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Understanding Growth Charts

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June 14, 2017
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During your child’s (many) check-ups during the first year after birth, it’s quite normal that your Naturopathic Doctor or Pediatrician will be filling out growth charts. Growth charts help to assess growth, nutritional status and well-being of your child. Understanding growth charts can be quite easy as they record weight, length, and head circumference. While there are 2 types of growth charts that doctors can use (WHO and CDC), WHO growth charts are the standard.

WHO created growth charts based on information from many children around the world who were primarily breastfed for at least 4 months. Measurements (of length and weight) were taken at many intervals to establish optimal growth patterns. CDC charts on the other hand, did not implement weight measurements when creating their chart especially between the 0-3 month range. Moreover, CDC charts took measurements from both breast and formula fed infants.

Breastfed infants grow more at the 2-3 month range and less rapid between 3-12 months (when compared to formula fed). In the 3-12 month interval, formula-fed infants grow more. This presents as an issue when a doctor is using a CDC chart to weight because at 5 months a formula fed child would be obtaining all his nutrients from mom, but not putting as much weight on when compared to a 5 month formula-fed baby. This may lead the doctor to want the mom (of the breast-fed baby) to begin solids or supplement with formula, so her baby can gain weight.

Growth Indicators

Length/height for age: reflects growth of length, which can be helpful when determining if a child is stunted due to prolonged malnutrition or chronic illness. While children can be tall for their age, it’s usually not an issue.

Weight for age: reflects body weight, to determine if a child is underweight. It it not used to assess if a child is overweight or obese. A body mass index (BMI) is calculated to determine if an individual is overweight or obese, usually over the age of 2.

Weight for length/height: reflects body weight in proportion to height, this determines if a child is wasting away due to food shortage or illness. However, it can be an indicator for the risk of becoming overweight or obese.

Head Circumference: indirectly reflects brain size and growth, and can help indicate brain health status. Keep in mind that most brain growth occurs before 2 years old.

Numbers

Growth charts assess the above indicators using one of two measurements: percentiles or z-scores. These numbers are used to determine where your child ‘ranks’ compared to others in his or her age range. Percentiles are commonly used by doctors as they are easier for everyone to understand. A percentile refers to where your child is compared to others (who’s data was used to determine the reference range). Anything below the 2nd and above the 98th are considered abnormal.

Once your child’s information has been plotted, you will be able to determine at which percentile they are at. At each visit, the measurements are compared to the previous set to assess growth pattern and if there is a need for further assessment.

Where your child is exactly on the percentile scale is less important than the range. Generally, they should be in the same range during each visit.  If they happen to drop 2 percentiles (ie. from 75 to 25, this would be a cause for concern). 

For children who were born prematurely (ie. 36 weeks and younger at gestation), their weight, length and head circumference is corrected for.  Weight, for example, is corrected for until 24 months, length for 40 months, and head circumference until 18 months.  

Things to keep in mind

Weight

  • Newborns may lose 10% of their weight in the first few days of life (especially if breast fed)
  • Weight at 6 months should be double its birth weight
  • Weight at 12 months should triple its birth weight
  • Weight at 24 months should quadruple birth weight
  • Weight from 2 years old to puberty will be a steady increase

Length/Height

  • Newborn length may not change much in the first few weeks, they may measure longer though as they become more stretched out
  • By 3 years old, height should be measured with the child standing
  • Height should increase by 30% by 5 months
  • Height should increase by 50% by 1 year
  • Height should be double by 5 years old

REFERENCES:

Guide to the Teen Menstrual Cycle

I vividly remember my first period – I was in grade 6 and wearing beige pants. I also didn’t tell my mom for two whole days. I relied on the teachings of Fully Alive (do kids still use this book?) and Are You There God? It’s Me Margaret as reference material for the big day. Nevertheless, I still found myself wholly unprepared. Chances are you’re reading this article on your daughter’s behalf. If so, I believe it’s really important to have open communication about menstruation – otherwise you may not hear about this huge life event until a few days later (sorry mom!). The Ontario curriculum discusses puberty and menstruation in grade 5 – usually when a girl is 10-11 years old. Most girls however, begin their menstrual cycle when they’re 12 years old (although some may experience as young as 8!). That said, girls may not remember the ins or outs of menstruation, or their teacher may not have have spent too much time on the subject.

What your daughter should know

1 | She may not experience normal periods…

…For the first couple of years. When menstruation begins, it’s common for a girl’s period to be irregular (mine skipped a month after I started). Moreover, her flow may not be what typical women commonly experience. She may experience a shorter flow with smaller amounts of blood. Not sure what a normal period should look like? Check this out!

2 | Painful periods are NOT normal

Every woman may feel slight cramping at the start of her menstrual cycle, after all her uterine muscle is contracting! But, extreme, constant pain is not normal and could be a sign of a health issue like PCOS or even endometriosis. Although some girls may turn to the birth control pill (BCP) to help decrease the pain – this doesn’t solve the problem. This acts as a bandage. When you or your daughter are using the BCP, you’re actually shutting down your normal hormonal cycle and aren’t ‘fixing’ anything. By the time your daughter comes off the pill, these conditions may have been manifesting for years – and may have unwanted implications on her fertility! It’s best to deal with the underlying issue right away and help get your daughter the support that she needs. It may be as easy as eliminating a particular food from her diet! Besides, the BCP can lead to many unwanted side effects including depression.

3 | She can get pregnant

I’m sure many moms of teens are worried that their child may have sex and become pregnant. It’s true – the start of her menstrual cycle indicates that she is now capable of becoming pregnant. However, getting pregnant depends on when a woman is ovulating. Women are only able to get pregnant a few days per cycle. Keep in mind that as a girl is beginning to experience her period, and if it’s not regular yet – she may not truly know when ovulation is occurring. Obviously having a conversation with your daughter (or son!) is warranted and you may want to ensure that all lines of communication are open. If she doesn’t feel comfortable speaking to you, perhaps she may want to speak to an older relative or friend, or even her doctor.

Sharing your experience with your daughter

You may not want to wait for your daughter to take the first step and ask you about your first experience – after all (like I was) she may be incredibly embarrassed. It may be a good idea for you to broach the issue and see if she’s ready to have the discussion. After all, more communication is better than no communication. Learning about your experience may also help her become more comfortable in her body.

Things you may want to share:

  • The age when you first got your period.
  • How was your first period? Has it stayed the same? Has it changed?
  • Have you ever had extremely painful periods?
  • Did you use anything to track your period? Or do you currently have a favourite app to track your period?
  • How long are your cycles?
  • Do you experience any clotting? Stringiness? What does the colour usually look like?
  • Do you notice a change in cervical fluid?
  • Is there a history of PCOS or endometriosis in your family?
  • Do you ever get any PMS symptoms?

Final Notes

Empowering your daughter with this information is incredibly important. She has the right to know what’s going on with her body during this transformative time. If you’re not comfortable sharing your experience, or you don’t think your experience is normal, you may want to visit a Naturopathic Doctor. My goal is to provide you with the correct information and at the very least help ensure that at your periods are regular and pain-free!

8 Simple Ways to Manage Eczema

August 29, 2016

eczema naturopathic doctor alexsia priolo bloor west children's health

This article originally appeared at ECOPARENT.CA and is republished here with permission. 

Eczema can occur at any age, even as early as a few weeks after birth! It commonly presents as itchy, red, and flaking skin, which may look like inflamed and oozing areas anywhere on the body, usually at the creases of the elbows, knees, and groin. It can later appear on the face, scalp, and behind the ears.

Remember the widespread use of antimicrobials? Well, turns out it may not be so helpful! When we protect (or try to anyway) our children from every single germ possible, we’re not allowing their immune systems to develop and mature. This causes their system to be constantly triggered by environmental factors – food, dust, pollen, chemicals, etc. As their immune system is triggered, it causes widespread problems such as inflammation, redness, and much more.

Conventional treatments for eczema, usually consisting of steroids or anti-histamines, are often prescribed to children. While they can lessen the symptoms and provide some relief, they don’t allow for the complete resolution of the underlying issue. For sustainable change in our health, we need to get to the root cause of the concern. Remember, eczema is a symptom of the body not in balance; a message the body is trying to communicate to us loud and clear!

If your child is suffering from eczema, here are a few easy tips on how to protect their skin:

  • Trim fingernails, to reduce bleeding and potential infection caused by scratching
  • Avoid anything that seems to make the symptoms worse (food, clothing, creams, etc.)
  • Avoid hot showers or baths
  • Keep a cool environment

A few holistic ways to re-establish a healthy immune balance, correct nutritional deficiencies and care for the skin to be considered are:

  1. Food elimination: Eczema most commonly presents as a symptom of food sensitivities, specifically dairy, gluten, eggs, and citrus fruits. Eliminating them from your child’s diet (or yours if you’re breastfeeding), may result in clear skin. Learn more about food sensitivities.
  2. Irritating ingredients: Be mindful of what is coming into contact with your child’s skin. Personal products that contain fragrance, parabens, or sodium laureth sulphate can be especially irritating to sensitive children, so be sure to dispose of them! Learn more about irritating ingredients here and  check the EWG’s Skin Deep database to see healthy alternatives for these products.
  3. Probiotics: A large part of our immune system is localized to our gut! Children with eczema are often thought to have unhealthy bacteria leading to symptoms such as irritated skin. Feeding our healthy bacteria, will help repopulate it and modulate the immune response.
  4. Sunlight: Sunlight helps our bodies produce Vitamin D – an essential vitamin for the immune system! Get outside and experience these natural benefits for a little while – just try to avoid the direct sun exposure between 10am-2pm, and don’t stay out in the sun for long periods of times.
  5. Fish oil: A good quality fish oil with high EPA to DHA ratio, will help decrease inflammatory processes within the body. Check with your health care provider for appropriate dosage in kids.
  6. Vitamin C: Vitamin C acts as a natural antihistamine and anti-inflammatory, thereby reducing symptoms like itchy and red skin.
  7. Calendula cream: The marigold flower contains a variety of botanical properties that helps relieve itching and burning, and promotes healing of the skin.
  8. Oatmeal bath: Wrap 1 cup of oatmeal in a cheesecloth or nylon pantyhose, tie it with an elastic or string, and let it soak in the bath under lukewarm running water. Letting your child soak in this bath, washing their body with the compress to help relieve itchy skin.

Although you may feel helpless when you see your child in discomfort, using these recommendations will help your child’s skin and immune system get back on track by addressing the underlying issue! Book an appointment with me if symptoms persist!