Malnutrition

Subject: Child Health Nursing

Overview

Malnutrition is a general term for a medical condition caused by an improper or insufficient diet. It must often refer to under-nutrition resulting from inadequate consumption, poor absorption or excessive loss of nutrition but the term can also encompass over nutrition resulting from overeating or excessive intake of specific nutrients.The causes of protein-energy malnutrition: Poverty, low birth weight, Infections like diarrhea, pneumonia, malaria, measles, whooping cough and tuberculosis and so on.Categories of protein-Energy malnutrition (PEM) according to the deficiency of protein and energy in varying degree, PEM is categorized into Mild PEM, Moderate PEM, and Severe PEM: kwashiorkor, Marasmus, Marasmic kwashiorkor.

Malnutrition is a general term for a health problem caused by a bad diet or not getting enough to eat. It usually means undernutrition caused by not eating enough, not absorbing enough, or losing too much nutrition, but it can also mean overnutrition caused by eating too much or taking in too much of certain nutrients.

Common forms of malnutrition include:

  1. Protein-energy malnutrition (PEM): Protein-energy malnutrition refers to inadequate availability or absorption of energy and protein in the body.
  2. Micronutrient Deficiency Disorders: deficiency of microelements such as Iron, Iodine in a body.

Causes of protein-energy malnutrition:

  1. Poverty
  2. Low birth weight
  3. Infections like diarrhea, pneumonia, malaria, measles, whooping cough, and tuberculosis
  4. Population growth: an increase in birth rate leads to population growth in the country is disproportionate to an increase in food production.
  5. Feeding habits: lack of exclusive breastfeeding for first 6 months, late initiation of weaning, diluted milk formula, use of improper weaning food early, stoppage of breast feeding, etc.
  6. Education: education is a vital cause of malnutrition because lack of awareness and knowledge regarding food preparation preservation, family planning, maintaining food hygiene, and way of feeding
  7. Geography: In high hill areas the soil is not good and it’s hard to cultivate crops. This leads low production leads the low production of food and low production leads to low consumption resulting in malnutrition.
  8. Other: high-pressure advertising of baby foods, chronic disease, starvation, psychological problem, alcoholism drug addiction over-consumption of fat and sugar industrial food processing and famine age (6-8 months), twin baby, short interval between birth, large family size, etc.

Classification of Nutritional status:

Malnutrition is classified into different classes, some of them are:

Welcome trust classification:

This is based on weight for the Age of the child and the presence and absence of Edema:

Range of weight for agenda

Edema +/-

Nutritional status

>80%

60-80%

60-80%

<60%

<60%

 

Absent

Absent

Present

Absent

Present

Normal

Undernutrition

Kwashiorkor

Marasmus

Marasmic kwashiorkor

Waterlow’s classification:

Based on the age of the child and the measurement of weight and height:

Weight for height

Height for age

Nutritional status

>80%

<80%

>80%

<80%

>90%

>90%

<90%

<90%

Normal

Wasted

Stunted

Wasted and stunted

Indicators of malnutrition:

  • Stunting: low weight for age- indicate chronic malnutrition, due to prolonged food deprivation, or disease.
  • Wasting: low weight for height- indicate acute malnutrition
  • Underweight: low weight for age

Categories of protein-Energy malnutrition (PEM)

According to the deficiency of protein and energy in varying degree, PEM is categorized into:

  1. Mild PEM
  2. Moderate PEM
  3. Severe PEM: kwashiorkor, Marasmus, Marasmic kwashiorkor

Mild PEM

This is common in children between 9 months and 3 years of age characterized by growth failure, repeated infection, and lethargy. The main cause of mild PEM is deficit dietary intake for a short period.

Moderate PEM

If the child doesn't get enough food for a long time, he or she will develop moderate PEM. This is also called Ruche, which is a local language used for moderate PEM. Ruche means "crying children," which is a good way to describe what a child who is always crying is thinking. Most of the time, moderate PEM lasts from 1 to 4 years. Moderate PEM looks like mild PEM, but it's easier to spot because the symptoms are more obvious. For example, children with moderate PEM seem slower and less energetic, they stop growing (and gain weight), they have thin arms and legs, flattened buttocks with wrinkled skin on the front of their thighs, a winged scapula, a swollen abdomen, repeated infections, and they lose fat under their skin.

Severe PEM

Severe forms of PEM is manifested as kwashiorkor, marasmus, and marasmus kwashiorkor

 

 

Things to remember
  • Malnutrition is a general term for a medical condition caused by an improper or insufficient diet.
  • It must often refer to under-nutrition resulting from inadequate consumption, poor absorption or excessive loss of nutrition but the term can also encompass over nutrition resulting from overeating or excessive intake of specific nutrients.
  • The causes of protein-energy malnutrition: Poverty, low birth weight, Infections like diarrhea, pneumonia, malaria, measles, whooping cough and tuberculosis and so on.
  • According to the deficiency of protein and energy in varying degree, PEM is categorized into Mild PEM, Moderate PEM, and Severe PEM: kwashiorkor, Marasmus, Marasmic kwashiorkor.
Questions and Answers

Malnutrition is the umbrella term for a medical condition brought on by an inadequate or improper diet. The term must frequently refer to undernutrition brought on by insufficient intake, poor absorption, or excessive nutrition loss, but it can also refer to overnutrition brought on by overeating or excessive intake of a particular nutrient.

  • Poverty
  • A little birth weight
  • Illnesses like whooping cough, tuberculosis, measles, pneumonia, malaria, and diarrhea
  • Population growth is disproportionate to the rise in food production and is caused by an increase in the birth rate.
  • Feeding practices: failure to exclusively breastfeed for the first six months, delayed weaning, diluted milk formula, early use of inappropriate weaning foods, cessation of breast feeling, etc.
  • Education: Lack of awareness and information about food preparation, preservation, family planning, maintaining food hygiene, and feeding practices are major contributors to malnutrition.
  • Geographically, it is difficult to farm crops in high hill places due to the poor soil. This results in poor food production, which results in low consumption, which results in malnutrition.
  • Other factors include high-pressure marketing of baby foods, chronic illness, starvation, psychological issues, alcoholism, drug addiction, excessive fat and sugar consumption, famine age (6 to 8 months), twins, close spacing between births, large family sizes, etc.

 

Categories of protein-Energy malnutrition (PEM)

PEM is divided into the following categories based on the varied degrees of protein and energy deficiency:

  • Light PEM
  • Medium PEM
  • PEM with severe symptoms: kwashiorkor, marasmus, and marasmic kwashiorkor
  • Mild PEM: This is characterized by lethargy, repeated infections, and failure to grow in children between the ages of 9 months and 3 years. Dietary deficits for a brief time are the main cause of mild PEM.
  • Moderate PEM will develop in the youngster if the food deficit lasts for an extended period of time. For moderate PEM, this is also known as Runche, which is a regional tongue. Children that are always crying are referred to as "crying children" in the meaning of the word "Runche." Moderate PEM often lasts between one and four years. Moderate PEM presents similarly to mild PEM, but it is more readily identifiable due to the following features: children who appear slower and less energetic; growth failure (more weight); thin limbs; flattened buttocks with wrinkled skin over the front of thighs; winged scapula; distended abdomen; repeated infection; and loss of subcutaneous fat beneath the skin.
  • Kwashiorkor, marasmus, and marasmus kwashiorkor are manifestations of severe PEM.

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