2.2 Conditions that have the potential to alter growth
While some conditions alter growth potential, other conditions have the potential to alter growth. These conditions may have associated biological or environmental factors that can influence a child's growth.
For these conditions, there is no clear rationale for the development of reference data for growth because there is no identifiable alteration in the genetic potential for growth in these conditions.
Three conditions that have the potential to alter growth are:
that impair ambulation
Some children with neurologic conditions affecting ambulation also have problems with feeding, which can be an additional factor influencing growth (Stevenson, 1995). This is discussed later in this section.
Low birth weight
Depending on the timing, duration and severity of the nutritional insult, as well as the success of postnatal nutrition intervention, the growth potential of children born SGA and who have IUGR may be permanently adversely affected (Anderson, 1999).
Low birth weight infants (infants weighing 1500-2500 grams at birth) are included in the CDC reference population, so it is appropriate to use CDC growth charts with these infants.
The CDC growth charts do not include growth data from very low birth weight (VLBW) infants (infants weighing less than 1500 grams at birth). For this reason, it may not be appropriate to use the CDC growth charts to assess the growth of VLBW infants. Alternate charts are available, based on data from two major studies:
More information about the use of the CDC growth charts with VLBW infants can be found in the module, Overview of the CDC Growth Charts.
Problems with feeding that interfere with an adequate nutrient intake have obvious effects on a child's growth.
Children with neurodevelopmental problems, such as cerebral palsy, often have feeding problems due to structural abnormalities of the oral area (teeth, gums, jaw) or oral-motor dysfunction due to abnormal tone or reflexes affecting their ability to close their lips, suck, swallow or chew (Cloud, 1997; Stevenson, 1995).
Tactile sensitivity or sensory defensiveness, common among children with cerebral palsy, autism, and spina bifida may cause a child to avoid putting things in his/her mouth (Cloud, 1997; Stevenson, 1995).
Without intervention, these difficulties can lead to inadequate food intake and slowed growth.
Children may also
have feeding problems as a result of behavioral or emotional issues, many
of which result from relational difficulties early in life. Other feeding
problems may be the result of complex perinatal medical interventions
that center around feeding or around the mouth, making subsequent oral
experiences, including feeding, unpleasant (Cloud,