Text VII. The Health of British Children

The International Hospital Federation has this year expressed particular interest in four specific aspects of children’s health: growth monitoring, early rehydration, breast feeding, and immunization.

In Britain, growth monitoring has long been a basic element of pediatric practice. The Child Welfare Service, now better described as the Community Child Health Service, was established in 1918 because the British government was becoming increasingly conscious of the importance of disease in childhood as the precursor of later disability. One of the service’s main functions was monitoring child health from an yearly age; this included growth measurements, usually height and weight.

Basic growth measurements related to the norm for any population can be plotted quickly on a growth chart – now part of the standard pediatric documentation used in hospital. Weight, height and head circumference are the parameters usually measured. While single measurements are of some value, serial measurements are of greater value in demonstrating any change in the state of a child’s health. Such a change may be induced by disease, but may also result from physical or emotional neglect. In the search for early evidence of childabuse, a deviation in weight from a previously established regular growth pattern has come to be recognized as an important sign.

Study of growth patterns has been an important element of pediatric research in Britain. Growth patterns for different diseases have been established and age-related variations have been defined.

In addition to expacted growth measurements at different ages, the idea of growth velocity has been developed. Growth at the time of birth is rapid. During the first year of life an infant will treble its birth weight, but the rate of growth diminishes. It continues to decline until adolescence, when there is a spurt in velocity. The timing of the spurt and of the various changes that occur in association with sexual maturation are important factors in the eastablishment of normal adulthood.

Studies over many years of growth standards achieved by the nation yield interesting information. Over the past fifty or sixty years the height and weight of British children have been increasing.

30. Revision questions:

1. When and where should first aid to the newborn be given?

2. What has helped to prevent fatal neonatal disorders and improve the survival statistics for newborns with developmental anomalies?

3. Is asphyxia considered to be a dangerous condition for the newborn or not?

4. What is the hallmark of the newborn intensive care unit?

5. Is ventilation by bag and mask an effective means of establishing lung expansion?

6. Supplemental oxygen is an important form of therapy for many infants with cardiopulmonary disorders, isn’t it?

7. What is PVS?

8. How may the majority of infants with cardiorespiratory depression be resuscitated?

9. What can you say about pharmacological therapy?

10. What is a technique for testing the infant to see how well he manages without the ventilator?

11. What means may mixtures of oxygen and air be delivered to an infant by?

12. What aspects of children’s health has the International Hospital Federation expressed interest for?