In fact, there are very few items for babies to judge malnutrition: one is gender, height and weight, the other is the thickness of subcutaneous fat, and the third is the change of skin, hair and nails.
Blood test: vitamins and trace elements (lead, zinc, copper, calcium, magnesium, iron, etc. ), blood routine: the ratio of hemoglobin to red blood cells decreased, blood biochemistry (albumin, total protein, transferrin, retinol binding protein, plasma protein and other proteins).
If you know these items, know how to judge, and don't take a blood test, you can probably judge whether the child is malnourished by the characteristics of these items. Of course, if you can check further, these can reflect the nutritional status of the body in time and sensitively.
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Skin: the whole body skin is dry, rough, without normal luster, desquamation, fading or pigmentation, hyperkeratosis and fish scales.
Hair quality change: the hair loses its normal luster and becomes thinner, thinner, dry and dull.
Nails: slow growth, fragile.
These changes can be used as a reference, and it is important to look at the subcutaneous fat in the abdomen.
When infants are severely malnourished, subcutaneous fat gradually fades, followed by abdomen, chest, back, waist, upper and lower limbs and cheeks. Therefore, when I doubt whether the baby is malnourished, we first measure the subcutaneous fat of the abdomen, pinch the abdominal fat with our thumb and forefinger, knead it into a wrinkle, and measure the thickness of this wrinkle. 1cm above, the baby's nutritional status is good.
The above is our general judgment on whether there is malnutrition.
Malnutrition is not common in the physical examination of infants. The reason is that in China society, everyone can afford meat and milk powder, and there is no poverty, hunger and war. Therefore, malnutrition caused by insufficient nutrition intake is rare, but there are still many improper feeding caused by lack of medical knowledge and bad eating habits (such as partial eclipse, picky eaters, anorexia, etc.). ) and insufficient breast milk.
How to judge the degree of malnutrition?
It can be divided into three degrees, one is light, and the second and third degrees are moderate and severe.
Primary malnutrition: mental state is normal, weight is lower than normal 15% to 25%, subcutaneous fat thickness of abdominal wall is about 0.4 to 0.8 cm, skin is dry, and height does not affect it.
Second-degree malnutrition: listlessness, restlessness, weakened muscle tension, muscle relaxation, 25% to 40% lower than normal weight, subcutaneous fat thickness of abdominal wall less than 0.4 cm, pale and dry skin, dull hair and lower than normal height.
Third-degree malnutrition: mental atrophy, lethargy, irritability appear alternately, mental retardation, muscle atrophy, low muscle tension, weight lower than normal people by more than 40%, subcutaneous fat of abdominal wall disappears, forehead wrinkles appear, face looks like an old man, skin is pale, dry and inelastic, hair is dry, and height is obviously lower than normal people.
From this classification, we can see that severe malnutrition is not only the changes of skin, hair and subcutaneous fat, but also mental problems, which not only affect growth and development, but also affect intellectual development.
If you look at this scale, you will see the weight and height, such as weight loss 15%, 25% and 40%. For example, the height is not affected, the height is slightly decreased, and the height is obviously decreased. The data is vague, malnutrition can only be judged roughly, and it is difficult to judge accurately.
So are there any more detailed data tables that can better judge the nutritional grading? The answer is yes.
In medicine, we use detailed data tables such as same-sex age and weight, same-sex age and height, and standard deviation of same-sex height and weight to judge the degree of malnutrition. That is to say, with gender, age, height and weight, we can know the degree of malnutrition. Let's look at these forms and see how to judge!
Figure 1: classification and grading of malnutrition!
Figure 2. Unit curve of standard deviation of body length and weight for girls aged 0-3 years in China.
Figure 3. Unit curve of standard deviation of body length and weight for boys aged 0-3 years in China.
Figure 4: The standard value of body length and weight for boys under 3 years old is 45- 1 10cm.
Figure 5: The standard length and weight of girls under 3 years old is 45- 1 10cm.
For example:
Baby, female, 16 months, 73cm long and 7.2kg in weight, what is the nutritional status?
At first glance, the weight of the same sex and age: that is, the intersection of the corresponding ordinate of 65438+June and the corresponding abscissa of 7.2kg, just falls below -3 standard deviation (see Figure 2), which is low weight (severe) compared with the standard of Figure 1.
Second, look at the height of the same sex and age: that is, the intersection of the vertical axis corresponding to 65438 in June and the horizontal axis corresponding to 73cm in July falls between -3 standard deviation and -2 standard deviation (see Figure 2). Compared with the standard in figure 1, it belongs to growth retardation (moderate).
Third, look at the weight of the same-sex height: that is, the intersection of the vertical axis corresponding to 73cm and the horizontal axis corresponding to 7.2kg just falls between -3 standard deviation and -2 standard deviation (see Figure 5). Compared with the standard in figure 1, it belongs to emaciation (moderate).
It can be seen that children should be severely malnourished according to their weight, and moderately malnourished according to their height and weight, indicating that weight loss is the most obvious. Considering that acute malnutrition is the main cause, as mentioned above, improper short-term feeding can cause acute malnutrition, and of course it can also cause acute malnutrition (diarrhea, chronic) in the disease state.
If at this time, you will find that the baby will have digestive dysfunction, such as diarrhea, always eating, emotional changes, crying, often catching a cold and having a fever, and the symptoms are very difficult.
If the blood test is carried out at this time, it will be found that the organ function of infants and young children will be abnormal, such as anemia, trace element deficiency, low albumin, etc., and these indicators can reflect the nutritional status of the body more timely and sensitively.