Three degrees of hypotrophy and ways to determine them

Hypotrophy is a malnutrition that relates to dystrophy and is characterized by a decrease in trophism of the tissues, growth and weight of the child. At a hypotrophy metabolic processes which lead to backlog in physical development of children are broken.

Depending on the time of occurrence, the congenital and acquired forms of hypotrophy are differentiated, and the overall incidence varies from 3 to 5% of all childhood diseases.

How to determine the degree of hypotrophy?

Degrees of hypotrophy mean how much the symptoms are expressed, and what weight deficit there is in relation to the growth of the child. So, for example, a born child is diagnosed with "grade 1 hypotrophy" in newborns, if he was born in gestation over 38 weeks, has a body weight of 2800 grams or less, and a body length is less than 50 cm. If a child has acquired form of hypotrophy, then calculate the so-called "index of weight loss" or fatness index by Chulickaya( professor at the University of Physical Education, St. Petersburg).

ISIC( fatness index of Chulicki) is the sum of the circumference of the shoulder, hip and lower leg, from which the length of the child's body is subtracted. Calculations are carried out in centimeters, and in normal children under the age of one year this figure is 25-30 cm. If children develop hypotrophy, this index decreases to 10-15 cm, which indicates the presence of grade 1 hypotrophy.

Deficiency of body weight is also calculated by the formula that is available to all pediatricians. The table contains the weight indicators to be added monthly:

• 1 month after birth - 600 y.
• 2 and 3 months - 800 yr.
• 4 month - 750 y.

The calculation of the fifth and all subsequent months is equal to the previous weight minus 50 g

When measuring the degree of hypotrophy, the actual weight of the child is compared and the one that is calculated according to the table according to age. For example, the child was born with a weight of 3500 g, and at the age of 2 months weighs 4000 g. The actual weight should be 3500 + 600 + 800 = 4900 g. The deficit is 900 g, which in percentage is 18%:

4900 g - 100%

900 g - X%

X =( 900 x 100) / 4900 = 18%

• Hypotrophy of the 1st degree - is given with a weight deficit of 10% to 20%.
• Hypotrophy of the 2nd degree - is given with a weight deficit of 20% to 30%.
• Hypotrophy of the third degree - is given with a weight deficit of 30% or higher.

Symptoms of 1 degree of hypotrophy

Each degree of hypotrophy has its clinical picture, signs and characteristic symptoms, which also can determine the stage of the development of the disease.

Symptoms characteristic of grade 1 hypotrophy are as follows:

• ISUD is 10-15 cm
• The subcutaneous fatty layer disappears on the abdomen.
• Skin folds are flabby and straightened slowly.
• Elasticity of soft tissues is reduced.
• Muscles become sluggish.
• Body weight below normal weight by 10-20%.
• There is no lag in growth.
• The child's well-being does not suffer and the psyche is not broken.
• The child is often ill with infectious and other diseases.
• There is a slight digestive disorder( regurgitation).
• Irritability and sleep disturbance appear.
• The child becomes restless and quickly gets tired.

Treatment of such a degree of hypotrophy is not difficult, and it is possible to normalize weight when regaining the regimen( the entire volume of food is divided into 7-8 receptions) and diet. The diet is dominated by carbohydrates, cereals, fruits, vegetables.

Signs of 2nd degree of disease

Hypotrophy of the 2nd degree is characterized by the following symptoms and signs:

• ISHU becomes less than 10 and to zero.
• The fat layer is absent practically on the whole area of ​​the body.
• Sucking and sagging appear on the skin.
• Joints and bones are clearly visible.
• There is a decrease or lack of appetite.
• Vomiting, nausea and frequent spitting of food.
• Irregular and unstable stool, and in stool there are remnants of undigested food.
• Signs of avitaminosis - dry hair, brittleness and thinning of nails, cracks in the corners of the mouth.
• Deficiency of weight reaches 20-30%.
• Growth lag is observed.
• Symptoms from the nervous system - lethargy, anxiety, fatigue, crying, irritability, sleep disturbance.
• Violation of the process of thermoregulation( the child quickly overheats and cools).
• Infectious diseases kid is sick often and for a long time.

Treatment of this degree of hypotrophy can be carried out both at home and in a hospital. For treatment, increase the number of feedings and reduce portions of food. From medicinal agents prescribe biostimulants, vitamins, minerals, enzymes.

Symptoms of 3rd degree of hypotrophy in children

This degree is considered severe, as all symptoms only worsen, and without timely treatment lead to fatal outcome in children. To all the above described signs signs of disruption of all organs and systems are added:

• Weight loss is 30% or more.
• Growth lag.
• Absence of subcutaneous fat.
• There is a violation of heart rate and heart function.
• Respiratory depression.
• Delay in mental development.
• Muscle atrophy and skin folding. Symptoms of anorexia.
• Infringement of thermoregulation and pressure decrease.

Treatment of this degree of hypotrophy should be carried out only in the hospital, as the work of metabolic processes and the activity of all organs and systems are disrupted. Drug treatment includes intravenous blood transfusion, plasma, glucose solution, hormones, as well as treatment with enzymes, vitamins, trace elements.