GOOD NUTRITION

CLINICAL CHALLENGE GROWTH CHARTS

You are examining 18-month old Jonathan. There is no growth chart available in his chart, the clinic has just run out of pre-printed copies, and the EMR is down for the afternoon. Where can you go for more growth charts?

Growth charts can easily be found through the Center for Disease Control at http://www.cdc.gov/growthcharts/. Note that growth charts from the World Health Organizations (WHO) are the preferred chart for children 0-3 years, and CDC charts for older children

Growth Charts

Jonathan's mother has all his previous records, so you can extract all the data points from previous visits.

 

Data to use for Clinical Challenge below

The data you extracted are as follows:

The data are plotted below. Note the change in weight relative to length.

data

growth chart

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

More Information:

Additional information about juice intake is available from the American Academy of Pediatrics policy statement on Lipid Screening and Cardiovascular Health in Childhood.

Table 5-1, or from the policy statement of the AAP on juice intake http://pediatrics.aappublications.org/content/107/5/1210.  

 

Clinical Challenge

Clinical Challenge: You take a dietary history and Johnny's mother tells you that he eats a variety of fruits and vegetables, and only a few types of meat proteins such as chicken nuggets and hot dogs. She breastfed him almost exclusively until a year. At a year, she introduced whole cows milk and juice. He currently nurses only before naps and bed time. He takes 6 oz of juice a day and 24 oz of whole milk.

 

Question: If you were to recommend one dietary change what would it be?

 
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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