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Heredity Heredity is the passing on of characteristics from parents to their children Children inherit some physical characteristics from

parents. If a child inherired shortness, he or she will be short even with the proper nourishment Environment Children grow up in family. What children experience in the family affects their growth and development. Children who are loved grow up with a feeling of security. If their physical, emotional, and social needs are provided. Surroundings affect children. If the place they live in is polluted, children are likely to be sickly. Heredity and Genetic factors 1. Phenotype A phenotype is any observable characteristic or trait of an organism. Parental traits are transmitted to the offsprings. Height, size of the head, structure of the chest, fatty tissue.. etc. have better genetic association than other somatic characteristics 2. Characteristics of parents Parents of high IQ having children of the same and vice versa. 3. Sex Boys are heavier and taller than girls at birth and this is maintained till 11 years of age. Once again the boys grow taller than girls once they reach the prepubertal growth spourt. 4. Bio-rhythm and maturation Daughters attaining menarche at similar age as their mothers Similar length of menstrual cycle. 5. Genetic disorders Environmental factors 1. Physical surroundings Hygiene, living standards 2. Social factors

Relation with other family members, teachers, friends Factors affecting child development Growth and development is a complex process that depends on the inherent biological potential as well as various environmental influences including social, emotional and pathological factors. Important factors affecting child development are as follows I. Intrinsic (Biological) factors affecting child development determine the inherent pace, pattern and ultimate potential for growth & development, achievable under best environmental situations and include a) Age: General pace of growth is highest in intrauterine life and early infancy, decelerates gradually with advancing childhood, followed by a second growth- spurt with onset of puberty. b) Sex: Boys are usually heavier and taller than girls in early childhood but puberty begins and completes earlier in girls. c) Ethnicity: Caucasians and children of developed countries have better growth, due to inherent potential as well as good environmental factors e.g. good nutrition and less infections. d) Hereditary: Children of taller parents are usually tall and vice-versa. Age of menarche in daughters usually correlates well with that in their mothers. e) Genetic disorders are associated with inherently altered growth potential e.g. short-stature in Turner syndrome, achondroplasia etc. and tall-stature in Marfan syndrome etc. II. Extrinsic (Organic) factors affecting child development are prime determinants of growth and development in developing countries, which directly facilitate or limit the achievement of inherent growth potential. The exact effect of these factors affecting child development depends on the age, quantum and duration of exposure in relation to the period of growth. Important organic factors affecting growth/development include a) Prenatal factors affecting child development involving maternal health e.g. maffiutrition, infections and systemic diseases affects growth of offsprings in three different ways i) during the period of organ differentiation i.e. embryogenesis, leading to higher risk of abortions or congenital malformations; ii) during late fetal phase of anatomical and functional maturation, leading to intrauterine growth retardation (IUGR) or stillbirths, iii) during postnatal life, when matemal ill-health may affect emotional attention & quality of baby-care during critical phase of growth. b) Obstetrical or perinatal factors affecting child development: Preterms and/or Low birth weight (LBW) babies behave differently than term babies during postnatal growth period while preterms grow faster in late infancy (catch-up growth) than the term babies, small for gestational age (IUGR) babies are unlikely to show significant catch-up growth and have limited growth potential throughout the life. Other perinatal events e.g. asphyxia/injuries, sepsis, kernicterus etc. may also have disastrous effects on subsequent growth and development.

c) Postnatal factors affecting child development: Postnatal growth is largely governed by hormonal influences e.g. growth hormone in prepubertal period and sex-steroids during puberty; apart from adequate supply of substrates e.g. nutrition, oxygen etc. and freedom from infections. Malnutrition, chronic infections e.g. tuberculosis and systemic illnesses e.g. asthma,heart diseases etc. are most important adverse factors influencing postnatal growth and development. Head injury may lead to mental retardation while growth of a particular limb may be affected after fractures of long bones. Prolonged steroids/cytotoxic therapy are important causes of iatrogenic growth suppression. III) Extrinsic (environmental) factors affecting child development are important hindrances for normal growth in developing countries, which indirectly affect nutrition, infection rate and quantum of health care. These include a) Socio-economic factors affecting child development: Children of affluent parents have better growth due to better nutrition and hygienic conditions than those of low socioeconomic status. b) Cultural factors affecting child development: Child-rearing practices vary in different communities, which may significantly impact childs growth. Routine practice of breast- feeding is a positive growth-promoting factor, while delayed weaning, food taboos and unhygienic living conditions are important adverse cultural influences in India. c) Emotional factors affecting child development: Adequate emotional stimulation is essential not only for psychosocial and linguistic development of a child but also for growth. Lower growth hormone levels are well documented in emotionally-deprived children like orphans. d) Climatic factors affecting child development: Growth is slower in summer than in spring season, probably as infections are common and appetite is poor in hot and humid climate. Climate also affects the food productivity.

Nutrition is perhaps the most influential non-genetic factor in fetal development.1 Maternal body composition, nutritional stores, diet, and ability to deliver nutrients through the placenta determines nutrient availability for the fetus.1 Prenatal nutrition influences fetal growth, normal development of physiological function2 and gestational weight gain (GWG). GWG is a complex progression that supports fetal growth and development. Maternal physiology and metabolism as well as placental metabolism also influence GWG. Maternal homeostasis changes can alter placental structure and function, influencing fetal growth.3 During the 1960s, high rates of infant mortality, disability and mental retardation in the US were realized to be a function of low birth weight. By 1970, the National Academy of Sciences reported that restricted weight gain for pregnant women was associated with increased risk of low-birth-weight infants. In 1990, the Institute of

Medicine (IOM) established weight-gain ranges for pregnant women, which were extensively adopted in the US to improve infant birth weights.4 In 2009, the IOM and Health Canada revised their guidelines to reflect the relevance of maternal body composition before conception. More women of childbearing age are severely obese, making maternal health concerns as well as infant birth size both relevant for maternal weight. Additionally, women become pregnant at an older age and more commonly enter pregnancy with chronic conditions (e.g. hypertension or diabetes), increasing the risk of pregnancy complications.3 (Table 1) During pregnancy, maternal weight gain affects fetal growth. 4 Small neonate size at birth is attributable to poor growth and shortened gestation, and the most unfavourable outcomes occur in the most immature infants. Low rate of pregnancy weight gain is associated with increased risk of preterm birth4, whereas low secondor third-trimester weight gain has been shown to be associated with spontaneous preterm delivery risk. Two factors related to maternal nutrition show a positive connection with infant birth weight: maternal prepregnancy body mass index (BMI, defined as weight/height2) and weight gain during pregnancy. Women with low prepregnancy BMI are at increased risk for preterm birth and intrauterine growth retardation (IUGR). However, women with low prepregnancy BMI are at increased risk of preterm delivery only if they fail to gain adequate weight.5 Appropriate GWG within target ranges can help improve maternal and fetal health.6 Inadequate GWG has been associated with low birth weight (<2500 g) and gaining more weight than recommended with high birth weight (>4000 g) and postpartum weight retention. Data from the Canadian Maternity Experiences Survey 20067 show that pregnant women who gain less weight than recommended are likely to give birth to infants weighing less than 2500 g vs. normal-weight (2500 to <4000 g), full-term infants (44% vs. 24%, respectively).8 Many Canadian women gain well above the recommended weight gain ranges as well.6 Based on the same 2006 survey7, 55% of overweight, 41% of normal weight and 26% of underweight women fall into this group. A majority of women (58%) who gain more weight than recommended deliver infants weighing 4000 g or more.8 Nutrition During Pregnancy and Breast-Feeding A complete balanced diet to support healthy fetal growth and development is required for the nutritional demands of pregnancy. Maternal nutrition determines birth weight outcomes as well.6 Low-protein diets are associated with adverse outcomes and should be avoided. Breast-feeding women also have increased nutritional needs. Energy requirements are actually higher during breast-feeding vs. pregnancy. To ensure proper nutrition, pregnant and breast-feeding women should eat a healthy diet, including multiple nutritious foods, and consume the recommended number of servings from the four major food groups of the Canadian Food Guide.

A healthy diet helps children grow and learn. It also helps prevent obesity and weight-related diseases, such as diabetes. The following guidelines will help you give your child a nutritious diet:

Offer five servings of fruits and vegetables a day Choose healthy sources of protein, such as lean meat, nuts and eggs Serve whole-grain breads and cereals because they are high in fiber Broil, grill or steam foods instead of frying them Limit fast food and junk food Offer water and milk instead of sugary fruit drinks and sodas

To develop to their optimal potential, it is vital that children are provided with nutritionally sound diets. Diet and exercise patterns during childhood and adolescence may spell the difference between health and risk of disease in later years. Different stages of the life cycle dictate differing nutrient needs.

What are the most important nutritional considerations in the first year of life?
In the first 12 months of life a baby will triple its weight and increase its length by 50 per cent. These gains in weight and height are the primary indices of nutritional status and their accurate measure at regular intervals are compared with standard growth charts. These measurements are important tools for monitoring a child's progress particularly during the first 6 to 12 months of life. Breast-feeding on demand remains the ideal form of feeding for healthy babies who are born at term. Human milk provides optimum nutrition for growth and development. The first 4-6 months are a period of very rapid growth, particularly for the brain, and the amino acid and fatty acid composition of breast milk is ideally suited to meet those needs. Breast milk also contains anti-bacterial and antiinfection agents, including immunoglobulins, which have an important role to play in boosting immune function. The colostrum, which is the fluid produced by the mammary gland during the first few days after birth, is rich in protein and has high levels of minerals and vitamins. Colostrum also contains antibodies, anti-infection agents, anti-inflammatory factors, growth factors, enzymes and hormones, which are beneficial for growth and development. Breast-feeding is strongly advocated for physiological, psychological and emotional reasons. There is no reason why breast-feeding should not continue for as long as it is nutritionally satisfactory for mother and child up to 2 years. However, with changing lifestyles and the availability of commercially prepared formulae, prepared formulae are generally safe provided that an approved infant formula is used under strict hygiene conditions. The infant formulae attempt to mimic as far as possible the composition of human milk and their use must comply with guidelines laid down by the European Union and the World Health Organization. Formula-fed infants also need to be demand fed and the formulae must be made up exactly according to the manufacturer's instructions for optimal growth. Special attention has to be taken to sterilise all the feeding equipment to reduce the potential risk of contamination, because formula-fed babies do not have the same degree of immunological protection as breast-fed babies.

When should solid foods be introduced?

Introduction of complementary solid food is usually a gradual process over several weeks or months, starting at about 6 months of age. The exact timing is determined by the individual infant and mother, and reflects the fact that breast milk will suffice in those first months but will no longer be able to provide adequate nutrition by itself as the baby grows. The introduction of complementary

foods by about 6 months is important to ensure normal chewing and speech development The quality, number and variety of solid feeds can be increased gradually at a pace that will be generally dictated by the child. Cereals are generally the first foods that are introduced into the infant's diet (mixed with a little breast milk or formula), with pures of vegetables and fruits and meats to follow. By exclusive breast feeding up to 4 to 6 months of age, the likelihood of allergies is lessened. Foods that are more likely to cause allergic reactions in sensitive children, such as egg whites and fish, are generally introduced after 12 months of age. With present changes in lifestyle, commercially available baby food plays a growing role in the diet of children and should therefore meet strict standards of quality and safety. The convenience and variety of foods available make them a good option to use to complement home-prepared foods. Commercial baby foods are prepared from fresh fruits, vegetables and meat with no added preservatives and must meet very strict standards. An important consideration in the first year of life is the amount of iron supplied in the diet and iron deficiency anaemia is routinely screened for during infancy. The use of an iron-fortified formula or cereal, and the provision of iron-rich foods such as pureed meats can help to prevent this problem.

What are the most important nutritional considerations for toddlers (1-3 years of age)?
During these years, a child begins to take on its own unique personality and to exert its independence by moving around freely and choosing foods to eat. Although the child is still growing, the rate of growth is slower than in the first 12 months of life. At the end of the third year of age, girls and boys will have achieved about 50 per cent of their adult height. During this period a child becomes able to drink through a straw and eat with a spoon, and frequently they become "fussy" eaters. The provision of a variety of foods will allow the child to choose from a range of foods with differing tastes, textures, and colours to help satisfy their appetite. The most important factor is to meet energy needs with a wide variety of foods. Food intake will be influenced increasingly by family eating patterns and peers. Early food experiences may have important effects on food likes and dislikes and eating patterns in later life. Meal times should not be rushed and a relaxed approach to feeding will pave the way for healthy attitudes to food.

What are the most important nutritional considerations in school-aged children?

After 4 years of age, a child's energy needs per kilogram of bodyweight are decreasing but the actual amount of energy (calories) required increases as the child gets older. From 5 years to adolescence, there is a period of slow but steady growth. Dietary intakes of some children may be less than recommended for iron, calcium, vitamins A and D and vitamin C, although in most cases deficiencies are unlikely, as long as the energy and protein intakes are adequate and a variety of foods, including fruit and vegetables, are eaten. Regular meals and healthy snacks that include carbohydrate-rich foods, fruits and vegetables, dairy products, lean meats, fish, poultry, eggs, legumes and nuts should contribute to proper growth and development without supplying excessive energy to the diet.

Children need to drink plenty of fluids, especially if it is hot or they are physically active. Water is obviously a good source of liquid and supplies fluid without calories. Variety is important in children's diets and other sources of fluid such as milk and milk drinks, fruit juices and soft drinks can also be chosen to provide needed fluids.
What is Sensory Stimulation? In its simplest terms, sensory stimulation refers to the impact the environment has on our minds and bodies as we receive information through our five senses. This form of stimulation is vital in early development (zero-to-five) for brain development and early learning. Years of research has proven that children who receive adquate stimulation achieve higher IQ scores than those who lack or receive improper stimulation. So, what is proper stimulation? At birth, an infant's brain is inmature and requires stimulation to fully develop. However, this requires appropriate dosification. Too much sensory-stimulation will cause an overload of information, which in turn will hinder the ability of the brain to learn and make new connections. For example, many parents have witnessed how easyly babies become irritated when over-exposed to music, lights or even touch. This emotional reaction signals that they feel overwhelemed by the amount of information received and cannot cope. How much is too much? Age, development, and individuality, all play a role in identifying the optimal stimulation threshold in a particular child. As a general guideline, stimulation activities should be limited to three sessions per day and not to exceed fifteen minutes per session. Your child will tell you when too much' is too much'. Does he become irritable after ten minutes? Does he push away the toys? Learn to read his cues and remember that sensory-stimulation activities are to be short in duration and individualized.

Kakambal ko
Taong 1975 nang ipinanganak ang dalawang bata na may iisang ina. Minuto lamang ang pagitan ng una sa huli. Pinangalanan ang una na Emmanuel at ang huli ay ako si Manuel. Magkamukha sa lahat ng pisikal na kaanyuan ngunit magkaiba ng pag-katao kami ni kuya. Siya ay lumaking mapagmahal sa aming magulang, masipag sa lahat ng bagay kayat gusto ng lahat.Paborito siya ng lahat at iyan din ang dahilan kung bakit pinili ko ang maging iba kay kuya. Sa eskwela lahat ng klase ng pang-aasar sa guro ko ay nagawa ko na. Halos ipagtabuyan na nga ko papalabas sa pintuan ng klase. Sinusuka na ako ng lahat ng nalipatan kong paaralan. Walang may gusto sa akin sa buong eskwelahan maliban kay kuya. Matiyaga nga lamang si Mama at patuloy na umaasa na balang araw ay titino din ako. magiging kagaya ni Kuya. Mabait talaga si kuya Emmanuel at kahit sa akin ay nararamdaman ko ito. Ang hindi niya pagsusumbong kay Papa sa tuwing mag-cutting classes ako upang panoorin ang palabas sa sine kahit pa nga iilang beses ko na itong inulit. Pagpapayuhan lamang niya ako na hindi tama ang aking ginagawa at sasagot naman ako na ito talaga ang gusto kong buhay. Maging iba sa kanya. Pinili ni kuya ang maging isang ganap na Doktor pagkat nais daw niyang tulungan ang lahat ng may karamdaman.Nagpursige siya na makatapos. Ginawa nga ito ni kuya na halos lahat ng kanyang ginagamot, nang maging ganap na doktor na siya ay Libre. Lahat ng oras niya ay ginugol sa mga nangangailangan sa kanya. Sabi ko nga matalino nga siya ngunit nagpapaloko naman.

Kung pagtulong sa kapwa ang pagkakakilala ng lahat kay kuya ay ako naman ay kilala bilang tarantado sa lugar namin, magnanakaw, mangloloko. Nagpakasama talaga ako. Masamang-masama. Dumating ang pinakakatakutan kong oras ang malulong sa bisyo ng bawal na gamot. Tinikman ko lahat at naging paborito ang paghithit nito. Sunog-baga ako. Sinunog ko pati na kaluluwa ko. Kung noon ay kinikilala ko pa si Kuya, si Papa at si Mama...ngayon wala na. Hindi ko sila kilalang lahat. Ang kilala ko lamang ay ang pinakamamahal kong alak at droga. Mas naging talamak ang panggagantso ko upang matustusan ko lamang ang bisyo ko at pumatay ako...pinatay ko ang asawa ni Mayor ng tumangging pautangin ako. Ngayon, utang na buhay din daw ang kabayaran sa ginawa kong pagpaslang sa asawa niya. Nagtago ako...Nagpakalayolayo. Si kuya Emmanuel pa rin ang tinakbuhan ko, ang hinihingan ko ng tulong nang maubusan ako ng pangangailangan upang mabuhay. Hindi naman siya nagdalawang salita. Siya na daw ang bahalang gumawa ng paraan upang maging malaya akong muli. Tulad ng dati ay umasa ako at naniwala sa kanya na siya na muli ang makakatulong sa problemang pinasok ko dahil alam kong hindi niya ako pababayaan. Tulad noong maliliit pa kami na siya ang sumasalo sa akin, sa may mga galit sa akin. Mahal na mahal ako ni kuya (mahal ko rin siya kahit lihim lang ito sa akin). Bukas bibitayin na si Manuel sa pamamagitan ng Lethal Injection sa salang pagpatay sa asawa ni Mayor at sa iba pa nitong mga pagkakasalang ginawa ang nabasa ko sa Dyaryo. Papanong nangyari eh nandidito ako sa malayong lugar at nagtatago,Putcha! si kuya. Si Kuya nga. Tulad ng dati ay gagawin niya ang lahat para sa ikaliligtas ko. Humangos ako.Umuwi sa amin. Sumuko. Sir, Judge hindi siya at ako ang may kasalanan sa lahat. Ako po Sir...ako. Huli na Emmanuel at nasentensyahan na kanina pa ang kuya mo. Patay na siya. Pinanagutan na niya ang kasalan mo tulad ni Kristo na niligtas tayo. Magbagong buhay ka na lamang upang maging masaya naman siya sa kabilang buhay. Bumalik ako sa bahay at niyakap si Mama. Ngayon ay nag-aaral ako muli at planong kumuha ng kursong Medesina at makatulong sa iba tulad ng nais ni kuya Emmanuel. end.