الفهرس 
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Abstract
Growth is the fundamental physiologic process that characterizes
childhood. Throughout the growing years of children, a stable
environment is required for normal growth. Lifestyle factor play big role
in children’s growth and development. In general growth and
development is result of multiple interacting and changeable factors like;
Genetics, gender, nutrition, physical activity, health problems,
environment, and hormones
Failure to thrive is a description applied to children whose current
weight or rate of weight gain are significantly below that of other children
of similar age and sex. It can be a result of many factors including
organic, nonorganic factors or combination of both organic and
nonorganic reasons.
Growth assessment is the single most useful tool for defining
health and nutritional status in children.
Anthropometry is the study of the measurement of the human body
in terms of the dimensions of bone, muscle, and adipose tissue. The
purpose of the anthropometry component is to collect high quality body
measurement data using standardized examination procedures and
caliberated equipment. Anthropometry is a key component of nutrition
status assessment in children and a much better anthropometric index for
determining nutritional status considers a child’s weight relative to his/her
height, which is a measure of shape (i.e., fatness, thinness or wasting).
The anthropometric data are used to evaluate health and dietary
status, disease risk, and body composition changes that occur over the
adult life span. The advantage of anthropometric measurement are non
invasive relatively economical to obtain objective and comprehesible to
communities at large, they can also supply information on malnutrition to
families and health care workers prior to the on set of severe growth
failure or excessive weight gain. The body measurement room is
equipped with unique features designed to facilitate accurate and efficient
measurement. The anthropomentry component equipment and supplies is
provided equipment (calibration weights – digital weight scale – portable
scales – sitting box – stadiometer – caliboration red – infantometer –
skinfold calipers – step wedge standard – knee caliper – head
circumference tape – steel measuring tape – height adjustment ruler).
Supplies (black/white cosmetic pencil – DROP dispenser – body oil
– gauze pads – masking tape – absorbent pad – blunt edge scissors – 9-
volt batlery – AA batteries – alcohol wipes – cotton cloth – bleach
disinfectant spray – scrub brush – sewing machine oil – Hex key set –
screw drivers – copper clips).
Types of anthropometric measurements:
Weight – standing height – sitting height – crown rumplength –
recumbent length – upper leg length – knee height – head circumference
– head breadth – head length – chest circumference – chest breadth –
abdominal circumference – buttocks circumference – thigh circumference
– arm span for height – shoulder breadth – biacromial breadth – biiliac
breadith – bitrochanteric diameter – upper arm length – mid-upper arm
circumference – triceps skinfold – subscapule skinfold – thing skinfold –
suprailiac skinfold – flank skinfold –upper to lower body ratio – height
and weight volecity – body mass index ) every measurement has special
procedures and techniques illustratced in this essay optimal growth
monitoring requires accurate anthropometric measurements using
approporiate equipment and techniques, trained reliable measures and
accurate plotting on aconsistent growth chart appropriate for age and
gender.
Growth charts are a graphic presentation of body measurements.
There is several growth charts had been developed, British charts,
eurogrowth study group, the American charts and WHO charts. Many
countries in the worlds tried to develop its own growth charts like Egypt.
In addition growth charts for normal population, there are growth charts
for special population, like that of preterm infant and children with
special health care need.
Differences in growth between populations are affected primarily
by environmental factors and the role of genetic factors is smaller than
previously thought. Therefore, use of a single international growth chart
is appropriate. In the absence of such a geographically diverse chart, the
American CDC growth charts and recently the new WHO growth
standards (from birth to age five) are recommended for use by pediatric
health care providers for the assessment and monitoring of growth for
infants and children in any country in the world including Egyptian
infants and children. While local growth charts are unnecessary, this does
not argue against the collection and use of local anthropometric survey
data to facilitate monitoring of the overall nutritional and health status of
Egyptian infants and children and trends within this population.
Distribution of anthropometric indices can be expressed in terms of
Z-score (SD). A Z-score is standardized score that dsecirbe a raw score
by considering its distance, in terms of standard deviation from the mean.
The Z-score identifies and describes the exact placement of every raw
score in adistrbution. Body mass index is an anthropometric index of
weight and height defined as body weight in kilograms divided by height
in meters squared BMI = weigh (kg)/height(m)2.
Anthropmetery is the single most universally applicable,
inexpensive and non-invasive method available als has been widely and
successfully applied for the assessment of health and nutritional risk
especially in children. Child growth is internationally recognized as an
important public health indiactor for monitoring nutritional status and
health in populations inaddition there is strong evidence that impaired
growth is associated with delayed mental development, poor school
performance and reduced intellectual capacity.
The internationally recommended way to assess malnutrition at
population level is to take body or anthropmetric measurement
anthropometry provides important indicators of overall socioeconomic
development among the poorest members of population and used to
assess and predict performance health and survival of individuals.
Anthropometry can be used for various purposes, depending on the
anthropometric indicators selected for example weight for height
(wasting) in useful for screening children at risk and for measuring short
term changes in nutritional status anthropometric measurements are being
investigated in order to identify possible indicators of unfitness.
Anthropometric measurements are collected to:
Provide objective health data which enable are to assess physical
growth and development – identify health problems (over weight and
underweight or poetential developmental or neurological disabilities) –
help to evaluate an individual nutritional status identify individuals in
need of treatment and follow-up care and achieving normative standards.
Indices reflect about the nutritional status of infants and children
are weight-for-age, height-for-age, weight-for-height. The three indices
are used to identify three nutritional conditions underweight, stunting and
wasting criteria for identifying individuals with potential problems
1. Low length or stature-for-age: less than the 5th percentile. This should
be assessed to determine if the short statue is due to heredity or
inadequate nutrition and poor health.
2. Low weight-for-age: than the 5th percentile. This suggests the child is
at risk of chronic or recurrent underweight.
3. Low weight-for-length or BMI-for-age: less than the 5th percentile.
This suggests that child is at risk of recent undernutrition.
4. High BMI-for-age or weight-for-length for children 2-5 years: greater
than the 95th percentile. This suggests the child is high risk overweight.
5. High BMI-for-age for children 2-5 years: greater than the 85th and
below the 95th percentile. This suggests the child is at risk of becoming
overweight.
6. A decrease of 25 percentiles or more in length-for-age. This suggests
that the child’s length or stature has recently become at risk for
stunting.
7. A decrease of 25 percentiles or more in weight-for-length. This
suggests that the child has recently become at risk for underweight.
There are several different criteria using weight and height to
classify malnutrition, and all must be judiciously applied. The most useful
and widely employed are the Waterlow classification and the Gomez
criteria, which are used to distinguish a chronically malnourished or –
stunted – child from an acutely malnourished or - wasted - child.
Almost nearly all chronic diseases has significant impact on child
growth and development in varying degree, the following chronic
diseases are reviewed regarding its effect on child growth:
Type 1 diabetes mellitus; is well known to adversely affect linear
growth and pubertal development particularly in patients with poor
metabolic control. Recently significant improvement in the
prognosis for growth and final height in children with diabetes has
been achieved.
Thalassemia; Modern medical therapy has allowed thalassemic
children to grow normally in the first decade of life but growth
retardation continues to be observed in a significant proportion of
these adolescents.
Asthma; Pubertal delay and growth suppression can occur in
children with moderate to sever asthma. One of the major causes of
growth retardation in asthma is use of glucocorticoid therapy.
Heart disease; Patients with CHD and cyanosis, pulmonary
hypertension and congestive heart failure appear to have an
increased prevalence of growth failure and malnutrition compared to
normal population.
Chronic renal failure; Spontaneous growth in children with CRF is
characterized by a rapidly increasing height deficit during the first 2
years of life, followed by a rather percentile-parallel growth pattern
in the mid-childhood years.
Chronic liver disease; Is often associated with protein-calorie
malnutrition, vitamin deficiencies, bone disease, and poor growth.
Short stature; short stature is a short child if his/her height is below
the 3rd percentile approximately (-1.9) standard deviations or (-2) on
the Z-score for his/her community.