How does your child "measure up"

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I was listening to an E-Lecture on abnormal growth in children and was struck by a few facts that I didn't know before. Firstly, it's not where you are born in this wonderful world that matters, but how things are in the home. According to a big International study completed by the WHO on children in various parts of the world, if they are given the optimum start in life, then those children all have the potential for normal growth and development for both height and weight - relevant to their age.

It's back to those critical first five years of life when so much potential can be developed, or so much permanent damage can be done.

The second point that registered was that "Hormones" play a relatively small part in the growth equation: much more important factors are Genes, Nutrition, and a healthy, positive domestic environment. From my experience, parents who bring their child in to see me and say they think Johnny is very small, "Could it be his hormones Doc?", the simple answer is it almost certainly isn't. The answer is usually there in front of you, with both parents being short, or perhaps the smell of tobacco/alcohol coming from the parents clothes!

The only way to determine whether the child has a definite "growth" problem is to have accurate growth charts and if you're interested in recording these yourself, then instead of using the back or the laundry door to mark with a pencil (it's always so hard to unscrew the doors and taken them to the Doctors surgery!) download the WHO charts from the CDC and then if necessary you can email them to your Doc for comment - after 6 to 12 months!

http://www.cdc.gov/growthcharts/who_charts.htm

But when it comes to measuring the child, it must be accurate:

Bare feet together: back flat against the wall: head up and looking straight ahead: bring the horizontal marker down till it touches the top of the head and note the height. THEN, get them to step away for a second and then repeat the process. The results should be within 3 to 4 mm of each other to be accurate. NB if your child wants to be "taller", then measure in the morning as the discs in the spine are more hydrated/thicker, meaning that the spine will be longer and your child "taller"!

Isolated measurements have no real meaning: what is much more important is the Velocity of Growth, and this will only become apparent over time, so the earlier accurate measurements are started, the sooner any anomaly will become apparent. But growth is not a smooth process and is affected by stresses of illness, social and domestic problems and poor nutrition. Even when these episodes have passed, it may take 3 to 4 months for growth to "catch up", which in nearly all cases it will do so.

Finally, if your child wants a rough estimate of how tall they will be by the time they have finished growing - assuming they live a healthy life within a normal domestic environment - then it's down to genetics.

      For boys: add 13cms to the height of the mother and then average that number with the height of the father.

      For girls: subtract 13cms from the height of the father and average that number with the height of the mother .

Remember that this is only an indicator and can vary up to 8.5cms either side of the resultant number.

Listening to the lecture highlighted the fact that investigation of growth issues in children is a slow process, but we can minimize many of those problems by making sure that our young children have good nutrition early in life, and that we raise them in a nurturing environment: something that needs to be done 365 days of every year. And for that to happen, we all need to lend a hand.

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