- WIPE, blah blah
- Mention you should take Hx and perform PE
- Mention taking vital signs
- Ask the child to remove their shoes and empty their pockets, if infants remove all clothes
- Head circumference:
- From the occipital protuberance to the area most prominent above the eyebrows
- Measure it 3 times and take the average
- Height and weight
- Infant:
- Length:
- Lay the infant down on infantometer
- Head facing upwards, knees completely extended, feet 90° angle
- Head + feet -> touch the ends of the board
- Weight: put the baby on the baby scale
- Length:
- Child:
- Height: (if < 2 yrs -> measure the length)
- Stand upright facing forward
- Head, shoulder blades, buttocks, heels -> should touch the back side of the stadiometer
- Weight: zero the scale before the child stands on it
- Height: (if < 2 yrs -> measure the length)
- Infant:
- Calculate BMI = Wt (kg) \ Ht² (m²)
Classification | BMI (> 2yrs) | Percentiles (< 2yrs) |
Underweight | < 18 | < 5th |
Normal | 18 – 25 | 5th – 85th |
Overweight | 25 – 30 | 85th – 95th |
Obese | > 30 | > 95th |
- What is failure to thrive?
- Wight falls or remains below the 3rd percentile for age and sex
- Weight falling and crossing over 2 or more percentiles
- Weight < 80% of the median weight for height
- What causes failure to thrive?
- Organic:
- Inadequate intake -> cleft lip\palate, neuromuscular, cerebral palsy, GERD
- Malabsorption -> celiac, CF
- Impaired metabolism -> chromosomal, enzymatic
- Increased requirements -> heart failure, chronic lung ds, chronic infections
- Non-organic: (>80%)
- Abuse \ negligent
- Poverty
- Poor infant bonding
- Improper formula preparation, breast-feeding technique
- Organic:
- If the child’s growth is normal, what will you do?
- Reassure parents + advise them the F\U after 6 months – 1 year
Download the PDF version: here
Â