As society progresses and living conditions improve, the growth and development of children is attracting more and more attention from parents. For example, in our hospital’s child growth clinic, we often encounter many questions about child growth and development from parents of children.
Hot spot 1: What factors affect the growth and development of children
1. Genetic factors
The genetic factors of both parents affect the characteristics, potential and tendency of children’s growth and development, such as skin shade, hair color, facial features, height, early sexual maturity and susceptibility to diseases. The growth and development of boys and girls have their own rules and characteristics, such as language and motor development of girls is slightly earlier than that of boys; puberty of girls is also earlier than that of boys, while the final physical development of boys is obviously beyond that of girls due to the longer extension of puberty. Therefore, the assessment of pediatric growth and development levels should be done according to the standards for boys and girls, respectively. The adult height of the human body depends 70% on genetic factors and only 30% on environmental conditions such as nutrition and exercise. Generally, children of high parents are also high, and children of short parents are also short. There are also some endocrine diseases, such as obvious growth hormone deficiency, precocious puberty and other endocrine problems, which can cause significant impact on the height of children. There are also some like hereditary metabolic diseases, epiphyseal cartilage development disorders, chromosomal disorders, Turner’s syndrome and chromosomal problems can affect height.
2.The influence of nutritional factors
Nutrition is the material basis of growth and development, the fetus gets nutrition from the pregnant mother, and after birth, it depends on self-intake. Reasonable nutrition should contain sufficient proportion of suitable calories, amino acids, vitamins and minerals to meet the needs of children’s metabolism and growth. Otherwise, it will prevent the normal growth and development of the organs of the body and lead to certain nutritional deficiencies. Nutrition is the material basis for growth, so giving children adequate and reasonable nutrition is the most fundamental guarantee for growth and development. If a child is malnourished during the fetal period, not only does his physical growth lag behind, but his brain development is also affected. Severe malnutrition within two years of birth can cause weight loss, restricted height growth, and low immune, endocrine and neurological regulation. Children need adequate daily calories and various nutrients, including protein, fat, carbohydrates, dietary fiber and vitamins. All these nutrients are found in grains, eggs, meat, milk, and vegetables and fruits.
Lack of protein, human growth and development will be affected, it is difficult to grow taller. Therefore, not only to ensure the amount of protein for children, but also to pay attention to the quality of protein. Animal foods, such as chicken, duck, fish, meat, eggs, milk, and soybean products, all contain high-quality protein, and should be given to children to eat some every day. Calcium is an important substance for bone growth, preschoolers need about 600 mg of calcium per day, elementary school students need about 800 mg per day, and secondary school students need about 1200 mg per day.
To eat more calcium-rich food, eat more soy products, shrimp, bone broth and vegetables, and drink more milk, “a glass of milk is strong for a nation” is the truth. Adequate intake of protein, but also pay attention to the carbohydrate supplement, the latter mainly from the cereal food. At the same time, sun exposure, because the sun’s ultraviolet rays will help convert vitamin D, promote the body’s absorption of calcium, which is conducive to bone growth. In post-war Japan, great importance was attached to children’s nutrition, and now the new generation of Japanese teenagers have changed their stature greatly, changing the image of short that people had in the past, especially for males, whose height growth is especially obvious.
3.The influence of exercise factor
Although exercise cannot increase the height determined by heredity, it can maximize the genetic potential. Appropriate physical exercise can accelerate blood circulation, enhance metabolism, so that epiphyseal cartilage cells get sufficient nutrients, is an effective means to promote children’s physical development and enhance physical fitness. Long-term exercisers thicken the diameter of bones, increase the size of the skeletal cavity, muscle fibers become group, the contraction of the heart is enhanced, the heart rate slows down, and physical fitness is significantly improved. Children who exercise regularly will be at least 2-3 cm taller than those who do not exercise, and more than 10 cm taller. Exercise also promotes the secretion of growth hormone, which is normally pulsed at low levels.
In general, the vast majority of physical activities, such as running, jumping rope, playing ball, high jump, long jump, etc. are conducive to growth, even weightlifting, dumbbells, wrestling and other so-called weight-bearing, compressive sports, as long as they take a moderate amount of exercise and intermittent practice, are also beneficial to growth. However, the most effective exercise program for growing taller is still the bar, rings, basketball, bouncing, free gymnastics and swimming. The reason is simple, pull-ups can stretch the spine, promote the growth of the spinal column bone; jumping, touch high can stretch the muscles, ligaments, have stimulated the role of epiphyseal cartilage growth; and swimming can make all parts of the body are fully stretched and exercise. Our young women are generally about 20 years old, young men are generally about 22 years old cartilage is completed ossification, no longer growing, therefore, want to increase the height of young people to participate in physical exercise the sooner the better.
4, the impact of sleep factors
The brain can secrete growth hormone during sleep, which can promote the body to grow taller, and children should have sufficient sleep time. The important feature of growth hormone secretion from pituitary gland is that paroxysmal pulse secretion starts 30 to 45 minutes after sleep, with more secretion during deep sleep, less secretion during light sleep and little secretion when awake. The secretion of growth hormone in the sleep state is about three times higher than that in the awake state, so ensuring sleep is beneficial to growth. Moreover, most of this growth hormone is secreted in the first half of the night, so children should not sleep too late. The duration of sleep in childhood is age-related and varies greatly from age to age. A day and night sleep time needs 10-12 hours for 1-3 years old, 10-11 hours for 4-6 years old, 10 hours for 7-10 years old, and no less than 9 hours for children over 10 years old. The pituitary gonadotropin, too, is secreted in distinct paroxysmal pulses during nighttime sleep, especially in early adolescence, but only after falling asleep at night. Therefore, it is very important to ensure sufficient sleep for the development of reproductive organs and sex characteristics.
5. Influence of other factors
The family’s economic status and parenting style, war, famine, economic depression and other social factors have an important impact on the growth and development of children. Dr. Fenho, a famous American psychiatrist, believes that healthy babies at birth can develop growth disorders if they live in families with long term mental depression, divorced or even abused parents. According to statistics, orphans who lost both parents in World War II, such as in Spain and Korea, were on average several centimeters lower in height than children of the same age in other countries. Emotions can also affect a child’s growth, so give them more warmth and affection to keep their spirits happy and healthy.
A good living environment with plenty of sunshine, fresh air and clean water, healthy living habits and scientific care, proper parenting and physical exercise, and perfect health care services are all important factors to ensure the best growth and development of children. Pay attention to hygiene and prevent diseases. If a child does not pay attention to hygiene or lacks good eating habits, he or she will easily fall ill or suffer from malnutrition, which will seriously affect the health and naturally the growth of the body. Seasonal and climatic factors also have an impact on the growth and development of children. In general, height growth is the fastest in spring, weight growth is the fastest in autumn, and some children suffer in the hot summer, with significant weight loss.
Long-term chronic diseases can affect the development of weight and height, and congenital diseases such as congenital heart disease have a more pronounced effect on growth and development. Abnormal development of height is associated with a number of diseases, such as cretinism caused by hypothyroidism, chondrodysplasia, and gigantism caused by abnormal secretion of the pituitary gland. If children’s height growth is found to be significantly abnormal, parents should promptly take them to the hospital for a detailed examination and do not delay the condition.
Hot point 2: What is the current status of children’s growth and development?
In the last 100 years, children and adolescents in most countries around the world have grown taller than one generation and their sexual development has advanced significantly. The long-term changes in growth and development were first seen in economically developed countries, mainly among adolescents with a high level of urban and cultural life. In Japan, post-war economic development was accompanied by accelerated growth, and the average height of male and female adolescents increased significantly. Since the founding of New China, the growth level of children and adolescents in China has also been increasing, and the growth of height is especially obvious during school age and adolescence. The trend toward earlier sexual maturation can be observed in almost all parts of the world. The age of menarche is much earlier in girls today, and as the age of menarche continues to advance, the age of appearance of secondary sexual characteristics also gradually advances, i.e., the entire puberty period advances. There is little increase in bust circumference, and the increase in height is mainly due to the increase in lower limb length and the phenomenon of slenderization of body shape. The age of menarche for young girls in major cities such as Beijing, Shanghai and Wuhan in China has advanced from 14-15 years old in 1960 to 12-13 years old in 1990.
In May 2005, the Ministry of Health conducted the fourth child physical development survey in urban and suburban counties of nine cities, including Beijing.
First, regional differences and urban-rural differences still exist. The growth and development levels of children in the central and western regions are significantly lower than those in the eastern regions; although the urban-rural differences are narrowing, the growth and development levels of rural children are still lower than those of urban children. These differences are obviously related to the level of socio-economic development, children’s nutritional status and differences in children’s health care capacity.
Second, malnutrition remains a major problem affecting children’s growth and health in some rural areas in the central and western regions. Although the prevalence of low weight, growth retardation and malnutrition among children has decreased significantly in recent decades, malnutrition is still a major problem affecting children’s growth and health in some rural areas in the central and western regions. Third, the number of overweight and obese children in urban areas has increased significantly and is on a rapid upward trend.
Obesity is not only harmful to children’s physical and mental health, but also closely related to the occurrence of many chronic diseases in adulthood, which needs to be paid great attention by the whole society and child health workers. The survey also found that the height and weight of children over 3 years old are better in the north than in the south. These differences may be related to geographical conditions, living and eating habits, and genetic factors. Northerners have more staple foods of flour and mixed grains, which contain nutrients such as protein, fat, calories and vitamin B1 than rice in the south. Among the side foods, northerners eat beef and mutton, while southerners are used to eating pork, and beef and mutton contain higher protein than pork. For children in the south, it is important to promote a diversified diet, with staple foods with flour grains, such as putting some adzuki beans, mung beans and cereals inside the porridge, and choosing varieties with high protein content, such as fish, meat and tofu, for side dishes.
Doctors have observed that 90 percent of children who come to the clinic do not have obvious pathological factors, and only 10 percent of children have obvious pathological factors that require special treatment. Traditionally, an adult male height below 1m6m and a female height below 1m5m is considered short. But most people are not satisfied with this definition, boys are not satisfied with less than 1 meter 7, girls are not satisfied with less than 1 meter 6, which is determined by the expectations. Now with the improvement of living standards, social competition pressure increases, from the parents, from the perspective of society, the height expectations are getting higher and higher.
Hot point 3: How should parents care about the growth and development of their children?
Although the growth and development of each person is individual, but its law is basically the same. If your child’s height is different from that of children of the same age, you should consult a doctor as soon as possible. For a child, a comprehensive health checkup including growth and development should be done annually, just like our health checkups. The most common indicators are height and weight. Clinically, growth disorders in children are more likely to manifest as short stature. Adolescent children also have some sexual development and the appearance of sexual characteristics, such as breast development in girls and vocal changes in boys.
A child with precocious puberty does not appear shorter than others, but may grow taller than children of the same age, only that he grows earlier. The best way to be alert in the case of a child who is obviously growing faster than children of the same age is to do a bone age test, which is the best indicator to assess the physiological maturity, and by judging this, we can find out if the child has an early developmental situation.
Bone age is short for skeletal age and is determined with the help of a specific image of the bones in an X-ray camera. It is a good indicator of the degree of maturity of the human body. It not only determines the biological age of the child, but also gives an early indication of the growth potential of the child and the trend of sexual maturity through bone age. When the maturity of the skeleton is considered in conjunction with the height of the child, it is possible to determine the type of height the child will have as an adult. If the child’s skeletal age and stature are both at low levels, i.e., the child is behind in skeletal age and short in stature, the child may develop into a person of normal height in the future (late development). If the child’s bone age is backward, but the height is medium or high, the child may develop into a high stature, many junior gymnasium selection of athletes often look for this type of children.
If the child is high in bone age but short in stature, he or she is likely to become a short statured person in the future. If the child’s bone age and height are both at a high level, the child also has little growth potential and may not eventually become a high statured (early developmental) person.
It is important to note that if a child’s bone age differs from the chronological age by more than two years, the child should be carefully examined at a hospital. This is because abnormalities in bone age are often an aspect of certain endocrine disorders manifested in pediatrics. As parents, when you find abnormal growth of your child, you should go to the hospital as soon as possible to ask the doctor to help find the cause, it is best to take an X-ray of the wrist to determine the bone age, decide whether to use drugs, with what kind of drugs, do not abuse “growth agents”, these drugs will accelerate the bone healing process, but inhibit the continued growth of height.
Parents are concerned about much more than these children’s growth issues, but the most critical can be said to be the child’s height, here we remind parents and friends must not believe in the false advertising in society, thus missing the most valuable growth period of children. It is the responsibility of parents to help their children seize the limited opportunities available to them, to ask experts to make correct judgments and predictions by checking the bone age, to prescribe the most suitable nutrition and exercise for the individual situation, and to give scientific interventions so that the child’s growth can reach its maximum potential and the best expected goals.