Do you want your child to develop harmoniously? Don't forget to show it to the endocrinologist.
Do you want your child to develop harmoniously? Do not forget to show it to the endocrinologist - this is what our expert, pediatric endocrinologist, Ph.D. Tatyana Varlamova
A child's character deteriorates, does he grow too rapidly or, on the contrary, suffers because he is the smallest in the class, too plump and chews all the time, or, on the contrary, is thin and categorically refuses to eat? “The transitional age,” we say, “time will correct everything.” And, exchanging experience with other parents, we are convinced that our baby is still nothing, but the son is with the neighbors …
But all these whims of behavior can be caused by endocrine disorders. And the sooner you examine the child to rule out certain diseases or start treatment, the better the result will be.
Modern children have become shorter, but fatter, because they eat improperly, get sick more often and are nervously excitable, to say the least - mentally unbalanced. Such unhappy conclusions were reached by experts dealing with children's he alth at the All-Russian Forum "He alth of the Nation", held in Moscow this spring. The results of recent scientific research have made it possible to assess the real state of children's he alth, which is very different from official statistics.
According to the Scientific Center for Children's He alth of the Russian Academy of Medical Sciences, only 2% of school graduates can be considered he althy. Over the past few years, children with normal physical development have decreased by 8.5%. A generation of conditionally he althy children, or, as doctors say, he althy patients, is growing. The term "retardation" has appeared, that is, a slowdown in physical development and the formation of functional systems in children and adolescents.
And the number of endocrine disorders in children for 15-20 years has increased significantly. This is due, firstly, to the epidemic of our century - obesity. Secondly, with the increased incidence of diabetes (both insulin-dependent type 1 diabetes and type 2 diabetes formerly known as geriatric diabetes), it has become much younger and is now increasingly occurring in children as well.
Naturally, this is connected both with the environment and with urbanization, that is, with the costs of urban life. And, of course, food. On the one hand, children began to eat more, on the other hand, not always what they need. Often, even at home, children are treated to fast food and sweet drinks - not only carbonated, but also oversweetened "morsiks" and "compotes".
In addition, children move less, which contributes to the development of functional disorders.
But the main risk factor is burdened heredity. True, if there are cases of diabetes in the family, this does not mean that the child will definitely get sick, but he is at risk. And this means that he needs special supervision of an endocrinologist (2-3 times a year) and nutritional correction. Now there are a lot of cases of obesity in children - I and II degrees! A violation of fat metabolism leads to a violation of carbohydrate metabolism and the development of diabetes.
Typical mistakes of parents:
• Overfeeding the baby. If the child is he althy, but thin and has a poor appetite, this may be a manifestation of gastroenterological diseases or increased excitability. So, it makes sense to show him to a neurologist and a gastroenterologist, but just don’t force him to eat, arranging painful hysterical performances from feeding.
• Unhe althy diet: products containing trans fats (cookies, chips) and excess sweets. The diet of the child must be balanced.
• Refusing to regularly check the child's body mass index.
• Feeding newborns throughout the day without a break at night. A typical mistake moms make is to breastfeed their baby at night every time he wakes up. So he has a need to eat and drink all the time. But the number of fat cells is laid precisely during this period of development - at the age of up to two years!
• A child cannot recover for a long time after suffering adenovirus infections, influenza or childhood diseases.
• Frequently thirsty and drinking too much liquid.
• He urinates frequently and profusely.
• He stays in a state of lethargy, irritability for a long time.
• Starts to noticeably lose weight.
These are possible signs of diabetes. Therefore, you should immediately check the level of glucose in the blood.
Height and bone age
When a child lags behind their peers, it is perceived as a tragedy by both parents and by themselves, teenagers are especially painful about it.
What does human growth depend on? It is influenced by two main factors - these are genes, that is, heredity, and again nutrition in early childhood. Tall parents and children are usually taller, and vice versa. And, if the parents are above average height, and the child is lagging behind, you need to check his level of somatotropic hormone (STH).
Growth rates can also be reduced by severe (especially chronic) diseases. A weakened baby temporarily diverts energy that should have been spent on growth into the process of recovery.
An important role is played by the mother's he alth during pregnancy, as well as the individual characteristics of the metabolic processes in the child's body.
And the functions of the endocrine glands - the thyroid gland and the sex hormone testosterone - have a very great influence on growth. An increase in its production stimulates bone growth up to a certain limit, but in the future it begins to suppress growth zones, stopping growth. This can be observed in young men during puberty, when the acceleration of growth is replaced in the period of maturity (at 16-18 years old) by its stop.
Norm and deviations:
It is very important to follow the growth rate during the first two years of life.
• During the first year, children grow by an average of 25-30 cm, in the second - up to 12 cm, and in the third - 6 cm. Then, rapid growth is replaced by the so-called uniform growth, that is, 4-8 cm are added per year.
• At the onset of puberty, children tend to experience growth spurts again. This period of rapid growth is caused by the influence of sex hormones - a hormonal "burst".
• For girls, this period begins at age 10 (maximum 12), when they gain an average of 8 cm per year.
• For boys aged 12-14, the increase in height is on average 10 cm per year, with possible individual deviations of 1-1.5 years.
• During the period of puberty "jump" (for boys it usually happens at 13-16 years old, for girls - at 12-15 years old), both main indicators of physical development - height and body weight - are intensively manifested. In a relatively short period of time, height can increase by 20%, and body weight - even by 50%.
For girls, this "leap" can begin at 10.5 years old, reaching its maximum expression at 12.5. And their body growth continues until 17-19 years old.
• Boys at the beginning of puberty lag behind girls, and at about 14.5 years old they begin to catch up intensively with them, and their growth continues until about 19-20 years old.
• Indicators of weight and height may vary - it depends on the individual characteristics of a particular child, so the reason for excitement should not be one figure, but a steady age trend of lagging or accelerating growth. Genes play a big role here, but the hereditary program can fail for some external reason.
• Adolescents in physical and sexual development may be delayed by 1-2 years compared to their peers who are actively involved in sports with constant physical activity (gymnastics, wrestling, etc.).
• Chronic diseases, such as gastritis, gastroduodenitis, which sometimes occur almost asymptomatically in adolescents, can significantly affect growth retardation.
• Cardiovascular diseases such as arterial hypertension, rheumatism, heart defects, some lung diseases also contribute to reduced height.
• And, of course, endocrine diseases, the first signs of which sometimes appear at an early age, and sometimes only in adolescence, lead to a slowdown in the physical development of the child - and primarily to a decrease in growth.
It is important not to lose time, to notice in time that the growth of the child is not normal, and be sure to contact a specialist - a pediatrician and an endocrinologist.
It is necessary also to check the bone age - its compliance with the passport - and growth zones. To do this, take an x-ray of the hands and wrist joints. The growth zones are clearly visible in the picture. If these zones closed at the age of 14-15, then the child will no longer grow, and this is an unfavorable sign.
The last two decades have been marked by a steady increase in thyroid disease in children. In addition to burdened heredity, the region of residence also plays an important role. If there is a shortage of iodine in the region, its deficiency must be replenished with iodine preparations - iodomarin, potassium iodide, etc.
To some extent, insufficient physical activity and even too much time at the computer at an early age can provoke the development of thyroid diseases, such as autoimmune thyroiditis - a deficiency of thyroid hormone, which leads to further functional impairment.
If after a careful examination and ultrasound it turns out that the gland is enlarged, but the level of thyroid hormones is normal, then iodine preparations are enough. If the level of the hormone is increased or decreased, a serious correction is necessary, treatment with hormonal drugs.
The widespread belief that the hormones that the mother took during pregnancy also lead to the development of endocrine disorders in children, doctors do not confirm. Hormones are usually prescribed to women with problems of the reproductive system - miscarriage, etc. Such a course of treatment under the supervision of a doctor almost never - there are many studies on this topic - does not affect the he alth of children. On the contrary, in the correct, precisely selected dosage, the hormonal drug helps to maintain the pregnancy.
Hypothyroidism can also be congenital - it is a hereditary disease when a child is already born with a "bad" thyroid gland. Therefore, we have been screening newborns for endocrine diseases since 1992.
This early diagnosis is very important: if you start treatment right away (and children with hypothyroidism need lifelong treatment), then you can avoid developmental delays.
Cases of congenital hypothyroidism in Russia average 1 in 4000 newborns. Therefore, the best prevention of endocrine system disorders in children is the examination of pregnant women in the early stages, when the nervous system and thyroid gland are laid in the fetus.
• Growth slowdown.
• Weight disorders - both its deficiency and excess. If the child is too fat, this may indicate a violation of metabolic processes.
• With thyroid hormone deficiency, children are lethargic, pasty, weak - they get tired quickly in comparison with their peers, it is very difficult to get up in the morning.
• If the gland is too active, there is weight loss, increased emotional excitability, especially in girls. They become whiny, even aggressive, hand tremors, eyeball enlargement, pressure difference - reduced diastolic and increased systolic (pulse), thin, tender, even dry skin and general fussiness of movements may appear.
An experienced doctor can determine violations already by the way a child enters the office: this is noticeable by his plasticity, hyperactive demeanor, excessive fussiness.
Puberty in children is mainly due to heredity, but not only genetic characteristics determine the type of development of the child, but the national, racial affiliation of parents - children of southern or eastern peoples, for example, mature earlier.
A sign of a norm or deviation may be the sequence of appearance of secondary sexual characteristics: girls must first develop mammary glands, then hair in the pubic area occurs, then menstruation occurs. If the sequence is broken, this is not yet a sign of the disease, but a reason for consulting an endocrinologist. When girls have hair on their arms, legs and back, it is necessary to exclude an excess of androgens by making special studies. With their excess, we can talk about the pathology of the adrenal glands. If the hormonal background is normal, this may be a manifestation of a constitutional feature.
Normally, girls at the age of 8-9 show the first signs of maturation: the areas of the nipples begin to protrude a little, slightly change color and shape. And then, from the age of 10-12, the redistribution of adipose tissue, the development of the mammary glands, etc. gradually begin to occur. areas.
Normal puberty in boys usually occurs between 9 and 14 years of age. The first signs are testicular enlargement, then, after 6 months, the appearance of pubic hair, reaching a peak in the final stage of genital growth.
Boys at this age sometimes have swelling of the mammary glands - one or both, as a rule, this is caused by an excess of prolactin and does not need treatment. This is not a disease, but a physiological phenomenon - the so-called gynecomastia. It may be due to obesity.
• Pubic hair in girls in the absence of other secondary sexual characteristics can be caused by a malfunction of the adrenal glands, such as an adrenal tumor. This is a serious reason to visit an endocrinologist.
• Lagging behind peers. In this case, it is necessary to conduct an examination for the correspondence of bone age to biological.
• Obesity in boys can also contribute to genital pathology.
• Endocrine abnormality - cryptorchidism, when one or both testicles do not descend into the scrotum in time, but remain in the abdominal cavity.
• Underdevelopment of the genitals, if, for example, a boy at the age of 13 began to have hair growth (axillary and in the pubic area), and the size of the genitals is still childish, the child is taken under the supervision of endocrinologists.
• Precocious puberty can occur in both sexes. This is an alarming symptom if secondary sexual characteristics appear in boys under 9 years of age or in girls under 8 years of age. In any case, it is necessary to see an endocrinologist, even in the absence of pronounced deviations, at least once a year.
How hormones work
The endocrine system is endocrine glands, such as the hypothalamus, pituitary gland, pineal gland, thyroid gland, pancreas, ovaries, testicles, etc. Hormones (endocrine substances) are secreted by the endocrine system directly into the bloodstream and regulate vital processes in the body. All over the world, there has recently been an increase in diseases associated with endocrine disorders. Moreover, most endocrine diseases manifest themselves in childhood.
Typical symptoms of endocrine disorders - causeless fatigue, mood swings, irritability, obesity or sudden weight loss, too early or delayed puberty - should be a serious reason to visit an endocrinologist.
How to determine the ideal weight of the child
For children from 1 to 12 years old, the deviation of body weight from the ideal can be assessed in points - from five to two. Body mass index (BMI) for children from 2 years of age is calculated using the same formula as for adults: weight in kg divided by height in cm squared.
You can calculate the ideal weight for your child, taking into account his constitutional body type, using the formula: MI \u003d (R x D): 240, where MI is ideal body weight in kg; R - height in cm; G - chest circumference in cm; 240 - constant calculation factor.