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IS YOUR CHILD MALNOURISHED?

How do health professionals evaluate the nutritional health of a child? They may analyze various signs and symptoms, ask questions about eating habits, and order a laboratory analysis to be made. However, they most commonly rely on fairly straightforward measurements. They measure the child’s body and compare the figures to reference standards. That helps them determine the type and seriousness of the malnutrition.

The most important measurements are weight, height, and the perimeter of the arm. Comparing weight and age reveals the degree of the undernourishment; if it is serious, the child is wasted and looks very thin. The illness is considered serious if the child’s weight is more than 40 percent below normal, moderate if it is 25 to 40 percent below, and mild if it is 10 to 25 percent below. A very low height-to-age ratio may reveal chronic undernourishment​—the child is stunted.

The most serious forms of protein-energy malnutrition (PEM) are marasmus, kwashiorkor, and a combination of both. Marasmus (progressive wasting) appears in nursing babies between 6 and 18 months of age. It establishes itself slowly as a chronic deficiency of calories and nutrients and develops as a result of insufficient nursing or the use of very diluted substitutes for human milk. The baby shows a great loss in weight, the muscles are so thin that the skin sticks to the bones, and growth is retarded. The baby also has “an old person’s face,” is irritable, and cries a lot.

The term kwashiorkor, taken from an African dialect, means “deposed child.” It refers to a child’s being replaced at the mother’s breast by a newborn sibling. This condition appears after weaning, and while it includes caloric deficiency, it develops from an acute lack of proteins. It causes the body to retain fluids, making the child appear bloated in the extremities and the abdomen. Sometimes it affects the face too, making it resemble a full moon. Skin lesions and alterations in the color and texture of the hair appear. Children with this condition show swelling of the liver and are apathetic and sad. This was the case with Erik, mentioned previously, whose mother fed him breast milk for only the first month of his life; then she gave him very diluted cow’s milk. At three months he was given vegetable soups and sugar water and was left in the care of a neighbor.

The third type of PEM includes characteristics of both marasmus and kwashiorkor. All of these conditions can prove fatal if not treated in time.

Lack of necessary nutrients causes the child to stop growing and developing properly. It cries a lot and is prone to sickness. As the condition worsens, weight loss becomes more pronounced, eyes and fontanel (the soft spot on top of the head) become sunken, skin and tissues lose elasticity, and the ability to maintain body temperature decreases.