Malnutrition in children: What should parents do?

Malnutrition is a condition in which an individual does not receive enough calories, protein, or micronutrients. This is a worldwide problem. It can lead to negative short- and long-term health outcomes. The rate of malnutrition is still alarming. Almost half of all deaths in children under the age of 5 are due to undernutrition. Malnutrition puts children at a higher risk of death than common infections. It also increases the frequency and severity of infections and slows down recovery.

The interaction between malnutrition and infection can create a dangerous cycle. This makes the disease worse and the nutritional status worse. Poor nutrition during the first 1,000 days of a child's life can also lead to slowed growth. At the same time, it is associated with poor cognitive ability and reduced performance at school and work.

content

• 1. What is malnutrition?
• 2. Symptoms of malnutrition
• 3. Cause 
• 4. Types of malnutrition
• 5. Harm of malnutrition
• 6. Treatment for severely malnourished children
• 7. Prevention of malnutrition and undernutrition

1. What is malnutrition?

Malnutrition is a term that refers to eating poorly. It occurs when a person consumes fewer calories for energy than needed over a long period of time. Body mass index (BMI) is a common indicator of malnutrition classification. It represents a person's weight in relation to height. The index is determined by dividing body weight in kilograms by body height (in meters) squared. A person with a body mass index (BMI) of 18.5 or less is considered malnourished.

2. Symptoms of malnutrition

Malnourished children show symptoms such as frequent feelings of weakness, fatigue, and lethargy. In many cases, there is mental retardation, reduced muscle mass as well as impaired intellectual development.

3. Cause 

The main causes of malnutrition in children are often related to:

• Poor
• Infection
• Unsafe, unsanitary water source. The World Health Organization estimated that in 2008 globally, half of all undernutrition cases among children under the age of 5 were due to unsafe, unsanitary water. This condition makes children susceptible to repeated diarrhea and intestinal worm infections due to lack of hygiene.

• Factors related to society, social inequality. In most countries, poor children have the highest rates of malnutrition. However, inequalities in malnutrition among children of poor and rich families vary from country to country. In 2000, rates of child malnutrition were much higher in low-income countries (36%) than in middle-income countries (12%) and the United States (1%).

4. Types of malnutrition

One form of childhood malnutrition is Marasmus. It occurs in children who do not eat enough protein, calories, carbohydrates, and other important nutrients.

Marasmus body malnutrition

The other form is the Kwashiorkor body. Kwashiorkor causes an accumulation of fluid in the body that can cause the face to become round and the abdomen to stretch. The distention of the abdomen is caused by water retention in the abdominal cavity and an enlarged liver. Kwashiorkor occurs in people with severe protein deficiency. Kwashiorkor malnourished children are often larger than Marasmus children. A diet that is mostly carbohydrates can lead to this condition.

Kwashiorkor Body malnutrition

5. Harm of malnutrition

Malnutrition affects every system in the body and always leads to an increased risk of other dangerous diseases such as tuberculosis. Disease complications also increase and in very severe cases even cause death.

Malnutrition in children causes direct damage to brain structure. It impairs the growth and movement of infants. Children who are undernourished before the age of two, gain weight rapidly during childhood, and adolescents are at increased risk for nutrition-related chronic diseases.

Studies have found a strong link between malnutrition and child mortality. Once malnutrition is treated, adequate growth is a good sign of health and recovery. Even if a child has recovered from severe malnutrition, he or she may still be stunted for the rest of his life.

Mild levels of malnutrition double the risk of death from respiratory disease, diarrhea and malaria. This risk is greatly increased in more severe cases of malnutrition.

Prenatal undernutrition can alter metabolism and normal growth physiological patterns. It has a lifelong effect on cardiovascular disease risk. Undernourished children are more likely to be physiologically deficient in adulthood, have lower educational attainment and economic status, and give birth to younger children. Children often face malnutrition during their rapid growth years, which can have long-term effects on health.

6. Treatment for severely malnourished children

Treatment of malnutrition depends on the underlying cause and extent of the child's malnutrition. The child may be advised to monitor at home. Or get support at home by a dietitian or healthcare professional. In severe cases, hospital treatment may be necessary.

Change your diet and add the necessary substances. A dietitian will advise the child on appropriate dietary changes. The aim is to ensure that children get enough nutrients.

They may suggest:

• A healthier, more balanced diet.

• Dietary changes, such as eating foods rich in energy and nutrients

• Snacking between meals

• Drinks high in calories

• Supplement vitamins and minerals

• High-energy nutritional supplement and protein. In this case, other treatments are not enough to provide the necessary nutrition.

Severely malnourished children need to be fed and rehydrated carefully. They cannot be fed normally right away. They will usually need special care in the hospital. Once well enough, your child can gradually start eating a normal diet and continue this treatment at home.

If these measures aren't enough, experts may recommend extra nutrients in supplement form. These should only be taken on the advice of a healthcare professional.

Your child will have regular appointments to check for any changes to the diet. The menu needs to be adjusted to make it more streamlined and efficient.

The treatment management of children follows the 10-point program according to the World Health Organization.

• Treat low blood sugar. Glucose can be given orally or intravenously.

• Treatment of hypothermia, an abnormally low body temperature. Regularly monitor body temperature. Blankets can provide warmth for babies.

• Reduce dehydration using special rehydration solutions for malnutrition. Care should be taken during rehydration to avoid circulatory overload and cardiac overload.

• Treatment of electrolyte imbalance disorders. This can be done by adding potassium and magnesium to the baby's food.

• Treatment and prevention of infections. Because the immune system in malnourished children is extremely weak, infections can occur without symptoms. So, as a precaution, children should take an antibiotic that prevents a wide range of infections. In addition, children in stable condition are vaccinated against measles.

• Make up for nutritional deficiencies, supplement vitamins and trace elements. Especially vitamin A, zinc, folic acid and iron.

• Feed with caution. During the stabilization phase, nutrition is carefully initiated to avoid overloading the weakened body. In addition, it is recommended to provide enough fluids, about 100-130 ml per kg of body weight.

• Promotes weight gain. During the rehabilitation phase, an aggressive dietary approach is needed to rapidly gain weight. Weight gain should be observed at regular intervals and ideally up to about 10 grams per kilogram of body weight per day.

• Create a positive environment. Malnourished children often lead to delays in mental development. Therefore, attention should be paid to providing children with a stimulating and protective environment.

• Regular check-ups and vaccinations.

7. Prevention of malnutrition and undernutrition

Mothers and families need to be educated about appropriate and child-friendly nutrition to prevent malnutrition. Mothers should be encouraged to breastfeed their babies. Because breastfeeding ensures the comprehensive development of the baby's immune system. During this time, it is equally important for mothers to be nourished with the right diet.

Breastfeeding

It is also important to have a balanced diet. In many regions where malnutrition is common, people often eat foods that often have too many carbohydrates and too few vitamins. The diet usually contains grains such as rice or millet. They lack vegetables and fruits that provide essential vitamins. Good nutrition from birth to three years old is the most important foundation for a baby's healthy physical and mental development.

In summary, malnutrition is a common disease in children. It has serious short- and long-term health consequences. As well as the mental development of children. In addition to equipping children with adequate knowledge about nutrition. Parents should pay attention to keeping the water source clean, keeping the child's body clean, avoiding infections. When having a malnourished child, parents need to bring the child to medical facilities for appropriate and timely dietary treatment. Early detection and proper treatment can help a child recover quickly. And does not affect physical and mental health in the future.

Doctor Hoang Thi Viet Trinh