Post on 09-Oct-2015
Diapositiva 1
ESTACAMENT PONDERAL EL PRIMER MES DE VIDA I HIPOGALCTIAHIPOGALACTIAHIPOGALCTIA??
ESTANCAMENT PONDERAL EL PRIMER MES DE VIDA!!!Ms del 80% de les mares volen alletarAls 4 mesos noms ho fa un 35%La causa s NO TENIR LLETDEFINICI (segons les mares)La mare diu: No tinc llet no va tenir la pujada (baixada) de la llet pits tous el beb plora el beb no dorm el beb no aguanta les 3 hores llet aigualida el nen no engreixa no va poder alletar un fill anterior la meva mare no va poder alletarCAUSA DE NEUMNIA:Un refredat mal curatAgafar fredEstar en un corrent daireVirusBacteris (nosocomial, comunitria)MycobacterisHIPOGALCTIADescartarem hipogalctia davant un escs guany ponderal
Escs guany de pes: variant de la normalitat malaltia del nen tcnica de lactncia incorrecta (no demanda, aigua i infusions) hipogalctia tractable hipogalcita intractableTipus dhipogalctia Hipogalctia veritable Per maneig innadequat Per malaltia del nen Falsa hipogalctiaIntractable: hipoplssia mamria, dficit de prolactina (Sheehan i pseudosheehan), reducci mamria.Tractable: hipotiroidisme, retenci placentria, frmacs inhibidors (diurtics, antihistamnics, salvia)Horaris, posici, sd de confusi, infusions, suplements de frmulaMalaltia que disminueix la ganaTrastorn per a mamar: tel lingual, hipotonia, succi immaduraAltres problemes: retard constitucional de creixement, plor, al.lrgiaCap problema: pits buits, rebuig del pit, no aguanta 3 hores, augment de pes normalTipus dhipogalctia Hipogalctia veritable Per maneig innadequat Per malaltia del nen Falsa hipogalctiaIntractable: hipoplssia mamria, dficit de prolactina (Sheehan i pseudosheehan), reducci mamria.Tractable: hipotiroidisme, retenci placentria, frmacs inhibidors (diurtics, antihistamnics, salvia)Horaris, posici, sd de confusi, infusions, suplements de frmulaMalaltia que disminueix la ganaTrastorn per a mamar: tel lingual, hipotonia, succi immaduraAltres problemes: retard constitucional de creixement, plor, al.lrgiaCap problema: pits buits, rebuig del pit, no aguanta 3 hores, augment de pes normalQUAN NO HI HA PROBLEMA Escoltar Mostrar respecte No donar consells No donar placebos: herbes i infusions aliments mgics canvis en la dieta frmacs beure aigua beure cervesa augmentar la freqncia de les presesSaraALTRES PROBLEMES Nens petits (el 3% per sota P3) Retard constitucional del creixement Plor Al.lrgia/intol.lerncia a la protena de la llet de vacalioMarMarCarlaTipus dhipogalctia Hipogalctia veritable Per maneig innadequat Per malaltia del nen Falsa hipogalctiaIntractable: hipoplssia mamria, dficit de prolactina (Sheehan i pseudosheehan), reducci mamria.Tractable: hipotiroidisme, retenci placentria, frmacs inhibidors (diurtics, antihistamnics, salvia)Horaris, posici, sd de confusi, infusions, suplements de frmulaMalaltia que disminueix la ganaTrastorn per a mamar: tel lingual, hipotonia, succi immaduraAltres problemes: retard constitucional de creixement, plor, al.lrgiaCap problema: pits buits, rebuig del pit, no aguanta 3 hores, augment de pes normalLionelNilLMPMotiliumTipus dhipogalctia Hipogalctia veritable Per maneig innadequat Per malaltia del nen Falsa hipogalctiaIntractable: hipoplssia mamria, dficit de prolactina (Sheehan i pseudosheehan), reducci mamria.Tractable: hipotiroidisme, retenci placentria, frmacs inhibidors (diurtics, antihistamnics, salvia)Horaris, posici, sd de confusi, infusions, suplements de frmulaMalaltia que disminueix la ganaTrastorn per a mamar: tel lingual, hipotonia, succi immaduraAltres problemes: retard constitucional de creixement, plor, al.lrgiaCap problema: pits buits, rebuig del pit, no aguanta 3 hores, augment de pes normalHipoplssia tubular mamria Reducci Sheehan o pseudosheehanHIPOGALCTIA VERITABLE INTRACTABLEAleixMotilium Retenci placentria Hipotiroidisme Frmacs: diurtics, antihistamnics, salvia
HIPOGALCTIA VERITABLE TRACTABLEMotiliumSTOPJliaTipus dhipogalctia Hipogalctia veritable Per maneig innadequat Per malaltia del nen Falsa hipogalctiaIntractable: hipoplssia mamria, dficit de prolactina (Sheehan i pseudosheehan), reducci mamria.Tractable: hipotiroidisme, retenci placentria, frmacs inhibidors (diurtics, antihistamnics, salvia)Horaris, posici, sd de confusi, infusions, suplements de frmulaMalaltia que disminueix la ganaTrastorn per a mamar: tel lingual, hipotonia, succi immaduraAltres problemes: retard constitucional de creixement, plor, al.lrgiaCap problema: pits buits, rebuig del pit, no aguanta 3 hores, augment de pes normalAina
AinaLucasMotiliumResumint
1er. Vosaltres no sou els pediatres/infermeres2on. Posici3er. Augmentar la producci (nen b col.locat/tirallets)4rt. Suplementar amb llet materna5. Posici5. Suplements hidrolitzats6. Augmentar la producci (tirallets/medicaci)
WHO Child Growth Standards
Weight-for-age GIRLSBirth to 6 months (percentiles)
Age (completed weeks or months)
Wei
ght
(kg)
3 4 5 6
2
3
4
5
6
7
8
9
10
2
3
4
5
6
7
8
9
10
10 2 3 4 5 6 7 8 9 10 11 12 13Weeks
Months
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age BOYSBirth to 2 years (percentiles)
Months
Age (completed months and years)
Wei
ght
(kg)
1 yearBirth 2 years
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Length-for-age BOYSBirth to 2 years (percentiles)
Months
Age (completed months and years)
Leng
th (c
m)
1 yearBirth 2 years
45
50
55
60
65
70
75
80
85
90
95
45
50
55
60
65
70
75
80
85
90
95
1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age GIRLSBirth to 2 years (percentiles)
Months
Age (completed months and years)
Wei
ght
(kg)
1 yearBirth 2 years
2
3
4
5
6
7
8
9
10
11
12
13
14
15
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Length-for-age GIRLSBirth to 2 years (percentiles)
Months
Age (completed months and years)
Leng
th (c
m)
1 yearBirth 2 years
45
50
55
60
65
70
75
80
85
90
95
45
50
55
60
65
70
75
80
85
90
95
1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age GIRLSBirth to 2 years (percentiles)
Months
Age (completed months and years)
Wei
ght
(kg)
1 yearBirth 2 years
2
3
4
5
6
7
8
9
10
11
12
13
14
15
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age BOYSBirth to 6 months (percentiles)
Age (completed weeks or months)
Wei
ght
(kg)
3 4 5 6
2
3
4
5
6
7
8
9
10
2
3
4
5
6
7
8
9
10
10 2 3 4 5 6 7 8 9 10 11 12 13Weeks
Months
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age BOYSBirth to 6 months (percentiles)
Age (completed weeks or months)
Wei
ght
(kg)
3 4 5 6
2
3
4
5
6
7
8
9
10
2
3
4
5
6
7
8
9
10
10 2 3 4 5 6 7 8 9 10 11 12 13Weeks
Months
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age BOYSBirth to 6 months (percentiles)
Age (completed weeks or months)
Wei
ght
(kg)
3 4 5 6
2
3
4
5
6
7
8
9
10
2
3
4
5
6
7
8
9
10
10 2 3 4 5 6 7 8 9 10 11 12 13Weeks
Months
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age GIRLSBirth to 6 months (percentiles)
Age (completed weeks or months)
Wei
ght
(kg)
3 4 5 6
2
3
4
5
6
7
8
9
10
2
3
4
5
6
7
8
9
10
10 2 3 4 5 6 7 8 9 10 11 12 13Weeks
Months
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age GIRLSBirth to 6 months (percentiles)
Age (completed weeks or months)
Wei
ght
(kg)
3 4 5 6
2
3
4
5
6
7
8
9
10
2
3
4
5
6
7
8
9
10
10 2 3 4 5 6 7 8 9 10 11 12 13Weeks
Months
15th
3rd
97th
50th
85th
WHO Child Growth Standards
Weight-for-age BOYSBirth to 6 months (percentiles)
Age (completed weeks or months)
Wei
ght
(kg)
3 4 5 6
2
3
4
5
6
7
8
9
10
2
3
4
5
6
7
8
9
10
10 2 3 4 5 6 7 8 9 10 11 12 13Weeks
Months
15th
3rd
97th
50th
85th