Dystrophy in children (malnutrition)

Dystrophy in children (malnutrition) is a chronic disorder of the power, one of the main manifestations of which is gradually growing depletion of the child. Distinguish between mild and severe forms of malnutrition. A clear boundary between these forms is often difficult to determine. Advanced form of malnutrition is called atrophy.
The etiology and pathogenesis. The causes of the development of dystrophy in children, is very diverse. It may be due to external and internal factors. The most common cause (external factor) - malnutrition in both quantitative and qualitative terms. Quantitative lack of food often is associated with malnutrition and may be from the first days of a child's life (lack of milk from the mother, the presence of tight breast cancer or flat and inverted nipples, sluggish sucking). Insufficient sucking more common in premature infantsand newborns in asphyxia and intracranial birth trauma. Obtaining sufficient quantities of food can interfere with various congenital malformations (cleft upper lip and hard palate, the pyloric stenosis and others). Malnutrition develops and as a result of the lack or absence of one of the major components of food (for example, protein, vitamins, salts), in violation of their right balance. Qualitative errors in diet, there are more mixed and artificial feeding. Of great importance to adverse environmental conditions (non-sanitary-hygienic regime, the lack of air, light, etc.), irregularity care. Some children who have dystrophy developed mainly due to the lack of appetite under the influence of improper feeding, medication, forced feeding. Infections and chronic diseases contribute to the development of dystrophy due to metabolism and the activity of regulatory mechanisms. With all these circumstances, the food entering the body, does not cover its needs; as a result, spent their own stocks of the child, which leads to depletion. In starvation distorted activity of all body systems, develops disorders of all kinds of currency. Such children have reduced the body's resistance and they are prone to various diseases, which flow from them seriously and are often the cause of death.
The clinic. The main manifestation dystrophy (malnutrition) -reducing the subcutaneous fat layer primarily on the abdomen, and then on the back, chest, limbs, and later on her face. 's happening. slow and even stop gaining weight, it becomes less normal.
There are three degrees of malnutrition. Hypotrophy of 1 degree is characterized by a delay in the weight by 10 to 15%, but the child has normal growth. It is noted decrease in subcutaneous fat on the abdomen and partly on the limbs. Skin color is normal or slightly pale, the overall condition is not disturbed.
When malnutrition 2 degree child's weight behind the norms of 20-30%, and there is a small lag in growth (1-3 cm). Subcutaneous fat layer is reduced everywhere. Child pale, a turgor of tissues is reduced, the skin folds of fat, flabby muscles. Violated the General condition, sleep, decreased appetite, mood becomes unstable, impaired or delayed development of static and motor functions.
Hypotrophy of the 3rd degree is characterized by a weight reduction of more than 30%, severe malnutrition and growth retardation. Subcutaneous fat layer is missing, the eye sink, forehead wrinkles, his chin pointed, the senile face. Muscles are flabby stomach pulled in, a large fontanel falls in, conjunctiva and the cornea of the eyes is prone to drying out and ulceration, Breathing shallow, slow-motion, the pulse is weak, heart sounds are muffled. Appetite is reduced, but there is a thirst, a tendency to diarrhea. Urination oregano. Develops hypochromic anemia, with a sharp thickening of the blood , the hemoglobin , and the number of erythrocytes. Children are oppressed, voice aforizmy, delayed development of static and motor skills, speech.
Diagnosis dystrophy in children (malnutrition) is established on the basis of the anamnesis, appearance of the child, clinical assessment, weight, height.
Treatment of malnutrition is a complex taking into account individual characteristics of the child, the conditions under which development of the disease. In severe forms - symptomatic, pathogenetic and stimulating therapy. It is very important to assign food. So, with malnutrition 1 degree must first assign your child nutrition is based on the weight that should be with him accordingly. The lack of breast milk in the mother appoint supplemented donor milk or formula. When artificial feeding temporarily appoint women's milk and mix.
With malnutrition 2 degree milk or sour mix appointed at the rate of 2/3 or % of the number required for the child's age (see Feeding children). If the child's weight has been reduced by 20%, the total amount of food rely on actual weight. If more than 20%, leading to an average weight, i.e. the actual plus 20% of it. The lack of volume of food Supplement fruit and vegetable broths, 5% glucose solution, juices. The number of feedings increased to 7-8 times a day.
After 5-7 days, the improvement of the child increases the amount of food, but calorie should not exceed 130 to 150 calories per 1 kg of body weight. If necessary, correction of proteins, carbohydrates and (gently) fats.
Especially gently appoint power with malnutrition 3 degrees. Daily calculation of the power produced by average weight between the intended and actual. In the early days of treatment irrespective of age shall only half of the required number and only breast milk. If you cannot provide the child with a sufficient number of women give milk sour mix. The lack of volume of food Supplement at the expense of liquid. The increase in the daily number of meals carried out very carefully, even when clear trend towards improvement. Calorie on the actual weight should not exceed 180 calories per 1 kg of body weight. All children with malnutrition need the vitamins and enzymes. To improve appetite appoint gastric juice 1/2-1 teaspoon 5 times a day, or 1% solution divorced hydrochloric acid with pepsin before feeding, Pancreatin 0,2 g 2 times a day in an hour after meal for 7-10 days. Shown by appointment of anabolic hormones (see Anabolic steroids). Activities to combat dehydration are conducted, as in toxic dyspepsia (see Dyspepsia in children). In severe cases, it is recommended that plasma and blood.
Prevention. Proper organization of General regime and feeding.
The prognosis depends on the extent of the disease, reactivity and timely treatment.