What is Child Hypotrophy?
Hypotrophy is a children’s pathology that can be congenital or acquired in nature, manifests itself as a large lack of weight.
The acquired form of malnutrition speaks of the wrong diet of the baby, about the lack of any substances. After birth, in some cases, the baby begins to lose body fat, the muscular skeleton is weak, and growth is slow. With a complex form of the disease, the child’s body practically does not resist the causative agents of infectious diseases, physiological disorders of the body gradually occur.
Hypotrophy can be fatal. This is due to malnutrition, because the body is open to the effects of most dangerous external factors.
A congenital form of malnutrition appears in a child during growth. Among the causes of illness of a pregnant woman, intrauterine hypoxia, heredity, infectious diseases of the fetus.
Hypotrophy and secondary infections
As noted above, with malnutrition, it is difficult for a child to cope with infections. Influenza, which is not dangerous for healthy children, in a child with malnutrition proceeds in complicated forms, the course is protracted. Common complications: latent mastoiditis, otitis media, bronchopneumonia.
Infections caused by pathogenic coli bacteria lead to malnutrition and – in most cases – to coli sepsis. Often there are long-lasting skin infections that are caused by pyogenic bacteria. Hypotrophy is also enhanced by interstitial plasmocellular pneumonia, which happens in the form of nosocomial endemicity. It is dangerous not only for children with malnutrition, but also for premature babies.
Infections that join hypotrophy are more likely to be fatal in any form of the disease. The reason is that the process of hypotrophy is accelerating, as well as infectious diseases begin to proceed very unfavorably. In third world countries, high mortality in children with classic infections is caused precisely by frequent malnutrition. For example, measles in developing countries 2-3 times more babies die than in developed countries.
Causes of Hypotrophy in a Child
Finding out the cause of malnutrition in a child is important for prescribing adequate treatment. Conduct a survey. There are times when a child has several diseases at once, and then they rapidly worsen the condition of the baby.
Common causes of malnutrition:
- organic diseases
- malformed diet
- lack of nutrition
- structural features of the baby’s body
- diarrhea that lasts for a long time and can occur with gastrointestinal tract disorders and malabsorption
- premature birth
- frequent or chronic infections
- poor quality of feeding the newborn
- environmental factors
Pathogenesis during Hypotrophy in a Child
Whatever the cause of malnutrition, this disease is always associated with partial starvation. If measures are not taken to stop hypotrophy, pathophysiological changes progress. In severe forms of the disease, the body becomes unable to maintain and regulate physiological constants: clearance decreases, blood circulation slows down, and the main metabolism decreases.
In children with a diagnosis of malnutrition, the body overheats and cools excessively due to the malfunctioning of many systems in the body. In children with the diagnosis in question, exposure to hypothermia is recorded. At normal temperatures, the body of a healthy child maintains a standard temperature, and a child with malnutrition cools down in just a few hours.
Children with malnutrition cool off quickly due to increased heat loss (the ratio of body surface to weight increases, the fat layer disappears) and due to the lack of chemical thermoregulation. Exposure to hypoglycemia is also dangerous for the baby’s life. Even 2-3 hours of fasting can lead to pronounced hypoglycemia.
But the ability to tolerate hypoglycemia in babies with malnutrition is very high. Signs Signs of severe hypoglycemia appear only when the blood sugar level becomes very low. A feature of hypoglycemia in case of malnutrition is the rarity of seizures.
Before the seizure, there is pallor, sometimes nystagmus. Then for 20-40 seconds breathing stops, the pulse slows down. After apnea, the child takes 2-4 convulsive breaths. If you do not help, the child will die due to paralysis of the respiratory muscles. In case of a seizure, the child needs an injection of glucose, then the condition quickly normalizes.
The ultimate causes of the violation of physiological functions in case of malnutrition have not yet been fully clarified. It is believed that the loss of somatic stability occurs due to dysfunction of the endocrine glands. The fact that during fasting the weight of the pituitary gland, thyroid gland, adrenal glands and gonads decreases is precisely established. Injection of the pituitary gland extract of normal animals by hypotrophic causes a rapid increase in the weight of those glands that are regulated by the pituitary triple hormones. Therefore, it is suggested that in the preterminal phase of prolonged partial starvation, a state of pseudohypophysectomy occurs, as it were.
Symptoms of Hypotrophy in a Child
Acquired hypotrophy in a child is characterized by the following symptoms:
- abnormally low body weight
- subcutaneous tissue deficiency
- loss of activity unlike recently
- reduced turgor of the subcutaneous fat
- dry skin and a clear lack of moisture on the mucous membranes
- changes in the face and body of the child
- visually the head seems larger than the rest of the body
- skin tightening and wrinkling
- lean muscle mass
- bones are “drawn” on the body
Underweight is of three degrees: first, second, third. Changes in the first degree are visible primarily on the abdomen. Muscle tone is noticeably reduced. Pale skin is noted. Large bruises appear under the eyes, in addition, the skin dries and loses elasticity. At the first degree of malnutrition, the weight of the child lags behind the norm by 15-20%, growth is normal, development is normal. The child can be capricious, be overly irritable, sleep poorly. There may be frequent spitting up and anemia.
In the second degree, there is completely no fat under the skin on the tummy, arms and legs, but it is still on the cheeks. The skin becomes grayish, flabby, with folds. Cracks appear in the corners of the mouth, brittle nails and brittle hair develop, as well as their loss. Breasts become not just irritable, but constantly crying. There is a lag in development. Symptoms such as anemia, pons are observed (not in all cases). Weight reduction – up to 30%.
The third degree of malnutrition in the child is the most severe. There is no body fat throughout the body. The skin is pale and dry, there may be cracks in the folds. Weight lost by more than 30%. Bloating may occur.
Diagnosis of Hypotrophy in a Child
Diagnose malnutrition according to the following criteria:
- Chulitskaya’s fatness index
- backlog of mass
- whether the structure and functioning of internal organs is disturbed
Doctors determine the cause, degree and severity of the disease. Carefully collect an anamnesis in which there may be insufficient nutrition. If the child is fed normally, but he does not gain weight from birth, then this may indicate a congenital form of the disease. If the baby developed normally after birth, and then stopped gaining weight, he is suspected of an infectious disease.
If no causes are found in the diet and infectious diseases, look for more rare metabolism, enzymopathy. Edema is almost always associated with a lack of protein in food, and sometimes with a loss of protein in the body.
Treatment of Hypotrophy in a Child
In a room where a child with hypotrophy is most of the day, you need to maintain a temperature of 24-27 ° C. You should control the clothes of the child when walking, as well as the time spent outside the apartment. If the street temperature is below 5 ° C, a child with malnutrition should not be taken out of the room.
Great attention should be paid to the hygiene of hypotrophs, because their immunity is very low. After the stool, the child is washed and treated with a baby moisturizer. Carefully choose clothes, paying attention to its composition. Coarse seams should not adhere to the body. Preference is given to natural fabrics. In other cases, the child may have allergies and skin irritations.
Create positive emotions every day for your child. Play with them more often. The child should eat properly, balanced and regularly. Use breast milk or special mixtures that are suitable for sick babies and babies with underweight for nutrition of newborns. Add vitamins and nutrients that the body needs in infants to the diet.
Food is divided into 2 phases. The body needs to be taught that the amount of carbohydrates, fats and proteins will increase. After getting used to, the baby’s body can be transferred to standard baby food in doses corresponding to the age of a healthy child. Despite the measures taken, hypotrophy can develop if it is based on a congenital severe defect or an abnormal metabolic disorder.
The prognosis is good with conventional malnutrition and adequate treatment. In severe forms of malnutrition, the prognosis depends on how much the baby is protected from secondary infections, especially from plasma-cell pneumonia, coli-enteritis, and repeated banal infections.
Symptomatic hypoglycemia worsens the prognosis, which suggests that hypotrophy is in the third degree. The chances of surviving a child in this case depend on his age. The prognosis is worse with concomitant malformations. The prognosis improves the favorable environment in which the child is after treatment in a hospital. After prolonged hypotrophy in infants, mental development may be impaired.
Prevention of Hypotrophy in a Child
Preventive measures are taken during pregnancy of the mother. A pregnant woman should eat regularly and balanced, sleep enough time and walk in the fresh air.
After giving birth, it is also important to monitor the diet. It should contain foods with enough protein, carbohydrates and fats, as well as vitamins. They try to keep the child on breastfeeding, timely introduce complementary foods into the diet. The child should be enough in the fresh air. If you suspect any disease, you should immediately consult a pediatrician by going to North Raleigh Pediatrics home page.