MALNUTRITION (UNDERNUTRITION)

Although malnutrition can mean undernutrition, overnutrition (see Obesity), vitamin deficiency, iron deficiency, calcium deficiency and iodine deficiency, this section covers undernutrition. 

A child is considered undernourished if he is below 80% of his expected weight. (See chapter on NORMAL GROWTH AND DEVELOPMENT).

We should be seriously concerned if the weight is below 65% of the expected weight, or if the child fails to gain weight in 3 successive months. Thus, a child whose expected weight is 10 kgs. and who weighs less than 8 kgs. is considered undernourished. If he is less than 6.5 kgs, I would be much more concerned and give extra attention to find the cause of his undernourishment.


Normal Variations
It bears repeating that a child who is much below his average weight, but is active, full of life, gains weight slowly but surely and does not fall ill too often, is not ill. I would observe him for a couple of months and look for other common causes of lower weight like the small size of his parents, low birth weight and failure to gain weight in the first few weeks of life from any cause which is rather difficult to be compensated later on. 


Common Causes Of Undernutrition:

• Premature termination of breastfeeding
• Improper artificial feeding
• Delayed addition of complementary foods
• Infections like diarrhoea, urinary infection and tuberculosis and infestation with parasites
• Heart disease
• Emotional factors
• Diabetes
• Unknown cause — I refer to the few children I see every year who just refuse to gain adequate weight. Even detailed investigations fail to reveal the cause.

Fortunately, quite a few such children have become confident young men and women and are doing well in life.

The causes given above are common to all socio-economic groups, though less fortunate families will have children who remain undernourished because of common factors like poor purchasing capacity, lack of education, unsafe water supply, poor environmental sanitation and personal hygiene, coupled with certain wrong notions like starving a child with diarrhoea, undue restrictions of diet in jaundice, delayed addition of solids in a small infant, and giving infants dal water or thin soup containing very little energy.

TREATMENT: First, let your doctor confirm if the child is undernourished. Attend to his diet. The doctor may try to find out any possible cause that may be contributing to the undernutrition and treat the same. He/she may then follow the weight of the child on the same weighing scale to monitor the progress over a period of time.

11 February, 2013