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Growth is one of the most important issues in baby and child development! We are sure that you, like many mothers, are wondering if your child is growing enough. In this article, we answered the questions of how to understand growth retardation in babies, what are the factors that cause it and how to treat it. Let’s find out what you’re wondering about developmental delay in babies!
How to detect growth retardation in babies?
Growth, which manifests itself as height and weight gain in children, starts from birth and continues until adulthood. It doesn’t always happen at the same speed. Infancy is the period in which physical growth is the fastest after the process in the mother’s womb.
Especially in the first 3 years, which is the active growth period, weight gain is very important. Because gaining weight properly means that the child is adequately nourished, developing and growing physically, emotionally and mentally. In this case, first of all, we need to examine the development of height and weight in infants.
How should babies gain weight?
- The baby loses about 10% of its birth weight in the first 7-10 days after birth. Then it starts to gain weight and reaches birth weight at the end of the 2nd week.
- The first 6 months after birth is the period when growth is the fastest. In the first 6 months, the baby should have an average of 600-900 g per month, and at the end of the 6th month, the birth weight should have doubled.
- In the second 6 months, the baby should gain about 400-600 g per month and should have reached 3 times the birth weight by the time he is 1 year old.
How should babies grow in height?
- In the first 6 months after birth, the baby grows approximately 15-16 cm, and in the second 6 months, approximately 9-10 cm, a total of 24-25 cm in a year.
- On average, a baby born with a weight of 3000 g and a height of 50 cm should have a six-month growth chart as follows.
| Birth | 6. Oh | 12. Oh | 18. Oh | 24. Oh |
|---|---|---|---|---|
| 3 kg | 6 kg | 9 kg | 10 kg | 11 kg |
| 50 cm | 65 cm | 75 cm | 81.5 cm | 87.5 cm |
- Even if he was born smaller than normal, the growth rate after birth shows us whether the baby’s growth is sufficient or not.
So what is the tool by which you can control whether its growth is progressing at a sufficient pace? Of course, the growth curve tracking, the percentile!
Signs of developmental delay in babies
- lag behind peers in height and weight,
- speech delay,
- Being late for actions involving motor skills such as walking, running or holding
- Lack of social skills,
- Aggression and irritability.
What is the growth curve?
Curves that show whether the growth is adequate, that is, within “normal” values, are called percentile curves (growth curves). There are separate growth curves for height, weight and head circumference.
It shows the 50% average value in the curves. Limit values are between 3% and 97%. In other words, values between 3% and 97% are considered “normal”.
Below you can see sample percentile values for boys based on WHO (World Health Organization) standards.
| 3% | 10% | 25% | 50% | 75% | 97% | |
|---|---|---|---|---|---|---|
| 3 is | 57.6 cm | 58.8 cm | 60.1 cm | 61.4 cm | 62.8 cm | 65.3 cm |
| 6 is | 63.6 cm | 64.9 cm | 66.2 cm | 67.6 cm | 69.1 cm | 71.6 cm |
| 9 is | 67.7 cm | 69.1 cm | 70.5 cm | 72 cm | 73.5 cm | 76.2 cm |
| 12 is | 71.3 cm | 72.7 cm | 74.1 cm | 75.7 cm | 77.4 cm | 80.2 cm |
What does the percentile value tell us?
If the height percentile for the child’s age is in the 10% percentile, this indicates that the child is older than 10 and younger than 90 of 100 children of the same age.
How do percentile values show us if there is a problem with growth?
A downward curve in the child’s curve at any time may indicate that a growth-impairing problem has arisen. However, some decreases in percentile values are also considered normal.
What mothers should pay attention to here is that when the height-weight percentile value falls below a critical value such as 10%, according to the age and gender of the child, they should definitely consult a pediatrician. In the diagnosis and diagnosis of growth retardation, the 10% limit should be followed up to school age and should be evaluated together with the pediatrician.
Factors affecting growth in infants
Growth is a good indicator for assessing a baby’s health and is affected by environmental factors as well as genetics.
nutritional deficiency
Inadequate or malnutrition is one of the main causes of growth retardation in children. It should be well investigated whether there is an underlying reason for insufficient weight gain, lack of expected height growth, and therefore the child’s physical backwardness compared to his peers. When a child’s growth stops or slows down, the first consideration is whether there is a nutritional problem that is preventing them from getting the calories they need.
A child who is malnourished and irregular may also have a lack of energy / protein, or a deficiency of certain nutrients such as zinc and iron. However, in the absence of such nutrients, problems such as hair loss, iron deficiency, and weakness begin to appear, as well as insufficient growth. Because the child cannot reach the elements he needs to be healthy.
Percentile values, that is, information such as height, weight, head circumference, should progress in accordance with their age. If the baby cannot be fed in a balanced and adequate way in terms of all nutritional values, growth retardation will occur in the baby.
growth hormone deficiency
Congenital or acquired thyroid or growth hormone deficiency can lead to growth retardation. In such cases, the child should be examined for hormone deficiency and should be under the control of a doctor.
chronic diseases
All congenital or chronic diseases can cause growth retardation in children. These; There may be chronic diseases such as Down syndrome or Turner syndrome, chronic diseases such as low birth weight, bone diseases, kidney, liver and heart diseases, or metabolic diseases.
Chronic infections and diabetes that are not well controlled can also cause growth retardation. Long-term cortisone treatment in children also has a negative effect on growth.
Treatment of child’s growth retardation
If there is a growth failure due to a cause of celiac disease , a gluten-free diet is started, and if there is a situation caused by insufficient secretion of thyroid hormone, hormone therapy is started. The treatment of developmental delay in the baby is done in accordance with the factor that causes this situation.
When the cause of growth failure is malnutrition, the treatment to be applied varies. Here, a specialist evaluates issues such as the child’s feeding and defecation pattern, physical activity, and sucking power if breast-fed. The aim of nutrition therapy is to provide the child with nutrients such as vitamin D , iron, phosphorus and calcium that cannot be stored in his body due to insufficient food intake and therefore cause growth retardation . For this purpose, a suitable nutrition program is created and it is aimed to replace the missing substances.
If the percentile value is below 10% for the age of the child or baby, specialist nutrition products may be recommended. These products, which are reimbursed by the state in case of diagnosis of growth retardation, are rich in protein, fat, carbohydrates, fibers and minerals. In some cases, they can also be used alone. Although these products are sometimes called food, they are not food but specialist nutrition products, they can even be called growth products.
Nutritional therapy for insufficient growth can be supported by the following recommendations!
- First of all, children should consume an appropriate amount of calories for their age and should not stay below this amount. The daily calorie amount may vary according to the child’s weight, age and physical movements. You can get the most accurate information from your doctor.
- Since they need much more energy, they should consume energy sources such as carbohydrates, fats and protein. Because children spend 3-5 kcal energy for every 1 g taken.
- They should get the vitamins and minerals they need at every meal.
- They should get enough carbohydrates, protein and vitamins together in one meal.
- They should be fed an appropriate amount of milk and dairy products for their age. This is important for calcium supplementation. However, milk consumption should not be exaggerated. Excessive consumption of milk can cause anemia.
- Consumption of breast milk in infancy is very important. However, it is very important to ensure that the baby reaches enough nutrients by supporting it with follow-on milk in cases where there is no or insufficient breast milk. The nutritional values of follow-on milk and its suitability for the baby should be checked, and formula should be preferred with the recommendation of the doctor.
- The transition period of babies to solid food is also important. In this process, it is important to offer fruits and vegetables at the same rate, rather than trying to feed babies mostly eggs, yogurt or meat varieties in order to maintain a healthy diet.
- No transition to additional food should be made at an early age, only breast milk should be used for up to 6 months and follow-on milk should be used in case of deficiency. Afterwards, balanced and healthy supplementary foods should be preferred in addition to breast milk or follow-on milk.
- As children get older, it becomes more difficult to provide them with a balanced diet. In particular, their interest in sugary and acidic foods increases. However, junk food, fried foods and packaged foods that have no nutritional value should be removed from the diet of children. In addition, as we mentioned above, habits that may cause unhealthy weight gain, such as feeding the child with tea or food water by dipping bread, should be avoided just to ensure weight gain.
- The contents of the lunchbox are also very important for school-age children. Donuts, bagels or unhealthy sandwiches in school canteens should never be offered to children to pass the meal. Again, a menu with a combination of fruit, dairy products, protein and carbohydrates would be appropriate. A cheese or chicken sandwich and homemade juice or fruit are good options.
- Children also need energy and healthy fats. To meet this need, healthy seeds such as walnuts, hazelnuts and almonds can be beneficial. These seeds are also a source of energy.
