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Monitoring Growth in Childhood: Practical Clinical Guide

Article information

J Korean Med Assoc. 2009;52(3):211-224
Publication date (electronic) : 2009 March 31
doi : https://doi.org/10.5124/jkma.2009.52.3.211
In Kyung Sung, MD
Department of Pediatrics, The Catholic University of Korea College of Medicine, Korea. sinky@catholic.ac.kr

Abstract

Growth is a potent indicator of child health. The child who grows well is generally healthy, and poor growth reflects his or her ill health. Identification of poor growth acts as a useful early warning of a possible problem. Monitoring children's growth status with appropriate assessments is an important part of pediatrics, and the recognition of growth problems in children is one of the major challenges facing primary care physicians. The process of growth assessment involves measurements of height and/or weight, and sometimes also involves more specialized measurements that are plotted on standard growth charts. In order to identify pathologic growth, a careful history and physical examination should also be obtained. The purpose of this article is to provide information for primary care physicians to guide the assessment of growth in children. Tools to assist in the assessment of growth are discussed as well as normal growth patterns of children.

Keywords: Child; Growth; Growth evaluation; Growth disorders

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Copyright © 2009 Korean Medical Association

Figure 1

Figure 1

Growth curve in normal children(I=1st growth spurt, from fetal period to 2years of age; II=slow growing period, from age 2year to puberty; III=2nd growth spurt, from puberty to age 15~16year; IV=from age 15~16year of decreasing growth rate).

Figure 2

Figure 2

Height velocity chart for boys and girls. The 97th, 50th, and 3rd percentile curves define the general pattern of growth during puberty. Shaded areas define velocities of children who have peak velocities at ages up to 2 standard deviations before or after the average age depicted by the percentile lines.

Figure 3

Figure 3

Points to consider when interpreting a weight chart.

Figure 4

Figure 4

Height-for-age curves of the four general causes of proportional short stature: postnatal onset pathologic short stature (A), constitutional growth delay (B), familial short stature (C), and prenatal onset short stature (D).

Table 1

Clinical recommendations for evaluating growth of a child

Table 1

*MPH for boys, cm: (father's height + mother's height + 13)/2

MPH for girls, cm: (father's height + mother's height + 13)/2

Table 2

Assessment of patient referred for short stature

Table 2

Table 3

Measurements indicated for particular growth conditions

Table 3

Table 4

Factors needed for effective growth monitoring

Table 4

Table 5

Possible signs of a growth failure

Table 5

Table 6

Endocrine PICNIC, the causes of pathological growth in children

Table 6

Table 7

Comparing constitutional growth delay with familial short stature

Table 7

Table 8

Clinical features suggesting pathological cause of a growth failure

Table 8