Factors influencing the growth of a newborn
The body length of a newborn depends on many factors. Among them are the following:
- gender (usually boys are taller than girls);
- heredity (tall parents give birth to tall children);
- quality of maternal nutrition during pregnancy;
- the state of the uteroplacental flow during the period of intrauterine development of the child.
According to WHO, there are some differences in the body length standards for female and male children. Thus, the average height for girls is 46.1 cm. At the same time, the lower limit of the norm is 40.36 cm, and the upper limit is 54.7 cm. The average height of boys is slightly higher: on average it is 49.9 cm. The minimum length indicator The body size of newborn boys corresponds to the figure of 44.2 cm, and the maximum is 55.66 cm.
Anthropometric data takes into account not only the height of the newborn, but also his body weight, head and chest circumference. Taken together, these data allow us to draw conclusions about how the child is developing: whether he has any problems or alarming symptoms that affect these parameters.
Anatomical and physiological characteristics of newborn children. Transitional states of newborns.
A newborn baby is a human child from the moment of birth until he reaches the age of 28 days. A newborn baby born at 37-42 weeks of gestation is considered full-term. Premature - a child born at less than 37 weeks of gestation. A post-term baby is born after 42 weeks of pregnancy. No matter how similar a child may be to an adult in appearance in terms of the structure of his body and its individual organs, he differs significantly from him in many quantitative and qualitative characteristics. A newborn baby is helpless in its environment, poorly adapted to the environment, and requires comfortable conditions and care. Therefore, the mother is responsible for her child and is obliged to care for him. If for some reason she cannot care for the child, then the child’s right to life must be respected. Parenting a child is an art and a 24/7 job.
Anthropometric indicators of full-term, premature and post-term infants can vary widely. A full-term baby weighs more than 2800 grams. The first weighing of a newborn is carried out within the first hour after birth with an accuracy of 10 g. Height is also measured within the first hour after birth. The average body length of a full-term newborn is 48-53 cm. The head circumference of a full-term baby is 34-36 cm, and the chest circumference is 32-34 cm.
The condition of each newborn baby after birth is assessed using the Apgar score. Healthy newborn babies have an Apgar score of 8-10 points.
The skin of a newborn baby is tender, elastic, pink, with remnants of vellus hair. The epidermis (outer layer of skin) actually consists of one thin layer of cells. Its richness in vessels and capillaries, poor development of sweat glands and active activity of the sebaceous glands lead to rapid overheating or hypothermia of the child. A newborn has easily vulnerable, fragile, sensitive skin, which is also important to consider, because... With improper care, diaper rash appears, infection easily penetrates through the pores and pustules appear. Due to the high lipid content it is more permeable. On the back of the head, upper eyelids, between the eyebrows there may be bluish or reddish spots caused by vasodilation (telangiectasia), or pinpoint hemorrhages. Sometimes there are yellowish-white nodules (milia) on the wings and dorsum of the nose. All these phenomena disappear in the first months of life. In the area of the sacrum there may also be an accumulation of skin pigment, the so-called. "Mongolian spot" It remains noticeable for a long time, sometimes throughout life, but is not a sign of any disorders. A newborn's hair is up to 2 cm long, eyebrows and eyelashes are almost invisible, nails reach to the fingertips. And the most developed type of sensation in infants is the sensation of touch (tactile perception). Skin is a baby's favorite sensory organ. A huge amount of information is perceived through the skin. Therefore, it is necessary to create a thorough and gentle skin care.
Basic rules for proper care of a child's skin. Do not use detergents that are not specifically approved for use in the care of children's skin. Minimize exposure to external irritants (urine, feces, washing powder residues, etc.). Maintain natural moisture levels. Avoid rubbing the skin. Limit possible changes in the bacterial flora of the skin. When to bathe a newborn baby? Bath a child - if he has a normal temperature - no earlier than 6 hours after birth with a body weight of at least 2000 grams and in satisfactory condition. For bathing you need a warm room, warm water and bathe quickly. Dry quickly and thoroughly. Dress and wrap warmly. Next, you need to bathe your child every day. Decide when it is more convenient to bathe your child: in the morning or in the evening. It is better to do this before feeding, so that the baby does not spit up, but while he is not yet hungry. It is important that bathing is enjoyable and does not cause discomfort or fear. When starting bathing, you need to prepare in advance everything you need so as not to be distracted and not leave your child during bathing. In any case, if you need to answer the phone, take a towel, never leave the child alone in the bath - wrap him in a towel and take him with you. In order for the water to be softer and “dry” the child’s skin less, it is better to add bathing foam to the water. Use baby soap 2 times a week. From the first days you will need a bath for bathing. When washing girls, wash from the front, boys from the back.
The skeletal system of a newborn contains few salts, which give it strength. An infant feature is the presence of non-ossified areas in the skull - fontanelles. The large one, in the shape of a diamond, is located in the area of the junction of the parietal and frontal bones, dimensions 1.8-2.6 x 2-3 cm. The small one, in the shape of a triangle, is located at the convergence of the parietal and occipital bones and is closed at birth in most children . Such a soft connection of the skull bones is of practical importance when the head passes through the narrow birth canal. Its natural deformation into an elongated “pear” is not scary and should not cause “panic”. The correct outline is a matter of time. The head looks too large, because it is 1-2 cm larger than the chest circumference, the arms are much longer than the legs.
Their increased tone predominates in the muscular system - the arms are bent at the elbows, the legs are pressed to the stomach: the posture is uterine due to the preserved inertia. The neck does not support the head - its muscles are weak.
Respiratory organs - the mucous membranes of the respiratory tract are delicate, contain a large number of blood vessels, therefore, with infections, often viral, swelling quickly develops, a large amount of mucus is released, which greatly complicates breathing. The auditory, or Eustachian, tube is wider and shorter than in older children, which facilitates the penetration of infection and the development of otitis media. The lungs are underdeveloped, breathing is shallow and is mainly carried out by the diaphragm - a muscle located on the border of the chest and abdominal cavities. Therefore, breathing is easily disrupted by the accumulation of gases in the stomach and intestines, constipation, tight swaddling, pushing the diaphragm upward. Hence the wish - to monitor regular bowel movements and not to swaddle the baby too tightly. Tight swaddling should be stopped for several reasons: blocking the movements of the diaphragm reduces ventilation of the lungs, blood circulation in various parts of the body decreases, the thin air layer between the baby’s body and the diaper does not allow for heat retention, restriction of limb movements prevents the development of neuromuscular coordination, tight swaddling with the head makes breastfeeding difficult, since the baby cannot move his head and open his mouth wide enough to properly attach to the breast; swaddled babies sleep more and ask for the breast less. The peculiarity of breathing is that the newborn breathes frequently. In a full-term newborn, the respiratory rate during quiet wakefulness is 40-50 per minute.
The frequency increases even with light load. The cardiovascular system. With the birth of a newborn, changes occur in the circulatory system, first functional - the umbilical vessels and vein stop their activity, and then anatomical - the intrauterine blood flow channels close. The heart rate is 120-140 beats per minute; when feeding or crying, it increases to 160 beats or more.
Digestive system: functionally immature, and since newborns have an increased metabolism, it bears a heavy burden - minor errors in the diet of a breastfeeding mother and the child’s diet can cause digestive disorders (dyspepsia).
The mucous membrane of the mouth is rich in blood vessels, thin, and easily vulnerable. The tongue is big. The child is usually born without teeth. Sometimes 1-2 front teeth erupt even before birth. They may interfere with the baby's ability to breastfeed and are recommended to be removed by the pediatric dentist.
The muscles that block the entrance from the esophagus to the stomach are also underdeveloped - this leads to frequent, light regurgitation. To prevent it after feeding, you need to hold the baby for 20 minutes in your arms, vertically, leaning against your chest. Initially, the stomach holds about 10 ml of liquid, by the end of the first month its capacity increases to 90-100 ml.
The intestinal muscles are still poorly trained and the movement of food through it is slow. That is why newborns are so tormented by accumulations of gases formed during the digestion of milk and bloating - flatulence. Constipation is common. A child's original stool (meconium) is a thick, odorless, olive-colored mass that is released in the first 1-3 days. The number of stools is up to 6-8 times a day. Meconium is formed from amniotic fluid, mucus, and bile, which enter the stomach and intestines of the fetus. During the first 10-20 hours of life, the child’s intestines are almost sterile, then they begin to colonize it with the bacterial flora necessary for digesting food. Genitourinary system. By the time of birth, the kidneys, ureters, and bladder are quite well formed. However, severe stress experienced by a child during childbirth short-term disrupts metabolism. In the areas where urine is formed, uric acid crystals are deposited and the kidney function is slightly reduced for the first few days. The child urinates only 5-6 times a day. From the 2nd week, the metabolism gradually stabilizes, the number of urinations increases to 20-25 times a day. The external genitalia are formed. In boys, the testicles most often descend into the scrotum, but if they are in the lower abdomen, they can descend on their own in the first 3 years. In girls, the labia majora cover the labia minora.
Hematopoiesis. In newborns, the main site of hematopoiesis is the red bone marrow of all bones, additional sites are the liver, spleen, and lymph nodes. Blood parameters include hemoglobin 180-240 g/l, red blood cells 4.5-6.0 x 1012/l, leukocytes 18-21 x 109/l, with a crossover in the leukocyte formula at the age of 4-5 days of life.
Nervous system. Immature. The convolutions of the brain are barely outlined. They are more strongly developed in those sections where the vital centers responsible for breathing, heart function, digestion, etc. are located. In infancy, they sleep most of the day, up to 16-18 hours a day, for 3-4 hours at a time, waking up only from hunger and discomfort. Before feeding, they wake up on their own and usually need feeding on demand, after about 2-3 hours (this is the time for digestion of human milk in the stomach). Those children who do not wake up at feeding time (every 2-3 hours) need to be woken up and fed. For the growth and development of a child, the gripping reflex is important - when something touches the child’s lips, he opens his mouth, his tongue moves down and moves forward. Sucking reflex - when something touches the baby's palate, he begins to suck. Swallowing reflex - when the baby's mouth is filled with milk, he swallows. Protective reflex – when placed on the baby’s stomach, the baby turns its head to the side.
Sense organs. In the first weeks, the olfactory organs feel almost no smell; only an extremely loud sound can wake them up, and only too bright light can disturb them. The child’s thoughtless gaze does not linger on anything; many experience physiological strabismus caused by weakness of the eye muscles, involuntary movements of the eyeballs - nystagmus. A newborn focuses his gaze on an object at a distance of 20-25 cm from the organ of vision. This is exactly the distance between the baby's eyes and the mother's face during feeding. Up to 2 months he cries without tears - the lacrimal glands do not produce fluid. So far, only the senses of taste, touch and temperature sensitivity help him to understand the world.
Immunity - some factors that play a protective role in the body are developed in utero. The child receives some of the immune substances from the mother with colostrum, in which their concentration is very high, and with breast milk, where their content is much lower, but in sufficient quantities. But in general, the immune system is imperfect, the child is vulnerable to infection.
Diagnosis and differentiation of physiological adaptation processes from pathological ones has difficulties. One must be able to distinguish between physiological adaptation processes, transition states and pathological processes.
States and reactions that reflect the process of adjustment (adaptation) to new living conditions are called transitional (borderline, transient, physiological) states of newborns. The period of adaptation to the conditions of extrauterine life lasts about 3 weeks for full-term infants, and 4 weeks for premature infants. Usually physiological for newborns, transitional states under certain conditions, depending on the gestational age at birth, the characteristics of the intrauterine period and the birth act, environmental conditions after birth, care, feeding, and the presence of diseases in the child, can take on a pathological character.
Transitional states include an initial loss of body weight. A loss of body weight not exceeding 6-10% is observed in all newborns. Restoration of body weight occurs by the 6-8th day of life. Weight loss directly depends on the volume of milk sucked, fluid administration, the time of the baby's first attachment to the breast, and the temperature and humidity of the environment. Natural, that is, breastfeeding, is highly desirable for a child. And medical workers who come into contact with pregnant and nursing mothers should be supporters of this type of feeding.
Physiological jaundice in full-term newborns appears on average at 2-3 days of life and disappears at 7-10 days of life. It is observed in 60% of full-term and 805 premature children. Caused by increased breakdown of newborn red blood cells. With late feeding and hypothermia, it becomes pathological, requiring treatment (phototherapy).
Transient disturbance of thermal balance is also a transitional condition in the newborn, although it more often occurs with inadequate care. The normal level of body temperature for a newborn is 36.5-37.5ºС. Newborns easily overheat and cool down when the temperature regime is violated. A decrease in body temperature to 36ºC is defined as cold stress. Severe hypothermia is diagnosed at 35.9-32ºС. Severe hypothermia - when the body temperature is below 32ºC. Transient hyperthermia occurs on the 3-5th day and, under optimal conditions for nursing a child, is very rare. There is an increase in body temperature, sometimes up to 38ºС and above. The child is restless, drinks greedily, has dry mucous membranes, and has lost a lot of weight. The most common cause of hyperthermia is dehydration, water imbalance, overheating (at an air temperature above 24ºC in a ward for healthy newborns, the bed is located near a heating radiator, in direct sunlight). With proper and free breastfeeding, it is rare. Transient hyperthermia requires intervention - the child is left unwrapped, additional fluids are prescribed, and physical cooling measures are usually sufficient. In rare cases, antipyretics are used.
A hormonal crisis after birth is observed in boys and girls. There is engorgement of the mammary glands, and in girls there is bloody discharge from the genital opening.
Simple skin erythema is a physiological redness of the skin observed in the first 1-2 days. Occurs after removal of the original lubricant, the first bath. Does not require treatment. Erythema toxicum - many newborns develop small white papules during the 1st-3rd day of life, which usually disappears after 2-3 days. For severe toxic erythema, it is advisable to prescribe antihistamines.
Rejection of the umbilical cord and epithelization of the umbilical wound occurs by the end of 3 days. Epithelization of the umbilical wound ends by the 10-19th day of life. The umbilical cord stump is treated with 70% alcohol and 5% potassium permanganate solution 2-3 times a day. The umbilical wound is also treated with either 3% hydrogen peroxide and a 2% solution of brilliant green (brilliant green).
In order for borderline conditions of newborns not to become pathological, an optimal thermal regime is necessary (room temperature not lower than 24ºC, humidity 60%), early skin-to-skin contact within 40 minutes immediately after birth (for seeding with the mother’s flora), early attachment to the mother’s breast and feeding the child with breast milk, timely measures to stimulate lactation in the mother, keeping the skin and umbilical wound clean.
If body length does not meet accepted standards: is there any reason for concern?
If the growth rate of the newborn is too low or too high, this may be an alarming signal that there is some kind of pathology in development (this may be a symptom of a certain disease). It is recommended to undergo an examination to determine the exact cause of this problem.
A slight deviation in the length of a newborn's body is not considered a cause for serious concern unless there are any other alarming symptoms.
Factors that affect your baby's weight
Proper nutrition plays an important role in the development and life of a small child. However, the main factor is still genetics. Parents should pay attention to what their relatives and grandparents were like.
The child often repeats the development and weight of his parents, less often - his grandfather or grandmother.
The high weight of a child at 3 years old is one of the factors in the improper development of your baby. At the same time, obese children are less mobile than others. If your child’s obesity is due only to overeating, most likely you need to take a closer look at his weight, for example, enroll him in a sports section or choose some kind of optimal diet. However, you still need to contact a specialist, take the necessary tests and be sure that everything is fine with your child. If there are deviations in development, perhaps a specialist will help with choosing the right diet and physical activity.
However, the cause of a child’s excess weight can be not only poor nutrition, but also violations of other functions and systems of the body, for example, the endocrine system. If the cause of excess weight is illness, you need to explain this to your three-year-old and choose an activity that your child will like and where he can express himself. Then he will become everyone’s favorite in the team.
If a child at 3 years old, under the influence of negative life situations, is not gaining weight well, this may also be a reason for your concern. At the same time, you need to show patience and love for your baby. Centile weight tables will also help you correct and clarify all changes in the weight of your three-year-old son or daughter.
We live in a time when obesity is the “disease of the century.” Thousands, if not millions, of people are on diets, and many more are planning to do so. Therefore, it is not surprising that many parents, watching their child gain weight, begin to wonder: is this good?
In fact, young children grow very quickly in their first year of life. Then the weight gain gradually slows down. All these processes are quite natural. Moreover, the World Health Organization even compiled a table of the average weight of children depending on gender and age. It is on the basis of this document that most modern pediatricians make a conclusion about whether the baby is underweight or overweight.
Yes, in this case, deviations in both one and the other direction are considered a bad indicator. So a “lean” child is not always a good thing either.
Newborn baby: growth dynamics in the first months of life
Newborn growth measurements are usually taken on the second or third day after birth. This is due to the fact that during this period the degree of deformation of the skull bones decreases and the swelling of the soft tissues of the head subsides.
According to experts, in the first days of life, the body length of a newborn decreases slightly. But subsequently, growth increases at a very rapid pace. Moreover, the younger the baby, the more intensively his growth occurs (this is especially true for the first three months of life).
The increase in body length over this short period of time is as much as 9 cm. Then the pace slows down somewhat. For example, from the third to the sixth month, the growth dynamics is 7.5 cm. From the sixth to the ninth month, the baby’s height increases by 4 – 6 cm.
Young mothers and fathers are very attentive to the anthropometric indicators of their baby, reacting warily to any minor deviations from the norm. On the one hand, this is the correct position, because these data indicate the state of the child’s health and determine his further development. However, on the other hand, one should not make hasty conclusions. We should not forget that each child develops individually, at his own pace.
