Postnatal hypotrophy: methods of treatment and diagnosis of the disease

Postnatal hypotrophy is a chronic acquired disorder. Nutrition due to insufficient intake or impaired nutrient absorption is characterized by a decrease in body weight, occurs in children under two years of age, often in the first year of life.

Factors contributing to the occurrence of postnatal hypotrophy:

• alimentary - hypogalactia, incorrect sucking habit in a child due to the flat shape of the nipple or the use of a dummy, later the introduction of complementary foods( after 6 months), improper introduction of complementary foods( with juices).
• infectious( intestinal infections, acute respiratory diseases)
• developmental defects( cleft lip and palate, megacolon, pyloric stenosis)
• constitutional features
• childcare defects
• intoxication( hypervitaminosis D)
• prematurity
• birth injury CNS
• endocrine pathology( diabetes mellitus, adrenogenital syndrome)

Clinical picture of postnatal hypotrophy

Clinic of the disease differs depending on the degree, postnatal hypotrophy can be of three stepsEney.

• I degree of hypotrophy is characterized by a decrease in body weight from 10 to 20% of the norm, a decrease in the thickness of subcutaneous fat on the whole body, except for the face, especially the thinning of the subcutaneous fat layer on the abdomen. The skin is pale, with reduced tissue turgor. Growth and development of the child does not lag behind. The child's well-being is satisfactory, sometimes there may be a disturbance of sleep, anxiety. Muscle tone is reduced. Stool and urination are not violated.
• II degree of hypotrophy, characterized by a decrease in body weight from 20 to 30% of normal, subcutaneous fat disappears on the abdomen and chest, thinning on the face and extremities. The child lags behind in growth and psychomotor development. There is hypodynamia, weakness, irritability, sleep disturbance, decreased appetite. Skin pale, turgor sharply reduced, children easily overheat and supercooled. Immunity decreases. On examination, muffling of heart sounds and enlargement of the liver are detected. The chair is unstable, constipation alternates with diarrhea. Often observed "hungry feces" - dark, dense, dry with a very unpleasant odor. At laboratory research the anemia, a hypoproteinemia, depression of activity of digestive enzymes is revealed.   
• III degree of hypotrophy( atrophy), characterized by child exhaustion and weight loss of more than 30% of the norm and the absence of subcutaneous fat, sometimes a very thin layer on the cheeks can be retained. The delay in growth and development is very pronounced. There is a sharp weakness, lethargy, there is no reaction to external stimuli, or very weak. A large fontanel and eyeballs fall. Mucous membranes are dry, bright red. The skin fold is not straightened, the skin is dry and pale with a grayish tinge. Atrophy of muscles, muscle tone increased. Breathing is superficial, often pathological, apnea may occur. Heart sounds are deaf, Pressure is lowered. The abdomen is swollen, there is "hungry feces".Urine is small. The body temperature is lowered, the immunity is sharply reduced.

Methods of diagnosing postnatal hypotrophy

1. Evaluation of nutrition
2. Inspection - evaluation of thickness of subcutaneous fat, skin condition, auscultation, palpation
3. Calculation of body mass index
4. Laboratory studies

Methods of treatment of postnatal hypotrophy

• Dietotherapy, organization of proper child care, elimination of vitamin deficiency andmetabolic disorders
• With hypogalactia - drugs that enhance lactation, the introduction of high-calorie mixtures in the diet of the child
• Sanitation focuss infections
• General strengthening procedures, massage, exercise therapy
• With atrophy parenteral nutrition, stimulants, hormones