Just when we thought that nutritional deficiencies were a problem of only the poor children, it was found that majority of these children are in homes which are not poor. In 2011, 52 million children under 5 years of age were moderately or severely wasted Worldwide. The reason could be negligence of working parents, disinterest in raising children, child abuse, behavior problems in children, lesser outdoor activities, infections and so on.

 

The nutritional deficiencies can fall under two categories:

Micronutrient deficiency:  iron, iodine, vitamin A, folate deficiencies

Protein energy malnutrition: Kwashiorkar, Marasmus

The two terms used frequently are stunting of growth and wasting. Stunting (low height for age) happens due to long term undernutrition. Wasting (low weight for height) captures short term but excessive undernutrition. Low weight will be present in both stunted growth and wasting. Stunting and other forms of undernutrition can lead to increased risk of disease, disability and even death in children. Children with weight of less than 2,500 grams at birth tend to stay low weight for few years after birth.

It is important to provide adequate food to pregnant mother to prevent low weight child. Pregnancy increases the need for more food and nutrition. Protein, calories, vitamin and mineral deficiencies are common during pregnancy. Poor nutrition of mother weakens the baby. Stunting is not reversible after a certain age. Adequate nutrition must be provided to women during pregnancy and to children from birth to 18 months of age.

Problems in kwashiorkor include bloated look, loss of appetite, irritability, changes in hair colour (yellow, orange), patches of skin abnormally light or dark, shedding of skin. The body of a malnourished child tries to save energy by reducing physical activity and growth, reducing internal body processes and shutting down the body’s response to infection. This reduced activity results in limited function of the organs putting the child at risk for low blood sugar, low body temperature, fluid overload, heart failure, infection. Stunting may cause less development of brain, which can cause long-lasting harmful consequences for cognitive ability, school performance and future earnings.

Pediatrician can easily diagnose malnutrition in children. Ask pediatrician if your child needs any specific testing for nutritional deficiencies. They can run tests to find any causes of malnutrition in the child.

Ask Pediatrician about adequate nutrition of pregnant mothers and babies. Breastfeeding should be started within one hour of birth and continued upto 2 years. Safe and adequate solid foods should be started from 6 months onwards. Supplements including vitamin A, D, K and iron should be started after birth. Mother and child should have access to clean drinking water and appropriate use of health services. Extra calories like cream, butter, ghee need to be added in food of malnourished child. Dietitians play a key role in formatting a diet plan for such children. Folic acid supplements during pregnancy help prevent neural tube disorders in baby. Iodised salt is need to prevent thyroid problems.

In developing countries like India, vitamin A, iron folic acid supplements are available in government health centers free of cost. These centers allow for the easy access of key health interventions including immunization, deworming, mosquito net provision, and medicines to combat infections.