Linear Growth

Mean Increments In Weight and Length for Boys Using CDC Growth Charts

Boys

Age (mos)

Weight (g/month

Weight (kg/yr)

Length (cm/month)

Length (cm/year)

2-3 yrs

132

1.6

0.7

9

3-4 yrs

156

1.9

0.6

7

4-5 yrs

181

2.2

0.5

6

5-6 yrs

189

2.3

0.6

7

6-7 yrs

197

2.4

0.5

6

7-8 yrs

205

2.5

0.5

6

8-9 yrs

247

3

0.5

6

9-10 yrs

271

3.3

0.4

5

10-11 yrs

329

4

0.4

5

11-12 yrs

378

4.6

0.5

6

12-13 yrs

419

5.1

0.6

7

13-14 yrs

444

5.4

0.6

7

14-15 yrs

436

5.3

0.5

6

15-16 yrs

378

4.6

0.3

4

16-17 yrs

304

3.7

0.2

2

17-18 yrs

214

2.6

 

 

18-19 yrs

156

1.9

 

 

19-20 yrs

123

1.5

 

 

 

Mean Increments In Weight and Length for Girls Using CDC Growth Charts

Girls

Age (mos)

Weight (g/month

Weight (kg/yr)

Length (cm/month)

Length (cm/year)

2-3 yrs

148

1.8

0.8

9

3-4 yrs

156

1.9

0.5

6

4-5 yrs

173

2.1

0.6

7

5-6 yrs

189

2.3

0.6

7

6-7 yrs

214

2.6

0.6

7

7-8 yrs

230

2.8

0.5

6

8-9 yrs

279

3.4

0.4

5

9-10 yrs

321

3.9

0.4

5

10-11 yrs

353

4.3

0.5

6

11-12 yrs

362

4.4

0.7

8

12-13 yrs

345

4.2

0.5

6

13-14 yrs

296

3.6

0.25

3

14-15 yrs

214

2.6

0.08

1

15-16 yrs

156

1.9

0.08

1

16-17 yrs

99

1.2

0.08

1

17-18 yrs

90

1.1

 

 

18-19 yrs

90

1.1

 

 

19-20 yrs

74

0.9

 

 

 

Patients with short bowel syndrome do not necessarily show standard growth patterns, particularly over the first 2 years of life.
 
 
McLaughlin CM, Channabasappa N, Pace J, Nguyen H, Piper HG. Growth Trajectory  in Children With Short Bowel Syndrome During the First 2 Years of Life. J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):484-488. doi: 10.1097/MPG.0000000000001762.
PubMed PMID: 28953527.
 
 
Raphael BP, Mitchell PD, Finkton D, Jiang H, Jaksic T, Duggan C. Necrotizing Enterocolitis and Central Line Associated Blood Stream Infection Are Predictors of Growth Outcomes in Infants with Short Bowel Syndrome. J Pediatr. 2015 Jul;167(1):35-40.e1. doi: 10.1016/j.jpeds.2015.02.053. Epub 2015 Apr 1. PubMed PMID: 25841540; PubMed Central PMCID: PMC4794334.

 

 

 

SOCIAL MEDIA
From Home Parenteral Nutrition at Boston Children's Hospital Facebook Program Group May 20, 2017: https://www.facebook.com/groups/HPNBostonChildrens/permalink/668579316680717/
"Parents & children both can feel nervous about weight checks during HPN visits. Feeling is normal and common.  Advice for HPN families how best to cope?"

cop4

Genetic height potential

  • Genetic constitution versus growth stunting
 
Boys
= (Father’s height + mother’s height + 13)/2
Girls
= (Father’s height + mother’s height - 13)/2

 

Tanner JM, Goldstein H, Whitehouse RH. Standards for Children's Height at Age 2 to 9 years allowing for height of Parents. Arch Dis Child. 1970 Dec;45(244):819. PubMed PMID: 21032457; PubMed Central PMCID: PMC1647447.
 

Height measurement

- Prone

- Standing >age 2

- Always make sure patient has shoes, hat off consistently

- Pt must have heels flush against the wall, arms straight

 

Short Stature

Short stature (Definition): Stature less than 2 standard deviations below the mean for age.  

 

Differential Diagnosis of short stature:  What's the bone age?

  1. Delayed bone age growth  compared with chronological age
  2. Normal bone age growth compared with chronological age
  3. Accelerated bone age growth compared with chronological age

 

Familial (genetic) short stature

  • Normal variant of growth
  • Normal growth velocity.
  • Normal bone age

 

Constitutional delay of growth and puberty

  • Normal variant of growth -- normal size at birth, short childhood stature, but normal adult stature
  • Delayed bone age

 

  • Most common
  • Low weight-for-height
  • Prevents achievement of full adult height
  • Rarely specific micronutrient leads to poor growth.
  • Delayed bone age
 
Poor Nutrition and Systemic Diseases
  • Malabsorption
  • Increased energy expenditure
  • Anorexia
  • Diarrhea
  • Delayed bone age
 
Cushing’s Syndrome (Cortisol, Stress, Hormone Excess)
  • Excessive weight-for-height.
  • Easy bruising
  • thinning of the skin
  • softening of the bones
  • muscular atrophy (wasting)
  • general body weakness
  • Diagnosis: Morning Cortisol level is elevated.
 
  • Growth retardation
  • Sluggish behavior
  • Tongue enlargement
  • Facial changes
  • Constipation
  • Thickened and puffy face and skin
  • Nurolodevelopment abnormalities.
  • Delayed bone age
 
Intrauterine Growth Retardation
  • Proportional stunting
  • Born small
  • Catch up by age 2 to be within normal limits