The malnourished child

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Malnutrition, a state of deficiencies, excesses or imbalances of a person’s intake, energy or nutrition, continues to be an epidemic in developing countries. It is a state of ill health that is so common globally that it is the most disturbing risk factor for illness and death, particularly in young children where an estimated 300,000 die per year as a result.

The height for a child’s age and, the weight for a child’s height are often used to diagnose children as malnourished. A child who has a low weight for their height is classified as acutely malnourished or wasted whilst a child with a low height for their age is classified as chronically malnourished or stunted.  Researchers have found that in developing countries, both wasting and stunting are commonly found in children under-five, between the ages of one and two. Although, by the age of three to four years, children who are still significantly underweight for their age are usually stunted rather than wasted (they have stopped growing taller but are of normal weight for their height).

Marasmus is a type of malnutrition that is found mostly during infancy. It is a condition where there is severe weight reduction, serious wasting of muscle and tissue, stunting and reduced oedema (watery fluid collected in cavities or tissues). Children often develop marasmus as a result of poor nutrition which may be a consequence of breastfeeding absence. A child with marasmus will have a build-up of fat in the liver which will affect their hair and skin. They will also be irritable and apathetic (show no feeling of enthusiasm or concern). This child will also have a low weight in relation to their height (wasted) and low height for their age (stunted).

Kwashiorkor is another type of malnutrition that is found in young infants as well as older children. Kwashiorkor develops often as a result of an unbalanced diet which is very low in protein and higher in carbohydrates. A child with kwashiorkor will have skin lesions, apathy, anorexia, a fatty liver and will suffer from changes to the composition their hair as a result of low keratin and other proteins. Severe protein-energy malnutrition has been reported to be the cause of death by 20% in some areas of the world, with many deaths occurring during the first few days after admission to hospital.

Aside from a poor diet where there are low intakes of protein, high rates of bacterial and parasitic diseases found mostly in developing countries and resource limited communities also contributes to malnutrition. A malnourished child is more prone to infection which is one of the major factors contributing to the increased morbidity (rate of disease) and mortality (death) associated particularly, with protein-energy malnutrition. The major infectious diseases with the highest morbidity and mortality rates are diarrhea and measles which affects nutrition status by reducing food intake, reducing the absorption of nutrients, increasing metabolic requirements.

The signs of a malnourished child will still visible after re-feeding and recovery. In adulthood, previously malnourished children may be mentally stunted, physically stunted and is likely to have an increased susceptibility to infections for the rest of their lives.

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(Picture by photographer: Pierre Holtz at UNICEF sourced from https://bit.ly/2RuuUiL)

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