Are you worried about your thin child.Why did my son very thin. Starting weight infants to school never rises. There have been many doctors visited, but most said son normal. Normal, but why can not fat like her sister? Even my son has suspected tuberculosis and must take medication 6 months, but were told to stop the drug by a lung specialist because my children are not people with tuberculosis. "
That is the complaint that is often experienced by some parents with children who have trouble gaining weight or failure to thrive. However, my parents had time to calm, do not worry, son. First you were like that, but after high school you're fat and high "Really so, whether the cause and how is it?
One problem that many parents experienced growth disorders in children is a form of interference increase body weight and height. The problems that often accompany the disorder is difficulty feeding the child or other eating disorders. Impaired weight gain and difficulty feeding the child can stand alone or can occur simultaneously.
Parents often worry when their children watched the growth of different. Finally, they often think how high and posture his future? Concern will grow again when her son seem shorter than friends her age. But maybe the child is still in the high normal range genetic potential.
Growth is one of a sensitive indicator of child health, nutritional status and genetic background. Deviations from the average growth in height and weight may indicate a health problem.
Impaired growth is often called failure to thrive or Failure to thrive is not a diagnosis, but it is a terminology that is used to declare a special problem. The term failure to thrive is used to describe children who can not grow as expected. The failure to grow or more specifically the failure to get weight gain, although in certain cases also accompanied by an interruption of linear growth and head circumference than other children the same age or gender.
In general, failure to thrive means children in the notes to the increase in weight and height according to the table below 3-5 percentile or down 2 levels in the percentile growth, such growth is initially 75 percentile to 25 percentile.
Impaired growth in general is strongly influenced by the quality and amount of calorie intake in children. The quality and amount of calories depends on several things such as inadequate caloric intake, absorption (absorption) is inadequate and that increased calorie needs.
Growth and development of children is a health issue that is very important to always be considered early. Often, growth disturbances occurred after the age of 6 months can not be detected properly. This situation is only realized after age rather large. When the disturbance growth occurs, usually accompanied by other nutritional deficiencies, such as iron, calcium, minerals and other vitamins.
Therefore, growth monitoring of children from birth is very important. In addition to determining the normal pattern of growth in children, also may determine the issues and factors that influence and interfere with growth since early childhood. If known at an early stage, the prevention and treatment of mental growth can be addressed early on. Unfortunately, almost 85% more health books that treated the child to the pediatrician or the doctor would never described the weight growth chart.
Precisely weight growth charts are often drawn by a cadre of neighborhood health center. So many disorders and health problems often occur late detection and handling. Some 50% of infants experiencing increasing disorder since the age of 6 months who had never detected by parents and doctors just because of his health was never illustrated book charts the increase in weight.
The most common cause
The cause disruption failed to grow so many and varied. The most common cause but most do not realize the parents and clinicians is a disorder of gastrointestinal function. This is often overlooked because of gastrointestinal disorders have signs and symptoms are very mild and is often considered normal.
This disorder often occurs since the age of 6 months, when babies begin to be given new food additives. This happens because of interference with the function of the gastrointestinal tract caused by the reaction of the intersection of food such as food allergy, food intolerance and seliak.
The disorder can be recognized in children according to age stages. At the age of infants, children often seem fussy, colicky or crying constantly for no reason at night (especially under 3 months of age), frequent hiccups, often dribbling (drooling), is often "defecate ngeden", bloating, frequent spit up, black stools or green, color arise defecate blood. Frequent bowel movements more than 2 times per day or bowel movements is not every day.
At the age of the child is usually the children often complain of abdominal pain, frequent bowel movements (> 2 times / day), bowel disorders (hard stool, defecate, not every day, defecate in his pants, black or green shit, shit ngeden) bloating, vomiting, difficult defecation, often waste wind, canker sores, halitosis. The tongue is often dirty and white.
Various other causes are rarely very many and too varied. Organic gastrointestinal disorders can also interfere with growth, but very rarely. Organic gastrointestinal disorders were included: Pyloric stenosis , cleft lip, Hirschsprung's disease, hepatitis, cirrhosis, biliary atresia .
Other rare causes of breastfeeding difficulties in the "insufficient milk supply syndrome", chronic infections (HIV, TB), urinary tract infections, chromosomal abnormalities (Down syndrome and Turner syndrome). In addition, a rare cause of the large organ system dangguan such as heart, kidney, brain hormone system abnormalities such as thyroid hormone deficiency, growth hormone deficiency, pituitary hormone, diabetes, adrenal, or other hormone deficiencies.
Damage to the brain or central nervous system, also can cause difficulty eating disorders that cause growth retardation. Other causes are abnormalities of the heart and respiratory systems, causing disruption in the distribution of oxygen and nutrients throughout the body, such as congestive heart failure, cystic fibrosis , nemia or other blood disorders, Fetal alcohol syndrome , food poisoning, malignant disease, poverty and child abuse .
Other disorders that rarely occur are short stature. Incidence of short stature often enough, but very little data on the epidemiology of short stature. In western countries, the incidence of 1:4000 children growth hormone deficiency, hypothyroidism with an examination of screening tests 1:3000-5000 births.
Short stature is not a clinical diagnosis. Short stature is a situation where a person's height below the normal size according to age, gender and easy to know immediately.
Other disorders that accompany
Disorder patients who experienced failure to thrive disorders of the gastrointestinal tract usually are often accompanied by skin disorders. Skin disorders include dry skin on the feet and hands and sensitive to the nose. The skin is very dull and rough and scaly. Usually accompanied by skin disorders or rash called dermatitis herpertiformis.
In children with failure to thrive is usually very active and can not be silent. In general, children like this are very agile and in some children have high intelligence and gross motor skills and a good workout. But most children are very high emotions, a little aggressive, stubborn and have concentrations that are not good at school but the child is very smart.
Generally, children are rarely sick, but a group of children who experience frequent nausea or vomiting disorder usually not a good body resistance and will easily sick coughs and colds. In this last group of kids sometimes accompanied by asthma or shortness of breath.
Handling
Parents need to be explained about the potential for normal growth of a child according to their genetic potential. Any child with growth disorders have identified the causes and handled in accordance with the cause.
In patients with gastrointestinal disturbances, usually caused by an allergic reaction to food because the intersections of food, food hypersensitivity and seliak. Often, simply by avoiding foods that interfere with the cause can improve gastrointestinal function and increase a child's weight. In general, the handling of such interference can only optimize your weight, but it is difficult to make children obese.
Giving vitamins or enzymes are not many useful and only a moment when the cause is not identified and corrected. With age, especially over the age of 2 years of complaints biasannya gastrointestinal disturbances will be reduced. But some new specific disorders could improve around the age of 5-7 years or even after before adulthood.
This is what affect the prognosis or repair disorders increase the weight. In certain groups of children and weight disorders difficult to eat will improve after age 2 years. But another group of children after the age of 5-7 years but there is also improving after junior high, high school or even after marriage. But some are still not improve his life.
In such cases, usually before the function cernanya improved natural channels usually the child's weight can only be optimized, but to become obese is relatively difficult. But it will be fat so the lack matangan cernanya channels improves with age. But it's best to fix it not to wait until adulthood, should be identified and corrected before early on.
All the appearance of health and weight in children is usually also experienced by one of his parents who have the same face. But that does not mean her father had a small and a small decrease in offspring weight bedan anaknnya. But that decline is genetically cernanya tract dysfunction. When the disorder in the handle so it is better than the parents first.
Currently, often gastrointestinal dysfunction that accompanies the growing disturbance is ignored by parents and clinicians. This is reasonable because the disorder is very mild and is often considered to be normal. Conversely, a very rare disorder often become the main scapegoat such as tuberculosis or the common people called "mole".
In the study author, in children experiencing disorders often fail to grow or overdiagnosis of TB does not have TB but are treated as tuberculosis. The overdiagnosis of TB cases by 32%. In patients with failure to thrive when diagnosed with TB should be made to other doctors for second opinion. Overdiagnosis of TB cases occur in children often fail to grow often experience cough cold pain.
In short stature disorders do not have to direct therapy, can only with pemantaukan periodically, but the majority of cases a clear cause can be treated according to the cause. The case of a clear cause such as endocrine disorders such as GHD and thyroid hormone deficiency can be treated immediately. Secondary growth disorders such as malnutrition and chronic diseases should also be treated according to the cause.
Source : dr. Widodo Judarwanto SpA
reposted by Abu Adil