Summary

This document discusses malnutrition in children, including definitions, classifications, risk factors, causes, management, and potential complications. It highlights important biological roles of various nutrients, including proteins, carbohydrates, fats, water, minerals, and vitamins. The document also presents growth rules for weight, height, and head circumference, and differentiates between mild, moderate, and severe acute malnutrition.

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Malnutrition in Children Presented By: DR. MONA MOHAMMED ALI Objectives Definitions and classifications of malnutrition Risk factors and causes of malnutrition Management of pt with PEM Complication of malnutrition IMPORTANT BIOLOGICAL ROLES OF VARIOUS NUTRIENT...

Malnutrition in Children Presented By: DR. MONA MOHAMMED ALI Objectives Definitions and classifications of malnutrition Risk factors and causes of malnutrition Management of pt with PEM Complication of malnutrition IMPORTANT BIOLOGICAL ROLES OF VARIOUS NUTRIENTS: 1) Proteins: needs 45-55g -for growth and repair of tissue cells -plasma proteins -enzymes… etc 2) CHO: needs31-35Kcal/kg Wt -source of energy - structure of cells 3) Fat: needs 5% of total calories (poly un sat.) -structure of cell membrane & nuclei -vehicle for absorption of fat sol. Vitamins 4) Water: -transport of nutrients & waste product -homeostatic function 5) Minerals and trace elements : 1) Calcium: skeletal rigidity, muscle function, and regulation of cell metabolism. 2) potassium: potassium deficit contributes to hypotonia, apathy, and impaired cardiac function. 3) Copper: aerobic metabolism, iron handling, and collagen synthesis. 4) Fluoride: dental protection. 5) Iodine: thyroid hormone synthesis. 6) Iron: cellular respiration. Iron deficiency leads to Hypochromic microcytic anaemia 7) Magnesium: growth control, muscle function. 8) Phosphorus: bone metabolism, cardiac, respiratory and neurological function. 9) Selenium: antioxidant. 10) Zinc: nucleic acid and membrane metabolism. Its deficiency leads to growth retardation and Dermatosis. 6)VITAMINS: Vit A: visual integrity, cell differentiation. Vit D: control of calcium and phosphorus metabolism. Its deficiency leads to rickets. Vit E: antioxidant. Vit K: integrity of coagulation cascade. Its deficiency leads to bleeding manifestations. Vit B1: ATP synthesis, cell membrane integrity. Vit B2: red-ox reaction co-factor. Vit B6: amino acid and lipid metabolism. Vit B12: DNA synthesis. Vit C: reducing agent critical to collagen synthesis. Its deficiency leads to scurvy. Folate: DNA synthesis. Rules of Thumb for Growth Weight Weight loss in first few days by 5%-10% of birth weight. Return to birth weight by 7-10 days of age Double birth weight at 4-5 mo Triple birth weight at 1 yr Quadruple birth weight at 2 yr Average weights: 3.5 kg at birth ,10 kg at 1 yr ,20 kg at 5 yr and 30 kg at 10 yr Height Average length: 20 inches at birth 30 inches at 1 yr At age 4 yr, the average child is 40 in tall (double birth length) Average annual height increase: 2-3 inches between age 4 yr and puberty Head Circumference (HC) Average HC: 35 cm at birth (13.5 inches) Head circumference increases by 2 cm per month in the first 3 moths of age , 1cm per month for second 3 months of age , then only 0.5 cm per month for the last 6 month of infancy. that means during the first year of age head circumference increase by 12 cm It increase by 10 cm for rest of life DEFINITION of Malnutrition: The inappropriate intake of one or more of the nutrients essential for normal growth and development of the body. A condition characterized by relative or absolute deficiency in one or more of the essential nutrients sufficient to produce disease. The World Health Organization defines malnutrition as "the cellular imbalance between supply of nutrients and energy and the body's demand for them to ensure growth, maintenance, and specific functions. INTRODUCTION: Malnutrition, in all its forms, includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related noncommunicable diseases. Globally in 2020, 149 million children under 5 were estimated to be stunted (too short for age), 45 million were estimated to be wasted (too thin for height), and 38.9 million were overweight or obese. Around 45% of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low- and middle- income countries. At the same time, in these same countries, rates of childhood overweight and obesity are rising. The developmental, economic, social, and medical impacts of the global burden of malnutrition are serious and lasting, for individuals and their families, for communities and for countries. Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition addresses 3 broad groups of conditions: 1. Undernutrition: which includes wasting (low weight-for- height), stunting (low height-for-age) and underweight (low weight-for-age) 2. Micronutrient-related malnutrition: which includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess; and 3. Overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers). Understanding the Difference Among MAM, SAM, and GAM and their Importance on a Population Basis: Weight for height (wasting) provides the clearest picture of acute malnutrition in a population at a specific point in time. Moderate Acute Malnutrition (MAM) is identified by moderate wasting :WFH < 2 z score and > 3 z score for children 0 59 months (or for children 6 59 months, MUAC 115 mm). Severe Acute Malnutrition (SAM) is identified by severe wasting: WFH < 3 z score for children 0 59 months (or for children 6 59 months, MUAC

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