Modern approaches to improving the health of children in preschool educational institutions

In this article:

Your child has turned 2 years old, which means he has entered the period before school age. This period is divided into “junior” and “senior”, covering ages from 2 to 7 years. Now the kids are active, love fresh air and active group games. This is a normal stage of physical development. Now boys and girls differ slightly in basic indicators of height and weight. The girls are still petite. Data on the height and weight of children will be shown in a simple development table below.

It is important to adhere to a certain diet and rest regimen. Do not overfeed children 2-7 years old. Their bodies know better when to stop.. The diet should be dominated by healthy foods: lean meat, fish, fresh vegetables and fruits, cereals. For proper physical development, follow the regimen: 4 meals a day. Breakfast should be the most satisfying, and dinner should be light.

Preschool age

The concept of “preschool age” can be divided into two large periods. Children are divided into two groups:

• junior preschool age - from 2 to 4 years;
• senior preschool age - from 4 to 7 years.

All this time, babies are actively developing physically. There is a good increase in height and weight, molars are appearing. Your baby is with everyone
As the years go by, he becomes more mature, more resilient and more active. The preschool period is associated with increased motor activity. Outdoor, group games are preferred. Now children need correct mode rest and nutrition.

Physical development closely related to the mental and emotional. If now parents limit the baby’s movements and force calm, quiet games on him, this will have a bad effect on nervous development. In addition, the brain needs a lot of oxygen, and movement and games in the fresh air can provide it.

The baby grows, and the main indicators of physical development also grow: height and weight. Much here depends on the parents, their lifestyle and diet. The main thing is to provide children at this age with healthy, balanced food.

Child development indicators

The main thing is to remember: every child develops according to individual plan. Hereditary and acquired characteristics are important here:

If the baby was born prematurely, the usual development table is not indicative. Such children slowly gain weight and catch up with full-term children only by 2-3 years. But in all other cases, remember: children do not develop identically.

Mothers often listen to the advice of neighbors and girlfriends who may criticize the baby’s height or weight. Don't take risks with recipes traditional medicine and self-medication of non-existent diseases. If you have any concerns, see a doctor. The child development table contains average indicators. A slight deviation is not a big deal. You should only do something if your doctor gives a referral for treatment.

Height

This is a very active period for a child's growth. The increase in height of preschool children is (according to average data) from 4 to 6 centimeters per year. Agree, this good indicator growth. The baby changes quickly, which means you need to buy more and more children's clothing.

Table of changes in height of children from 2 to 7 years (in cm)

As you can see, boys are ahead of girls in height at this time. This situation will continue until puberty.

Weight

During this developmental period, it is absolutely normal for your baby to gain 2 to 3 kg per year. If the increase is significantly greater, then you should see a doctor. The exception is the end of the period when the child is already 6-7 years old. Now weight can be added by 5-6 kg per year. All this time, boys look more wiry than girls. Nutrition should not be blamed for this - it’s just that preschool boys’ metabolism is much faster and they are more active than girls.

Table of weight changes for children from 2 to 7 years old (in kg)

Parents should weigh their children on a room scale themselves, and also be monitored by a pediatrician. The belief that children need to be “fed to be healthy” is just a myth. Overeating at this age will lead to more problems in the future.

Pulse in children

There is another important indicator of physical development - pulse. This is a reflection physical condition body, work internal organs. The most important thing is the work of the heart and blood vessels. For boys and girls, the heart rate is approximately the same at this age.

Table of data on the pulse of children 2 to 7 years old (beats per minute)

A child's heart beats much faster than an adult's. Only after 16 years of age does the child’s heart rate and pulse become “like that of an adult.” Of course, we are talking about a healthy child, without pathologies of heart development.

Replacing teeth with molars

Replacing baby teeth with molars is also one of the indicators of the baby’s physical development. By the age of 4 years, 20 baby teeth should appear. But they won’t “stick around” for long. In just a couple of years (by 5-6 years) their complete change should occur. Usually the change of teeth occurs without problems and severe discomfort for the baby himself.

Main -
immediately explain to children what they need for their teeth daily care. And parents need to remember that baby teeth can also hurt. Exactly the same caries appears on them, which will be treated in the dentist's office. If this is not done, then it will spread lower - to the molar.

Teeth are very important for physical development. This is an opportunity to eat normally, eat solid foods, fresh vegetables and fruits. If dental problems occur, the baby may lose weight. This also indicates that he lacks calcium.

Physical capabilities

During early preschool age, physical capabilities are, of course, lower. At this time, your baby normally loses fat, begins to build muscle tissue, and his bones and joints become stronger. Already with 2-3 years You can start doing gymnastics in the morning. Just 10-15 minutes after morning sleep - the simplest exercises. Parents can turn
it's a game of doing exercises all together. Now it is important to interest the baby in activities, and not force him or scare him. He is already very mobile.

The older children get, the more physical activity they need. It affects proper metabolism and organ development. IN kindergarten The child has much more opportunities for movement:

• walk;
• physical education classes (20-25 minutes);
• active games with the whole group (tag, catch-up...).

Development indicators are often measured by the physical education teacher: tests of endurance, speed, flexibility and jumping ability are carried out. Before school, a test is required at the doctor's office.
Load test:

• squats (10-15);
• tilts (10-15 times).

The standard time for squats is 20 seconds. If the pulse increases by 50-70%, this is normal indicator. The indicators should completely return to normal in 2-3 minutes. Such tests are not carried out for children with disabilities.

Proper nutrition

At 2-3 years old, the baby is already very interested in what his parents eat there. He is increasingly switching to solid food. For the proper development of preschool children, it is necessary to adhere to a diet. Now parents must make a choice in favor
healthy products, healthy food. Children are now interested in adult food, but in reality it is difficult to persuade them to eat.

Parents are not recommended to make a cult out of food. If your baby eats a little less than normal (doesn’t finish 1-2 spoons of soup, for example), think: maybe this is his normal? If a child’s body refuses an extra meatball, apple, or piece of bread, then most likely he doesn’t need it right now. The child’s body knows what is needed most for physical development and what will be superfluous.

• At least 65% of the protein in the diet should be lean meat and poultry (turkey is best);
• at least 15% of fats are of vegetable origin.

For children from 2 to 4 years old, the diet is 4 times a day, small portions. Moreover, the largest meal of the day is breakfast. Then you can give porridge, a sandwich with cheese, cocoa. This is one example, but not a permanent diet. It is necessary to change the menu for kids.

At 5-7 years old you can
continue to give 4 meals a day, but now lunch should also be voluminous. The main thing is that the food is healthy. Now stomach, intestines, liver and pancreas very vulnerable. It is best to reduce to a minimum:

• fried in oil, deep-fried;
• fat;
• spicy, pickled;
• salty;
• sweets (cakes, pastries).

For preschool children, these products are not at all necessary. It is best to include in your diet:

• fish;
• lean meat, poultry;
• vegetables and fruits;
• mushrooms, nuts, cereals;
• dairy products.

This way, normal weight gain is maintained.

Correct mode

Children 2-4 years old need to sleep 2 times during the day (1-1.5 hours each) and 10 hours at night. Babies usually don’t want to sleep during the day, but parents need to persuade them and lull them to sleep with a fairy tale. Rest is necessary, because in a dream the processes of physical and mental development take place.

Children from 5 to 7 years They can already sleep once a day for 1-1.5 hours. If your baby has already gone to school, he still really needs sleep. This is normal rest, which provides a smooth transition to more serious loads.

Be sure to go for a walk with your child, even just for 30-40 minutes. Fresh air useful to him. If he doesn’t go to kindergarten, then you can take him to the park, playground, etc. 2 times a day:

• before lunch;
• before dinner.

Such walks bring great pleasure to the child.

MONITORING THE PHYSICAL DEVELOPMENT OF CHILDREN

It is known that physical development, together with other indicators of children, is a significant indicator of the health status of children. The state of physical development depends on congenital characteristics, as well as on the environmental conditions in which the organism grows and develops. Trained people should be allowed to conduct examinations of the physical development of children, in particular anthropometry. medical workers, since the technique and methods of anthropometric measurements require certain knowledge and practical skills.

Children in the first year of life are measured in a lying position using a horizontal stadiometer. The child is laid on his back so that his head tightly touches the transverse bar of the stadiometer. The head is placed in a position in which the lower edge of the orbit and the upper edge of the ear tragus are in the same vertical plane. The assistant firmly fixes the child's head. The legs should be straightened with light pressure from the left hand on the child's knees. With your right hand, bring the movable bar of the stadiometer tightly to your heels, bending your feet to a right angle. The distance between the fixed and movable bar will correspond to the height of the child.

Measuring height in children over a year old carried out in a standing position using a stadiometer. The child stands on the stadiometer platform with his back to the vertical stand, in a natural, straightened position, touching the vertical stand with his heels, buttocks, interscapular area and the back of the head, arms down along the body, heels together, toes apart. The head is placed in a position in which the lower edge of the orbit and the upper edge of the ear tragus are in the same horizontal plane. The movable bar is applied to the head without pressure.

Determination of body weight in children early age carried out on scales with a maximum permissible load of up to 20 kg. First, the diaper is weighed. It is placed on the scale tray so that the edges of the diaper do not hang over the tray. The child is placed on the wide part of the tray with his head and shoulder girdle, with his legs on the narrow part of the tray. If the child can be seated, then he is placed on the wide part of the tray with his buttocks, and his legs on the narrow part. A child can be placed on or off the scale only with the scale beam closed, standing not on the side, but directly on the side of the scale beam. The weight readings are taken from the side of the weight where there are notches or notches (the lower weight must be placed only in the notches on the lower scale). After recording the weight, the weights are set to zero. To determine the baby's weight, it is necessary to subtract the weight of the diaper from the scale readings.

Weighing of children under one year in preschool institutions is carried out every 10 days, from 1 to 3 years - once a month.

The chest circumference is measured using a rubberized tape in a state of quiet breathing (pause, and for older children, during inhalation and exhalation). The tape is applied at the back - at the angles of the shoulder blades, and at the front - at the level of the lower edge of the nipples.

In addition to anthropometric measurements, muscle tone, tissue turgor, the nature of fat deposition, etc. are noted. The thickness of the subcutaneous fat layer should be determined not in one particular area, but in different places (on the chest - between the nipple and sternum, on the stomach - at the level of the navel, on the back - under the shoulder blades, on the limbs - on the outer surface of the thigh and shoulder, on the face - in the cheek area). Depending on the thickness of the subcutaneous fat layer, they speak of normal, excessive and insufficient fat deposition. Attention is drawn to the uniform (over the entire body) or uneven distribution of the subcutaneous fat layer.

Determination of soft tissue turgor is carried out by squeezing with the thumb and forefinger right hand skin and
all soft tissues on the inner surface of the thigh and shoulder, while a feeling of resistance or elasticity is perceived, called turgor. If the turgor is reduced, then when squeezed, a feeling of lethargy or flabby is determined.

Muscle tone is determined using passive flexion
and extension of the upper and lower extremities. By the degree of resistance that occurs during passive movements, as well as by the consistency of muscle tissue, determined by touch, muscle tone is judged. In healthy children, muscle tone and mass in symmetrical places should be the same.

These descriptive features are rated by severity as “small”, “medium”, and “large”.

An individual assessment of physical development is based on a comparison of its anthropometric data with regional standards developed by the method of regression analysis. The use of normative or dental tables allows us to give a differentiated description of the child’s physical development and identify children who need constant monitoring and specialist advice.

Delay in physical development may be due to a number of reasons that need to be identified by a doctor. preschool. The hereditary-constitutional factor has a certain significance. Most often, the cause of unsatisfactory physical development is chronic infections and intoxications, primarily rheumatism, tonsillogenic cardiopathy, chronic pyelonephritis, and hypothyroidism. We can talk about nanism only if the growth rate is more than 10% below the standard.

A detailed examination of the child allows us to identify the characteristics of his skin, lymphatic system, skeletal system. Preschool children may have scoliosis or pectus excavatum rib cage. Timely detection of this pathology prevents the development of disability in the future. All children with suspected pathology of the musculoskeletal system should be referred for consultation to an orthopedist, and corrective gymnastics is indicated.

DEVELOPMENT INDICATORS OF PRESCHOOL CHILDREN

Physical development a child is a set of morphological and functional characteristics in their interrelation and dependence on environmental conditions that characterize the process of maturation at a given point in time.

In clinical pediatrics, the term “physical development” is interpreted as a dynamic process of growth (increase in length, weight and development of individual parts of the body) and biological maturation of a child during various periods of childhood.

Algorithm for assessing physical development

Determination of passport age

Evaluation of measurement results

Assessment of the harmony of physical development

Conclusion on physical development

Determining the child's passport age :

Date of measurement - Date of birth = Passport age of the child

Body weight measurement:

The weight of children under 18 months should be measured on a scale with the ability to “reset the scale”, calibration and the ability to estimate weight gain up to 10 g.

Babies should be weighed either naked or wearing a clean diaper.

Weighing is best done in the morning.

To do this, you should put the child on the scale, record his body weight on the scale, and write down the indicators.

Children over 18 months of age should be weighed on a scale with a 100 g scale.

It is better to weigh in in the morning, with a minimum amount of clothing.

To weigh yourself, you should put the child on the scale, record his body weight on the scale, and write down the indicators.

Body Length and Height Measurement:

A child under 2 years of age should be measured in a supine position (body length), with his legs resting against the fixed partition of the measuring table.

The child should be positioned so that:

The head rested against the stationary partition

Legs were straightened

The heels “looked” at the leg septum, the toes - upward.

The height of a child from 2 to 18 years old should be measured using stadiometers (height meters), when he stands with his back to the scale, with a movable limiter on top. It is better to take measurements in the morning, while exhaling, head position - the upper edge of the ear and eyes are located on the same horizontal line

Place the child straight without shoes or headgear, with his back to the scale, feet completely on the floor, legs straightened. Heels, buttocks, shoulder blades are pressed against the scale.

If the child is in the correct position, record its length and record the indicators.

Head circumference measurement :

This parameter needs to be determined only in children under 36 months.

Head circumference is measured using the “occipital-frontal” circle - the largest circumference of the head with an accuracy of 1 cm.

Apply the tape along the line above the eyebrows, then above the ears, and at the back along the widest part of the head.

Chest circumference measurement :

Flexible, non-stretch graduated tape should be used.

Measurements should be taken with an undressed child, while exhaling, with his arms down.

In a standing or sitting position, place the tape in front at the level of the nipple line, and in the back - at the subscapular line.

When the tape is in the correct position, record the indicators and write down the results.

Evaluation of measurement results.

The resulting scores can be converted into percentiles or Z-scores.

tables of standards for each indicator depending on the age and gender of the child.

Centile distributions most strictly and objectively reflect the distribution of traits among healthy people .

The columns of centile tables show the quantitative boundaries of a trait in a certain proportion or percentage (centile) of children of a given age and gender. In this case, the values ​​characteristic of half of healthy children of a given sex and age in the range from the 25th to 75th centile are taken as average or conditionally normal values.

Each measured characteristic (height, body weight, chest circumference)

may accordingly be placed in its own area, or its own

“corridor”, centile scale in the corresponding table. None

no calculations are made. Depending on where

this “corridor” is located, one can formulate an evaluative

judgment and make medical decisions.

In a one-time assessment, it is customary to classify these as normal variants.

measurements assigned to 3-5 intervals, i.e. in the zone from the 10th to the 90th centile.

(except for body length) is the basis for including a child in

group of “observation” by a local pediatrician and assignment to the 2nd health group.

The position of indicators in zones 1 and 7 intervals indicates

the need for in-depth research to differentiate

possible diseases.

Find the position of the obtained measurements in centile intervals according to

tables of standards for each indicator depending on age

and the gender of the child.

The Z-score or standard deviation is a more accurate predictor, especially in children who fall below the 5th or above the 95th centile.

Modern Z-score graphs (nomograms) of body weight and height have an X-axis (for age) and a Y-axis (for weight, length/height, head circumference).

The obtained values ​​of body weight, length/height, and head circumference should be plotted on Z-score graphs. Horizontally (X-axis) find the age of the child, using a ruler to draw a vertical line from this point. Vertically (Y axis) find the measured value of weight, length/height, head circumference. Using a ruler, draw a horizontal line until it intersects with the X-axis. Mark the intersection with a dot.

When interpreting the results of the Z-test, the interval -1+1 is taken as the average value. According to WHO recommendations, values ​​of Z = -2 and -3 for height are indicators of stunting, for weight - underweight and emaciation. Values ​​Z=+2 and +3 for weight can be regarded as problems with growth, according to weight-to-height ratio graphs - as overweight and obesity.

Assessment of the harmony of physical development :

Find the difference between the maximum and minimum numbers

centile scale corridors obtained for mass, height and

chest circumference relative to age. If the difference is 0 or 1

– physical development is harmonious, if the difference is 2 – physical

development is disharmonious, if the difference is 3 or more – physical

development is considered sharply disharmonious.

Conclusion on physical development.

A conclusion is given about the compliance of actual anthropometric data with the required ones in comparison with tables of percentiles or graphs of Z-scores.

A general assessment of anthropometric data and the degree of harmony of physical development is formulated.

MONITORING THE PHYSICAL DEVELOPMENT OF CHILDREN

It is known that physical development, together with other indicators of children, is a significant indicator of the health status of children. The state of physical development depends on congenital characteristics, as well as on the environmental conditions in which the organism grows and develops. Trained medical workers should be allowed to conduct examinations of the physical development of children, in particular anthropometry, since the technique and methods of anthropometric measurements require certain knowledge and practical skills.

Children in the first year of life are measured in a lying position using a horizontal stadiometer. The child is laid on his back so that his head tightly touches the transverse bar of the stadiometer. The head is placed in a position in which the lower edge of the orbit and the upper edge of the ear tragus are in the same vertical plane. The assistant firmly fixes the child's head. The legs should be straightened with light pressure from the left hand on the child's knees. With your right hand, bring the movable bar of the stadiometer tightly to your heels, bending your feet to a right angle. The distance between the fixed and movable bar will correspond to the height of the child.

Height measurements in children older than one year are carried out in a standing position using a stadiometer. The child stands on the stadiometer platform with his back to the vertical stand, in a natural, straightened position, touching the vertical stand with his heels, buttocks, interscapular area and the back of the head, arms down along the body, heels together, toes apart. The head is placed in a position in which the lower edge of the orbit and the upper edge of the ear tragus are in the same horizontal plane. The movable bar is applied to the head without pressure.

Determination of body weight in young children is carried out on scales with a maximum permissible load of up to 20 kg. First, the diaper is weighed. It is placed on the scale tray so that the edges of the diaper do not hang over the tray. The child is placed on the wide part of the tray with his head and shoulder girdle, with his legs on the narrow part of the tray. If the child can be seated, then he is placed on the wide part of the tray with his buttocks, and his legs on the narrow part. A child can be placed on or off the scale only with the scale beam closed, standing not on the side, but directly on the side of the scale beam. The weight readings are taken from the side of the weight where there are notches or notches (the lower weight must be placed only in the notches on the lower scale). After recording the weight, the weights are set to zero. To determine the baby's weight, it is necessary to subtract the weight of the diaper from the scale readings.

Weighing of children under one year in preschool institutions is carried out every 10 days, from 1 to 3 years - once a month.

The chest circumference is measured using a rubberized tape in a state of quiet breathing (pause, and for older children, during inhalation and exhalation). The tape is applied at the back - at the angles of the shoulder blades, and at the front - at the level of the lower edge of the nipples.

In addition to anthropometric measurements, muscle tone, tissue turgor, the nature of fat deposition, etc. are noted. The thickness of the subcutaneous fat layer should be determined not in one particular area, but in different places (on the chest - between the nipple and sternum, on the stomach - at the level of the navel, on the back - under the shoulder blades, on the limbs - on the outer surface of the thigh and shoulder, on the face - in the cheek area). Depending on the thickness of the subcutaneous fat layer, they speak of normal, excessive and insufficient fat deposition. Attention is drawn to the uniform (over the entire body) or uneven distribution of the subcutaneous fat layer.

Determination of soft tissue turgor is carried out by squeezing the skin with the thumb and forefinger of the right hand and
all soft tissues on the inner surface of the thigh and shoulder, while a feeling of resistance or elasticity is perceived, called turgor. If the turgor is reduced, then when squeezed, a feeling of lethargy or flabby is determined.

Muscle tone is determined using passive flexion
and extension of the upper and lower extremities. By the degree of resistance that occurs during passive movements, as well as by the consistency of muscle tissue, determined by touch, muscle tone is judged. In healthy children, muscle tone and mass in symmetrical places should be the same.

These descriptive features are rated by severity as “small”, “medium”, and “large”.

An individual assessment of physical development is based on a comparison of its anthropometric data with regional standards developed by the method of regression analysis. The use of normative or dental tables allows us to give a differentiated description of the child’s physical development and identify children who need constant monitoring and specialist advice.

Delays in physical development may be due to a number of reasons that need to be identified by the preschool doctor. The hereditary-constitutional factor has a certain significance. Most often, the cause of unsatisfactory physical development is chronic infections and intoxications, primarily rheumatism, tonsillogenic cardiopathy, chronic pyelonephritis, and hypothyroidism. We can talk about nanism only if the growth rate is more than 10% below the standard.

A detailed examination of the child allows us to identify the characteristics of his skin, lymphatic system, and skeletal system. Preschool children may have scoliosis or pectus excavatum. Timely detection of this pathology prevents the development of disability in the future. All children with suspected pathology of the musculoskeletal system should be referred for consultation to an orthopedist, and corrective gymnastics is indicated.

DEVELOPMENT INDICATORS OF PRESCHOOL CHILDREN

AGE

1. Methods for research and assessment of the health status of children and adolescents

2. Methods for studying and assessing the physical development of children and adolescents

3. Hygiene assessment of the organization physical education in children's institutions

4. Hygienic foundations of the educational process in children's institutions.

5. Diagnosis of children's readiness for school

6. Hygiene of the educational process in secondary school

According to WHO (1990), the health status of children is one of the most pressing problems throughout the world. Its importance is largely due to the progressive deterioration of the environment. A child’s body, which is in the process of development, is more susceptible to the influence of both favorable and unfavorable factors, and reacts more quickly and sharply to changes in the environment. When studying the influence various factors It is important to determine their complexes of influence, and also to find out how their combination modifies the influence of each factor. The integral result of the environmental impact on child population is the level and quality of children's health. A pediatrician must be able to determine these two indicators and determine the health status of the D&P.

Health is a criterion for --------- relationships child's body with the environment. It is formed under the influence of a complex set of biological, environmental and social factors.

Therefore, for hygienists, the closest in spirit is the definition of health adopted by the WHO Constitution: “Health is a state of complete physical, spiritual and social well-being, characterized by the dynamic balance of the body with the environment, as well as the absence of diseases and physical defects.”

Health, as a measure of vitality, the body’s ability to function optimally, is characterized in this case not only by the absence of clinically pronounced symptoms of diseases, but also by the absence of their initial manifestations, pre-illness states, and the so-called “minor pathology”, often detected at the level of functional, easily reversible changes indicating a decrease in the body’s overall resistance to the effects of adverse environmental factors.

The health indicators revealed as a result of demographic studies (morbidity, mortality, disability, etc.) are only the visible tip of the iceberg, the underwater part of which consists of prepathological (prenosological) conditions, reflecting the stages of movement from health to disease. The study of these conditions as the basis for determining the “level” of health healthy child is the subject of hygienic diagnostics (“hygienic monitoring”), which studies the environment, health and the relationship between them. It is the health of the team that in this case acts as a criterion for pre-nosological diagnosis, a “marker” of the negative influence of the environment on a person, and a criterion for the effectiveness of all preventive work carried out by the sanitary-epidemiological service.

In order to bring primary prevention closer to the main goal - increasing people's life expectancy, hygienic diagnostics, having 3 objects of study (health status, habitat, their relationship), is designed to identify the stages of the health scale

Full health

Practical health

Pre-disease

This is necessary to prevent states from transitioning to various diseases.

The interaction between hygienic diagnostics and clinical examination should be carried out in 4 stages

Stage 1 - study of the environmental situation, living conditions, lifestyle

Stage 2 - medical examination

Stage 3 - recreational activities

Stage 4 - dynamic clinical observation

A comprehensive assessment of the nature of development and health status of a child requires mandatory consideration of the physical and neuropsychic development, the degree and harmony of the usefulness of the functional state of his body.

The availability of methods for diagnosing prepathological (prenosological) conditions, quantitative assessment of the depth and degree of reversibility of these processes can become the scientific basis of such preventive measures, which will correspond to the objectives of primary and secondary prevention. Based on this, prevention becomes aimed not at preventing specific diseases, but at reducing the likelihood of their development in general. The following factors influence the health of children and adolescents.

Factors shaping the health of children

| |Socially | |

| |economic | |

| |conditions | |

|Environment|Heredity|physical |

| | | education |

|Food | | |

| Living conditions | Condition | Daily routine |

| | health | |

| |children's | |

| |population | |

| |Indicators | |

| |mortality | |

| |morbidity | |

| |disability | |

| |physical development | |

| | |Training conditions|

| |Medical and sanitary| |

| |I help | |

It is necessary to pay attention to the role of such factors influencing the formation of health as biological (age of the mother, state of her health, body length, number of births, weight of the child at birth, presence of abnormalities in the act - ---------- - and early postnatal periods, etc. 0 and social (apartment area, per capita income, parental education, public and family education child, daily routine, including duration of sleep and stay in the open air).

2. Medical monitoring of the health status of children.

One of the most important tasks of a pediatrician is to monitor the formation and dynamics of the health status of the pediatrician.

Monitoring the dynamics of health status is regulated by the order of the Ministry of Health of the Russian Federation dated March 14, 95 No. 60 “On approval of instructions for conducting preventive examinations of children of preschool and school age based on medical and economic standards”

Health monitoring is currently carried out on the basis of mass screening tests and represents a new principle for organizing in-depth examinations of children and adolescents. It is carried out in several stages:

Stage 1 - examination of all children according to the screening program, which is carried out mainly nurse child care facility; 7

Stage 2 - examination of children, performed according to screening tests, by a doctor at a child care institution;

Stage 3 - examination by specialists of the clinic of children sent from a preschool institution (school) for consultation.

This principle of organizing a medical examination ensures a significant increase in the role of the average medical professional. staff of the children's institution in monitoring the health status of children, and also ensures the rational use of the working time of doctors and narrow specialists with differentiated monitoring of the health status of children.

The screening program includes:

1. Questionnaire test - a survey of parents or students using a special questionnaire. The survey is aimed at identifying anamnestic data and complaints characteristic of changes in the nervous, cardiovascular, digestive, urinary systems, as well as typical for diseases of the nasopharynx and allergic diseases and states (Appendix 1).

This questionnaire, in the form of simple questions, groups the main “key” complaints that arise in children and adolescents in the presence of deviations in their health according to the leading systems. When examining preschoolers and students in grades 1-4, the questionnaire is filled out by parents, and from grade 5 - by the students themselves.

Strong physique: 100% of boys and 100% of girls aged 2-6 years have a very weak physique. Such low indicator values ​​indicate poor development of preschool children, which can be caused by numerous factors. In the future, we will continue to further study anthropometric parameters in schoolchildren aged 7-16 years to establish the physical status of the school and...

This adaptive norm is passed on from generation to generation. In this way, the variability of a whole complex of mutually related characteristics is controlled. Let's consider this using the example of the physical development of children of preschool and primary school age belonging to various groups of the indigenous and old-timer population of the North of Russia. According to T.V. Chiryatieva, Khanty children aged 3–7 years...

Mastering motor skills, able to navigate the environment, actively overcome difficulties encountered, and showing a desire for creative searches. The theory of physical education of preschool children is continuously developing and enriched with new knowledge obtained as a result of research covering the diverse aspects of child upbringing. Research data...

The frequency of examination of children is determined by the pace of their physical development. Children of the first year of life are examined once a month, from 1 year to 3 years - once every 3 months, from 3 to 7 years - at least once every six months. Depending on medical indications, children who are weakened or are lagging behind in physical development are examined more often.

A healthy child has a harmonious ratio of the main indicators of physical development: body length and weight, chest circumference, sufficiently deep and even breathing. The psychological status of a healthy child is characterized by stability and friendly relationships among peers. Leading everyone purposefully to such a state is the main professional concern of the educator. It is necessary to make every effort to not only prevent the health of the children in the group from deteriorating, but also to enhance the healing effect. When assessing health pedagogically, it is advisable to distinguish 3 qualitatively characteristic groups of children: healthy (have not been sick for a year); those who are often ill for a long time (4 or more times a year – group BCH); occasionally ill (1-3 times a year – EB group).

The teacher receives information about the child’s health from the parents and the head nurse of the preschool institution (according to the child’s medical record). Observing children, analyzing their well-being and behavior, the teacher supplements this information and shares information with parents and the doctor.

Based on the data obtained, it is predicted possible improvement in the health of each child at the end of the year. For some, this will be a decrease in the duration and number of diseases during the year (1st stage of the prognosis), for others - a transition from the BW group to the EB group (2nd stage of the prognosis) or to the healthy group (3rd stage of the prognosis). Based on the obtained individual health indicators, overall results for the group are displayed. They are determined by the health index (the percentage of healthy children on the payroll) and the number of frequently ill children. Indicators of effective physical education and health work are: positive individual health dynamics (decrease in the number and duration of illnesses per year, taking into account the forecast), and for the group as a whole - an increase in the health index and a decrease in the number of frequently ill children.

The degree of physical development of children allows us to some extent judge the functional state of organs and, conversely, violations of the functional ability of organs entail changes in physical development.

To assess the functional state of the child’s body, pulse rate and blood pressure are measured. Blood pressure in children depends on age, gender, biological maturity, stroke and minute volumes of blood, vascular resistance, their elasticity, the amount of circulating blood in the body, its viscosity and other indicators.

When characterizing the functional state of a preschooler’s body during the period of exposure to various physical activities, it is necessary to focus on the age-related physiometric indicators of children at rest (data from the Republican Sports Medicine Dispensary and the Republican Methodological Office for physical culture, table 2).

The intensity of muscle load depends on the selection of physical exercises, their complexity and combination, and frequency of repetitions. When rationing the physical activity that children receive in physical education classes, they are guided by on heart rate.

2 Table 2. Dynamics of physiometric indicators of children aged 3-7 years.

Heart rate reflects the effect of physical activity on the body of children and has a direct connection with the nature of the energy supply to muscle activity.

Formation of posture is one of the most important tasks in children’s physical education.

Of great importance in the process of developing good posture are a strictly observed daily routine, the size of furniture, and the posture of children during classes, work and other types of independent activities.

Furniture is selected in accordance with age and individual characteristics children. The dimensions of tables and chairs must meet the requirements of GOST “Children's preschool furniture. Functional dimensions of tables", "Children's preschool furniture. Functional dimensions of chairs” (Table 3). Chairs must be installed together with a table of the same group and marking.

3 Table 3. Basic dimensions of tables and chairs.

The design of the table and chair should ensure:

firstly, support for the torso, arms and legs;

secondly, the symmetrical position of the head and shoulder girdle.

The dimensions of the furniture correspond to the height of the child: the length of the chair seat is the length of the hips, the height of its legs is the length of the legs. It’s good if the back of the chair has a slight tilt back, which allows you to lean back, relax, and give your spine a rest. Feet should be on the floor (or on a stand if the chair is too large for the child). The bed should not be too soft, the pillow should not be large. The length of the bed is 20–25 cm greater than the child’s height, so that he can stretch out freely.

The child’s posture in any of his activities should always be the focus of adults’ attention.

It is necessary to control the seating arrangement of children in each group, analyze the correspondence of furniture to the height and physical characteristics of children - 2 times a year (I half of the year - September, II half of the year - January) (Appendix 1)