Growth Curves발음듣기
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Growth Curves
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Female Voiceover: One of the most powerful methods that we have for monitoring the well being of a child is a tool called growth monitoring.발음듣기
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That's usually recorded at birth, especially if there is a health professional with a scale nearby.발음듣기
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All of these variables together give us a sense of how that child is growing and how their overall health is.발음듣기
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Two of these variables, the weight and the length, are usually put, at least in the United States, on the same curve.발음듣기
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The lower band, this band over here, also on the y-axis, is going to represent the weight of the child.발음듣기
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This would be birth and then a younger child's growth curve or growth chart usually goes up until 3 years of age and then their data gets put onto a different kind of growth curve.발음듣기
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That means that about half of children will fall above that line and half will fall below, and similarly for length, we have a 50th percentile line.발음듣기
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That means that a child that falls on that line is taller than 95% of the children in that age group.발음듣기
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Let's say that this child was born slightly on the lower side and maybe sort of at the 50th percentile for height.발음듣기
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What we then need to do is as this child grows, with each visit to the doctor and in the US babies visit the doctor every two months usually at the beginning for the first six months.발음듣기
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We would get a data point and it's not unusual in that first year for babies to cross percentile lines.발음듣기
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Maybe this child would catch up and by one year of age this child would be right at the 50th percentile.발음듣기
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All of these data points put together give us an overall reassuring picture of the child's health because of the fact that they are growing along a nice smooth line.발음듣기
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Let's say one of them came in on Monday to see you and this 2-year-old was sort of weighing in at the 5th percentile.발음듣기
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The other 2-year-old, and you haven't seen either of these children before, the other 2-year-old was, let's say at the 25th percentile.발음듣기
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You might think, just looking at these two data points, that if we were going to be concerned about any of these children, we would be concerned about this one here because this child is right on the bottom line.발음듣기
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What if I told you throughout this child's two years of life, this child had consistently tracked along the 5th percentile?발음듣기
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Let's say this child's parents were small or there was another reason that this child was a small child but a healthy small child.발음듣기
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Let's say in contrast that this child up here in purple, this child had let's say been born kind of on the heavier side and had been tracking along nicely along the 95th percentile line, and then let's say this child's weight had dropped off.발음듣기
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But this kind of a drop off, a crossing of percentiles, especially nearing the second year of life, when usually children have sort of decided on which percentile they're going to stick to, that would be much more concerning than this child, even though this child is at a lower percentile.발음듣기
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Let's say the child in green versus the child in yellow, we would definitely be more concerned about the child in green, because of the fact that they're so far below the 5th percentile.발음듣기
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The further below the lowest percentile, the greater our index of suspicion or our worry and yet we do need to have multiple data points in order to make a judgment about whether something is really going wrong with the child.발음듣기
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Another thing to note here is that a drop off in weight is usually kind of an acute indicator.발음듣기
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Let's say this child could have been tracking nicely along the 70th percentile and then let's say their height dropped off.발음듣기
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Now this is a concerning trend because we're seeing a drop off in height and we call that growth stunting.발음듣기
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Well, especially in developing countries, there are three reasons why growth monitoring is very important.발음듣기
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Even in poor families, when a child within the family is identified as being underweight for age, the family will often just ever so suddenly redistribute their income to support that child's nutrition.발음듣기
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Secondly, if there are sources of external aid available to a community, growth monitoring and identification of children who are failing to thrive, or who are underweight for age, that will allow targeted distribution of that aid toward children who need it most.발음듣기
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It makes parents and caregivers aware of the importance of adequate nutrition in order for children to grow to be healthy.발음듣기
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Failure to thrive, it's the term that we use to describe a child who has a concerning profile on one of these growth monitoring charts.발음듣기
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So for example, a child who is acutely falling off or a child who is growth stunted, and failure to thrive has two origins.발음듣기
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Organic failure to thrive occurs when there is something physiologically wrong with the child where they are unable to make use of the nutrients that they are taking into their body.발음듣기
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Maybe they are unable to digest the nutrients or they are unable to absorb them, but for some reason the nutrients aren't getting to the tissues to help the body grow.발음듣기
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