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Desnutrición infantil
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Desnutrición infantil

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La desnutrición es definida como la condición patológica derivada de la subutilización de los nutrientes esenciales en las células del cuerpo.
Decimos que se trata de desnutrición primaria cuando los aportes de nutrientes no pueden ser aportados por la situación económica, cultural y/o educativa; así mismo, se clasificará como desnutrición secundaria si los aportes nutricionales son adecuados pero, debido a otras enfermedades, la absorción o utilización de estos alimentos no es adecuada.
La pérdida de peso y las alteraciones en el crecimiento son las principales manifestaciones del mal estado nutricional y basados en el peso esperado del niño (de acuerdo a su edad o estatura) hacemos el cálculo que determina el grado de desnutrición.
Para calcular el porcentaje de desnutrición tomamos el peso actual del niño y lo dividimos entre el peso esperado según la edad:
% de desnutrición según el peso esperado para la edad = (peso real / peso esperado) * 100
También es posible obtener el porcentaje de desnutrición cuando se evalúa el peso esperado según la talla:
% de desnutrición según el peso esperado para la talla = (peso real / peso esperado) * 100
Posteriormente clasificamos el grado de desnutrición de acuerdo a la  siguiente tabla:



Desnutrición leve

Desnutrición moderada

 Desnutrición severa

Déficit de peso esperado según la edad

90 - 100 %

80 - 90 %

70 - 80 %

< 70 %

Déficit de peso esperado según la talla

95 - 105%

90 - 95 %

85 - 90 %

< 85 %

Por ejemplo: un niño de 5 años peso 13 kgs. Tomamos el peso esperado para niños de esta edad (ver  tabla de peso y talla según la edad ) que es de 17,6 kgs. Ahora dividimos el peso real del niño (13 kgs) entre el peso esperado (17,6) y el resultado será multiplicado por 100. Esta operación nos da  73.8 %. Este resultado es el déficit de peso que tiene este niño; observamos que corresponde a un estado de desnutrición moderada.
Los signos físicos que acompañan a la desnutrición son:
·         Déficit del peso y de la estatura que se espera para la edad
·         Atrofia muscular (se observa un desarrollo inadecuado de los músculos)
·         Retardo en la pubertad
Los signos psicológicos que siempre encontramos en la desnutrición son:
Alteración en el desarrollo del lenguaje, alteración en el desarrollo motor y alteración en el desarrollo del comportamiento (irritabilidad, indiferencia u hostilidad).
El médico también encuentra cambios en los exámenes sanguíneos y otros hallazgos que indican la cronicidad de la desnutrición y que, en muchos casos, son muy llamativos:
·         La piel estará seca, áspera y descamándose. Generalmente se observan fisuras en los párpados, labios y en los pliegues de codos y rodillas. Pueden verse lesiones de tipo pequeños hematomas en los casos que el déficit de vitamina C es importante. Si existe una desnutrición severa el niño tendrá los dedos de las manos y los pies muy fríos y azulados debidos a trastornos circulatorios. Generalmente estos niños tendrán lesiones en piel sobreinfectada con bacterias u hongos.
·         El cabello es seco, quebradizo, de color rojizo (o pajizo) y se desprende fácilmente. Es muy frecuente observar que el cabello del niño tiene varios colores (negruzco en la punta, rojizo en el medio y claro o amarillento en la base de éste) Igualmente, las uñas son muy delgadas y frágiles.
·         La falta de vitamina A conduce a úlcera en la córnea y puede llevar a la ceguera.
·         Los niños, paradójicamente, tienen anorexia; crecimiento del hígado (hepatomegalia) y alteración en el ritmo de las deposiciones fecales.
·         La frecuencia cardíaca está acelerada (taquicardia) y son frecuentes las contínuas infecciones respiratorias.
·         El médico encuentra raquitismo, osteoporosis, escorbuto, debilidad muscular, anemia por falta de hierro o vitamina B12, anemia por falta de ácido fólico, anemia por falta de vitamina C o anemia por infecciones.
Las condiciones de salud que ocasionan desnutrición por una inadecuada absorción o utilización de los nutrientes pueden ser las enfermedades renales crónicas, las enfermedades cardiopulmonares, las enfermedades digestivas, pancreáticas o hepáticas, el cáncer, los errores del metabolismo, etc.
Es muy frecuentes que los niños desnutridos tengan infecciones repetidamente; de hecho, es la principal causa de mortalidad en ellos. Esto es debido a que el déficit de nutrientes altera las barreas de inmunidad que protegen contra los gérmenes y éstos pueden invadir fácilmente. Entre los gérmenes que más frecuentemente atacan a las personas desnutridas están el virus del sarampión, del herpes, de la hepatitis, el bacilo de la tuberculosis y los hongos. medicosecuador
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