Stunting
Introduction
Introduction to stunting Stunting refers to the phenomenon of slowing or abnormal sequence during growth and development. The incidence rate is between 6% and 8%. In normal internal and external environments, children can develop normally, and all factors that are not conducive to children's growth and development can affect their development to varying degrees, resulting in children's growth retardation. There are many reasons for growth retardation, some are natural processes, some are genetic factors, and some are diseases. Among them, 80% to 90% of growth retardation children are normal growth variations, such as familial short stature and physicality. Delayed development and low birth weight shortness, which are related to congenital genetic factors or intrauterine dysplasia, the growth rate is basically normal, and no special treatment is needed. Through medical history, physical and laboratory tests, based on detailed data and laboratory results, comprehensive analysis, to determine the cause of children's dwarf, and finally determine the treatment principles. basic knowledge Sickness ratio: 0.0001% Susceptible people: more common in childhood Mode of infection: non-infectious Complications: epilepsy
Cause
Stunting cause
Genetic factors (35%):
There are many reasons for growth retardation, some are natural processes, some are genetic factors, and some are diseases. Among them, 80% to 90% of growth retardation children are normal growth variations, such as familial short stature and physicality. Delayed development and low birth weight shortness, which are related to congenital genetic factors or intrauterine dysplasia, the growth rate is basically normal, and no special treatment is needed. But for such children, parents should still create good acquired external conditions to promote the growth potential to the maximum.
Other factors (17%):
Other reasons are pathological, such as chromosomal abnormalities (Down's syndrome, Turner syndrome), metabolic diseases, bone diseases (osteochondral hypoplasia), chronic diseases, chronic dystrophic diseases, endocrine diseases (such as Growth retardation caused by growth hormone deficiency, hypothyroidism, etc., for this part of the body caused by disease, the body should be examined to find the cause of slow growth and treatment.
Prevention
Stunting prevention
(1) Give more stimulation to encourage the child to speak: For example, start to ask the child to call "mother". If the child does not call the mother, the mother should smile and nod. If she does not call her mother, she will nod with a smile to indicate. Finally, the child suddenly shouts "Mom. "You should embrace or kiss your child passionately." In this way, the child will experience the love that the mother gets, and mobilize the interest and enthusiasm of speaking.
(2) Let the children have more contact with society and nature: more contact with society and nature will enrich the child's life, broaden the horizons, and have a wide range of knowledge. Naturally, there is a demand for speaking. If you work with language training, your child's language skills will develop accordingly.
(3) Spiritual factors: improve the living environment and provide children with spiritual comfort and care in life.
Complication
Stunting complications Complications
If the condition is extremely serious, the patient's feelings and perceptions are significantly reduced. The motor function is significantly impeded, the hands and feet are not flexible or can not walk for life. There are often multiple disability and epileptic seizures. Personal life can't be dealt with, and most of them die early. Survivors can react to the skill training of their opponent's feet.
Symptom
Stunting symptoms common symptoms mental retardation language developmental delays
In the newborn or in March, the baby is easily stunned, crying, crying sharply, or screaming, crying, no tone change. It is difficult to get tired of breasts and sleep, it is difficult to feed early, there is hooliganism, it is easy to be shocked by noise, and the hug reflection is enhanced with crying. In March, when there is no standing or stepping, the fist is fisted, and the thumb is still inward in April, and the hand is not open. When I was waisted from April to May, I still swayed. After seeing the object in May, I still wouldnt reach out and grab it. I still cant laugh after 4-6 weeks, I dont recognize people, Im slow, my muscles are too soft, I cant turn over, my movements are slow. , stiff, do not like to take a bath, good to fight, bilateral limb movement asymmetry, premature development, turning over is reflective, not segmental turning, poor crawling awareness, no hand support climbing, no separation movement, more sleep, no purpose Hyperactivity, attention time is short.
Examine
Stunting check
Physical examination
Children's height is lower than the standard deviation (-2SD, standard line SD) of the same height, the same age, and the average height of children of the same race, or the annual growth rate is less than 5 cm.
2. Trace elements
Detection of more than 60 kinds of metals, non-metallic elements such as cadmium, lead, copper, zinc, iron, calcium, magnesium, manganese, iodine, selenium and phosphorus in whole blood, serum, hair and urine, and edible synthetic pigments, sodium saccharin and benzoic acid And other organic matter.
3. Children's IQ assessment
Make an accurate assessment of children's intellectual development.
Diagnosis
Developmental delay diagnosis
Child physical development index
The general characteristics of children's growth and development are: height and weight gain in the first 2 years after birth, a relatively stable increase from 2 years old to adolescence, rapid growth in puberty, and gradually stopped later. Physical development has a head-to-tail pattern, that is, the head development in infants and young children is leading. With the increase of age, the head growth is not much, and the growth rate of limbs and trunk is accelerated. Infant head height is 1/4 of the whole body, and adult head height is 1/8 of height. Commonly used indicators of growth and development of children are: weight, height, head circumference, chest circumference.
1, weight
Body weight is the most important and sensitive indicator of growth and development in children. Because weight reflects the child's nutritional status, especially the recent nutritional status. Weight can be affected by many factors such as nutrition, food supplements, and diseases. The weight gains the fastest in the first 3 months of life, generally increasing by 600 to 1000 grams per month, preferably not less than 600 grams. After 3 to 6 months, the average monthly increase is 600 to 800 grams. An average of 300 grams per month for 6 to 12 months. After 1 year of age, the growth rate of children was significantly slowed down. The average weight of children aged 1 to 3 years increased by 150 grams per month. The weight of a child after 1 year of age can be calculated by the following formula: body weight (kg) = age (years) × 2 + 7 (or 8).
2, height
Height is also an important indicator of the growth and development of children, but it reflects the long-term nutritional status, and the factors affecting growth and development (nutrition, disease, etc.) in the short term have no obvious effect on height. It is mainly affected by genetic, ethnic and environmental influences. The increase in height is the same as the weight, and it is the fastest growth in the first year after birth, with an average annual growth of 25 cm. In the second year, the average growth rate was 10 cm, and the third year averaged 4 to 7.5 cm. The body shape of children in early childhood changes from the fattening type to the elongated type in infancy. During this period, the trunk is slightly longer and the lower limbs are shorter. After the early childhood, the growth of the limbs is gradually faster than the growth of the trunk. The formula for the average height after one year old is: height (cm) = age (years) × 5 + 80 (cm). The height and weight of children can be assessed using the standards of the International Health Organization.
3, head circumference
Head circumference is an important indicator of the brain development of children. Head circumference grew fastest in the first year of life. The average head circumference is 34cm at birth; the average is 46cm at 1 year; the second year is 2cm, and the third year is 1-2cm. At the age of 3, the average head circumference is 48cm, which is not much different from that of adults. It can be seen that brain development is mainly in the first 3 years after birth. After normal children, the cardia was closed for 3 months, and the anterior cardia was closed from 1 to 1 year old. Too late closure should consider the possibility of rickets. Some children are born with smaller tips and close earlier. This is related to the better nutritional status of the mother during pregnancy. Therefore, to comprehensively look at this problem, if you do not take cod liver oil or overdose and inject vitamin D, the general problem is not big. It should be noted that it is not as people think: the more a child's head is smart, the cleverness is not proportional to the size of the head circumference. Your child's head circumference is within the normal range. If the head circumference is too large, it is necessary to consider whether there is a brain tumor or hydrocephalus.
4, bust
When the child is born, the bust is smaller than the head circumference. As the age of the child grows, the bust gradually catches up with the head circumference. Generally, when the child is 1 year old, the bust is equal to the head circumference. But now because of the general nutritional status, many babies catch up with the bust when they are less than 1 year old. Factors affecting the growth of the bust are: poor nutritional status, lack of physical activity and disease caused by thoracic deformities, such as: chicken breast, funnel chest and so on. After the child is 1 year old, the bust grows significantly faster than the head circumference, and the bust gradually exceeds the head circumference. By the time of adolescence, the thorax develops rapidly and changes to an adult body shape.
0-4 years old child development index
1 month: The pelvis is elevated in the prone position, the knee flexes most of the time in the lower part of the abdomen, occasionally the hip is stretched out and the knee is occasionally lifted off the bed. When you are sitting or sitting, the head can occasionally stand for a moment, and the hand is often clenched, and the mother can look at the mother's face when talking with him.
2 months: When the prone position is in the lower position, the lower cheek can be lifted off the bed surface. When the sitting position is in the sitting position, the head can support the moment, the hand is often opened, and the holding reflection is weak. When you speak to it, you can smile and snap the pronunciation. When you are in the supine position, you can watch the moving hanging toy.
3 months: The prone position can raise the head, the upper limb can support part of the weight, the lower cheek and shoulder can leave the bed, and the angle between the face and the bed is 45 degrees to 90 degrees. The hand is often opened and the grip reflection disappears. When you are happy, you will wow.
4 months: When the prone position is in the prone position, the head and chest can be lifted off the bed surface, and the face and bed are 90 degrees. When the sitting position is held, the head can stand upright and not fall back and forth, but the head still sways when tilted to the left and right. When you are in the supine position, your hands are often placed in front of your eyes, and you are playing with your hands and talking about your hands. Will pull the clothes on the face, will shake the "raise", will laugh loudly.
5 months: When you are seated, you will not sway. When you are supine, your hands and feet can be put on your mouth. You can grab things at will, you can wrinkle the paper, and when you take a shower, you will slap the water and smile at the mirror. Will beat the bottle.
6 months: The forearm can be stretched and held in the prone position, and the chest and upper abdomen can leave the bed. Can sit alone, but with both hands in front, both hands can hold the bottle, will grab the building blocks with the palm of your hand, when the parents want to hold him, they will straighten their arms, afraid and shy to the stranger, when the cup is placed on his mouth When you use a cup
7 months: You can turn from the supine position to the prone position. When you are standing up, you can jump up and down happily. You can pour the building blocks from one hand to the other, and you will chew the biscuits, and the name will respond. Syllables such as "ba", "da", "ka".
8 months: I can sit very stable. When I sit down, I will bend forward and explore my body to get things. I can try to climb in the prone position. Sometimes I will climb back first and can send out "ba-ba" and "ma-ma". "Sequence repeat syllables.
9 months: The bed can stand, use the thumb and other fingertips to get the raisin-sized items, and put the palm on the face to prevent the mother from washing his face.
10 months: I climbed very well, but my abdomen couldn't leave the bed. I could sit up and pull myself up. I could use finger items to respond to some simple sentences. If you ask him "Where is Dad?", he can look to his father and will do "goodbye" to shake hands.
11 months: When the figure is standing, one leg can be lifted. When the foot is crawling, the foot is on the ground. The abdomen leaves the bed. When the mother dresses him, he can help the arm, but often the upper arm is stretched out of the sleeve, and the head b will be shaken. ".
1 year old: You can climb your hands and feet like a bear. If you can walk with one hand, you will throw things on the ground intentionally. After you pick it up, you can continue to throw it. You can say two or three words and understand more words.
1 year and a half: can walk independently on the ground, take one hand to go upstairs, will sit on a chair independently, can put 3 to 4 square blocks together, will point out the body parts, can control a few urine, basically no during the day Wet pants.
2 years old: I can go up and down the stairs alone, but I need to step on a step with two feet. I can run, pick up things and not fall, rotate the door handle, turn the round bottle cap, wash my hands and dry, wear shoes, socks, pants. Can use the language to indicate drinking water, urine, meals, etc., will use the pronoun "you", "I", no longer wet the bed after urination before going to sleep.
3 years old: Step up one step on the stairs, step by step on the next floor, can stand on the foot for a few seconds, ride a buggy, wear and take off your shoes, but sometimes you need your family to help clear the left and right sides of the shoes. And the side buttons, need someone to help the buckle, will say some children's songs, can count the number of 1 to 10, increased speech content, keep asking questions.
When you are 4 years old: Step down one step at a time, you can wear all the clothes buckles, draw cross lines with pencils, tell stories, and go to the toilet yourself.
Differential diagnosis
Adolescent stunting needs to be differentiated from gonadal dysplasia.
