FACTORS AFFECTING GROWTH AND DEVELOPMENT

Introduction:
Growth is a dominant biological activity during the first two decades or so of
human life, including nine months of prenatal life. Although growth and
development- physical, mental, social, emotional, sexual and spiritual- proceed
at different rates, they are so interrelated in the majority of children that the
result is a progressive development of the whole child, from infancy to
adulthood. Each child has individualised pattern of growth and development.

Definitions:
Growth: -
This is the process of physical maturation. It refers to an increase in physical
size of the whole body and various organs. It occurs by multiplication of cells
and an increase in intracellular substance. It is a quantitative change of the

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body. It can be measured in Kg, pounds, meters, inches, etc. It is progressive
and measurable phenomenon.

Development: -
It is the process of functional and physiological maturation of the individual.
It Is progressive increase in the skill and capacity to function. It is related to
maturation and myelination of the nervous system, it includes psychological,
emotional and social changes. It is a qualitative aspect of maturation and
difficult to measure. It is orderly.

Factors affecting growth and development:

Growth and development depend on not one but a combination of many
factors, all interdependent. The relatively typical pattern of growth and
development is influenced by heredity and environment. Heredity determines
the extend of growth and development that is possible, but environment
determines the degree to which the potential is achieved.
The integrated nature of growth and maturation is largely maintained by a
constant interaction of genes, hormones, nutrients and other factors. These
factors also influence physical performance. Some are hereditary in origin.
Others such as season, dietary restrictions, severe psychological stress,
originate in the environment and simply the rate of growth at the time they

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are acting. Others such as socio-economic class reflect a complicated mixture
of hereditary and environmental influences and probably act throughout the
whole period of growth.
1. Heredity
2. Environment
3. External environment
4. Internal environment

HEREDITY:
The heredity of a man and woman determines that of their children. The
health history of several generations of the families of each of the parents is
studies to determine the hereditary traits likely to exist in the child.
Embryonic life begins with the cytoplasm and the nucleus of the
fertilized ovum, genetically determined by both parents.
The rate of growth is more alike among siblings than among unrelated
persons
Some children are small not because of endocrine or nutritional
disturbances but because of their genetic constitution
Before the largeness or smallness of a child is evaluated, the size of the
parents must be observed first

A) Sex:
- Genetic factors probably lay the leading part in the difference
between male and female patterns of growth.
- Sex is determined at conception.
- After birth the male infant is both longer and heavier than the
female infant.
- Girls mature earlier, reach the period of accelerated growth
earlier than males, and are taller on the average.
- During the prepubertal spurt of growth and thereafter, boys are
again taller than girls.
- Bone development is more advanced in girls than in boys.
- Permanent teeth erupt earlier in girls than boys.

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 B) Race:
- Distinguishing characteristics called racial or subracial developed
in prehistoric human.
- Tall and short examples exist among all races and subraces
- Intermarriage has produced mixed racial types

C) National characteristics:
- Physical characteristics of national groups arise because the
inhabitants of various nations tend to be made up of homogenous
subracial groups with specific characteristics.

ENVIRONMENT:
Although each human being at birth has a gene=determined physical, mental,
and biochemical potential, this potential may not be reached because of the
influence of the environment. The influences of heredity and environment are
so interrelated that they are inseparable.
A) Prenatal Environment:
- Prenatal conditions are part of the environmental climate in which
the child develops.
- The uterus shields the fetus from the full impact of external
adverse reactions and thus the intrauterine environment has a
great influence on the future development of the child.
Harmful prenatal factors-
 Nutritional deficiencies due to poor maternal nutrition
 Mechanical problems – malposition in utero
 Metabolic endocrine disturbances in mother- Diabetes mellitus
 Infections in mother
 Smoking and alcohol use by mother

B) Postnatal Environment:
- An environment that provides satisfying experiences promotes
growth.
- Growth in one are influences and in turn is influenced by growth
in all other areas.

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EXTERNAL ENVIRONMENT:
A) Cultural Influences:
Groups of human beings create their own cultures, whereas each
individual is influenced or shaped by the culture of which he or she is
part. The culture of a group consists of shared ways of behaving feeling
and knowing. The uniformities found in a group may be considered a set
of ideals or norms that regulate or govern the particular and recurring
activities within the group. The effect of a culture on a child begins
before the birth.
- The nutrients the mother receives are culturally determined
- Whether the mother is expected to deliver her baby in a sterile
environment of a hospital is also culturally determined
- After birth the child is cared for according to the culture
- The child is fed the diet that is dictated and given health care as
defined by the culture.
- Child internalize the ideals, traits and abstractions of the cultural
group
- The behaviors expected of the child at each stage of growth and
development are culturally defined.
- The values that children learn are considered ‘right’ and will be
the guideline for their behavior throughout life.
- Individuals who have a different set of values are considered
different or wrong in their beliefs.

B) Socioeconomic status of the family:

- The environment of lower socio-economic groups may be less
favorable than that of the middle and upper groups.
- Lower socio-economic group parents lack modern scientific care;
they lack money for essential health and diet; and often unable,
unwilling or unsure of how to obtain public health and hospital
services.

C) Nutrition:
Nutrition is related to both the quantitative and the qualitative supply
of food elements- proteins, fats, carbohydrates, minerals and vitamins. If
essential nutrients are received in the balanced amount necessary to

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 sustain life, to allow for energy expenditure, and to promote growth and
development, a child is well nourished.
During periods of rapid growth, such as the prenatal period, infancy,
puberty, and adolescence, the need for proteins and calories is
increased.

Causes of undernutrition: An inadequate nutritional intake, both

quantitatively and qualitatively
i. Physical hyperactivity or lack of adequate rest
ii. A physical illness that causes an increase in nutritional need but at
the same time results in poor appetite and poor food absorption
iii. An emotional illness that causes decreased food intake or
inadequate absorption because of vomiting or diarrhoea.

D) Climate and season:

- Climatic variations influence the infant’s health
- Families where there is inadequate refrigeration of food and
extermination of flies and other insects, infants are prone to suffer
from diarrhoea with subsequent dehydration.
- The seasons of the year influence the growth rates in height and
weight especially in older children.
- Weight gains are lowest in spring and greatest in late summer and
autumn. This may be because of variations in activities of children
due to variations in climate.

E) Deviation from positive health:

These may be caused by hereditary or congenital conditions, illness or
injury and may result in altered levels of growth and development.
- Hereditary or congenital conditions may contribute to growth
impairment or to an increase in height. Conditions causing
shortened stature includes various types of dwarfism, Turner
syndrome. Conditions causing height above normal include
Klinefelter syndrome.
- Long-term illnesses like cystic fibrosis or malabsorption syndrome
may lead to growth retardation. Congenital anomalies or chronic
infections present during rapid growth periods and critical periods

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 of development have temporary or permanent delaying effect on
the achievement of normal growth and development.

F) Exercise:
- Exercise increases the circulation and promotes physiological
activity and stimulates muscular development.
- Fresh air and moderate sunshine favor health and growth
- Prolonged exposure to sunshine in extremely warm areas may
cause tissue damage of the skin and even more serious
consequences if the child is unprotected from the sun ray.

G) Ordinal position in the family:

The ordinal position of the child has a bearing on the parent-child
relationship and the child rearing practices that are followed. Birth order
has a significant influence on the intelligence, personality traits and
methods of coping.
- The first born may be raised rigidly and with anxiety and may
develop a more anxious, perfectionist personality. He may learn,
at an early age, to control and organize the behavior of others.
- An only child is likely to develop more rapidly intellectually than
are children with siblings. He may have higher self-esteem, but
motor development may be slower as they don’t have older
siblings to guide them.
- Middle child gets less attention and learns to be adaptable and
less achievement oriented. He is less aggressive in achieving life
goals.
- Youngest child tends to be more peer oriented, less intellectually
inclined and less achievement oriented. The youngest child may
be relatively slow in certain areas of development because of less
need to explore. The child tends to develop a good-natured,
friendly, warm personality with high self-esteem.

INTERNAL ENVIRONMENT:
A) Intelligence:
- The child of high intelligence is likely to be taller
- Intelligence influences mental and social development

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B) Hormonal Influences:
Somatotrophic hormone, thyroid hormone and hormones that
stimulate the gonads influences growth

a) Somatotrophic hormone (STH)/Growth hormone:

- Its major effect is on linear growth in height
- It is essential in the proliferation of cartilage cells at the
epiphyseal plates
- It stimulates skeletal and protein anabolism
- Excess of the hormone causes gigantism and lack of it causes
dwarfism.

b) Thyroid hormones:
- Thyroxine (T1), Triiodothyronine (T3) and Thyrotropic hormone
(TH) stimulate the thyroid gland to secrete Thyroxine (T4).
- These hormones stimulate the general metabolism and are
necessary for growth and development after birth.
- An excess produces advanced linear growth and deficiency
causes cretinism with stunted physical growth and mental
retardation.

c) Hormones that stimulate the gonads:

- Adrenocorticotropic hormone (ACTH) causes secretion of
gonadotropic hormones which stimulate secretion of
testosterone and oestrogens.
- Testosterone stimulates the development of secondary sexual
characteristics and production of spermatozoa in young men
- Oestrogen stimulates the development of secondary sexual
characteristics and the production of ova in young women.
- An excess in any of these hormones causes precocious puberty
and deficiency results in delayed sexual development.

C) Emotions:
Relationships with significant other persons, mother, father, siblings,
peers and teachers play a vital role in the emotional, social and
intellectual development of the child. If the child, the infant especially, is
not given the necessary care and love that promote healthy

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 development, growth and developmental retardation can occur. Such
emotionally deprived infants may eat adequately but will not gain
weight as expected. They will be listless, pale and unresponsive to social
overtures from adults, such as smiling, holding and cuddling. If
emotional deprivation continues, these infants will have repeated bouts
of illness, become emotionally ill, or die at a young age.

CONCLUSION:
The process of growth and development starts before the baby born i.e. from
the conception in the mother’s womb the period extends throughout the
lifestyle. The study of growth and development is essential to the nurses to
provide appropriate care to the children.

BIBLOGRAPHY:
1. Marlow R Dorothy, ‘Marlow’s Textbook of Paediatric nursing’, 2019,
South Asian Edition, Elsevier Publications, Page no: 101- 105
2. Datta Parul, ‘Paediatric Nursing’,2018, 4th Edition, Jaypee brothers’
medical publishers, Page no:109-111.
3. https://www.slideshare.net/JaysGeorge/factors-affecting-growth-and-
development-80786414
4. https://www.slideshare.net/jeena.aejy/factors-affecting-growth-
development-of-children