Slide 1 : Growth Monitoring
- Dr.K.Mallikharjuna Rao
Slide 2 : Growth – Physical maturation – increase in body size and proportions
Development – Functional maturation – acquisition of skills.
Growth is measured in terms of linear growth – height or length and body weight.
The height of an individual is influenced both by genetic and environmental factors.
The maximum growth potential of an individual is determined by the hereditary factors, while the environmental factors (eg. Nutrition, morbidity) determine the extent of exploitation of that genetic potential.
Slide 3 : Inadequate dietary intake and/ or infections reduce the nutrients at the cellular level, resulting in slowing of growth rate (growth reduction).
If this process continues over a longtime, linear growth rate may slow down and will lead to a short stature (stunting).
Severe bouts of infections like diarrhoea result in drastic reduction in body weight. The body weight is an indicator of current nutritional status of the child, while the height for age is an indicator of long duration malnutrition.
Slide 4 : GROWTH MONITORING
It is necessary to find out whether the child is growing normally as expected or not. This process of observing growth of the child at regular intervals (i.e. monthly or quarterly) is called growth monitoring.
Growth monitoring provides a visual record of the growth pattern of the child.
Slide 5 : USES OF GROWTH MONITORING
Assess the child’s nutritional status
Early detection of growth failure in children so as to initiate action at an appropriate time to improve the growth status
As a tool to educate the mother about the child’s growth and its relationship with child care and feeding.
Slide 6 : STEPS IN GROWTH MONITORING
Assess the age of the child accurately to the nearest month-using date of birth/local events calendar.
Record the weight of the child accurately (nearest to 100g) using standard weighing scale after adjusting the balance for zero error with minimum clothing on the child.
Plot the child’s weight correctly on the growth chart.
Interpret the growth of the child from the weight recorded for the consecutive periods on the growth chart to identify growth faltering, if any.
Use this information to educate the mother about her child’s growth.
Monitor the changes in nutritional status of children in the area.
Slide 7 : GROWTH FALTERING
When two marks indicating the weight of the child for two consecutive periods are joined, the direction to which the line is pointing will indicate how the child is growing.
The direction of the line may be
Upward weight gain
Horizontal no change in weight
Downward loss of weight
Slide 8 : Identification of growth faltering will help the workers to ascertain the reasons from the mothers for growth faltering and record the cause for the same on the growth chart.
Advice the mother to provide proper care to ensure the child’s optimal growth.
This provides a record of the child’s illness and care provided for the same.
Slide 9 : A child in any grade can have growth faltering i.e. a normal child also can loose weight or may not gain any weight.
Change from higher grade to a lower grade i.e. indicating loss of body weight indicates growth faltering.
Similarly, either no change or loss in weight within the same grade is also termed as growth faltering.
Slide 10 : Identification of growth faltering should be considered as an early warning signal of the child’s growth status.
Immediate initiation of curative and preventive care is essential to save the child from further deterioration of his/her condition.
Slide 11 : CLASSIFICATION OF NUTRITIONAL STATUS
The standards being used in ICDS to assess the nutritional status of the children are based on Harvard Standards and the Indian Academy of Paediatrics (IAP) classification is used to grade the children.
IAP Classification
Weight for age Nutritional grade
? 80% Normal
70 – 80% Grade I
60 – 70% Grade II
50 – 60% Grade III
< 50% Grade IV