Introduction. One of the most important characteristics of a child's health is physical development, which depends on many factors and reflects not only hereditary predisposition, but also the influence of all environmental factors (national and regional features of lifestyle, ecological situation, presence or absence of diseases, etc.) [1, p.91].
Monitoring of the physical development of children is considered by the WHO to be one of the most effective measures, which is carried out by medical workers, in terms of reducing the level of mortality and morbidity of children of early age [2, p. 67].
Assessment of the physical development of children under the age of 3 years is carried out on the basis of Order of the Ministry of Health of Ukraine No. 149 of 20.03.2008 "Clinical protocol of medical care for a healthy child under the age of 3 years" at every mandatory medical examination of the child [3, p.15]. In most cases, the identified deviations indicate a violation of the children's health condition and require a thorough analysis of the situation and appropriate measures.
In our country, a unified approach of pediatricians to this study is implemented, given that percentile diagrams (or graphic percentile curves) are used all over the world, as well as evaluation on the Z-score scale with calculation of the number of standard deviations. The updated versions of the analysis of physical development offered by WHO have multilingual options, consisting of an anthropometric calculator, which allow an individual assessment of the child's parameters and the state of his nutrition.
The method is currently relevant and modern, it requires active promotion and, of course, introduction into the broad practical layers of the pediatric cohort [2, p. 67].
In Ukraine, pediatricians determine "corridors" based on centile-type physical development charts and/or centile tables, to which the anthropometric indicators of a particular child are assigned [4, p. 65].
Nutritional status is a complex of clinical, anthropometric and laboratory indicators, marked by the quantitative ratio of muscle and fat mass of the patient's body. The nutritional status of newborn babies has a significant impact on the child's further development, including physical development. Body weight gain, height, head and chest circumference in children are the main anthropometric indicators of a child's development.
Many medico-biological factors affect the nutritional status of children of early age (obstetric history, adequate feeding, proper care, previous diseases, age and bad habits of parents, etc.) [5, p. 288].
The purpose of the work. Analysis of the results of assessment of the nutritional status of one-month-old children with neonatal hyperbilirubinemia.
Material and methods. Assessment of the child's nutritional status is based on anthropometric, laboratory data and clinical examination.
An examination of 22 one-month-old children who suffered neonatal jaundice and were treated in the neonatal pathology department of the perinatal center was conducted. The level of total bilirubin fluctuated from 143 to 278 mmol/l. All children were born full-term (12 boys, 10 girls), gestational age 38-40 weeks, Apgar score 8-9.
Results and discussions. It was established that the average body weight at birth was 3320±0.67 gr., length - 51.7±0.062 cm. 81.8% of children were breastfed, 18.2% - artificially.
At the age of the 1st month of life, body weight reached 4702±0.85 g, height - 54.6±0.058 cm, monthly increase in body weight was 1382±0.28 g, height - 2.9±0.087 cm. Other anthropometric parameters were also within the P25 to P95 centile range.
The main criteria for the effectiveness of feeding children in the first month of life were not only anthropometric indicators of body weight gain, height, but also the content of hemoglobin, erythrocytes, protein, glucose, bilirubin, creatinine, and urea in the blood serum, which were within the age norm.
Ultrasound examination of the organs of the abdominal cavity did not reveal any pathology in the examined contingent of children.
Conclusions. Thus, knowledge of the patterns of physical development of children in the first month of life is necessary for the correct assessment and interpretation of the degree of physical development of each specific child. Neonatal jaundice, which took place in the perinatal period, did not have a negative effect on the nutritional status of full-term children of monthly age. It should be noted that this category of children needs further thorough clinical examination to search for hidden diseases and pathological conditions. Such tactics of the doctor are important in timely diagnosis and occupy an important place in preventive medicine.
References:
1. Шумна Т. Є., Левчук Т. О. Характеристика фізичного розвитку дітей першого року життя, які народжені з малою масою тіла /Т. Є. Шумна, Т. О. Левчук //Запорожский медицинский журнал. 2018. Т. 20, № 1(106). С. 91-96.
2. Sharma, D., Shastri, S., & Sharma, P. (2016). Intrauterine Growth Restriction: Antenatal and Postnatal Aspects [Intrauterine Growth Restriction: Antenatal and Postnatal Aspects]. Clin Med Insights Pediatrm, 10, 67-83. doi: 10.4137/CMPed.S40070
3.Наказ МОЗ України №149 от 20.03.2008 «Клінічний протокол медичного догляду за здоровою дитиною віком до 3 років».
4.Фізичний розвиток дитини: навч. посібник для студентів 3 курсу мед. факультету / О. Г. Іванько, М. В. Пацера, Н. В. Кизима [та ін.]. Запоріжжя: [ЗДМУ], 2013. 65 с.
5.Фролова Т.В., Стенкова Н.Ф., Бородіна О.С., Сіняєва І.Р. Фізичний розвиток дітей: методи оцінки, семіотика основних порушень. / Здоровье ребенка. 2018. № 3 (13). С. 288-293.
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