Malnutrition in children, what are the signs and causes?

In order for optimal growth and development, parents need to ensure that children's nutritional intake is properly fulfilled. But sometimes, children's nutritional needs are not in line with the daily food intake they get. If you walk long enough, this can lead to malnutrition in your little one. The following is an explanation of malnutrition in children that parents need to pay attention to.

What is the condition of malnourished children?

Source: BBC

Lack of nutrition is the impact of not fulfilling children's nutritional needs that have been going on for a long time.

In fact, this condition can start in infancy or in the womb.

Not only that, after the baby is born, the fulfillment of nutrition for children still needs to be considered at least until he is 2 years old.

This should be the main concern that should not be underestimated.

The reason is, from pregnancy to 2 years of early childhood is a golden period that will determine the next child's life.

Lack of nutrition can be exacerbated if the child often experiences infectious diseases.

As a result, malnutrition in children can interfere with the growth and development of the child's brain and physically.

Broadly speaking, malnourished children generally have less weight (underweight), thin (wasting), short (stunting) , as well as vitamin and mineral deficiencies.

In Indonesia alone, the problem of malnutrition in children is still a serious concern.

Based on the 2013 Riskesdas data, the number of children under five who suffer from malnutrition is 13.9 percent, short (stunting) by 19.2 percent, and thin (wasting) by 6.8 percent.

What are the common symptoms when a child is malnourished?

The characteristics of malnourished children can be distinguished based on their age, such as the age of infants and children over 5 years. The following is the full explanation.

Symptoms of a malnourished baby

Babies who are malnourished will usually show some physical characteristics or signs. Launching from the NHS page, the symptoms that appear when the baby is malnourished, namely:

• The baby's growth is not running as it should be, for example, the baby's weight does not increase.
• Babies experience behavioral changes, such as feeling restless and often fussy.
• It is easy to feel tired because the energy supply is less than optimal than babies of his age.

The bad news is that apart from being able to cause severe problems with baby nutrition and physical health, this malnutrition is also a risk to your little one's life.

It is also important to note that there is a nutritional deficiency that can be divided into two, namely moderate malnutrition (moderate malnutrition) and acute malnutrition (severe acute malnutrition).

If moderate malnutrition in infants is left for a long time, this condition can develop into acute malnutrition.

In fact, it does not rule out that moderate malnutrition can lead to wasting and stunting in a more severe form.

Symptoms of malnourished children

In children who are malnourished, various signs appear, namely:

• Low appetite
• The child has failed to thrive (judged by weight, height, or both that are not appropriate for their age)
• Losing body fat and muscle mass
• The muscle strength of the body disappears
• It's easy to get angry, look lethargic, and even cry excessively
• Experiencing anxiety and less attention to the environment
• Difficulty concentrating well.
• Dry skin and hair, and even hair fall out easily
• Cheeks and eyes appear sunken
• The wound healing process is very long
• Vulnerable to disease, with a healing process that tends to take a long time
• The risk of complications increases with surgery

It is also possible, the development of toddlers in terms of behavior and intellectual abilities of children is quite slow.

In fact, children can experience learning difficulties when their nutritional intake is lacking.

What are the problems with malnutrition in children?

According to WHO, there are various problems that arise when children experience malnutrition (undernutrition), includes:

1. Lack of weight (underweight)

Underweight or underweight children are indicated when the child's weight is not equivalent to the normal weight in their age group.

However, this condition also indicates a mismatch between the child's weight and height. In a sense, the weight of the child is usually too light for the height he has.

Therefore, underweight can be measured using indicators of body weight for age (BW / U) or in proportion to height (BW / TB).

The child is said to have less weight when the value is measured z score in the growth chart it is between <-2 SD to -3 standard deviation (SD).

In addition to a thin body, another characteristic symptom that appears when the child is underweight is that he is very susceptible to disease.

This condition is difficult to determine by parents themselves. Need help from a pediatric nutrition doctor to check it.

2. Skinny (wasting)

In contrast to underweight (underweight), a very thin child (wasting) has a very low weight and does not match his height.

The weight of the child who experiences it wasting usually well below the normal range it should be.

Indicators used to assess likelihood wasting in children, namely body weight compared to height (BW / TB).

The condition of severely malnourished children is also often used to describe wasting .

The reason is, children who are very thin usually do not get enough nutrition for a long time.

In fact, these children may also experience diseases related to weight loss, such as diarrhea.

Typical symptoms that are easily seen if the child experiences wasting that is, to have a very thin body because of very low body weight.

3.Short (stunting)

Short (stunting) is a condition that disturbs the growth of the child's body, so that the child's height is not normal or not equal to his peers.

Stunting does not occur in a short time, but has been formed for a long time due to insufficient nutritional needs of children during the growing period.

In addition to nutritional intake, stunting also caused by recurrent infectious diseases and low birth weight (LBW).

Since the child is 3 months old, the condition stunting generally it has started to increase, so the process slows down even more when the child is around 3 years old.

Starting from this point, the growth chart for the child's height moves to follow the normal graph, but with an assessment that is below normal.

Indicators used to assess likelihood stunting in children, namely height for age (TB / U).

The child is stated to have a body stunting if the height growth graph according to age is less than -2 SD.

4. Lack of vitamins and minerals

Not only malnourished children can experience vitamin and mineral deficiencies, but children of normal weight have the same risk.

A sign of vitamin deficiency is one of the conditions for malnourished children.

Quoting from WHO, some of the most common types of vitamin and mineral deficiencies are:

Vitamin A.

Vitamin A deficiency occurs when the daily intake of vitamin A from toddlers is not able to meet their needs.

This condition can get worse if the child is prone to infectious diseases, such as diarrhea and measles.

Difficulty seeing at night is one of the typical symptoms of vitamin A deficiency.

In more severe conditions, vitamin A deficiency in children can result in blindness due to damage to the retina and cornea of ​​the eye.

If not addressed immediately, children who are deficient in vitamin A are at risk for respiratory problems and infectious diseases.

On the other hand, this condition also leads to inhibition of the growth rate and development of children's bones.

When a child is deficient in vitamin A, some of the symptoms that appear include:

• Dry skin and eyes
• Stunted growth
• Children's vision is less than optimal at night or when the light conditions are dim
• Respiratory tract infection
• The wound healing process is slow

Immediately consult a doctor for further treatment.

Iron

Lack of blood or anemia occurs when the iron stores in the blood run out, and the supply in the muscles is very low.

If you have anemia, it means that the iron deficiency condition experienced by your child is classified as severe.

In other words, the levels of hemoglobin and hematocrit in red blood cells have been below normal values ​​or cut off .

If the child is malnourished due to iron, various symptoms will look like:

• Pale skin
• Tiring easily
• Slow growth and development
• Decreased appetite
• Feeling difficulty in breathing
• Often experience infectious diseases
• The desire to eat certain foods increases, such as ice cream, carbohydrate sources, or others

Immediately consult a doctor for further examination.

Iodine

Iodine is a type of mineral that is important for supporting the production of thyroid hormones, thyroxine and triodotyronine. Various symptoms of iodine deficiency in children such as:

• Swelling in the neck (goiter)
• Severe fatigue
• Hair loss easily
• Dry skin
• Heart rate slows down
• Difficulty in studying and concentrating

If your child shows the signs as mentioned earlier, you should immediately take your child to the doctor.

How to deal with malnutrition in children?

Actually, the handling of malnutrition in children will be readjusted according to the severity and special conditions experienced by each child.

The existence of complications that contribute to malnutrition will also be a separate consideration.

Infants under 6 months

For babies under six months and included in the category of malnutrition (thin), basically there is no addition of other processed baby food.

The handling given must focus on breastfeeding because this age is still in the period of exclusive breastfeeding.

Breastfeeding should be more frequent than usual and avoid directly giving mixed formula milk to overcome this problem.

Addition of formula milk to babies is only done for certain problems under the supervision of a doctor or nutritionist.

If you do not have other health problems, the baby should still be exclusively breastfed.

So, exclusive breastfeeding for babies younger than six months is highly recommended as long as it is possible.

It should be noted that if your baby has not gained weight for 2 months in a row or the growth is not according to the growth chart for babies <6 months, you need to consult a doctor.

Meanwhile, for infants under six months who experience acute malnutrition (severe acute malnutrition) should give supplementary food at 4 months of age in consultation with a doctor beforehand.

This must continue until the baby's weight has increased according to the normal standards for his age.

Infants over 6 months

Infants over six months are advised to gradually increase their intake of energy, protein, carbohydrates, fluids, vitamins and minerals in order to overcome malnutrition.

The goal is to gain weight and strengthen the immune system so that the baby is not at high risk of infection.

In addition to changes in diet, meal schedule, and children's diet, other treatments are needed to improve the nutritional status of infants, namely:

• Emotional support from family
• Certain medications if any are related to the cause why the child is becoming thin
• Provision of special vitamins and minerals

After the baby is healthy enough and his weight has started to increase so that he meets the standards, his diet can be adjusted according to his daily needs.

Children 1 year and over

In general, the following are various treatments that can be done to recover malnourished children:

Change the child's diet

The pediatrician or pediatrician may recommend changes in the type and amount of your child's diet, and may prescribe dietary supplements such as vitamins, minerals, and protein.

Changes in a child's diet will usually be advised to gradually increase their intake of calories, protein, carbohydrates, fluids, vitamins and minerals.

This is done to reduce the risk of your child developing complications such as infection.

Your child may also be advised to take special nutritional supplements that can increase their energy and protein intake.

Children with severe malnutrition need to be fed and drank with great care so that they cannot be fed a normal diet immediately.

If the condition is like that, your child needs special care in the hospital.

Supplementation

Vitamin and mineral supplements, either in powder or tablet form, for adolescents with malnutrition are beneficial to increase their appetite.

However, it would be better if you consult further with your doctor.

Doctors may prescribe certain types of vitamins to increase children's appetite depending on the health condition and the severity of malnutrition in adolescents.

Monitor child's development and nutritional status

Check with the doctor regularly to find out how the development of the child's condition and nutritional status.

In addition, even if you do treatment at home, you still need direction from a doctor or nutritionist to meet the nutritional needs of children who are malnourished.

What can be done to prevent malnutrition in children?

The most important way to prevent malnutrition in children is to provide food with balanced nutrition.

The balanced nutritious food consists of four main food groups, namely:

• Fruits and vegetables, give children at least 5 servings per day.
• Food sources of carbohydrates, namely rice, potatoes, bread, pasta, and cereals.
• Food sources of protein, namely meat, eggs, chicken, fish, nuts and their products.
• Milk and dairy products, such as cheese and yogurt.

Give complete immunization to children to increase the child's immunity so that children avoid infectious diseases.

Also give vitamin A capsules every February and August until the child is 5 years old.

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