Malnutrition

Malnutrition is a general term for a health problem caused by a bad diet or not getting enough to eat. It usually means undernutrition caused by not eating enough, not absorbing enough, or losing too much nutrition, but it can also mean overnutrition caused by eating too much or taking in too much of certain nutrients.

Common forms of malnutrition include:

1. Protein-energy malnutrition (PEM): Protein-energy malnutrition refers to inadequate availability or absorption of energy and protein in the body.
2. Micronutrient Deficiency Disorders: deficiency of microelements such as Iron, Iodine in a body.

Causes of protein-energy malnutrition:

1. Poverty
2. Low birth weight
3. Infections like diarrhea, pneumonia, malaria, measles, whooping cough, and tuberculosis
4. Population growth: an increase in birth rate leads to population growth in the country is disproportionate to an increase in food production.
5. Feeding habits: lack of exclusive breastfeeding for first 6 months, late initiation of weaning, diluted milk formula, use of improper weaning food early, stoppage of breast feeding, etc.
6. Education: education is a vital cause of malnutrition because lack of awareness and knowledge regarding food preparation preservation, family planning, maintaining food hygiene, and way of feeding
7. Geography: In high hill areas the soil is not good and it’s hard to cultivate crops. This leads low production leads the low production of food and low production leads to low consumption resulting in malnutrition.
8. Other: high-pressure advertising of baby foods, chronic disease, starvation, psychological problem, alcoholism drug addiction over-consumption of fat and sugar industrial food processing and famine age (6-8 months), twin baby, short interval between birth, large family size, etc.

Classification of Nutritional status:

Malnutrition is classified into different classes, some of them are:

Welcome trust classification:

This is based on weight for the Age of the child and the presence and absence of Edema:

Waterlow’s classification:

Based on the age of the child and the measurement of weight and height:

Indicators of malnutrition:

• Stunting: low weight for age- indicate chronic malnutrition, due to prolonged food deprivation, or disease.
• Wasting: low weight for height- indicate acute malnutrition
• Underweight: low weight for age

Categories of protein-Energy malnutrition (PEM)

According to the deficiency of protein and energy in varying degree, PEM is categorized into:

1. Mild PEM
2. Moderate PEM
3. Severe PEM: kwashiorkor, Marasmus, Marasmic kwashiorkor

Mild PEM

This is common in children between 9 months and 3 years of age characterized by growth failure, repeated infection, and lethargy. The main cause of mild PEM is deficit dietary intake for a short period.

Moderate PEM

If the child doesn't get enough food for a long time, he or she will develop moderate PEM. This is also called Ruche, which is a local language used for moderate PEM. Ruche means "crying children," which is a good way to describe what a child who is always crying is thinking. Most of the time, moderate PEM lasts from 1 to 4 years. Moderate PEM looks like mild PEM, but it's easier to spot because the symptoms are more obvious. For example, children with moderate PEM seem slower and less energetic, they stop growing (and gain weight), they have thin arms and legs, flattened buttocks with wrinkled skin on the front of their thighs, a winged scapula, a swollen abdomen, repeated infections, and they lose fat under their skin.

Severe PEM

Severe forms of PEM is manifested as kwashiorkor, marasmus, and marasmus kwashiorkor