Nothing scares a mother more than incomprehensible changes in the baby's body. That is, there are changes, the mother sees them, but cannot explain. This is where confusion and anxiety come from. A lot of worries can cause the smell of acetone from the mouth of a child. Scary things come to mind. Pediatrician Yevgeny Komarovsky, well-known in Russia and the CIS, who enjoys indisputable authority among millions of mothers, tells parents what this can mean and how to help the baby.
What it is?
When there is a smell of acetone from the mouth or in the urine of a baby, acetone is detected in the laboratory (scary to think!), We are talking about acetonemic syndrome. This diagnosis is made by about 6-8% of children aged from one to 13 years. The people have long shortened the complex name of the problem to the phrase "acetone in children."
The onset of the syndrome is due to the fact that the content of ketone bodies in the child's blood significantly increases, which, in turn, are formed as a result of the breakdown of fat. During this complex process, acetone is released. It is excreted in the urine, if there is even a slight deficiency of fluid in the body, it enters the bloodstream, irritates the stomach and intestines, and acts aggressively on the brain. This is how acetone vomiting occurs - a dangerous condition that requires immediate assistance.
The formation of acetone begins when the child's liver runs out of glycogen stores. It is this substance that helps the body to draw energy for life. If the load is large (stress, illness, active physical activity), energy is consumed faster, glucose may not be enough. It is then that fats begin to break down with the release of the "culprit" - acetone.
In adults, this condition rarely occurs, since they have much richer glycogen stores. Children with their still imperfect livers can only dream of such. Hence, the frequency of the development of syndromes in childhood.
At risk are children of thin build, suffering from neuroses and sleep disorders, fearful, overly mobile. According to doctors' observations, they develop speech earlier, they have higher indicators of mental and intellectual development in comparison with their peers.
Symptoms
It is possible to suspect acetone syndrome in a child by some characteristic features:
- The child is lethargic and lethargic, the skin is pale, there are dark circles under the eyes.
- He has a poor appetite and is not in the mood.
- The child complains of headaches, which are in the nature of attacks.
It is possible to talk about the onset of acetone vomiting when a child develops severe nausea and vomiting, which can quickly lead to fluid loss, an imbalance in salt balance, in severe form - to the appearance of cramps, abdominal pain, concomitant diarrhea, and in case of failure to provide timely assistance - to death from dehydration.
The first "swallows" of the syndrome can be seen when the child turns 2-3 years old, most often crises can recur at the age of 6-8 years, and by the age of 13, as a rule, all signs of the disease disappear completely, since the liver is already formed and the body this age accumulates a sufficient supply of glucose.
The causes of exacerbations of acetone syndrome are rooted in many factors, including malnutrition, burdened heredity. If the child's family had relatives with metabolic disorders (with diabetes mellitus, gallstone disease, padagra), then the risk of the condition in the baby increases.
A doctor can accurately establish a diagnosis based on laboratory tests of urine and blood.
Komarovsky about acetone in children
Acetonemic syndrome is not a disease, Komarovsky believes, but just an individual feature of the child's metabolism. Parents should have a detailed idea of what processes take place in the child's body. They were briefly described above.
The causes of the syndrome is a rather controversial issue, the doctor believes. Among the main ones he names diabetes mellitus, starvation, liver diseases, disorders in the activity of the pancreas and adrenal glands, severe infectious diseases, as well as, oddly enough, concussion and traumatic brain injury.
Release of the program of Dr. Komarovsky on the topic "Acetone in children"
Heredity alone is not enough here, the doctor is sure. Much depends on the child himself, on the ability of his kidneys to excrete harmful substances, on the health of the liver, on the speed of metabolic processes, in particular on how quickly he can break down fats.
The doctor emphasizes that it is not worth panicking to parents who have discovered the smell of acetone from the mouth of a child. However, it is impossible to leave him unattended, if necessary, mom and dad should be ready to provide first aid.
Treatment
The treatment of the syndrome should appeal to babies, as it is quite delicious. The main remedy for eliminating glucose deficiency is sweet drinks, sweets. A child with acetone syndrome should get enough of them. Therefore, already at the first suspicion, as soon as the parents smelled the smell of acetone from the child, they should start giving him glucose. It can be a tablet or a solution. The main thing is to drink it often - a teaspoon every five minutes, if we are talking about a baby, a tablespoon or two tablespoons at the same intervals, if the child is already quite large.
It is advisable to give the child a cleansing enema with soda (a teaspoon of baking soda and a glass of warm water), and prepare a supply of "Regidron" in case you need to restore the water-salt balance.
If the parents manage to seize the initiative in time, then everything will end there. If the slightest delay was allowed, the onset of a more severe manifestation of the syndrome, vomiting, is likely.
With acetonemia, it is usually so intense that it is no longer possible to give the child sweet tea or compote. Everything he drank is immediately outside. Here Komarovsky recommends to act quickly. You should call a doctor, preferably an ambulance. To stop such vomiting, in most cases, it is required to introduce a large amount of sweet liquid - pharmacy glucose through a dropper.
In addition, the baby will not be hurt by an injection of the drug from vomiting (usually "Cerucal" is used). When the gag reflex subsides under the influence of medication, it is necessary to start actively giving the child sweet water, tea with sugar, glucose. The main thing is to drink really plentiful. It should be remembered, says Komarovsky, that "Tserukal" and similar drugs act on average for 2-3 hours. Parents have only this time to completely restore fluid loss and glucose supply, otherwise vomiting will begin again and the child's condition will worsen.
It will be better if the baby will endure a severe attack of the syndrome not at home, but in a hospital. Self-medication, emphasizes Yevgeny Olegovich, can do much harm, so it will be better if the treatment is under the supervision of specialists.
Doctor Komarovsky's advice
It is easier to prevent crises of acetone syndrome than to eliminate urgently, says Evgeny Olegovich. There is no need to specifically treat the condition with something; certain rules should be introduced into the daily life of the family in general and the child in particular.
The child's diet should contain as little animal fats as possible. Ideally, they shouldn't be at all. In other words, you do not need to give your child butter, a large amount of meat, margarine, eggs, you need to give milk very carefully. Smoked meats, soda, pickles, pickled vegetables and spices are strictly prohibited. And less salt.
After a crisis, the child should be allowed to eat at any of his requests, since the baby's body must quickly restore the glycogen reserve. The child should eat at least 5-6 times a day. The total duration of the diet is about a month. Komarovsky recommends giving him porridge on the water, mashed potatoes, oven-baked apples, dried fruit compote, pure raisins, low-fat meat in small quantities, fresh fruits and vegetables, vegetable broths and soups. If the child asks to eat more often, between meals, you can give him the so-called light carbohydrates - banana, semolina in water.
- In the home medicine cabinet of the family where the child lives "with acetone" there must be special pharmaceutical test strips for the determination of ketone bodies in urine. While you are diluting your child with another portion of glucose, you can do such an analysis at home. The result will be assessed visually: the test shows "+/-" - the child's condition is characterized as mild, the number of ketone bodies does not exceed 0.5 mmol per liter. If the test shows "+", the amount of ketone bodies is approximately 1.5 mmol per liter. This is also a mild condition, the child can be treated at home. The strip that shows "++" indicates that there are about 4 mmol of ketone bodies per liter in the urine. This is a moderate condition. It is advisable to take your child to a doctor. "+++" on the test - a distress signal! This means that the child is in serious condition, the number of ketone bodies is more than 10 mmol per liter. I need urgent hospitalization.
When giving the child a plentiful drink, parents should know that the liquid will be absorbed faster if it is not cold, but has a temperature similar to that of the baby's body.
To prevent recurrent attacks, Komarovsky advises to buy a vitamin preparation "Nicotinamide" (the main vitamin PP) at the pharmacy and give the child according to the instructions, as it effectively participates in the regulation of glucose metabolism.
The described treatment regimen, Komarovsky emphasizes, is relevant for most types of acetonemic syndrome, with the exception of the condition caused by diabetes mellitus. With this serious ailment, there is no glucose deficiency as such, there is another problem - it is not absorbed by the body. Such "acetone" should be treated in a different way, and an endocrinologist should do it.
- A child who has at least once suffered an acetone crisis needs to spend more time in the fresh air, walk a lot, and play sports. However, parents definitely need to control the physical activity of their child. They should not be excessive, the child should not be allowed to go to exercise or walk on an empty stomach. The release of energy will require glucose, and if it is not enough, the attack may recur.
