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  1. FACTORS AFFECTING GROWTH AND DEVELOPMENT Mrs. D. Melba Sahaya Sweety M.Sc Nursing (Pediatric Nursing) GIMSAR
  2. Introduction • Although the terms growth and development are used synonymously, they have different meanings biologically. Growth refers to the incremental changes in physical characteristics such as height, weight, size, etc., while development refers to qualitative changes to growth in an orderly and meaningful fashion which results in maturity. • Growth and development contribute to each other, are inseparable, and occur simultaneously. For example, most babies, by the time they grow up to be 8 months old, can weigh around 8 to 10 kilograms and can sit up. • Growth and development depend on combination of many interdependent factors especially by heredity and environment.
  3. Factors influencing Growth and Development Factors Influencing Growth and Development Heredity or Genetic factors Sex Race and Nationality Environment Prenatal Postnatal
  4. Genetic Factors • Each child has a different genetic potential. Genetic predisposition is the important factors which influences the growth and development of children. Different characteristics such as height, body structure,color of skin,eyes and hair etc.., depend upon inherited gene from parents . Thus tall parents have tall children and parent with high intelligence are more likely to have children with high level of inherent intelligence. • Abnormal genes from ancestors may produce different familial diseases which usually hinders the growth and development e.g. thalassemia, hemophillia,galactosemia etc.., The process of growth and development is also affected in children with chromosomal abnormalities , e.g. in Down’s syndrome, Turner’s syndrome , klinefelter Syndrome
  5. Sex • The sex of children influences their physical attributes and patterns of growth. Sex is determined at conception. At birth , male babies are heavier and longer than the females babies. Boys maintain this superiority until about 11 years of age. Girls mature earlier than boys and bone development is more advanced in girls. But mean height and weight are usually less in girls than boys at the time of full maturity.
  6. Race and Nationality • Growth potential of different racial groups is different in varying extent. Physical characteristics of different national groups also vary. Height and stature of Americans and Indians are usually differing because of the differences in growth patterns.
  7. Environment • The environment plays a critical role in the development of children and it represents the sum total of physical and psychological stimulation the child receives. Where you live also has a great influence on how your children turn out to be. • The schools they attend, the neighbourhood they live in, the opportunities offered by the community and their peer circles are some of the social factors affecting a child’s development. Living in an enriching community that has parks, libraries and community centres for group activities and sports all play a role in developing the child’s skills, talents, and behaviour. Uninteresting communities can push some children to not go outside often but play video games at home instead. Even the weather of a place influences children in the form of bodily rhythms, allergies and other health conditions.
  8. Prenatal Factors Intrauterine environment is an important predominant factors of growth and development. Various conditions influence the fetal growth in utero. Maternal Malnutrition Maternal Infections Maternal Substance Abuse Maternal Illness Hormones Miscellaneous
  9. Maternal Malnutrition • Dietary insufficiency and anemia leads to intrauterine growth retardation. Low birth weight and preterm babies have poor growth potentials . In later life, those children are usually having disturbances of growth and development
  10. Maternal Infections • Different intrauterine infections like HIV, HBV,STORCH, etc.., may transmit to the fetus via placenta and affect the fetal growth. Various complications may occur like congenital anomalies, congenital infections etc.., which ultimately affect the growth and development in extrauterine life.
  11. Maternal Substance Abuse • Intake of teratogenic drugs (thalidomide, phenytoin, etc.,) by the pregnant women in the first trimester affects the organogenesis and lead to congenital malformations which hinder fetal growth. Presence of congenital anomalies in later life influence childhood growth and development. Maternal tobacco intake (smoking and Chewing) and alcohol abuse also produce fetal growth restriction.
  12. Maternal Illness • Pregnancy – induced hypertension, Anemia, Heart disease, Hypothyroidism, Diabetes mellitus, chronic renal failure, Hyperpyrexia , etc., have adverse effects on fetal growth. Iodine deficiency of the mother may leads to mental retardation of the baby in later life.
  13. Hormones • Hormones like thyroxine and insulin influence the fetal growth. Thyroxine deficiency retards the skeletal maturation of the fetus. Maternal myxedema results in fetal hypothyroidism. Antithyroid drug therapy and iodides during last trimester of pregnancy may lead to fetal growth leading to large size fetus with excessive birth weight due to macrosomia.
  14. Miscellaneous Various prenatal conditions which may also influence fetal growth include uterinemalformations (septate uterus, bicornuate uterus). Malpositions of the fetus oligohydramnious, polyhydramnious,faulty pacental implantation or malfunction, maternal emotion during pregnancy, inadequate prenatal care etc.,
  15. Post natal Factors Post natal Factors Growth Potential Nutrition Childhood illness Physical Environment Cultural Influences Socioeconomic status Climate and season Play and Exercise Birth Order of the child Intelligence Hormonal Influence Learning and reinforcement
  16. Growth Potential • Growth potential is indicated by the child’s size at birth. The smaller the child at birth, the smaller • she/he is likely to be in subsequent years. The larger the child at birth, the larger she/he is likely to be in subsequent years . Low birth weight babies have various complications in later life which retards child’s growth.
  17. • Nutrition is a critical factor in growth as everything the body needs to build and repair itself comes from the food we eat. Malnutrition can cause deficiency diseases that adversely affect the growth and development of children. On the other hand, overeating can lead to obesity and health problems in the long run, such as diabetes and heart disease. A balanced diet that is rich in vitamins, minerals, proteins, carbohydrates and fats is essential for the development of the brain and body. Nutrition
  18. • Chronic childhood diseases of heart, (congenital heart disease, rheumatic heart disease), chest (tuberculosis, asthma), Kidney (nephrotic syndrome), liver (cirrhosis), malignancy, Malabsorption syndrome, digestive disorders, endocrinal abnormalities, blood disorders, worm infestations, metabolic disorders,etc. generally leads to growth impairement. • Acute illnesses like ARI,diarrhea, repeated attack of infections result in malnutrition and growth retardation. • Congenital anomalies , accidental injury and prolong hospitalization usually have adverse effect on growth and development. Childhood Illnesses
  19. • Housing living conditions , safety measures, environmental sanitation, sunshine, ventilation, and fresh air, hygiene, safe water supply, etc., are having direct influence on child’s growth and development. Drought, famine and disaster also influence the child growth. Physical Environment
  20. Families have the most profound impact in nurturing a child and determining the ways in which they develop psychologically and socially. Whether they are raised by their parents, grandparents or foster care, they need basic love, care and courtesy to develop as healthy functional individuals. The most positive growth is seen when families invest time, energy and love in the development of the child through activities, such as reading to them, playing with them and having deep meaningful conversations. Families that abuse or neglect children would affect their positive development. These children may end up as individuals who have poor social skills and difficulty bonding with other people as adults. Helicopter parenting also has negative effects as they render children dependent on the parents even as young adults and unable to deal with difficulties in life on their own. Psychological Environment
  21. • Growth and Development of an individual child are influenced by the culture in which he or she is growing up. The childrearing practices ,food habits traditional beliefs , social taboos, attitude towards health, standard of health,educational level, etc., influence the child growth and development. • The child learn standard of traits like honesty, discipline, intellectual inquiry, manners, aggression, individual industry and acheivement from the culture of the family and society Cultural Influences
  22. • The socio-economic status of a family determines the quality of the opportunity a child gets. Studying in better schools that are more expensive definitely has benefits in the long run. Well-off families can also offer better learning resources for their children and they afford special aid if the kids need it. Children from poorer families may not have access to educational resources and good nutrition to reach their full potential. They may also have working parents who work too many hours and cannot invest enough quality time in their development Socio-ecnomic Status
  23. • Climatic variation and seasonal changes influence the child health. Weight gain is more in late summers, rainy season and autumn. Maximum gain in height among children occurs in the spring. These variations may be due to difference in activity level. Climate and Season
  24. The word exercise here does not mean physical exercise as a discipline or children deliberately engaging in physical activities knowing it would help them grow. Play and Exercise help the body gain an increase in muscular strength and put on bone mass. Proper exercise helps children grow well and reach milestones on time or sooner. Exercise also keeps them healthy and fights off diseases by strengthening the immune system, especially if they play outside. This is because outdoor play exposes them to microbes that help them build resistance and prevent allergies. Play and exercise
  25. • Birth order does not alone determine intelligence, personality trait or method of coping but it has a significant influence on all of these. • The first born child gets full attention until the second born, they learn from adult ,whereas the second born child learn mainly from elder one . Middle born child gets less attention during rearing • The first born child is usually intelligent ,achievement oriented, perfectionist and anxious. The only child is likely to develop rapidly and intellectual with higher self-esteem but may be more dependent. The middle born is more adaptable , less achievement oriented,less aggressive towards goal and learn how to compromise. • The youngest child receives a great deal of love and attention, and tend to develop a good natured , friendly, warm personality and with higher esteem. • However ,each child is different and need total attention and care from parents to develop their personality to the fullest extent possible. Birth order of the child
  26. • Intelligence of the child influences mental and social development. A child with higher intelligence adjust with environment promptly and fullfil own needs and demands, whereas a child with low level of intelligence fails to do that , Intelligence is correlated to some degree with physical development. Intelligence
  27. • Hormones belong to the endocrine system and influence the various functions of our bodies. They are produced by different glands that are situated in specific parts of the body to secrete hormones that control body functions. Their timely functioning is critical for normal physical growth and development in children. Imbalances in the functioning of hormone-secreting glands can result in growth defects, obesity, behavioural problems and other diseases. During puberty, the gonads produce sex hormones which control the development of the sex organs and the appearance of secondary sexual characteristics in boys and girls. Hormonal Influence
  28. Learning involves much more than schooling. It is also concerned with building the child up mentally, intellectually, emotionally, and socially so they operate as healthy functional individuals in the society. This is where the development of the mind takes place and the child can gain some maturity. Reinforcement is a component of learning where an activity or exercise is repeated and refined to solidify the lessons learned. An example is playing a musical instrument; they get better at playing it as they practice playing the instrument. Therefore, any lesson that is taught has to be repeated until the right results are obtained. Learning and Reinforcement
  29. Conclusion • Thus growth and development is a complex process with the influence of various factors. Favorable conditions promote growth and development . whereas unfavorable factors inhibit the process leading the growth retardation or growth failure or developmental delays.