exploring the physiological changes of childhood

the journey of infancy to childhood

Transition from infancy to childhood and the major milestones reached

during this period.

• Growth spurts and their impact on physical development.

• The role of nutrition and overall health in supporting these changes

growth charts

• to provide a brief history of

  • antropometry- growth measurements

  • growth references, the statistical summary of anthropometry

  • growth charts, the visual representation of growth reference for clinical use

distance plot and velocity plot of height in count de montbillards son

The growth rate of a child varies being

highest during fetal life and infancy,

slowing down during childhood,

accelerating during puberty, and then

ultimately ending when adult height has

been reached by the end of the

adolescent period

• Data is reproducible

• Some differences: gender, gestational age

etc

special cohorts BNFC

The growth rate of a child varies being

highest during fetal life and infancy,

slowing down during childhood,

accelerating during puberty, and then

ultimately ending when adult height has

been reached by the end of the

adolescent period

• Data is reproducible

• Some differences: gender, gestational age

etc

stages in human growth and development

• feral stage

• postnatal stage

fetal stage

Fetal health issues can have detrimental effects on postnatal growth. A 1/3rd

of neonates with IUGR might have curtailed postnatal growth. Good perinatal care is an

essential factor in promoting fetal health and indirectly postnatal growth.

postnatal stage

The process of postnatal growth and development happens together

but at different rates. There are five significant phases in human growth and development:

• Infancy (neonate and up to one year age)

• Toddler (one to five years of age)

• Childhood (three to eleven years old) – early childhood is from three to eight years

old, and middle childhood is from nine to eleven years old.

• Adolescence or teenage (from 12 to 18 years old)

• Adulthood

onset of GH dependent growth

• prenatal growth

• neonatal period

• early infancy

• childhood growth

• pubertal growth spurt

prenatal growth

Even before birth, growth hormone plays a vital role in fetal

development. It promotes overall growth, particularly in the development of organs

and tissues. But fetal growth and development is largely under the control of IGFs.

neonatal period

Although GH levels are high at birth, they don't significantly

influence growth during the initial weeks of life. Instead, growth during this period is

primarily influenced by nutritional status and other hormonal factors.

early infancy

After birth, growth hormone continues to support growth and

development. During this period, growth rates are typically high, and infants

experience rapid weight gain and an increase in linear height

childhood growth: onset of GH dependent growth

During early to mid-childhood, GH remains essential for linear growth. In this period, called the

childhood growth phase, growth velocity significantly impacts a child's physical

development. Height velocity tends to be highest during the first two years of life,

gradually decreasing as children enter childhood

pubertal growth spurt

One notable period of growth hormone-dependent growth is the pubertal growth spurt. With the onset of puberty, typically around the age of 10-12 in girls and 12-14 in boys, there is an increase in the secretion of growth hormone.

growth plate: how long bones lengthen

resting zone reserve chondrocytes- proliferative zone cell division + columns- hypertriohic zone chondrocytes enlarge- ossification cartilage replaced by bone

growth plate closure

Eventually, the growth plates in the bones (epiphysealplates) close under the influence of sex steroids,marking the end of linear growth. This typically occurs in late adolescence

factors affecting growth rate

• genetics

• nutrition

• overall health

• hormonal balance

healthy habit to support physiological changes

Proper nutrition, regular exercise, and sufficient sleep are needed for

healthy physiological development.

physiological consideration when prescribing for children

1. Dosage and Formulation

2. Pharmacokinetics and Pharmacodynamics

3. Age-Related Safety Considerations

4. Limited Paediatric-Specific Data

5. Adherence and Compliance

6. Communication and Education

medications that impact on children growth and development

• corticosteroids

• stimulant medications

• antiepileptic drug

• antipsychotic medication

• cancer chemotherapy

• systemic glucocorticoid

• isotretinoin

corticosteroids

They can slow down linear growth and increase the risk of

developing osteoporosis or thinning of bones

stimulant medication

associated with modest reductions in height and weight

during the first years of use; however, the impact on long-term growth remains

controversial.

anti epileptic drugs

Valproic acid has been associated with an increased risk of

developmental delays, low IQ, and potential birth defects if taken during

pregnancy.

antipsychotic medications

Atypical antipsychotics, such as risperidone or

quetiapine, may cause weight gain and metabolic changes in children.

cancer chemotherapy

may interfere with normal cell division, resulting in

delayed growth and development

systemic glucocorticoids

can impact growth and development, especially when

used at high doses or for long periods

isotretinoin

commonly used to treat severe acne and has been associated with

potential growth plate abnormalities and skeletal changes in some individuals