Dr. Komarovsky about the smell of acetone from the mouth of a child

Nothing scares mom as incomprehensible changes in the body of the baby. That is, there is a change, the mother sees them, but can not explain. From here confusion and anxiety are taken. A lot of anxiety can cause the smell of acetone from the mouth of a child. Scary things come to mind. The fact that this can mean and how to help the crumbs, is told to parents by the well-known pediatrician Yevgeny Komarovsky, who is indisputable authority among millions of moms, on the territory of Russia and the CIS.

When appears smell acetone from the mouth or in the urine of the baby is detected laboratory (scary to think!) acetone, we are talking about acetonemic syndrome. This diagnosis is made by approximately 6-8% of children aged from one year to 13 years. In the people, the difficult name of the problem was long ago reduced to the phrase “acetone in children».

The emergence 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 at least a small deficiency of fluid in the body, it enters the bloodstream, irritates the stomach and intestines, and acts aggressively on the brain. This is how acetonemic vomiting occurs - a dangerous condition that requires immediate assistance.

The formation of acetone begins when the child’s glycogen stores run out. This substance helps the body draw energy for life. If the load is large (stress, illness, active physical exertion), energy is consumed faster, glucose may not be enough. It is then that fats begin to split with the release of the “culprit” - acetone.

In adults, this condition occurs rarely, because they have much richer glycogen stores. Children with their still imperfect liver can only dream of such. From here and frequency of development of syndromes at children's age.

One can suspect acetonemic syndrome in a child by some characteristic signs:

• The child is lethargic and inhibited, the skin is pale, under eyes - dark circles.
• He has a bad appetite and no mood.
• The child complains of headaches, which are in the nature of attacks.

It is possible to talk about the onset of acetonemic vomiting when a child has severe nausea and vomiting, which can quickly lead to loss of fluid, disruption of salt balance, severe form of seizures, abdominal pain, concomitant diarrhea and in case of failure to provide timely assistance - Fatal from dehydration.

The first “swallows” of the syndrome can be seen when a 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 to this age accumulates an adequate supply of glucose.

Causes of exacerbations of acetonemic syndrome are rooted in a variety of factors, including poor diet, burdened heredity.If the family had relatives with metabolic disorders (diabetes, gallstone disease, padagroy), then the risk of a baby’s condition increases.

Acetonemic syndrome is not a disease, according to Komarovsky, but only an individual feature of the metabolism of a child. Parents should be fully aware of exactly what processes occur in the children's body. In short, they were described above.

The causes of the syndrome - a rather controversial issue, the doctor said. He calls diabetes mellitus, starvation, liver diseases, pancreatic and adrenal gland disorders, severe infectious diseases, as well as, brain concussion and brain injuries among the main ones.

The release of the transfer of Dr. Komarovsky on "Acetone in children"

Heredity alone is not enough, the doctor is sure. Much depends on the child himself, on the ability of his kidneys to remove harmful substances, on the health of the liver, on the speed of metabolic processes, in particular, on how quickly fats can decompose.

The doctor stresses that there is no need to panic for parents who have detected the smell of acetone from the mouth of the child. However, it is impossible to leave him alone, if necessary, mom and dad should be ready to provide first aid.

Treatment of the syndrome should appeal to kids, because it is quite very tasty. The main remedy for the elimination of glucose deficiency is sweet drink, sweets. A child with acetonemic syndrome should receive them in sufficient quantities. Therefore, even at the first suspicions, as soon as the parents smelled acetone from the child, you should start giving him glucose. This may be a drug in tablets or in solution. The main thing is to drink it often - a teaspoon every five minutes, if you 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 put the child a cleansing enema with soda (a teaspoon of soda and a glass of warm water), and prepare a stock "Rehydron»In case you need to restore the water-salt balance.

If the parents manage to seize the initiative in time, then this will all end. If the slightest delay was allowed, the onset of a more severe manifestation of the syndrome, vomiting, is likely.

In case of acetonemia, it is usually so intense that it is no longer possible to feed the child with sweet tea or compote. All he drank is immediately outside. Here Komarovsky recommends to act quickly. It is necessary to call a doctor, better "First Aid". To stop such vomiting, in most cases it is required to introduce a large amount of a sweet liquid — pharmacy glucose — to the child through a dropper.

In addition, the kid will not interfere with the injection of the drug from vomiting (usually usedZeercal"). When the gag reflex under the influence of medications subsides, we must begin to actively water the child with sweet water, tea with sugar, glucose. The main thing is to drink really abundant. It should be remembered, says Komarovsky, that “Tsirukal” and drugs like it act for an average of 2-3 hours. The parents have only this time to completely restore the loss of fluid and the supply of glucose, otherwise vomiting will begin again, and the child’s condition will worsen.

It would be better if the baby suffered a severe attack of the syndrome not at home, but in the hospital. Self-treatment, emphasizes Evgeny Olegovich, can do great harm, therefore it would be better if the treatment is carried out under the supervision of specialists.

Crises of acetonemic syndrome are easier to prevent than urgently eliminate, says Yevgeny Olegovich.Specially with something to treat the condition is not necessary, you should introduce certain rules in the daily life of the family in general and the child in particular.

• In the diet of the child should be as little animal fat as possible. Ideally, they should not be at all. In other words, do not give the child butter, a large amount of meat, margarine, eggs, very carefully you need to give milk. Smoked foods, soda, pickles, pickled vegetables and seasonings are strictly prohibited. And less salt.

  After a crisis, the child needs to be given food on any demand, since the baby’s body must quickly restore its glycogenic reserve. A 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 in water, mashed potatoes, baked apples, dried fruit compote, raisins in pure form, lean meat in small quantities, fresh fruits and vegetables, vegetable broths and soups. If a child asks to eat more often, between meals you can give him so-called light carbohydrates - banana, semolina porridge on water.

• In the family first aid kit of the family where the child “with acetone” lives, there must be special pharmacy test strips on the determination of ketone bodies in the urine. While you are breeding your child with another portion of glucose, you can do this analysis at home. The result will be evaluated 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 about 1.5 mmol per liter. This is also an easy condition, the child can be treated at home. The strip that shows “++” indicates that there is about 4 mmol of ketone bodies per liter in the urine. This is a state of moderate severity. It is advisable to go with the child to the doctor. “+++” on the test is a distress signal! This means that the child is in serious condition, the amount of ketone bodies is more than 10 mmol per liter. Need urgent hospitalization.

• When giving a child plenty of 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 seizures, Komarovsky advises buying at the pharmacy and giving the child Nicotinamide vitamin supplement (basic vitamin PP) according to the instructions, since he is effectively involved in regulating glucose metabolism.

• The described treatment regimen, Komarovsky emphasizes, is relevant to most types of acetonemic syndrome, with the exception of the condition caused by diabetes mellitus. In this serious illness there is no deficiency of glucose as such, there is another problem - it is not absorbed by the body. Treat this "acetone" in a different way, and the doctor-endocrinologist should do this.

• A child who has suffered an acetonemic crisis at least once needs to spend more time outdoors, walk a lot, play sports. However, parents definitely need to control the physical loads of their offspring. They should not be excessive; one should not allow the child to go to train or walk on an empty stomach. The release of energy will require glucose, and if it is not enough, the attack can recur.