Malnutrition

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It can be defined as an imbalance in dietary intake and occurs when a child had too much or too little food or lack of essential nutrients. In other words, a child may become malnourished if they do not eat enough food overall or if they eat plenty but do not have enough variation in their diet.

It can lead to:

  • Short and long-term health problems
  • Slow recovery from wounds and illnesses
  • A higher risk of infection
  • Marasmus which is a severe form of malnutrition (It is a deficiency of protein and overall energy intake. A child with marasmus will have small muscle or fat on their body)

Overnutrition

This is another type of malnutrition. It occurs when a child takes in more nutrients than they need and this results in an accumulation of body fat from the excess nutrients, resulting in overweight or obesity.

Persons who are overweight or obese are more at risk of:

  • Heart diseases
  • High blood pressure
  • Diabetes
  • Cancer
  • High cholesterol

(The World Health Organization reports that in 2020, 5.7% of children under 5 were overweight, which is an increase from 5.4% in 2000)

Signs and Symptoms may include;

  • A lack of growth and low bodyweight
  • Tiredness and a lack of energy
  • Irritability and Anxiety
  • Slow behavioral and intellectual development, which may result in learning difficulties
  • No appetite
  • An inability to concentrate effectively
  • Always feeling cold
  • Depression
  • More prone to illnesses  and taking longer to heal
  • Longer healing time for wounds

Causes

Malnutrition may occur for various reasons and this may include;

  • Low intake of food
  • Mental health problems of schizophrenia, depression
  • Eating disorders
  • Social and mobility problems
  • Digestive disorders and stomach conditions eg Crohn’s disease, Celiac disease
  • Alcohol use disorder

Risk factors

Those at risk of malnutrition include;

  • Older adults, usually when they are in the hospital or in a long-term institutional care
  • Persons who are socially isolated- for example, due to mobility issues, health problems or other factors
  • Persons with a low income
  • Persons recovering from or living with a serious illness or condition
  • Persons who have difficulty absorbing nutrients
  • Persons with chronic eating disorders, such as bulinia nervosa or anorexia nervosa

When do you contact a doctor?...

A few key signs of malnutrition may indicate that it is time for your child to seek care from a doctor and these include;

  • Unexplained, unintentional loss of weight that is more than 5% in the last 3-6months
  • Presence of any other malnutrition symptoms ad listed above
  • Signs of malnourishment
  • Signs of an eating disorder

(For Healthcare professionals only)

Diagnosis

If a child shows any symptoms of malnutrition, the first step is to find out why. A healthcare professional may carry out the following;

  • Blood tests usually for general screening and monitoring
  • Tests that indicate the presence of specific nutrients, such as iron and vitamins
  • Prealbumin tests, as malnutrition usually affects levels of this protein
  • Albumin tests, which can indicate liver or kidney disease

A tool to identify risk of malnutrition…

Some tools can help identify persons who have or are at risk of malnutrition and one of such tools is the ‘Malnutrition Universal Screening Tool’ (MUST).

It is a 5-step plan to help healthcare professionals diagnose and treat these conditions. The five steps are as follows:

  • Measure a person’s height and weight, calculate their body mass index and provide a score
  • Note down the percentage of unplanned weight loss and provide a score
  • Point-out any mental or physical health conditions and provide a score for it
  • Add the scores from step 1,2&3 to obtain an overall risk score
  • Use local guidelines to develop a care plan based on the score acquired
The score can be one among the following:

  • Low risk: 0
  • Medium risk: 1
  • High risk: 2 or more

(N.B: Doctors only use MUST to point-out an overall malnutrition or the risk of malnutrition in adults. The test will not identify particular nutritional imbalances or deficiencies)

Treatment

This usually depends on the severity of the malnutrition and the presence of any other underlying conditions or complications and may include:

  • Ongoing screening and monitoring
  • Making a dietary plan, which may include taking supplements
  • Treating specific symptoms such as nausea
  • Treating any infections that maybe present
  • Checking for any difficulty in problems
  • Suggesting alternative eating utensils
In severe cases, nutrients maybe administered intravenously 

Prevention 

To prevent malnutrition, your child needs to consume a range of nutrients from various     food types. 

Older adults, young children and others may need additional care to obtain the nutrients they need.

If your child starts to show signs of malnutrition or undernutrition, do not hesitate to take him/ her to the doctor immediately for diagnosis and treatment.

Dr.Favvy

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