How to correctly estimate a child's weight
A single weighing says little: what matters is the position of the indicators on the centile curves and their dynamics over time. The doctor compares weight with height and age, assesses the head circumference of babies and looks at whether the child is walking along his corridor or sliding down. Heredity is also taken into account: short, slender parents rarely have large children. It is alarming when a child stops gaining weight, crosses the centile corridors downwards, or begins to lag not only in weight, but also in height.
- Evaluation using centile tables, not by eye
- The ratio of weight and height is more important than the absolute number
- Dynamics over several months
- Taking into account parents' height
- Stunting is a more serious sign
- Regular measurement under the same conditions
Main reasons
All reasons can be divided into three groups. The first is insufficient food intake: difficulties in breastfeeding, improperly diluted formula, late or poor complementary feeding, extremely selective nutrition in older children, as well as restrictive diets without indications. The second is a violation of absorption: celiac disease, lactase deficiency, cystic fibrosis, parasitosis, chronic intestinal diseases. The third is increased needs for chronic infections, congenital heart defects, kidney diseases and endocrine disorders.
- Not enough milk or formula
- Errors in formula dilution and feeding regimen
- Late or inadequate complementary feeding
- Extreme selectivity in food
- Celiac disease and other malabsorption disorders
- Parasitoses and chronic intestinal infections
- Heart defects and chronic diseases
- Endocrine disorders
How it manifests itself
First, the subcutaneous fat layer on the abdomen and limbs decreases, the child looks thinner than his peers, but remains active. As the deficiency increases, the skin becomes dry and pale, turgor decreases, lethargy and irritability appear, and sleep deteriorates. Children are more likely to get infections and take longer to recover. In severe cases, psychomotor development suffers, growth slows down, and swelling is possible due to lack of protein. In schoolchildren, malnutrition also manifests itself as fatigue and decreased academic performance.
- Reduction of subcutaneous fat layer
- Pale and dry skin
- Lethargy or irritability
- Frequent and persistent infections
- Psychomotor development delay
- Slow growth with prolonged deficiency
- Edema due to severe protein deficiency
Survey
They start with a detailed analysis of nutrition: what, how much and how often does the child eat, how is feeding done, and are there any difficulties with chewing and swallowing. The doctor examines the child, evaluates the indicators using tables, asks about stool, vomiting, and past illnesses. Basic tests include a complete blood count, protein and iron levels, a coprogram and a test for helminths. Based on the results, an examination for malabsorption, ultrasound of the abdominal cavity, assessment of thyroid function and other studies are added. A food diary for several days is often more informative than analysis.
- Food diary for 3–7 days
- Measuring height, weight and circumference
- General blood test
- Total protein and albumin
- Iron and ferritin
- Coprogram and feces for helminth eggs
- Ultrasound of the abdominal cavity according to indications
- Testing for celiac disease if suspected
Nutrition and treatment
The tactic depends on the reason. If the issue is the amount of food, the pediatrician helps to establish feeding: checks the feeding technique, mode, volume of the mixture, composition of complementary foods. The diet is enriched with complete protein, fats and calories from regular foods, and in case of severe deficiency, the doctor may prescribe special medicinal mixtures. You cannot force feed: this reinforces refusal to eat. A calm ritual of eating without gadgets and persuasion is important. If a disease is identified, it is treated, and weight usually begins to be restored. Vitamins and supplements are prescribed by the doctor, not the parents.
- Correction of technique and feeding regimen
- Enriching your diet with protein and calories
- Regular meals without forcing
- Calm atmosphere at the table without gadgets
- Medicinal mixtures as prescribed by a doctor
- Treatment of the underlying disease
- Weight control once every 1–2 weeks
- Vitamins and microelements only as indicated