Growth and Development Dilip K Mukherjee, MKC Nair
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1Growth and Development
Under the aegis of
Institute of Growth and Development
Kolkata (India)
2Growth and Development
Editors Dilip K Mukherjee MD(Ped) DCH PhD FIAP FAMS Professor of Pediatrics Ex-Dean Vivekananda Institute of Medical Sciences Ramakrishna Mission Seva Pratishthan Kolkata, India MKC Nair MD FIAP Director, Child Development Center SAT Hospital, Trivandrum, India
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India
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Branches
Growth and Development
© 2008, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor's and the publisher.
First Edition: 2008
9788184482942
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
4Dedicated to
all who are involved in the care of children especially the undergraduates, residents and postgraduate students of pediatrics as well as the researchers in the field of human growth and development
5Contributors 7Message
Growth is an important parameter for assessment of health status of children. The appropriate techniques of measurement of growth and development of children are therefore of utmost importance to assess growth. If methods are not identical, it becomes impossible to compare and understand the difference of performance with regard to national and international reference standards.
It is heartening to come to know that a thoroughly revised and much enlarged edition of the book on ‘Growth and Development’ under the aegis of the Institute of Growth and Development is going to be released soon. A publication with the same title had been made some years ago by the Indian Academy of Pediatrics, but the need for bringing out an edition on the lines of forthcoming one was being keenly felt for sometime past in view of the plethora of new ideas and developments occurring everywhere during the last ten years. The result is this new volume, edited as before by Prof. Dilip K Mukherjee and Prof MKC Nair, eminent pediatricians.
We are glad to know that this book fulfils all the requisites for postgraduate students to keep abreast of the recent knowledge and know-how about the growth and development of children. Several likeminded researchers and teachers in this field across the country and abroad have come up recently with the establishment of ‘The Institute of Growth and Development’ to cater guidelines and norms for assessment of the children's growth and development not only in our country but also in neighboring countries.
I extend my good wishes to this endeavor and I hope and believe that the book will be immensely useful for the students and the researchers of growth and development of children for whom it is basically meant.
(Swami Sarvalokananda)
Secretary
Ramakrishna Mission Seva Pratishthan Vivekananda Institute of Medical Sciences, Kolkata
8Preface
Growth is a measurable index of health. The study of growth is of paramount importance in pediatrics. A pediatrician needs to be well versed with the knowledge and practice of measurement of growth and its proper assessment to enable him to find out if the child is growing adequately or not in reference to individual performance capability and also the community.
The basic need in studying growth is to know and use appropriate, scientifically sound and statistically relevant methods. If methods are not identical, it becomes impossible to compare and understand the difference of performance of different children with regard to national and international reference standards.
Growth and development is a continuous process from fertilization till maturity. Besides genetic factors, growth is influenced by nutrition. Illness and social economic and psychological environment. To study in totality all aspects of this fascinating subject is the sailing through an ocean which has no other shore. In our humble endeavor, we have touched upon the important aspects of physical growth from the intrauterine period till adolescence, the methods of assessment as well as neurobehavioral development of newborn through infancy to childhood along with its abnormalities and early intervention.
Growth and development comprise the basic science in the field of pediatrics. Pediatricians owe responsibility for care of the child and should thus be familiar with the methods of study and assessment of growth, their normal patterns and milestones of normal development, thus enabling them to recognize any deviations from norm at the earliest. This should enable us to detect deficiencies or disorders and to give appropriate and timely attention and care.
Child development is a fascinating subject to many clinicians and nonclinical investigators. But unfortunately what is taught in books and what is practiced does not match, so a wholesome practicable scientific approach towards understanding the evolution of development is the need of the hour. Pediatricians have always concentrated on the developmental syndromes, but the large majority of the vulnerable newborns with biological and environmental risks for developmental delay are getting ignored. Early intervention through this delicate periods of neuroplasticity is often rewarded with a normal or near normal outcome. For the older children also, problems of motor, visual, language, perceptual and writing difficulties need to be addressed with great care and concern for assessment and intervention. The Child Development Center (CDC) in Thiruvananthapuram with the patronage from Government of Kerala is successfully practicing towards this aspect as a pioneer institute for long years. The lessons on child development in this book is largely based on the experience from this institute and the like researches through the world.9
To understand the growth and development of children in our country, to propagate the knowledge acquired and to sensitize to community, an institute of Growth and Development have been formed with national and international collaboration by interested pediatricians from Vivekananda Institute of Medical Sciences, Kolkata, Child Development Center (CDC), Thiruvananthapuram and the department of pediatric endocrinology, the Royal Manchester Children Hospital, UK. This book is the first endeavor of the institute towards this aim.
We had our first attempt on this subject published in 1997 which enjoyed enormous support from the pediatric fraternity. Based on the recent changes in this subject proper emphasis needs to be given on newer statistical procedures, consensus on growth norms, childhood obesity, tall stature, problems of puberty, psychological concerns of adolescence, various behavioral problem, early stimulation program, autism, language delay. A new approach to this subject was justified and in this present book we have tried to fulfill the lacunae those were not dealt with in our first attempt.
This book has been divided into 2 sections — deals with physical growth (Chapter 121) and is concerned with development and its problems (Chapter 2231).
We hope that this book will fulfill the need of the students in pediatrics both undergraduate and postgraduate as well as the researchers in the field of human growth and development.
Dilip K Mukherjee
MKC Nair
10Acknowledgements
We express our sincere gratitude to Srimat Swami Sarvalokanandaji Maharaj, a versatile personality and the dynamic secretary of Ramakrishna Mission Seva Pratishthan, Vivekananda Institute of Medical Sciences for his constant support, encouragement and all sorts of logistics help towards the preparation of the manuscript. We are very much indebted to him for his generous help and honored to have his divine blessing which has added glory and new dimension to this book.
We are extremely grateful to all the authors who have enriched the book by their excellent contribution. We take the opportunity to thank them one and all.
We express our sincere thanks to Dr Indraneel Banerjee, MD, MRCPCh, Consultant Pediatric Endocrinologist of Manchester University Hospital, UK for kindly going through the manuscript and for his valuable suggestions and editing. Dr Anindya K Saha, third year MD PGT in department of pediatrics of our institute has taken the photographs for the book and took great pain to work day and night to do tips and bits of final editing and compilation of the manuscript and CD. It is for him that this book has come up in a short time.
We also express our sincere gratitude to the postgraduate students, residents and our colleagues in the department of Pediatrics in Ramakrishna Mission Seva Pratishthan, Vivekananda Institute of Medical Sciences who were constantly a source of inspiration for us to bring out this book as early as possible. It is for their persistent and sustained demand that this book has become a reality. We acknowledge their enormous help towards the publication of this book.
The staffs of Child Development Center (CDC), of Thiruvananthapuram, deserve sincere thanks for their help towards the preparation of the manuscript of the development section of the book.
We are grateful to Sri Parimal Kar and Sri Tapan Haldar for doing the composition and also typing the manuscript.
Last but not the least we offer our heartiest thanks and gratitude to Shri JP Vij, CMD, Jaypee Brothers Medical Publishers (P) Ltd., without whose initiative and special interest this book could not be published in such a short time.