Growth and Development of a Child

Growth and Development of a Child

Growth and Development of a Child

Growth is the progressive increase in the size of a child or parts of a child. Development is progressive acquisition of various skills (abilities) such as head support, speaking, learning, expressing the feelings and relating with other people.

Patterns of Growth and Development

Growth and development are directional and follow detectable patterns.

  1. Cephalo-caudal: Meaning that growth and development proceed from head to tail. Structures and functions originating in the head develop before those in the lower parts of the body. The fetal head initially grows the fastest, followed by the trunk and later the legs. At birth, the head is larger, the trunk is long, and the arms are larger than the legs. As the child matures, body proportions gradually change, and by adulthood, the legs have increased in size from 38% to 50% of total body weight.

  2. Proximal-distal pattern: Growth occurs from the center outwards. In the respiratory system, the trachea develops first in the embryo, followed by branching and growth outwards in the bronchi, bronchioles, and alveoli in the fetus and infant. Motor control of the arms comes before control of the hands, and hands control comes before finger control.

Critical Periods in Growth and Development

These are sensitive periods during which children demonstrate readiness to learn particular tasks, such as walking. Many factors affect a child’s sensitive learning period, including injury, illness, and malnutrition.

Factors Influencing Growth and Development

Factors Influencing Growth and Development

  • Genetics (Heredity): Existence of certain traits may hinder or facilitate growth and development.
  • Environment: Conditions affecting the child before and after birth, such as smoking, infections, socioeconomic factors, and environmental hazards.
  • Culture: Habits, beliefs, and values.
  • Nutrition: Adequate nutrition is necessary for brain growth prenatally and in the first year of life.
  • Infections: Infections can affect the delivery of nutrients, hormones, and oxygen to organs and tissues.
  • Play: Play is most frequent during periods of rapid growth and development and may be related directly to expanding intellectual, motor, language, and social development.

Factors Contributing to Effective Growth and Development

  • Breastfeeding for at least 2 years with exclusive breastfeeding for at least 6 months.
  • Supplementing breastfeeding with the right (quality and quantity) food at 6 months.
  • Providing regular meals containing all nutrients.
  • Prevention of childhood illnesses through immunization and proper environmental sanitation.
  • Early diagnosis and treatment of malaria, worm infestations, diarrhea, vomiting, and respiratory infections.
  • Use of family planning services to prevent risks resulting from a mother getting pregnant too soon.
  • Raising awareness among mothers regarding balanced nutrients in relation to the growth and development of children under five.
  • Seeking treatment for early childhood illnesses as early as possible.
  • Involving parents in growth monitoring, interpretation of the weight chart, and seeking help.

Factors Contributing to Poor Growth or Failure to Thrive

  • Low birth weight or prematurity due to general health status of the mother during pregnancy, such as anemia, malaria, STIs.
  • Unsuccessful breastfeeding due to improper position and attachment of the baby to the breast.
  • Very early introduction of complementary feeds before 6 months.
  • Early weaning of the baby off breastfeeding.
  • Lack of information by the mother.
  • Ill health of the baby due to childhood diseases.
  • Late introduction of solids in the diet.
  • Children born to mothers with too many, too close, too early, multiple pregnancies.
  • Poor socioeconomic status of the family leading to poor feeding or food shortage.
  • Generalized famine in the community.
  • Ignorance of the mother on how to mix available food to provide a balanced diet.
  • Poor general health of the mother.
  • Death of the mother or both parents.
Developmental Milestones

Developmental Milestones

Birth to 1 Month
  • Important pediatric age.
  • Birth weight is usually 2.5 to 4.3kg.
  • The newborn will lift the head when placed in a prone position (normal reflex).
  • Demonstrates reflex activities.
  • Maintains eye contact; vision is poor.
  • Communicates by crying.
  • Mongolian spots may occur in dark-skinned children.
  • Vaginal bleeding/discharge is not uncommon due to maternal hormones.
  • Vital signs: Pulse 100-180 b/m, Temperature 36.5-37.5°C, BP 50-100/20-60mmHg, RR 30-50 breaths/min.
2nd Month
  • Closure of the posterior fontanelle.
  • Several newborn reflexes disappear.
  • Less head lag.
  • Can lift head almost 45 degrees when placed on abdomen.
  • Less flexing of arms and legs while lying on the stomach.
  • Sensory and cognitive markers: beginning to look at close objects, coos, different cries for different needs.
  • Play recommendations: expose the baby to sounds outside the home, take the baby for rides in the car or walks in the neighborhood, provide bright room with pictures and mirrors, bright-colored toys, read to the baby, talk to the baby about objects and people in the environment, hold and comfort the baby if they are upset or crying.
3rd Month
  • Major motor skills: Rests on forearms, lifts head and upper chest while lying on abdomen, sits with support, holds a rattle briefly and moves it towards their face.
  • Language: Begins to laugh, ‘coo,’ and vocalize in vowel sounds.
  • Vision and hearing: Eyes converge on near objects, attend to nearby voice or meaningful sounds.
  • Social achievements: Coo, cry, smile, chuckle, and have a quick social response to friendly faces.
  • Play recommendations: read, sing, and talk to your child, imitate words to help baby learn language, play peek-a-boo, provide an unbreakable mirror, provide large, bright-colored toys, provide paper to tear, blow bubbles, speak clearly, start pointing to and naming body parts and the environment.
4th Month
  • Physical and motor skills: Gains weight at a slower rate, sits for long periods, rolls from front to back, holds and lets go of an object, plays with a rattle, grasps a rattle with both hands, places objects in the mouth, sleeps 9 to 10 hours at night with 2 naps during the day.
  • Sensory and cognitive skills: Well-established close vision, increased eye contact with parents, beginning hand-eye coordination, ability to coo and laugh out loud, memory and anticipation of feeding.
  • Play recommendations: place the baby in front of a mirror, provide bright-colored toys, repeat sounds the infant makes, help the infant roll over, use an infant swing at the park, play on the abdomen.
5th Month
  • Physical and motor skill markers: Hold almost all weight when supported in a standing position, transfer objects from one hand to the other, lift chest and head while on abdomen, able to pick up a dropped object, sit in a high chair with a straight back, sit on the floor with lower back support, beginning of teething, increased drooling.
  • Sensory and cognitive markers: Begins to fear strangers, imitates actions and sounds, understands the permanence of objects, can locate sounds not made directly at ear level, enjoys hearing own voice, makes sounds to mirror and toys, makes sounds resembling one-syllable words.
  • Play recommendations: provide picture books, expose to different stimuli, build vocabulary, teach hot and cold, provide large, bright-colored toys, read, sing songs, and avoid television time until age 2.
6th Month
  • Social and Emotional: Knows familiar faces, likes to play with others, especially parents, responds to other people’s emotions and often seems happy, likes to look at self in a mirror.
  • Language/Communication: Responds to sounds by making sounds, strings vowels together when babbling, responds to own name, makes sounds to show joy and displeasure, begins to say consonant sounds (jabbering with “m,” “b”).
  • Cognitive (learning, thinking, problem-solving): Looks around at things nearby, brings things to mouth, shows curiosity about things, begins to pass things from one hand to the other, begins to realize that if an object is dropped, it is still there and just needs to be picked up, can locate sounds not made directly at the ear level, enjoys hearing own voice, makes sounds resembling one-syllable words, prefers more complex sounds, recognizes parents.
  • Play: Place the baby in front of a mirror, provide bright-colored toys, repeat sounds the infant makes, help the infant roll over, use an infant swing at the park if the baby has head control, play on the abdomen.
9th Month
  • Physical characteristics and motor skills: Gains weight at a slower rate, increases in length, bowel and bladder become more regular, demonstrates reflex activities, maintains eye contact, vision is poor, communicates by crying.
  • Cognitive (learning, thinking, problem-solving): Able to crawl, sit for long periods, pull self to a standing position, reach for objects while sitting, bang objects together, grasp objects between the tip of the thumb and index finger, feeds self with fingers, throws or shakes objects.
  • Sensory and cognitive skills: Babbles, has separation anxiety and may cling to parents, is developing depth perception, understands that objects continue to exist even when they are not seen (object constancy), responds to simple commands, responds to name, understands the meaning of “no,” imitates speech sounds, may be afraid of being left alone, plays interactive games.
  • Play: provide picture books, expose to different stimuli, build vocabulary, teach hot and cold, provide large, bright-colored toys, read, sing songs, avoid television time until age 2, try using a transition object to help decrease separation anxiety.
1 Year
  • Social and Emotional: Is shy or nervous with strangers, cries when mom or dad leaves, has favorite things and people, shows fear in some situations, hands you a book when he wants to hear a story, repeats sounds or actions to get attention, puts out an arm or leg to help with dressing, plays games such as “peek-a-boo” and “pat-a-cake.”
  • Language/Communication: Responds to simple spoken requests, uses simple gestures, like shaking head “no” or waving “bye-bye,” makes sounds with changes in tone, says “mama” and “dada” and exclamations like “uh-oh,” tries to say words you say.

Cognitive (Learning, Thinking, Problem-Solving)

  • Counts 10 or more things, can draw a person with at least 6 body parts, can print some letters or numbers, copies a triangle and other geometric shapes, knows about things used every day, like money and food.

Movement/Physical Development

  • Stands on one foot for 10 seconds or longer, balances with eyes closed, hops, may be able to skip, can do a somersault, uses a fork and spoon, and sometimes a table knife, can use the toilet on her own, swings and climbs.
6-12 Years
  • Can learn to swim, ride a bicycle.
  • Ties shoes.
  • Uses pencil well.
  • Forms clubs or gangs.
  • Demonstrates awareness of rule-governed behavior.
  • Has a strong sense of “what’s fair.”
  • Uses complex sentences.
  • Reads.
  • Counts.
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