Pregnancy week by week

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Toddler

Understanding growth and development


                                  

Growth and development begin at the moment of conception and are continuous processes, until the epiphyses fuse and growth in height ceases. The term growth denotes increase in size or body mass while development is the emerging and expanding skills of a child to provide progressively greater faculties in functions. The first five years of your child’s life are a time of incredible growth and learning. An understanding of the changes in your child’s developmental status prepares you to give active and purposeful attention to the preschool years. It will not only promote early learning but also lay the foundation for later learning as well.

Your baby may walk at 11 months while your neighbour’s baby may still be crawling. One child may be talking in sentences at two years old; another may have just started to put two words together. Both are fine. Each child is different because each individual is developmentally unique. Your baby will grow faster while he is an infant than at any other time in his life. Your doctor will keep a record of his growth on “growth chart” during your baby’s regular check-ups. He will write down the following changes each time you bring him in for a check up. Make sure that you keep appointments with your doctor for routine medical checkups and vaccination.


                                             Weight and height


Many factor influence how your baby grows, apart from how your baby is feeding. Girls are born with more fat while boys are born longer and heavier, and boys begin by growing faster. Genetic factors are important; if both you and your partner are taller than average, for example, your baby will be taller, too.

Breast fed babies grow at different rates to formula- fed babies; often they tend to put up more weight at first than formula-fed babies, but then they become leaner and lighter, appearing to “dip” on the charts at around four months, falling below formula fed babies at around 6-12 months. However, what is happening is that formula fed babies are simple accumulating more fat at this point.

Growth and weight gain is a useful guide to general progress and development. You can have your baby weighed at your doctor’s clinic. Steady weight gain is a sign that feeding is going well and your baby is healthy. In the early days after birth, it is normal for a baby to lose some weight, so your baby needs to be weighed to make sure they regain their birth weight. Four out of five healthy babies are at or above birth weight by 14 days. If your baby loses a large amount of weight, your doctor will talk to you about how feeding is going and look at your baby’s health in general.

 
Baby doubles his birth weight by 5 months; three times by his first birthday; quadruple his birth weight at 2 years; five times at 3 years and 6 times his birth weight at 6 years. The average gain is 1 kg per month for first 3 months; 0.5 kg per month by 6 months; and during 1 to 2 years 0.25kg/month. After the early months, your baby will be weighed during the routine immunisation visits.  Your doctor may ask you to bring your baby more often if they think more regular monitoring might be needed.

The physical growth by the end of second year slows down. The average weight gain is 2 kg per year between 1 to 5 years. The expected height at 2 years is 86 to 87 cm and 100 cm by 4 years which is double the length at birth. Thereafter, the child gains 1 cm per month between 1 to 3 years and 3 cm per year between 4 to 6 years of age.

The average length of the baby at birth is 50 cm and the gain in length is 60 cm at 3 months, 70 cm at 9 months, 73-75 at 12 months. Thus 50% gain in length occurs by first birthday. Measuring your baby’s length is done using appropriate equipment. By two, your child’s height can be measured standing up.

The velocity of growth of body in length, weight and skull circumference is more rapid during the last 3 months of gestation and first 4-5 months after birth than at any other age. Brain growth is very rapid during 20 to 36 weeks of intrauterine life and infancy, attaining around 67% of the adult size at birth and 90% on the first birthday.


                                       Understanding your child's chart


Your child’s growth will be recorded on a centile chart, so it’s easy to see how their height and weight compare with the other children of the same age. Boys and girls have different charts because boys are on average heavier and taller and their growth pattern is slightly different. The chart is based on measurements taken by the WHO from healthy breastfed children, with non-smoking parents, from a range of countries. They represent the pattern of growth that healthy children should follow, whether they are breast fed or formula fed.

The curves on the chart, or centile lines, show the range of weights and heights of most children. If your child’s height is on the 25th centile, for example, this means that if you lined up 100 children of the same age in order from the shortest to the tallest, your child would be number 25; 75 children would be taller than your child. It is quite normal for a child’s weight or height to be anywhere within the centile lines on the chart.

The centile lines also show roughly the pattern of growth expected in weight and in length, but this will not follow one centile line exactly. The weight will usually track within one centile space (a centile space is the distance between two of the marked centile lines on the chart). All babies are different, and your baby’s growth chart will not look exactly the same as another baby’s (even their brother or sister).

Usually, weight gain is the quickest in the first six to nine months and then gradually slows down as children move into toddler years. If your baby is ill, weight gain may slow down for a while. Toddlers may actually lose weight when ill. When they recover, their weight will usually return to normal within two to three weeks. If your baby drops two or more centile spaces from their normal position, ask your doctor to check them.

Your child’s height after the age of two can give some indication of how tall they will be when they grow up. It’s quite normal for your child to be on different centiles for their weight and their height/length, but the two are usually similar. If there is a big difference, or if your doctor is concerned about your child’s weight, they will calculate their body mass index (BMI) centile. This will help to show whether your child is overweight or underweight.  In this case, you can talk to your doctor about your child’s diet and levels of physical activity and plan any changes needed.

 



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