Normal manifestations in the digestive system of young children

The function of the digestive system varies with the level of maturity of the child; An expression that may be abnormal in older children (like reflux) is normal in young children. Pregnancy can swallow amniotic fluid from the 12th week of pregnancy, but sucking activity starts to appear in babies since the 34th week of pregnancy.

From the 4th month, children like solid foods (Photo: TTO) About 1 month old, children begin to feel like food is sweet and salty. From the 4th month, children like solid foods. Current opinion recommends using solid foods for children from the 6th month based on nutritional needs rather than relying on the maturity of swallowing activity. While eating, children often swallow air and therefore need to burp the baby to prevent stomach distension.

The mouth area of ​​young children is considered normal

Short tongue strings can make parents anxious, but this pattern rarely affects children's chewing or pronunciation and often does not require surgical intervention. The tongue flap is also a normal morphological expression, so is the double-edged tongue, even in the case of a short pair in the back of the soft palate.

Reflux phenomenon in children

In the first year, young children have signs of outflow from the mouth that may be natural reflux or deliberate reflux. In healthy children with reflux, the amount of vomit fluid is usually about 15-30ml, or maybe more. Most children will still be happy after each reflux (although they may be hungry). In 1 day, reflux episodes may not occur or occur several times. 80% of cases of reflux often go away when the baby is 6 months old, and 90% self-exclusion when the child is 12 months old. If the child has complications of reflux or still has prolonged reflux after the above age, it is considered a pathology and not a normal morphological development characteristics, need to assess the level of influence and intervention treatment. Complications of reflux include poor growth, lung disease (dyspnea or pneumonia due to inhalation), esophagitis and esophageal lesions.

Eating in children

Toddlers often eat lazily or refuse to swallow food. There is a tendency to recommend that only toddlers and young children eat small amounts of food at each meal. Parents should also evaluate the nutritional quality of a meal a few days rather than day by day. Older children, who are in rapid growth, need nutritious and delicious food to help their children eat. Young children from the age of schooling to school age often have reduced appetite. Children should be regularly monitored and evaluated according to the standard growth chart.

Difference of stool color

The weight, color and nature of feces differ widely in one child or between children in the same age and cannot be explained. Stool immediately after birth is called meconium, dark, usually at 48 hours after birth. After the child receives the nourishment, meconium is replaced by temporary green-colored manure, usually with curd, lasting 4-5 days, then replaced with yellow-brown feces with milk.

In normal children, the number of bowel movements is unstable, possibly from 0-7 times / day. In breast-fed infants, small feces are stable with soft stool (temporary stool), then 2-3 weeks after the baby can go soft stool is not always stable. Breastfed babies may not have a bowel movement for 1-2 weeks and then still have normal bowel movements. Fecal color is less significant except in case of blood or bilirubin deficiency (white stool instead of yellow brown).

The presence of plant particles (pea or corn) in the stool of older children or toddlers is normal, indicating that the child chews food incorrectly, not being malabsorption. Irregular loose stool (called diarrhea of ​​toddlers) usually occurs in children 1-3 years old. This expression also occurs in healthy children who consume lots of carbohydrate-rich drinks and children who eat lots of snacks during the day; These children often go to the toilet during the day and have less bowel movements at night, the volume of water in the stool is often very much. This type of liquid digestion can be solved by giving children a non-carbohydrate drink and eating fatty foods.

Big belly is common in young children right after a full meal

This manifestation is due to a combination of causes: weak abdominal wall system; Big abdominal organs and postural scoliosis. In the first year after birth, the baby's liver may appear about 1-2cm below the right side of the rib. Normal liver when lightly tapping feels soft and uniform density. Riedel lobe is a piece of protruding protruding from the right lobe of the liver, which is palpable in the lower margin of the right abdominal wall.

It is also possible to feel the soft outer end of the spleen in normal conditions. In thin children, it is easy to feel the spine easily and the tissues that rise above the spine are often mistaken for tumors. Usually, the pulse of the aorta is recognized. Normally, it is possible to feel the fecal mass in the lower left half of the abdomen, where the colon is down and the sigmoid colon.

Jaundice

Jaundice usually occurs in newborns, especially in preterm infants, often due to immature liver and is associated with associated bilirubin disease, causing indirect bilirubin. Prolonged indirect bilirubin in breastfed infants may be due to jaundice caused by breast milk, usually benign in term infants, can be treated with replacement of breast milk with formula. Direct bilirubin is never normal, often suggesting liver disease, although the child may have a non-hepatic infection (eg urinary tract infection).

Direct bilirubin rates need to be more than 15-20% of the total bilirubin content. The disease of indirect indirect hyperbilirubinemia (which occurs in normal newborns) often causes mild yellowing (as bright as gold metal) in the sclera and skin of children, and the pathology of direct hyperbilirubinemia usually causes dark yellow.

Assoc. Dr. Doctor NGUYEN TRI DUNG