Malnutrition in children is defined as an imbalance in nutrient intake and utilization. Statistics suggest that 155 million children under five had stunted growth, while 41 million were overweight or obese in 2016 (1) (2). Growth stunting results from inadequate energy and nutrient intake, whereas overweight or obesity results from excessive intake. Poor eating habits, nutritional malabsorption, and genetic predisposition are common causes of child malnutrition (3). Malnutrition also impacts a child’s growth, development, and general health. However, it can be mitigated by identifying and treating the exact cause and effects of the condition. Read on to learn more about the causes and symptoms of malnutrition and how it can be treated and prevented in children.
Types Of Malnutrition
There are two types of malnutrition (1) (3).
1. Undernutrition
Undernutrition can be of many types depending on the deficient nutrient in the child’s diet. A type of undernutrition that significantly affects a child’s growth is protein-energy undernutrition or malnutrition. It is associated with the insufficiency or deficiency of protein and energy in a child’s diet, hence protein-energy malnutrition. This type of undernutrition can be acute or chronic, depending on the period of deficiency (4). i. Acute malnutrition is a state in which a child has a below-average weight-for-height for a given age. It is caused by a sudden insufficiency of protein and energy, most commonly caused by an illness. Based on the severity of insufficiency or deficiency, the condition is further divided into:
Kwashiorkor: In this condition, there is severely deficient protein intake. A child with kwashiorkor develops bilateral pitting pedal edema (accumulation of fluid in the feet and lower legs) and ascites (abnormal fluid retention in the abdomen). It is often called edematous malnutrition.
Marasmus: It is a condition associated with insufficient intake of both total energy and protein, leading to wasting. Wasting is known as an excessive loss of adipose tissue and muscle due to protein and energy deficiency. It is also referred to as wasting syndrome.
ii. Chronic malnutrition, also known as stunting, is low height for age caused by prolonged or recurrent protein and energy deficiency. Stunting affects the physical and mental development of a child, affecting their overall quality of life. A malnourished child can be stunted, wasted, or both.
2. Overnutrition
Overnutrition is a state where the child gets more energy and nutrients than required. It is a chronic condition that results in excess weight gain when calorie consumption is more than the calorie expenditure. Abnormal or excessive weight gain increases the risk of chronic health conditions, such as type-2 diabetes and cardiovascular diseases (CVD). Consumption of calorie-rich foods and less exercise put a child at the risk of overnutrition. Both undernutrition and overnutrition can lead to micronutrient deficiencies making the child prone to infections and illnesses. Iodine, vitamin A, iron, and zinc deficiency are some of the common deficiencies that affect malnourished children. Micronutrient excess has also been recognized as a cause of malnutrition in the recent years.
Signs And Symptoms Of Malnutrition
Signs and symptoms of malnutrition depend on its cause. They can be mild or severe based on the extent of malnourishment. Some of the common malnutrition symptoms warranting attention are the following (5) (6). Signs and symptoms of undernutrition
Lack of energy and lethargy Loss of appetite Unintentional weight loss Excessive loss of fat and muscle mass Changes in nail, hair, and skin quality and color Sunken eyes and hollow cheeks Swollen bleeding gums and decaying teeth
Mood swings and behavioral changes, such as irritability and anxiety Frequent illnesses and delayed recovery Failure to thrive, i.e., failure to grow (height and weight) as expected Poor mental development affecting learning
Signs and symptoms of overnutrition
Unintentional weight gain, which is often abnormal or excessive Changes in hair, nail, and skin quality and color due to micronutrient deficiencies Behavioral problems, such as social isolation and depression, due to excessive weight gain Development of chronic health conditions, such as type-2 diabetes
Evaluating the signs and symptoms can help identify the cause of malnutrition and mitigate its adverse effects.
Causes Of Malnutrition
A child could be at risk of undernutrition or overnutrition due to the following factors (7). Besides the above reasons, some medicines may suppress or increase appetite, resulting in under or overeating. All these factors take time to affect health, and malnutrition does not happen overnight. A timely diagnosis can thus prevent any long-term consequences.
Diagnosis Of Malnutrition
A doctor will collect the child’s family, medical, and diet history and have a detailed discussion of the child’s signs and symptoms. Based on the evaluation, the doctor will conduct the following tests (9). Pediatricians use standardized growth charts to compare a child’s anthropometry against other children of the same age. This is one of the best ways to assess the nutritional status of a child. Based on the evaluation and test results, the doctor will chart a suitable treatment plan for the child.
Treatment For Malnutrition In Children
The treatment for malnutrition depends on its cause and severity. A team of health professionals, such as a pediatrician and certified nutritionist, will draft the treatment plan. In most cases, appropriate home care can help reverse malnutrition (10). During treatment, regular monitoring of the child’s height, weight, and other growth and development parameters is important. It will determine the efficacy of the treatment for the child. The child may be referred to a specialist if there is no improvement. Nutrition rehabilitation is typically a time consuming process. It needs involvement of a knowledgeable pediatrician, skilled nutritionist, and dedicated parents along with a supportive family. But once good dietary habits become a way of life, it pays rich dividends.
Prevention Of Malnutrition In Children
Preventing malnutrition is possible with appropriate dietary and lifestyle practices. You could try the following tips to balance your child’s nutritional intake.
