, liver enlargement.

After 10 years of age, the lower segment (LS) is greater than the upper segment (US).

GH deficiency is a condition where the pituitary gland does not produce enough growth hormone, leading to stunted growth and other health issues.

Achondroplasia is a genetic disorder that causes short stature with disproportionate limb length.

Some diseases can be prevented by vaccination.

Poor hygiene, untreated medical issues, consistent hunger, and inappropriate clothing for weather conditions.

Common dermatological diseases in children include eczema, psoriasis, impetigo, and atopic dermatitis.

Sudden changes in behavior, withdrawal from friends or usual activities, anxiety, depression, and unexplained injuries.

Determine if the child is ill or well, describe the lesions, assess the extent of distribution, check if the rash is itchy or non-itchy, identify if it has acute or chronic features, and note if it involves the scalp, mucocutaneous membranes, conjunctiva, palms, and soles. Also, look for systemic features such as fever, pallor, jaundice, and joint involvement.

Systemic diseases can manifest dermatologically in children through symptoms like rashes, lesions, and changes in skin color or texture.

Atopic dermatitis is a chronic skin condition characterized by itchy, inflamed skin, often presenting in children as red, swollen, and cracked skin.

GH deficiency can be caused by genetic mutations, damage to the pituitary gland, or unknown factors.

Genetic factors include congenital anomalies of systems.

Excessive fearfulness, extreme behavior (such as aggression or passivity), delayed emotional development, and lack of attachment to the parent or caregiver.

Psoriasis in children typically presents as red, scaly patches on the skin, often on the scalp, elbows, and knees.

Prevention of diseases is important to ensure normal growth and development in children.

Effective management involves treating existing health issues and implementing strategies to prevent future problems.

Children are routinely vaccinated against tuberculosis (BCG), diphtheria, pertussis, tetanus (DPT), hepatitis B, Hib, polio (OPV, IPV), measles, mumps, and rubella (MMR).

Jaundice in newborns is often caused by the immaturity of the liver, which is not yet efficient at processing bilirubin.

They can manifest as difficulty in speaking, understanding language, or using words to communicate.

Jaundice is diagnosed through physical examination and blood tests to measure bilirubin levels.

Children differ from adults in terms of physical size, developmental stages, and physiological functions.

Normal developmental milestones include specific physical, cognitive, and social skills that most children achieve by certain ages.

At 7 months, a baby will transfer a toy from hand to hand.

Indicators include difficulty in learning, thinking, problem-solving, or understanding concepts.

Common treatments for jaundice in infants include phototherapy and, in severe cases, exchange transfusion.

Physical growth refers to the increase in size and mass of the body and its organs.

By observing the child's abilities and comparing them to standardized developmental checklists.

At 10 months, a baby shows an immature pincer grasp.

Untreated jaundice can lead to serious complications such as kernicterus, which can cause brain damage.

Signs include difficulty in interacting with others, forming relationships, or managing emotions.

Growth is measured using methods such as height, weight, and head circumference measurements.

Factors include genetics, nutrition, environment, and health conditions.

At 12 months, a baby shows a mature pincer grasp.

Potential causes include genetic factors, complications during pregnancy or birth, and environmental factors.

Reference growth curves are standardized charts used to compare a child's growth to a population norm.

A normal healthy child typically shows consistent growth, meets developmental milestones, and has no significant health issues.

At 18 months, a baby can hold a cup and drink.

Early intervention can provide support and resources to help children catch up in their development.

A child's growth is considered normal if it follows the patterns on reference growth curves and falls within the expected range for their age and sex.

Basic examination includes checking vital signs, growth measurements, and a physical assessment of all body systems.

At 2 years, a child can scribble with a pen.

CHDR stands for Child Health Development Record.

At 3 years, a child can draw circles.

CHDR provides information on a child's growth measurements, developmental milestones, immunizations, and health screenings.

At birth, with a second dose after 6 months up to 5 years if no scar is present.

At birth, a baby demonstrates no deliberate fine motor skills; only reflex movements are seen.

Pentavalent 1 (DPT, Hep B, Hib), OPV 1, and IPV (fractional) 1st dose.

At 3 months, a baby can keep/hold an object given to their hand.

Pentavalent 2 (DPT, Hep B, Hib), OPV 2, and IPV (fractional) 2nd dose.

At 6 months, a baby reaches out for objects.

Pentavalent 3 (DPT, Hep B, Hib), OPV 3, and IPV (fractional) 3rd dose.

At 7 months, a baby will transfer a toy from hand to hand.

At 9 months.

At 10 months, a baby shows an immature pincer grasp.

At 12 months.

At 12 months, a baby shows a mature pincer grasp.

DPT and OPV 4th dose.

At 18 months, a baby can hold a cup and drink.

Measles & Rubella (MR) or MMR 2nd dose.

At 2 years, a child can scribble with a pen.

At 5 years.

At 3 years, a child can draw circles.

At 11 years.