Assessment Of Growth In Children Research Articles

Understanding Early Detection of Child Growth and Development Using Pre-Screening as the Basis for the Formation of Health Cadres in the Mamajang Health Center Area

Assessment of child growth and development needs to be done to find out early any deviations in growth and development experienced by children. According to Widata, about 16% of toddlers experience developmental disorders, about 62% occur at preschool age. The purpose of community service activities is so that health cadres can monitor early growth and development and have knowledge about how to early detect child growth and development using developmental pre-screening questionnaires. The method used is the provision of material by means of lectures and demonstrations which were initially carried out pre-test and post-test. The result achieved was that about 16 out of 20 cadres (80%) obtained scores above 75%. The average pre-test score of cadres is 6.6 (33%), after participating in the activity there is an increase in post-test results of around 12.5 (62.5%) it can be said that there are 100% of cadres who have been trained to obtain scores above 60% and exceed the predetermined target. The conclusion is that there is an increase in cadre knowledge after participating in community service through the assessment of pre-screening developmental questionnaires.

Longitudinal assessment of early growth in children with IgE- and non–IgE-mediated food allergy in a healthy infant cohort

BackgroundThere are conflicting associations reported between food allergies (FAs) and poor growth, with some indication that children with multiple FAs are at highest risk. ObjectiveWe analyzed longitudinal weight-for-length (WFL) trajectories from our healthy cohort to evaluate growth in children with IgE-mediated FAs and food protein-induced allergic proctocolitis (FPIAP), a non–IgE-mediated FA. MethodsOur observational cohort of 903 healthy newborn infants was prospectively enrolled to evaluate the development of FAs. Longitudinal mixed effects modeling was used to compare differences in WFL among children with IgE-FA and FPIAP, compared with unaffected children, through age 2. ResultsAmong the 804 participants who met inclusion criteria, FPIAP cases had significantly lower WFL than unaffected controls during active disease, which resolved by 1 year of age. In contrast, children with IgE-FA had significantly lower WFL than unaffected controls after 1 year. We also found that children with IgE-FA to cow's milk had significantly lower WFL over the first 2 years of age. Children with multiple IgE-FAs had markedly lower WFL over the first 2 years of age. ConclusionChildren with FPIAP have impaired growth during active disease in the first year of age which resolves, whereas children with IgE-FA, particularly those with multiple IgE-FA, have impaired growth more prominently after the first year of age. It may be appropriate to focus nutritional assessment and interventions accordingly during these higher risk periods in these patient populations.

Characterising school-age health and function in rural Zimbabwe using the SAHARAN toolbox.

We developed the School-Age Health, Activity, Resilience, Anthropometry and Neurocognitive (SAHARAN) toolbox to address the shortage of school-age assessment tools that combine growth, physical and cognitive function. Here we present i) development, acceptability and feasibility of the SAHARAN toolbox; ii) characteristics of a pilot cohort; and iii) associations between the domains measured in the cohort. Growth was measured with anthropometry, knee-heel length and skinfold thicknesses. Bioimpedance analysis measured lean mass index and phase angle. Cognition was assessed using the mental processing index, derived from the Kaufman Assessment Battery for Children version 2, a fine motor finger-tapping task, and School Achievement Test (SAT). Physical function combined grip strength, broad jump and the 20m shuttle-run test to produce a total physical score. A caregiver questionnaire was performed in parallel. The SAHARAN toolbox was feasible to implement in rural Zimbabwe, and highly acceptable to children and caregivers following some minor modifications. Eighty children with mean (SD) age 7.6 (0.2) years had mean height-for-age (HAZ) and weight-for-age Z-scores (WAZ) of -0.63 (0.81) and -0.55 (0.85), respectively. Lean mass index and total skinfold thicknesses were related to WAZ and BMI Z-score, but not to HAZ. Total physical score was associated with unit rises in HAZ (1.29, 95% CI 0.75, 1.82, p<0.001), and lean mass index (0.50, 95% CI 0.16, 0.83, p = 0.004), but not skinfold thicknesses. The SAT was associated with unit increases in the mental processing index and child socioemotional score. The caregiver questionnaire identified high levels of adversity and food insecurity. The SAHARAN toolbox provided a feasible and acceptable holistic assessment of child growth and function in mid-childhood. We found clear associations between growth, height-adjusted lean mass and physical function, but not cognitive function. The SAHARAN toolbox could be deployed to characterise school-age growth, development and function elsewhere in sub-Saharan Africa.

12 Reliability of Two-Person Anthropometric Measurement of Young Children with Parent Facilitator

Abstract Background Body Mass Index is recommended by the World Health Organization for the measurement of growth and the diagnosis of overweight and obesity in children. The reliability of anthropometric measurements is important for assessment of child growth due to the challenges faced when measuring younger children, including the difficulty of having the child remain still during measurement collection. The current gold-standard for anthropometric measurement collection in children in a clinical research setting, set by the World Health Organization, requires the use of two trained anthropometrists. Objectives The purpose of this study was to determine the reliability of anthropometric measurements between two trained anthropometrists working in a pair and one trained anthropometrist working with a child’s parent/caregiver in a primary healthcare setting. Design/Methods An observational study to determine measurement reliability was conducted in a primary care child research network in Canada. 76 children 0 – 5 years old had their length/height, weight, head, arm, and waist circumference measured a total of four consecutive times: twice by two trained anthropometrists working in a pair (researcher-researcher team) and twice by one trained anthropometrist working with a child’s parent/caregiver (researcher-parent team). Inter- and intra- observer reliability was calculated using the technical error of measurement (TEM), relative TEM (%TEM) and the coefficient of reliability (R). Results The %TEM values across both age groups, children 0 - &amp;lt; 2 and 2 – 5 years of age, for length/height and weight were &amp;lt; 2% and the R coefficient values were &amp;gt;0.99, indicating a high degree of inter- and intra- observer reliability. The TEM values were greater for inter- and intra- observer reliability across all age groups for length/height in comparison to other anthropometric measurement parameters, with greater variation seen in the length for children 0 - &amp;lt; 2 years of age. The TEM values across both age groups for inter- and intra- observer reliability of arm circumference was outside of the acceptable range of &amp;lt; 2%, indicating greater measurement error. There was greater variation seen in waist circumference across both age groups. Conclusion This study suggests that anthropometric measurement, including length/height and weight, taken by one trained anthropometrist with the assistance of a parent/caregiver is reliable. These findings can be used to encourage the utilization of a child’s parent/caregiver to assist with anthropometric measurement collection in clinical setting(s) to enhance feasibility and efficiency and reduce the research costs of including a second trained anthropometrist.

Body growth assessment in children with IgE-mediated cow's milk protein allergy fed with a new amino acid-based formula.

BackgroundAmino acid-based formula (AAF) is a relevant dietary option for non-breastfed children. The present study was designed to evaluate the body growth pattern in cow's milk protein allergy (CMPA) children treated for 6 months with a new AAF.MethodsThis was an open-label, single arm study evaluating body growth pattern in immunoglobulin E (IgE)-mediated CMPA infants receiving a new AAF for 6 months. The outcomes were anthropometry (weight, length, head circumference), adherence to the study formula and occurrence of adverse events (AEs).ResultsFifteen children [all Caucasian and born at term; 53.3% born with spontaneous delivery; 80% male; 80% with familial allergy risk; mean age (±SD) 3 ± 2.5 months at IgE-mediated CMPA diagnosis; mean age (±SD) 16.7 ± 5.9 months at enrolment, mean total serum IgE (±SD) 298.2 ± 200.4 kU/L] were included and completed the 6-month study. Data from fifteen age- and sex-matched healthy controls were also adopted as comparison. At baseline, all CMPA patients were weaned and were receiving the new AAF. All 15 patients completed the 6-month study period. For the entire CMPA pediatric patients’ cohort, from baseline to the end of the study period, the body growth pattern resulted within the normal range of World Health Organization (WHO) growth references and resulted similar to healthy controls anthropometric values. The formula was well tolerated. The adherence was optimal and no AEs related to AAF use were reported.ConclusionsThe new AAF ensured normal growth in subjects affected by IgE-mediated CMPA. This formula constitutes another suitable safe option for the management of pediatric patients affected by CMPA.

Longitudinal Study of Growth Variation and Its Determinants in Body Weight of Children Aged 1 - 15 Years in Ethiopia

Background: Child growth assessment serves as a tool for assessing children's health and nutritional condition. Longitudinal studies have statistical power in inspecting growth changes. Objectives: This study aimed to examine the longitudinal growth differences and determinants of children's body weight in Ethiopia. Methods: Longitudinal data were obtained from the Young Lives cohort study conducted in Ethiopia from 2002 to 2016. The study involved 1,665 Ethiopian children who were followed from age 1 to 15 years. The obtained data were analyzed using a fractional polynomial mixed-effect model. Results: Children's weight gain followed non-linear trajectories. There were considerable differences in children's body weight across different regions of Ethiopia. Children in Addis Ababa, Oromiya, and SNNPR had much faster weight growth than Tigray children. There was no substantial difference in the children's rate of weight gain between Tigray and the Amhara region. Boys had a faster rate of change in weight gain than girls. Conclusions: Controlling for other factors, gender, residence, region, parental education, household size, wealth, and mother's age had significant influences on the longitudinal weight growth of children. However, safe drinking water, sleeping time, and father's age were not related to the weight trajectory over time.

Auxology of small samples: A method to describe child growth when restrictions prevent surveys.

Child growth in populations is commonly characterised by cross-sectional surveys. These require data collection from large samples of individuals across age ranges spanning 1-20 years. Such surveys are expensive and impossible in restrictive situations, such as, e.g. the COVID pandemic or limited size of isolated communities. A method allowing description of child growth based on small samples is needed. Small samples of data (N~50) for boys and girls 6-20 years old from different socio-economic situations in Africa and Europe were randomly extracted from surveys of thousands of children. Data included arm circumference, hip width, grip strength, height and weight. Polynomial regressions of these measurements on age were explored. Polynomial curves based on small samples correlated well (r = 0.97 to 1.00) with results of surveys of thousands of children from same communities and correctly reflected sexual dimorphism and socio-economic differences. Fitting of curvilinear regressions to small data samples allows expeditious assessment of child growth in a number of characteristics when situations change rapidly, resources are limited and access to children is restricted.

Maternal and child surveillance in peri-urban communities: Perceptions of women and community health workers from Pakistan.

Community health workers (CHWs) in maternal, newborn, and child health (MNCH) programs play an important role in demographic surveillance activities; however, there is lack of literature regarding the community and CHWs' perceptions about these activities. The purpose of this study was to explore perceptions of married women of reproductive age (MWRA) regarding the role of CHWs involved in maternal and child surveillance and explore facilitators and barriers for CHWs involved in surveillance activities. A qualitative study was conducted in five peri-urban surveillance sites along the coastal belt of Bin Qasim Town, Karachi, Pakistan. In-depth interviews were conducted with 25 randomly selected MWRAs and 15 CHWs. A thematic analysis was performed to explore perceptions, barriers, and facilitators of the study participants about maternal and child surveillance activities. The results showed that MWRAs perceived surveillance CHWs as service providers with regards to standard counselling i.e. importance of antenatal care, nutrition, immunization, and distribution of iron and folic acid tablets to pregnant women, child growth assessment, and referral of sick children to the health facility. Trust in the CHWs was an enabler for MWRAs, whereas lack of incentives was cited as a barrier to share their health data. CHWs perceived themselves as a bridge in liaising community with the primary health care facility. They highlighted an enabling environment such as appreciation, supportive supervision, training, and utilization of digital data collection tools as facilitators for their work. Low health literacy of the communities, lack of provision of incentives by CHWs to the community, and facility-based experiences of the community were reported as barriers. Surveillance CHWs are an integral link between the health facility and MWRAs. Hence an enabling environment may lead to improved health service delivery, translating into meaningful impact for the mother and child.

How Is Context Addressed in Growth Monitoring? A Comparison of the Tanzanian, Indian, and Dutch Manuals

ABSTRACTBackgroundTo address malnutrition in all its forms, context should be taken into account in growth-monitoring (GM) practices.ObjectivesThe aim was to compare GM manuals of countries with different nutrition problems, and to assess how these manuals are adapted to the different biological, socioeconomic, and cultural contexts.MethodsGM manuals from Tanzania, India, and the Netherlands were compared with each other, and with the materials for the WHO training course on child growth assessment. First, the aims of GM, growth measurements, interpretation of these measurements, and counseling approaches are compared. Second, contextual determinants of malnutrition are identified using the UNICEF framework for malnutrition as an analytical model.ResultsOur results show that the GM manuals differ in their descriptions of the aim of GM, growth measurements, their interpretation, and counseling approaches. Assessing normal growth and detecting growth problems are among the aims of GM in all of the analyzed countries. In Tanzania and India, the focus is mainly on undernutrition, whereas the Dutch manuals focus on overweight and on underlying pathologies that contribute to poor linear growth. The findings of our analysis of contextual factors within the UNICEF framework show that the Tanzanian protocol is only minimally adapted to the local context. Of the manuals examined in our study, the Indian manual is most focused on the contextual determinants of malnutrition, and stresses the importance of taking customs and beliefs into account. The Dutch protocol, by contrast, emphasizes the importance of the biological environment, including parental height and ethnicity, as determinants of child growth.ConclusionsThe country manuals we analyzed only partly reflect the contexts in which children live. To address malnutrition in all its forms, the GM manuals should take children's biological, socioeconomic, and cultural contexts into account, as this would help health professionals to tailor counseling messages for parents.

Effectiveness of Training Module on Knowledge of the Mother Regarding Child Growth Assessment

Background: Under-five children represent 12% of the general population in India. Under-five Children mortality in India is as high as 4.9% of all deaths. The first 5 years of the life in child hood have a great importance. The growth and development play a vital role during this period. Objectives: to assess the effectiveness of training module on knowledge of mothers of under- five children regarding growth assessment Method: Evaluative approach with Quasi experimental one group pretest and posttest design was used to assess the knowledge of mothers of under five children sample size was 60 mothers of under-five children in selected settings with systematic random technique was adopted to select the sample. Results: Majority of the mothers 53 (88.3%) belongs to the age group of 15-25 years. The majority of the mothers 27(45%) are having adequate knowledge and practice after administering the training module The results showed statistically significant increase in knowledge and interpretation. (P&lt; 0.05). Conclusion: The study concluded that the training module was effective in improving the knowledge of mothers Regarding Child Growth Assessment.

Nutritional Status and Eating Habits of Children in Orphanages in Bamenda (North West Cameroon)

Regular growth assessment of children helps maintain adequate dietary intake and physical growth. However, very little or no information is available on the nutritional status of children in orphanages in Cameroon making control of deficiency diseases in children very difficult in these institutions. The main aim of this study was to determine the nutritional status and eating habits of children in some orphanages in Bamenda (North West Cameroon). The height and weight of 205 children (97 boys and 108 girls) ages 1-18 years were measured and their BMI (Body Mass Index) was calculated. A structured questionnaire was used for eating habits and dietary data collection. A usual intake of nutrients was collected and some food samples from the orphanages were collected for three days and analyzed in the laboratory to determine children’s usual intakes of nutrients. The data were analyzed by descriptive statistics. The results revealed that 15.7% of girls and 18.6% of boys were underweight, 3.7% of girls and 4.1% of boys were stunted and 16.5% of boys and 23.1% of girls were overweight/obese. The most eaten foods were cereals and the least were dairy products. Vegetables, fruits and milk consumption rates were low. The average intake of energy, protein and total fats was inadequate for orphanage children aged 14 to 18 years. The average intake of vitamin A, calcium and iron was inadequate in all orphanages compared to the RDA (Recommended Dietary Intake) values. Efforts should be directed towards educating the orphanage caregivers on meal planning and preparation to increase micronutrient intake in the orphanages’ diets and improve the health of the children. Food or financial aid should also be granted to these institutional care homes to enable them to improve on the overall nutritional content of foods.

Growth assessment of children during the COVID-19 pandemic-Can we rely on parental measurements?

AimThe COVID‐19 pandemic prompted the rapid development of remote medical services. During lockdown periods, children's growth data were obtained from parents’ home assessments. This study aimed to assess the accuracy of home height and weight measurements and analyse their utility in clinical decision‐making.MethodsA retrospective, single‐centre observational study. Children aged 3–18 years were measured for weight and height at home using guidance provided to parents on proper measurements techniques before subsequent professional re‐evaluation at our endocrine institution clinic. The two sets of measurements were compared and analysed according to various clinical parameters.ResultsHeight measurements at home and in the clinic were comparable (diff = 0.1 ± 1.3cm, p = 0.42) amongst the 107 children (mean age 10.2 ± 3.7, 56.1% males) participating in the study, except in overweight and obese children where they were significantly higher in the clinic (diff = 0.86 ± 1.48cm, p = 0.018). Weight and BMI were significantly higher in the clinic (diff = 0.45 ± 0.8kg and diff = 0.3 ± 0.6kg/m2, p<0.001 and p<0.001, respectively).ConclusionsHeight measurements of children by their parents were accurate except in obese and overweight children, whereas weight measurements tended to be lower than in the clinic. With proper guidance, parents’ home measurements of height and weight are accurate and suitable for clinical decision‐making.

The legacy of a standard of normality in child nutrition research

Anthropometric evaluation of children is among the most vital and widely used instruments of public health and clinical medicine. Anthropometry is used for establishing norms, identifying variations, and monitoring development. Yet the accurate assessment of physical growth and development of children remains a perpetually beleaguering subject. This paper focuses on the evolution of anthropometry as a science and its associated measurements, indices, indicators, standards, references, and best practices. This paper seeks to clarify aspects of the assessment of child growth, explores the historical trajectory of the study of anthropometry and its contemporary limitations, and contributes to the debate surrounding references and standards, and the applicability of international anthropometric standards to an individual's health. Among its findings is a surprisingly nonlinear and contested record of events, up to and including leading contemporary practices and datasets. It contextualizes the legacy of child malnutrition studies in a broad framework, including the linkage between the early eugenics movement and contemporary notions of a “normal” child, the interpersonal and intuitional competition to become the preeminent child growth authority, the obfuscated distinction between reference growth charts and standards of growth, and the hidden consequences of universal growth standards that no longer reflect any observable populations.

Effect of Sickle Cell Related Therapies on Growth in Children with Sickle Cell Disease: Evidence from the Displace Study

Introduction Reduced growth and delayed maturation have been previously described in children with sickle cell disease (SCD) due to multifactorial causes including chronic anemia and increased hemolysis. Interventions that decrease anemia and inflammation may have a beneficial effect on growth in children with SCD. Previous studies have demonstrated that children with SCD treated with hydroxyurea (HU) and chronic red cell transfusion therapy (CRCT) experience linear growth and increase in body mass index (BMI) compared to their counterparts not on therapy. Unfortunately, most of these studies were limited due to small sample size, cross-sectional study design or were conducted from single or a few center(s). DISPLACE (Dissemination and Implementation of Stroke Prevention Looking at the Care Environment) is a large, NHLBI (National Heart, Lung, and Blood Institute) funded consortium to improve stroke prevention implementation in SCD. DISPLACE includes the largest database of children with SCD from 28 different centers in the US. These data allow for an optimal assessment of growth in children with SCD on different disease modifying therapies. Using the DISPLACE database, we conducted a cross-sectional sub-study to evaluate how HU and CRCT affect growth in children over time. Methods The DISPLACE study collected data on 5,247 children aged 2-19 years with SCD from 28 centers in the US between 2012-2016. The majority of children have data collected from at least five years of continuous care. At baseline and annually thereafter, all children had routine standard of care anthropometric measurements including height and weight, vital signs, laboratory tests including complete blood count and chemistries and SCD-related therapies including chronic blood transfusion therapy and hydroxyurea therapy. Body mass index was converted to z-scores (zBMI) based on the Centers for Disease Control guide for age and sex. Children were categorized based on the zBMI score as underweight, normal, and overweight/obese. Our inclusion criteria included children with documented results of weight, height, vital signs, clinical and laboratory tests at baseline. Children who do not have sufficient data for evaluation (at least one missing anthropometric measurement or laboratory value) were excluded. Results Of the 3,305 children included in the study, 19.8%, 66.1%, 14.2% were underweight, normal, and overweight/obese at their initial (baseline) visit respectively. Children who were overweight/obese had a significantly higher hemoglobin level (p&amp;lt;0.0001) and significantly lower reticulocyte count (p = 0.0334) at baseline than normal and underweight children. Children who are overweight/obese had a significantly higher systolic and diastolic blood pressure compared to those who are normal or underweight (p = 0.0079 and p = 0.0003 respectively). A higher proportion of children who were overweight/obese were on CRCT at baseline compared to children with normal or underweight zBMI (p = 0.0002). The proportion of children on HU therapy at baseline was similar across zBMI categories (p = 0.2412). The multivariable adjusted model showed that the baseline hemoglobin levels were associated with the odds of being underweight (OR 0.93, 95% CI: 0.86 - 0.99), or overweight/obese (OR: 1.26, 95% CI: 1.17 - 1.36) compared with normal zBMI. At baseline, blood transfusion was associated with being overweight/obese versus normal (OR: 1.85, 95% CI: 1.31 - 2.60). After two years of therapy, there was a statistically significant increase in median zBMI from baseline among children initiating blood transfusion versus controls, (p = 0.0481), but the zBMI difference in hydroxyurea therapy versus controls remain same. (p=0.3925). Conclusion In our US-based study, the majority of children with SCD (70%) had normal zBMI. As baseline hemoglobin is associated with zBMI, that may predict who is at risk for being underweight or overweight. In addition, patients treated with CRCT are more likely to be overweight and have higher blood pressure. These findings suggest that individuals on CRCT should be monitored and may need lower calories than those not on disease modifying therapies. Disclosures Kanter: bluebird bio, inc: Consultancy, Honoraria; Novartis: Consultancy; Sanofi: Consultancy; Medscape: Honoraria; Guidepoint Global: Honoraria; GLG: Honoraria; Jeffries: Honoraria; Cowen: Honoraria; Wells Fargo: Honoraria; NHLBI Sickle Cell Advisory Board: Membership on an entity's Board of Directors or advisory committees; SCDAA Medical and Research Advisory Board: Membership on an entity's Board of Directors or advisory committees; AGIOS: Membership on an entity's Board of Directors or advisory committees; BEAM: Membership on an entity's Board of Directors or advisory committees.

Improving assessment of child growth in a pediatric hospital setting

BackgroundAccurate anthropometric measurements are essential for assessing nutritional status, monitoring child growth, and informing clinical care. We aimed to improve height measurements of hospitalized pediatrics patients through implementation of gold standard measurement techniques.MethodsA quality improvement project implemented computerized training modules on anthropometry and standardized wooden boards for height measurements in a tertiary children’s hospital. Heights were collected pre- and post-intervention on general pediatric inpatients under 5 years of age. Accuracy of height measurements was determined by analyzing the variance and by comparing to World Health Organization’s defined biologically plausible height-for-age z-scores. Qualitative interviews assessed staff attitudes.ResultsNinety-six hospital staff completed the anthropometry training. Data were available on 632 children pre- and 933 post-intervention. Training did not increase the proportion of patients measured for height (78.6% pre-intervention vs. 75.8% post-intervention, p = 0.19). Post-intervention, wooden height boards were used to measure height of 34.8% patients, while tape measures and wingspan accounted for 42.0% and 3.5% of measurements, respectively. There was no improvement in the quality of height measurements based on plausibility (approximately 3% height-for-age z-scores measurements flagged out of range pre- and post-intervention), digit preference (13.4% of digits pre- and 12.3% post-intervention requiring reclassification), or dispersion of measurements (height-for-age z-scores standard deviation 1.9 pre- and post-intervention). Staff reported that using the wooden board was too labor consuming and cumbersome.ConclusionsOur findings suggest that efforts to improve anthropometric measurements of hospitalized children have multiple obstacles, and further investigation of less cumbersome methods of measurements may be warranted.

Low food quality hinders male height growth more than female’s in Burkina Faso

As in many developing countries, stunting is a public health problem in Burkina Faso. More than one in four children does not reach his or her growth potential. In addition, all nutrition surveys conducted in the country reveal that boys are more affected. This stunting gender bias is supported by the Trivers-Willard theory that there is a natural discriminating investment in reproduction according to sex through sociodemographic characteristics, behaviour and biology. The present study is intended to investigate the role of food quality in the occurrence of this phenomenon.&#x0D; This cross-sectional and explanatory study of children under five years of age is based on data from Burkina Faso’s latest 2010 Demographic and Health Survey. Analyses were carried out on only the subsample of 6994 under-five year old children on which the anthropometric measures were taken. The assessment of child growth is based on the anthropometric index height-for-age z-score and the food quality assessment is based on the joint WHO/Unicef standard. The explanatory model used to examine the effect of the food quality is based on logistic regression.&#x0D; The prevalence of balanced diets among the children was 7.2% and there was no gender difference. On the other hand, stunting prevalence was significantly higher for boys (37.7% versus 32.6%). Children who were subjected to suboptimal feeding practices had three times more adjusted risk of stunting for both sexes. In addition, poor feeding practices led to a significantly higher growth deficit in boys compared to girls. However, when the diet was adequate, this risk gap dwindled. The higher prevalence of stunting of boys in the absence of food discrimination led us to single out behaviour and biology effects as the likely explanatory variables. Girls' natural resilience to certain infections and nutritional deficiencies could explain this difference in risk.&#x0D; Improved under-five year old child feeding practices contribute to improving overall growth stature and contribute also to bridging the gender gap in stunting.

Growth assessment in children with Williams-Beuren syndrome: a systematic review.

Williams-Beuren syndrome (WBS) is a rare genetic disease caused by a sporadic heterozygous microdeletion in 7q11.23. It is characterized by distinctive facial appearance, cardiopathy, short stature, intellectual disability, and endocrine abnormalities. To evaluate the growth pattern of patients with WBS and to identify the prevalence of malnutrition, overweight, and obesity in this population, a systematic review of studies published in English, between 1987 and 2018, was performed following the PRISMA protocol using the PubMed, Cochrane, and BIREME databases. Original articles and articles that evaluated growth status using weight, or height, or head circumference (HC), or body mass index (BMI) of individuals with WBS were included. Case reports, articles with data from other syndromes, and articles that did not present as a central theme the evaluation of growth were not included. WBS presented specific growth pattern, characterized by intrauterine growth restriction, low weight, length, and HC at birth. This global growth delay persisted during childhood and adolescence. BMI was not different to the reference population, and obesity was not observed in childhood. The mechanisms that determine this typical growth pattern are not totally clear; however, the typical pubertal development of these patients and the intrinsic and secondary lesions caused by microdeletion at 7q11.23 seem to be the major factors involved. Conclusion: Patients with WBS have a growth pattern different from the general reference population. The reference charts for normal population should notbe used for WBS patients because it often underestimate their growth. Specific growth charts for WBS patients are necessary.

Physical development of children in St. Petersburg: to the discussion about methods of evaluation

Anthropometric evaluation is an essential feature of pediatric evaluation. Different countries use different approaches in pediatric growth assessment. The article presents a comparative analysis of the body length (BL) indicators of modern school-age children in St. Petersburg with regional standards (1991) and international standards (WHO Growth Reference 2007). Anthropometric evaluation was conducted among 6207 children aged 7 to 17 years; the median, standard deviation and centile distribution of the BL values of school-age children were determined. We found that the values of BL of modern school-age children are higher than that their peers had thirty years ago; in boys, the maximum difference is found during the pubertal growth spurt; Non-parametric and parametric indicators of BL in senior pupils of St. Petersburg are higher than in the standards of the World Health Organization; in junior schoolchildren no difference was found. The data we obtained create the prerequisites for the development of modern regional standards for growth assessment of children and school-age children in St. Petersburg and their practical use for pediatric examinations.

National anthropometric reference values and growth curves for Japanese children: history and critical review

Context: Child health statistics are a critical component of child health assessment. However, the importance of nationally representative data on growth is not well recognised for Japanese children.Objective: The aim of this paper is to review the national growth surveys for Japanese children and to discuss the clinical use of the national growth reference values and growth curves.Methods: There are five governmental organisations surveying health and growth in Japanese children. Based on these studies, several aspects of the current governmental policy on child growth assessment have been examined. This review focussed on national anthropometric studies reported by Japanese investigators in English for international readers to understand Japanese issues.Results: A variety of growth reference curves have been developed since the early 1980s in Japan. However, these references have several limitations: incomplete data for both infants and young adults, limited description of socio-economic factors and continued governmental use of weight-for-height rather than BMI.Conclusion: Japanese child health statistics use measures that are applicable only to Japanese children.

Common problems in child growth assessment

儿童体格生长的监测和评价是儿科医生工作的重要内容。为便于儿科医生在工作中认识儿童生长规律，正确使用生长曲线，早期发现儿童生长偏离并及时干预，本文就相关问题进行讨论。.