Child
growthMonitoring
Monitor growth and growth velocity over 6 months. Children who are "crossing the centiles" should be considered for further investigation.
Check parental centiles by:
- plot like-sexed parent's height on right of centile chart
- plot mother's height + 12.5cm on boy's chart
- plot father's height - 12.5cm on girl's chart
Assess bone age
- Xray L wrist/hand
Investigations
- FBC
- ESR
- T4
- Urea
- Chromosomes (girls only)
Consider referral if:
- Height <3SD, no constitutional effect
- Clinical signs of wasting
- Suspicion of congenital heart disease
- Possible malabsorption
- Documented reduced growth velocity
- Suspicion of neglect
Head circumference
Head circumference showing a progressive rise not parallel to the weight centile should be monitored more closely, with head measurements (preferably taken by the same person) and weight measurements. Progressive hydrocephalus without an associated myelomeningocoele is very rare.
Further information on growth at http://www.healthforallchildren.co.uk.