4 Nutritional problems in infants that can occur and their treatment

Since the beginning of birth, paying attention to all daily nutritional intake is one of the important things to meet the nutritional needs of the baby. Unfortunately, the baby's daily nutritional intake can sometimes not match their needs, causing problems for the little one's growth and development. What are the nutritional disorders or problems that are at risk for a baby?

Various nutritional problems in babies

The nutritional status of a baby actually begins to form from the time he is in the womb until he is even two years old. This time span is also known as the first 1000 days of life starting from the beginning of pregnancy or the golden period.

During the first 1000 days or the golden period, it is hoped that the baby will get a daily nutrient intake that is commensurate with their needs.

The reason is because during the first 1000 days, the growth of your little one's body and brain is developing very rapidly.

Adequate nutritional intake while in the womb until the baby turns two years old will make it born and grow properly.

Conversely, if the baby's nutritional intake is not fulfilled optimally, this condition can cause growth and development to experience obstacles.

In fact, the stunted growth and development of your little one can be difficult to fix so that it will eventually affect his adulthood.

Do not rule out, babies can experience nutritional problems as a result of inadequate daily nutritional intake. In order to better understand, here are some nutritional problems in babies that may occur:

1. Nutritional problems with low birth weight babies

Low birth weight (LBW) is one of the nutritional problems in infants. As the name implies, this low birth weight condition occurs when a newborn has a weight below the normal range.

Ideally, a newborn is classified as having a normal body weight if the measurement results are in the range of 2.5 kilograms (kg) or 2,500 grams (gr) to 3.5 kg or 3,500 grams.

So, if a newborn's weight is below 2,500 grams, it indicates that he is experiencing nutritional problems in the form of LBW.

However, you need to remember that the normal weight range applies to newborns at 37-42 weeks of gestation.

According to the Indonesian Doctors Association (IDAI), several groups of low birth weight in babies are:

• Low birth weight (LBW): birth weight less than 2,500 g (2.5 kg)
• Very low birth weight (LBW): birth weight in the range of 1,000 to less than 1,500 g (1 kg to less than 1.5 kg)
• Very very low birth weight (LBW): birth weight less than 1,000 grams (less than 1 kg)

Handling action

Treatment methods for problems with low birth weight babies are usually adjusted according to their symptoms, age, and general health.

The doctor will also assess how severe the condition of your little one is to determine the appropriate treatment measures.

Quoting from the University of Rochester Medical Center, treatment for problems in babies with low birth weight, namely:

• Babies receive special care in the neonatal intensive care unit (NICU)
• Monitoring of the baby's sleeping room temperature
• Babies are given special food, either through a tube that flows directly into the stomach or an intravenous tube that enters a vein

In addition, the World Health Organization recommends breastfeeding for babies who have LBW since they were born. In fact, it would be even better if breastfeeding was continued for a full six months, aka exclusive breastfeeding.

2. Poor baby nutrition problems

Malnutrition is one of several nutritional problems in infants caused by an imbalance between energy intake and daily nutritional needs.

In other words, babies with undernourished daily intake tend to be less and unable to meet their body's needs.

Based on Permenkes No. 2/2020 concerning Anthropometric Standards for Children, infants are included in the malnutrition group when their weight measurement according to their height is below normal.

You see, the measurement of a baby's weight and height has a unit called the standard deviation (SD).

Normally, babies are said to be well-nourished when their weight based on their height ranges from -2 SD to 2 SD.

Meanwhile, if your child is malnourished, the measurements are in the range of -3 SD to less than -2 SD.

WHO further explained that the problem of malnutrition in infants can include stunting, wasting, low body weight, and vitamin and mineral deficiencies.

In fact, minerals and vitamins for babies include a small portion of nutrients whose intake cannot be lacking. The problem of malnutrition in infants does not occur suddenly, but has been formed due to malnutrition for a long time.

Babies who are malnourished may experience insufficient nutrition from the time they are in the womb or from birth.

This condition can be caused by insufficient nutritional intake of the baby or because the baby has difficulty eating.

Handling action

Infants who are undernourished are strongly advised to get exclusive breastfeeding for the full six months. However, this treatment only applies to babies who are under six months of age.

Meanwhile, babies over six months with malnutrition can be overcome by providing complementary foods with complementary foods (complementary foods).

Complete here means that it can meet all the nutritional needs of your little one. In addition, you are advised not to skip snacks or baby snacks between the main meals.

If necessary, babies can be given solid foods that have been fortified or added with various nutrients to complement their daily needs.

Also adjust the MPASI menu to the baby's appetite to help increase his appetite.

3. The problem of malnutrition in babies

Another nutritional problem in babies is malnutrition. Malnutrition is a condition when the weight based on the baby's height is far from the range it should be.

Permenkes No. 2/2020 concerning Children's Anthropometric Standards describes that the measurement of infants with malnutrition is less than -3 SD.

Just as malnutrition covers several problems, malnutrition is no different.

Malnutrition in babies can be divided into kwashiorkor, marasmus, and marasmus-kwashiorkor.

Marasmus is a condition of malnutrition due to insufficient energy intake. Kwashiorkor is a malnutrition problem caused by a lack of protein intake in babies.

While marasmus-kwashiorkor is a combination of the two, it is a problem because protein and energy intake is less than what it should be.

Handling action

Treatment of malnutrition problems in infants will later be adjusted back to their conditions, for example experiencing marasmus, kwashiorkor, or marasmus kwashiorkor.

If the baby has marasmus, treatment can be done by giving formula F 75.

Formula milk F 75 is processed from sugar, vegetable oil, and milk protein called casein which are mixed together.

In addition, the daily intake of baby food will also be regulated so that it contains sufficient nutrients, including calories and carbohydrates to meet their energy needs.

Like babies with marasmus, malnutrition in the form of kwashiorkor in infants also requires feeding the formula F 75.

However, daily feeding will usually be a little different because your little one should get food sources of calories including sugar, carbohydrates, and fat.

After that, new babies can be given food sources with high protein content to meet their lacking needs.

Likewise, the handling of cases of marasmus-kwashiorkor in infants can be done by combining the two previous treatments.

You must consult a doctor for further treatment.

4. Over nutrition problems in babies

Another nutritional problem that babies can also experience is excess nutrition. Excess nutrition, aka overnutrition, is a condition when the weight based on your little one's height is above its normal range.

Infants with more nutrition can have one of two conditions, namely between overweight (overweight) and obesity in infants.

Infants were said to be overweight when their measurements were in the range of +2 SD to +3 SD. Meanwhile, obesity is different from ordinary fat because it is above the +3 SD measurement.

Handling action

The best way to deal with over nutrition problems in babies is to regulate their daily intake of food and drinks.

As much as possible, you need to keep your little one's daily food and drink intake so that they don't gain weight.

Replace distractions such as sweet bread with fruit for the baby. Infants aged 0-2 years who are obese do not need to reduce daily calorie intake.

Doctors usually recommend maintaining as well as reducing weight gain.

So, you should still control the appropriate number of calories so you don't overdo it. This is because in this period of 0-2 years, the baby is in a linear growth process.

This means that the nutritional status of children in the future or when they are adults will be largely determined by their current condition.

If the baby's age has entered complementary feeding (MPASI) but the portion and schedule of infant complementary foods is outside the normal rules, try to justify it again.

Give the baby the right frequency and portion of food according to his age.

If it turns out that the doctor recommends that your little one reduces their daily calorie intake, usually your baby will get a special menu recommendation.

This aims to ensure that the baby's needs are well fulfilled and do not cause deficiencies in certain nutrients that are at risk of hindering their growth and development.

5. Nutritional problems with stunting in infants

Stunting is a growth disorder in the baby's body. This condition makes the length or height of the baby not suitable for the average child his age.

Stunting in infants is not something that can be underestimated. If it is not immediately recognized and treated appropriately, stunting can hamper the baby's physical and cognitive development and be less than optimal in the future.

This is because the condition of babies who are stunted is generally difficult to return to normal when it has already occurred.

The assessment of stunting in infants and children is usually carried out using the Child Growth Chart (GPA) from the World Health Organization.

Babies can be said to be stunted when the measurement results of length or height show a number below -2 standard deviation (SD).

Standard deviation is the unit used to measure the length or height of an infant. Stunting nutritional problems in infants can be caused by various factors.

These factors include the nutrition of the mother during pregnancy, the socioeconomic condition of the family, the baby's nutritional intake, to the baby's medical condition.

In more detail, the health condition and nutritional intake of the mother before, during, and after birth can affect the baby's growth.

In addition, short posture, too young an age to get pregnant, and too close to a pregnancy are also at risk of stunting the baby.

Meanwhile in infants, failed exclusive breastfeeding and weaning (solid food feeding) too early are some of the factors that cause stunting.

Handling action

Treatment for stunting nutritional problems in infants can be done by doing parenting (caring). These parenting measures include early initiation of breastfeeding (IMD) at birth and then exclusive breastfeeding until the baby is 6 months old.

Furthermore, babies must also be given complementary foods (complementary foods) until the age of 2 years to support their growth and development.

Don't forget to also pay attention to the frequency of breastfeeding for stunted babies, such as:

If the baby is breastfed:

• Age 6-8 months: eat 2 meals per day or more
• 9-23 months: 3 meals per day or more

If the baby is not breastfeeding:

• Age 6-23 months: eat 4 meals per day or more

This provision is minimum meal frequency (MMF) aka the minimum frequency of eating. MMF can be applied to stunting infants aged 6-23 months in all conditions.

These conditions include infants aged 6-23 months who are or are no longer breastfed and have already eaten solids (soft, solid, or given infant formula because they are no longer breastfed).

The conditions mentioned above require special attention from a doctor. Therefore you need to consult a doctor for further treatment.

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