UG class from MCH chapter of Park textbook and other onl. Includes topics such as- child growth and development, preterm, low birth weight, KMC, feeding, neonate, growth assessment, growth charts.

1. Child Growth
Dr Mamta G, Community Medicine, GMC Siddipet

3. KMC- https://www.youtube.com/watch?v=EkFvYhOMC4o&ab_channel=care4cute
https://www.youtube.com/watch?v=y8Wlc5wFHf4&ab_channel=Nestl%C3%A9Nutri
tionInstitute
https://youtu.be/JGAoHkkrGnk

4. Measuring the baby
• Birth weight
• Length
• Head circumference

6. Low birth weight= due to Short gestation or IUGR

9. PRETERM
(<37 WEEKS)
POSTERM
(>42 WEEKS)
TERM
(37-42 WEEKS)
EXTREME
<28
VERY
28-32
MODERATE/LATE
32-37

10. Preterm
Labour
Genetic
Psychological
Medical^
Nutritional
Lifestyle
Infection
Multiple
pregnancy
Age/spacing
^ including induction

11. Causes of preterm birth
Bmj.com

12. Causes of death in preterm babies
Atelectasis Malformation Pulmonary hge
Causes of death in preterm babies
Atelectasis
Malformation
Pulmonary hge
Intracranial
bleeding
Intracranial
bleeding
Pneumonia etc
infections

13. IUGR = Small For Date babies
Maternal
causes
Placental
causes
Fetal
causes

14. Infection
Unregulated
fertility
Malnutrition
The root of it all

15. Prevention of LBW
• Direct interventions:
Nutrition, infections, early detection of conditions
• Indirect interventions:
Family planning
Sanitation
Development
Social services

16. Treatment of LBW
• Incubatory care- temp, O2, humidity
• Feeding
• Prevention of infections

17. Feeding of infants
1. Breastfeeding
• Advantages?
• Feed by the clock?
2. Artificial feeding
• Principles of artificial feeding?
• Options?

18. BFHI
1. Written breastfeeding policy
2. Training of staff
3. Inform mothers
4. Help mothers initiate
5. Show mothers for separation
6. Exclusive breastfeeding
7. Rooming-in
8. On demand
9. No pacifiers
10.Support groups

19. • Prohibits promotion of
Infant food
Infant milk substitutes
Feeding bottles
National guidelines on infant and young child feeding

20. Growth and development
• Physical size
• Skills and functions
Determined by:
1. Genetics
2. Nutrition
3. Age
4. Sex
5. Environment
6. Psychology
7. Infections
8. Economics
9. Others
What’s Normal????
Upto 2 SD or between 3rd and 97th percentiles

21. Growth assessment & Surveillance
1. Harvard/Boston
2. WHO reference
3. ICMR
1. Physical growth
2. Behavioral
Development

22. Growth chart

23. Methods of growth
monitoring
1. Growth monitoring
2. Diagnostic tool
3. Planning and policy
making
4. Educational tool
5. Tool for action
6. Evaluation
7. Tool for teaching
Uses of Growth
chart
1. Growth chart
2. Height for age
3. Weight for height
4. Arm circumference

24. Height measurement in
Anganwadi
Youtube channel: Anganwadi helpline

25. https://www.youtube.com/watch?v=euamVLL1gRs&ab_chan
nel=Nestl%C3%A9NutritionInstitute

26. Care of preschool child
• 10% population of our population
• 45% deaths relate to malnutrition
• 40% have mild PEM
• Crucial period for growth and development
• Less accessible age
• Vulnerable age which may decide for adult life

27. Child health problems
Low birth
weight
Malnutrition Infections
Accidents Behavioral

28. Malnutrition
??What’s in the Gallery ??

30. c

31. D
Peripheral smear

32. E

33. Infections and parasitosis
??What’s in the Gallery??

34. F

35. G

36. H

37. I

38. J

39. Homework: Read, discuss among yourselves
Integrated services delivery package for
maternal, newborn and child health (Figure)

40. Next class- Social services and Geriatrics

41. Class work- To do-
Mark the following children in growth charts.
1.Akshay, Mch DOB 20.10.2019, Birth weight: 2.6kg,
today (25.10.21): 15kg
2.Disha, Fch DOB 12.01.2021, B.wt: 2kg, at 4mth: 6kg, today: 9 kg
3.Harith, Mch DOB 1.11.2018, B.wt: 3kg, at 9 mth: 5kg,
at 18 mth: 14kg, today: 16kg

42. Key for the quiz:
A. KWASHIORKOR
B. MARASMUS
C. BITOTS SPOT = VIT A DEFICIENCY
D. PALLOR=ANEMIA
E. HYPOTHYROIDISM/IODINE DEFIENCY/CRETINISM
F. DEHYDRATION (MAY BE DUE TO DIARRHEA)
G. CHEST RETRACTION ON INSPIRATION WITH NASAL FLARING (SIGNS OF
PNEUMONIA)
H. MEASLES (CHARACTERSTIC RASHES)
I. POLIO
J. DIPHTHERIA (CHARACTERISTIC)

43. KEY FOR GROWTH CHARTS
1. Not appropriate to mark and comment on growth curve with only
two known points (should have minimum 3 points); current weight
lies in severely underweight category; baby needs immediate
medical attention and is at high risk for various infections)
2. Normal growth curve but current measurement lies in overweight
category
3. Normal growth curve but is overweight for age
Note: some one or two kg deviation beyond normal can be over looked
in under-5 kids and isn’t a cause for concern