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Insufficient growth in children

Insufficient growth in children

Question:

- We have a little girl of 6 months and a half and we started diversifying the diet from 3 and a half months. Now although he eats 5 meals a day plus breast milk, for about 2 months he has only fattened 400gr, now he has 6kg and 200gr. I have to tell you that at 5 months he had chickenpox and at the analysis he came out with anemia. I gave him syrup with iron, pickled and vitamin c but after he passed the chicken pox did not put on weight. What do you advise me to do?

Answer:


Insufficiency of growth in infants and young children is of 2 types:

  • primary: which is a component of some diseases and is called "staturo-weight hypotrophy"
  • secondary: caused by a food deficit, also called malnutrition (dystrophy).
    Staturo-weight hypotrophy occurs under the conditions of a proper dietary intake, but in the presence of organic causes (congenital malformations, metabolic diseases, fetal infections such as toxoplasmosis, syphilis, etc.) being frequently associated with a low birth weight.
    Malnutrition, however, occurs in children who have had a normal birth weight, as a result of a qualitative or quantitative deficit in food intake, as a result of chronic, dragging infections (bronchopneumonia, otomastoiditis, urinary infections, diarrhea, TB, etc.), lack of care (absence of the mother, neglect of the rhythm of feeding, hospitalization, pollution, cold).
    The assessment of the physical development of the baby takes into account both the birth weight and the weight in relation to the age and the waist. In the first year of life the weight growth rate is on average 750g / month in the first 4 months, 500g / month in months 5-8 and 250g / month in months 9-12.
    In case of insufficient growth, the doctor performs a nutritional balance, taking into account certain criteria:
  • anthropometric: the weight index (IP = G. real / G. ideal for age), the statural index (IS = real height / height for age), nutritional index (IN = G, real / G. corresponding to waist), skull perimeter, fold cutaneous etc.
  • clinical: the presence of adipose tissue, the appearance of the weight curve, the condition of the teguments (friable hair and nails, skin depigmentation, seborrheic dermatitis, peeling, paleness, etc.), trophic and muscle tone, bone age and development of the tooth.
  • functional: appreciation of digestive tolerance, resistance to infections and neuropsychological development
  • biochemicals: which include paraclinical investigations meant to detect both the degree of nutritional deficiency and to identify any possible factors (eg infections).
    Therefore, I advise you to consult your pediatrician for a clinical and paraclinical record, which can determine if it is a dystrophy, determine its cause and indicate a therapeutic behavior.
    Alina Pop-Began
    - Resident physician - Anesthesia and Intensive Care -

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