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Maternal and Child Health Bureau ~ 4

neurologic disorders that impair ambulation

low birth weight

feeding problems

Neurologic disorders that impair ambulation Children who are non-ambulatory due to neurological conditions such as severe cerebral palsy or neural tube defects such as spina bifida (myelomeningocele), do not grow normally. This is thought to be due to a lack of weight-bearing which normally provides the physical stress on the long bones of the leg required to stimulate bone growth (Stevenson, Roberts, Vogtle, 1995).

Some children with neurologic conditions affecting ambulation also have problems with feeding, which can be an additional environmental factor influencing growth (Stevenson, 1995). This is discussed later in this section.

Low birth weight Babies born weighing 1500-2500 grams have a low birth weight. Babies born weighing less than 1500 grams have a very low birth weight. They may or may not have intrauterine growth retardation (IUGR), depending on their gestational age.

If an infant is born prematurely, the low weight may be appropriate for gestational age (AGA) and not have IUGR.

On the other hand, an infant may be born at term weighing less than 2500 grams; that infant is small for gestational age (SGA) and has IUGR.

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:

National Institute of Child Health and Human Development Neonatal Research Network centers (Ehrenkranz, 1999) extend 3 or 4 months of age

Infant Health and Development Program (IHDP) (Guo et al., 1997; Guo, et al. 1996; Roche, et al., 1997) extend to age 36 months

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.

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