The document discusses growth and development in children from birth through adolescence. It defines growth as the physical increase in body size, while development refers to changes toward maturity. Key factors that influence growth include genetics, nutrition, environment, socioeconomic status, and caregiver involvement. The document also describes the maturation of major body systems from birth through childhood, including the nervous, respiratory, cardiovascular, gastrointestinal, renal, skeletal, and immune systems. Effective nursing care requires understanding normal growth and development patterns.

1. PEDIATRIC HEALTH NURSING
UNIT II : GROWTH & DEVELOPMENT IN CHILDREN
MUHAMMAD SULIMAN
Post RN BSc.N
ROYAL COLLEGE OF NURSING
SWAT
15/25/2015

2. IMPORTANT POINTS
➧ Growth is the physical increase in the body’s
size.
Development is the progression of changes in the
child toward maturity, which is completed growth
and development.
➧ Growth following an orderly pattern from the
head downward is called cephalocaudal.
Proximodistal growth starts in the center and
progresses outward.

3. CONT…
➧ Height and weight are monitored and plotted on
growth charts to provide a comparison of
measurements and patterns of a child’s growth.
➧ Growth charts and developmental assessment
tools are used to compare a child’s growth to other
children of the same age and sex. They are also
used to compare the child’s current measurements
with his or her previous measurements.

4. CONT…
➧ Genetics, nutrition, and environment are all
influences on a child’s growth and development.
➧ A lower socioeconomic level, decreased caregiver
time and involvement, and media exposure are
environmental factors that may influence growth
and development. Homelessness, divorce, latchkey
situations, running away from home, and living in a
household in which parents are addicted to drugs or
alcohol are also environmental factors that influence
a child’s growth and development.

5. Cont…
➧ The body systems are in place at birth and mature as
the child grows.
• At birth the nervous system is immature. As the child
grows, the quality of the nerve impulses sent
through the nervous system develops and matures,
allowing for the development of gross and fine
motor skills.
• Visual acuity of children gradually increases from
birth until about 7 years of age, when most children
have 20/20 vision. Hearing in children is acute, and
the infant will respond to sounds within the first
month of life.

6. Cont…
• An infant or child’s respiratory system, because
of its small size and underdeveloped anatomical
structures, is more prone to respiratory problems,
obstruction, and distress. As the child grows, the
use of the thoracic muscles takes the place of the
use of the diaphragm and abdominal muscles for
breathing.

7. Cont…
• At birth, both the right and left ventricles are
about the same size, but by a few months of age,
the left ventricle is about two times the size of
the right. Although the size is smaller, by the time
the child is 5 years old, the heart has matured,
developed, and functions just as the adult’s.
• The GI tract of the newborn works in the same
manner as that of the adult but with some
limitations.

8. Cont…
For example, the enzymes secreted by the liver
and pancreas are reduced. The smaller capacity
of the infant’s stomach and the increased speed
at which food moves through the GI tract
require feeding smaller amounts at more
frequent intervals. In addition, the small capacity
of the colon leads to a bowel movement after
each feeding.

9. Cont…
• In infants and children, emptying the bladder is a
reflex action. Between ages 2 and 3 years, the
child develops control of urination.
• The kidneys in children are located lower in
relationship to the ribs than in adults. This
placement and the fact that the child has less of
a fat cushion around the kidneys cause the child
to be at greater risk for trauma to the kidneys.

10. Cont…
• Bone growth takes place between birth and
puberty. During childhood the bones are more
sponge-like and can bend and break more easily
than in adults. Because the bones are still in the
process of growing, breaks in the bone heal more
quickly than do breaks in adults.
• As the child grows and develops, the immune
system also develops. The antibodies in the child
increase as the child progresses through
childhood.

11. Cont…
➧ Understanding the growth and development of
the child and influences on the child and family
caregivers is important for effective
communication. Listening, maintaining eye
contact, having playful engagement, and playing
with children can encourage communication.
Infants evaluate actions and respond to sensory
cues. Young children are egocentric and tend to
be frightened of strangers.

12. Cont…
Use short sentences, positive explanations,
familiar and nonthreatening terms, and concrete
explanations. School-age children are interested
in knowing the “what” and “why” of things.
Provide simple, concrete responses using age-
appropriate vocabulary. Choices should be
simple and limited. Let adolescents know that
you will listen in an open-minded, non-
judgmental way.

13. Cont…
Phrase questions regarding sensitive information in
a way that encourages the adolescent to respond
without feeling embarrassed. Include caregivers
in providing information, problem solving, and
planning of care. Keep caregivers well informed of
what is going on.
➧ The nurse who understands normal growth and
development is better able to develop an
appropriate plan of care for the child, including
the areas of communication, safety, and family
teaching.

14. REFERENCES
 Berger, K. S. (2005). The developing person through the life
span (6th ed.). New York: Worth Publishers.
 Berger, K. S. (2006). The developing person through childhood
and adolescence (7th ed.). New York: Worth Publishers.
 Bowlby, J. (1969). Attachment. New York: Basic Books.
 Brazelton, T. B., & Greenspan, S. (2001). The irreducible needs
of children: What every child must have to grow, learn, and
flourish. Cambridge, MA: Perseus Publishing.
 Cocking, R. R., & Greenfield, P. M. (Eds.). (1994). Crosscultural
roots of minority child development. Hillside, NJ: Lawrence
Erlbaum Associates.
 Dudek, S. G. (2006). Nutrition essentials for nursing practice
(5th ed.). Philadelphia: Lippincott Williams & Wilkins.