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Overweight children

concern is the high number of children in our country show a clear overweight. Of this, a minority are obese may suffer some kind of metabolic disease that determines the accumulation of fat. By contrast the remaining majority of these children are obese, that is, that overweight has been determined primarily by psychological factors, family or cultural. Both

corresponding to one group or the other, are showing a little upset, and it is advisable to naturally remedy soon.

to reply to your most important questions about obesity.

why obesity occurs?

A person becomes obese when they eat more calories than you expend. Those calories add up, in the form of fat in cells called adipocytes. There are obese have overcrowded cells (hypertrophic obesity), and others who have more amount of fat cells than normal, leading to obesity called hyperplasia.

Can you increase the number of adipocytes in a child?

In some periods, such as early childhood and puberty, fat cells reproduce. If the child is fed improperly during these stages, there is a risk of unduly increasing the number of these cells, which favors the formation of obesity in children.

Many parents let their kids get fat if they "lose weight and when I grow up", this is obviously a serious error.

Is hereditary?

hunger and satiety Both are regulated by the hypothalamus, by chemical transmission, yet are not entirely clear these mechanisms. Appear to be inherited the amount of food they eat to feel full to eat much parents usually have children who eat more of the account as well.

In a study of twins who are separated and raised in different households, concluded that obesity is partly hereditary. This study found that most obese children have parents who are too. Thus, if both parents are normal weight, as a nine per cent of cases children are chubby, whereas if one parent outweighs the children will account for 41 percent chance to weigh more. The figure increases if both parents are obese, but in these cases the risk of obesity as high as 73 percent.

Does excess weight gain may result from a disease?

Some central nervous system lesions and certain endocrine problems such as hypothyroidism, can cause this symptom. Just as the excess of corticosteroids, whether they produced by the body or taken to combat other diseases.

The excess kilos in children is a major problem not only for its psychological consequences but also because the little "chubby" can become obese adults.

When a child is considered obese?

When weighs 10 percent more than indicate the tables as the ideal weight for age is considered overweight, and obese if he exceeds by 20 percent (or more) the amount that these tables show how the weight.

What should parents do when they discover their child weighs more than necessary?
It is advisable to go to the pediatrician and so to remedy this weight gain and prevent runoff to become a fat or in the worst cases, in an obese.

What is the treatment?

Childhood obesity is easy to correct, especially when not associated with any disease. Proper diet, that regulates the intake of sugars and fats, which are abundant in vegetables and fruits, it works. In general, it is necessary to prescribe medications to children chubby.
What physical hazards involved in obesity? Virtually none

childhood. The most serious of all is that it determines an obesity as an adult, and then carries big risks, such as heart disease.

What steps can parents take a child obese?

addition to go to the pediatrician, parents should avoid offering "fast food" (chips, cookies, candies). It is also important to play with him to move and exercise.

tricks parents
The most important help you can give parents a fat is to support and to avoid all kinds of temptations.

• not leave food in view of the child. Do not buy anything
• need to prohibit their child.
• whole family warns, so it is not eating because food has never been., No one suffers from not eating sweets, cakes, drinks etc. .. leave them for the holidays.
• if on a pancake, making it disappear from view, otherwise, it is certainly he who eats it.
• Serve small plates, they rarely ask for repetition.
• establish a fixed place to eat. Do not allow watching TV or reading.
  

A psychological system

The fat is not synonymous with health and happiness . "The popular image of happy fat" is not a myth - because most of obese children are intensely unhappy. Not only have to face ridicule and rejection from other children but also, they see themselves as something unpleasant. They get to live their fat as a kind of misfortune that has stock up when mud is that it is motivated by bad habits acquired gradually. If you get a chocolate when you are sad, fries when they fall into the square and, when bored, a piece of cake the child can confuse any unpleasant feeling of hunger. Wrong with this learning, anxiety, boredom or depression, will lead inexorably to the kitchen, where you will find a comfort inadequate.

If he thins it help. An evaluation of their eating habits: how much you eat, when, before which certain situations. In order to modify their behavior, and it is agreed with the quantity and quality of food to be eaten. Surely the child will make mistakes, but it is increasingly to reduce the number of those ".

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Sudden Infant Death

Introduction.

The sudden death (MS) in infants is one of the most tragic conditions in the family life, representing one of the most frequent causes d infant death in developed countries. Despite all the effort many aspects unknown which occurs this tragedy

How is it defined?

The sudden death (SD) infant is defined as the death of a child under one year, with history, physical examination and post-mortem evaluation revealed no known cause. Frequency



Since 1999, the MS is the third leading cause of infant death in North America, most cases being children aged between 3 and 5 months of age (90% occur before 6 months). In Chile, information about exact figures for the incidence of MS.

Why does it occur?

To date, no mechanisms have been identified to explain their cause. Have been postulated multiple theories.

In addition, most cases of MS are probably in a sequence started by a defect in the control of respiratory or cardiac center during vulnerable periods of neurological maturation. Findings

after the tragedy

MS diagnosis necessarily involves a study of autopsy. The findings are classically blue color of the skin and mucous membranes, abundant mucus in the oral and nasal cavity. Autopsies reveal the presence of food debris in the airway, which supported the theory of aspiration horn cause of MS, but it is unclear if this phenomenon would occur post-deceased
RISK FACTORS


There are numerous risk factors for MS, extrapolated from population studies., Within this group, highlights the prenatal and postnatal maternal smoking, which increases the nsk up to 3 times. There is much evidence that MS is more common in lower socioeconomic population. Foreign population studies show that 57% of mothers of children with sudden death had not completed studies and 32% were teenage mothers.

risk factors associated with sudden death while sleeping position




Males Smoking




Prematurity Low birth weight and delay
Intrauterine growth


Socioeconomic

prone sleeping position:

Prone position prone infant sleep has been linked to increased risk of MS;

The introduction of mass media campaigns promoting the supine position during sleep showed a significant reduction in the numbers of MS.

The decrease in the incidence of MS has been more than 50% since 1992 in countries where the campaign was built. New recommendations



While in 1992, the American Academy of Pediatrics (AAP) recommended as safe "any position not prone" to sleep currently is no consistent evidence that states that the lateral position is equally risky to sleep in the prone position.

The risk of lateral decubitus position attributed to the possibility of turning prone during sleep. Based on the above is that the AAP in its latest recommendations only recommends supine sleep position for infants. "Supine means sleeping face up



proper mattress sleep habits, such as the use of soft surfaces, pillows and soft blankets have been associated with an increased risk of suffocation and MS

Sharing bed with parents is a topic of debate. Although studies have shown sleep patterns in infants that promote breastfeeding, reported cases of suffocation and death in infants who shared a bed with their parents have questioned this behavior.

The risk is also higher, having a history of smoking or drug abuse in parents of children.

The AAP recommends that infants under 6 months, the safest place to sleep is a crib in the same room of parents and not in the same bed with them.

pacifier use.

pacifier use as a protective factor has been supported by multiple studies, with an OR of 0.47 on average. The mechanism by which the use of pacifiers decrease the MS is not clear, it postulates a reduction to wake up. Pacifier use in this age group has not shown cause problems with breastfeeding or dental care, however, there is no consensus on its use.

Sobreabrigar the child

sobreabrigar There is some evidence that infants would be associated with greater MS, especially in children who sleep in the prone position.

more frequent in children of low birth weight

About 30% of children who died from MS weighed <2500g al nacer y tenían el antecedente de ser prematuros de menos de 37 semanas. El riesgo se hace mayor a menor peso de nacimiento < 1500g.

Relationship

vaccines present no evidence linking MS to vaccines and immunizations. There are case reports that linked the vaccine Diphtheria-Tetanus-Pertussis with MS, however, no data to support this assertion. Relationship

breastfeeding

The association between breastfeeding and MS is unclear and not been a consensus among experts. Physiological studies show that breastfed infants have a lower threshold of wakefulness that formula-fed peers. This would support a protective effect of breastfeeding on the MS. However, epidemiological studies do not reflect this benefit, there is a reduced risk of MS or sufficient evidence in the literature to establish breastfeeding as a protective factor for MS.


INFANTICIDE AND CHILD ABUSE
First reports made in the 1970's that supported the theory of cardiorespiratory control in a family with several children with MS were found to be infanticide, after the confession 30 years after the mother of these children. It is recommended to maintain a high suspicion of infanticide in recurrent cases or doubtful. An undercover murder could be the cause of MS in 6 to 10%.

MANAGEMENT AND DISPLAY OF MONITOR

The indication of a cardiorespiratory monitor in patients with risk factors or sudden death frustrates "event or apparent threat to life (ALTE) was for many years, the mainstay of prevention a possible MS future. However, there is no evidence in the literature to support the use of a cardiorespiratory monitor for the prevention of MS.

The current AAP recommendation is for the following cases:

• Patients with ALTE or life-threatening event "
• Patients with tracheotomy or alterations of the airway that can lead to unstable air.
• infants with metabolic or neurology affecting respiratory control.
• Patients with chronic lung disease requiring oxygen therapy or home ventilation.
  

machine plus some

The recommendation of a monitor must be accompanied by teaching CPR to parents. Should be advised of the real impact of the monitor and that does not prevent MS, but allows recognition of possible risk events by parents or caregivers of patients at risk



Brothers with MS MS in the recurrence of another brother is low. Described in the literature reports a frequency of about I%, the twins have a higher risk of recurrence to 4%. The indication of a cardiorespiratory monitor in a patient's siblings died of MS is controversial. There is insufficient evidence to support this practice

Recommendations

final recommendations to prevent MS suggested by the AAP are summarized below:

1. promote supine sleep position for infants prone
2. Avoid positions and lateral
3. Prevent infants sleeping on soft surfaces
4. Avoid soft items like stuffed animals, blankets, etc. in the cradle of the infant
Suspend
5. pre-and postnatal smoking.
6. suggest that infants sleep close (in a cot) but not with parents in the same bed.
7. sobreabrigar not sleep.
8. cardiorespiratory not use the monitor as a preventive method of MS and indicate when really justified.
   

Consider using a pacifier to sleep, but not use force once the child is released.

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A fat child is a healthy child when

The first thing we note is that these concepts are outmoded and now parents, advised by the doctor, have an essential role in preventing obesity in children.

Most children presented a simple obesity that is caused by an imbalance between their physical requirements and what you eat.

rare cases of secondary disease due to other conditions such as hypothyroidism, genopatía ...

An important concept, however, is that each organism has requirements different, ie not all children need to eat the same amount. Denying, in some cases, can contribute to obesity.

Another premise is remarkable that we can not measure our love for the child by the stomach. Not so much happiness because he ate it all, nor offering candy because it is crying ...

The number of obese increases day by day. There is an undeniable influence on all media that promote consumption of various foods with high calories and little nutritional value.

There are four fundamental conditions that lead us to seriously worry about the problem of obesity and its prevention.

First, are the proven biological risks for lower fat, expressed in a deterioration and shortening of adult life with diabetes, hypertension or coronary heart disease.
There are also concrete evidence that obesity in childhood is brewing, so the pediatrician's role is crucial.

must also take into account how difficult and disappointing that it is today, although the propaganda to the contrary, an effective treatment for obesity.

Finally, this disease has increased alarmingly in our environment.

But what is obesity?

In itself not a disease but is a symptom complex due to the accumulation of fat in larger quantities than normal in the body, resulting in excessive weight.

What does childhood obesity?

The inconvenience is basically the emotional, psychological and particularly the increased risk that these kids have to become obese adults.
is estimated that two out of ten children under two years, with fat, are obese future school age, but on the other hand, only 10 percent of school children were obese chubby infants. Another

age at which future obesity is given in adolescence. In other words, seven out of ten pubescent attending this age overweight will become obese adults. At that age, pediatricians and lost the opportunity of changing habits.

What are the risks that obesity poses for adults?

There is a risk three times higher for diabetes mellitus, hypertension and cardiovascular disease for people with normal weight.

also complicate respiratory diseases have a higher frequency of varicose veins, more digestive problems, especially gallstones, especially in women.

Interestingly, we recently found increased the incidence of some cancers in obese people.

Other complications include skin lesions at the folds and an increased risk for problems in the lower extremities, preferably osteoarthritis.

For all these reasons the role of the pediatrician is crucial in the prevention of obesity in the first year of life.

Obesity, is synonymous with eating too much?

has traditionally been regarded as the result of eating too much and move frequently.
The information we have now is that this is true, are factors that relate to it, but there are other factors, including genetics, which are very important the development of this disorder. Pediatrics has a great opportunity to survey this group of children in their earliest years to bring the habits necessary for a proper diet high risk group!

How is the diagnosis of this disease?

Any of us, having never studied medicine can say "this child is obese." It's up to feel the folds in the abdomen, to see the face, thighs. The naked eye has more than 80 percent of coincidence as medical diagnosis. This usually can do the family or people living with the child.

qualifies How overweight?

Doctors use the scale. It is most common. But an absolute number does not matter if it relates to the child's height. It should compare the table of weights and heights, parameters used by health services throughout the country.

The weight is variable from one person to another because tissues, as well as body fat, are different from one organism to another. Also, muscle tissue and bone are different.

A person can weigh more than his due, but if you are an athlete that overweight corresponds to muscle and not fat. It would be a mistake to call it a obese.

definitive diagnosis of the disease a physician, who through a proper assessment of fat, muscle and bone tissue can determine the percentage of overweight. And, even more, with the support of the laboratory, discard secondary diseases.

Is it the same overweight obesity?

A person is overweight when it exceeds 10 percent of weight for their height. Obese when this figure is higher than 20 percent.