The aspects of the clinical evolution of malnutrition in early childhood

Abstract

Introduction: Hypotrophy - a chronic disorder of nutrition caused by protein and energy starvation. According to the statistics provided by the WHO, the child mortality is mostly determined by acute respiratory diseases, diarrheal diseases and perinatal factors in equal proportions (approximately 19%). Every second child who suffered and died from these diseases was diagnosed with hypotrophy. Aim: The research of the hypotrophy course with varying degrees of manifestation taking into account the duration of the disease and comorbidities. To identify the most common malnutrition’s causes and nutritional errors that caused the hypotrophy. Methods and materials: A retrospective analysis of clinical and paraclinical examination data of 50 children suffering from hypotrophy treated at the Clinical Republican Hospital for Children ‘E.Cotsaga during 2010 - 2011 was carried out. The researchers used the software ‘WHO Anthro’ to establish the nutritional status of the researched children (the ‘WHO Anthro’ software for PC, version 3, 2009 - software designed for the assessment of the worldwide growth and development of children. Geneva, WHO, 2009 - http://www.who.int/childgrowth/software/ru/). Results and discussions: The average age of children was 10 ±7, 3 months. The research concentrated upon the study of second and third degree hypotrophy. The anamnesis has shown that 9 children (18%) were breastfed, 18 children (36%) were fed replacement products (11 children (22%) were fed partially adopted mixtures, 7 children (14%) were fed unadapted mixtures (whole cow’s milk), 15 children (30%) mixed-fed. Approximately 40% of children were mixed-fed on NAN lactose-free mixtures, Alfare, Nutrilac/Nutrilon, Maliutka (Малютка). Approximately 24% of children suffered from exogenous hypotrophy development while as a manifestation of endogenous factors, the hypotrophy was marked in the case of 18% of children; 58% of children suffered from hypotrophy caused by violations of nutrition types (unadapted milk mixtures, flour products’ excess, and lactose intolerance). Conclusions: Main causes of hypotrophy diagnosed among researched children were gastrointestinal diseases (gastroduodenitis, enterolitis) with the development of the secondary malabsorbtion syndrome as well as prenatal facts (congenital malformations, prematurity and cystic fibrosis). The most frequent diet errors were early transition of children to mixed and artificial feeding using whole cow’s milk and flour products. A number of breast-fed children were diagnosed with a lactase deficiency.