Protein energy malnutrition in children - HHM

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Saturday, 5 November 2016

Protein energy malnutrition in children


    Baby Smiles

    Protein energy malnutrition (PEM) was formerly known as protein calorie malnutrition (PCM). 

    It affects children under 5 years of age and is prevalent in developing countries due to Socio-economic factors like poverty, insufficient food supply, ignorance and insufficient food production.


    It is a condition arising due to the excess or deficiency in the body’s need for protein, energy or both. When the body’s energy or protein need cannot be met, the body’s cellular processes are affected and thus the condition and symptoms of protein energy malnutrition appears.



    For sometimes now studies on infant health and wellbeing have been carried out by researchers around the globe in order to ascertain the cause of infant diseases, death and also to offer ameliorative methods or ways to combat or prevent its occurrence.



    Despite the wide knowledge and understanding of human nutritional requirements, protein energy malnutrition still assume international position as one of the leading contributor to infant death. Sometimes it is considered as one of the unascertained cause of sudden infant death syndrome (SIDS) and other sleep related infant deaths




    Classification of protein energy malnutrition with signs and symptoms.

    Protein energy malnutrition can be grouped into three categories;

    Kwashiorkor:

    • Swelling (from excessive accumulation of watery fluid in cells and tissues) 
    • Hair changes and skin disorders
    • Growth retardation
    • Muscles reduce in size and performance
    • Behavioural changes arising from accumulation of substances in the body which affects brain performance.
    • Wasting away of the body fat and muscles 
    • The lack of growth and development.

    Marasmus:
    Marasmic kwashiorkor:

    appears in a weaned child who is nourished with an adequate or near adequate caloric diet but deficient in protein. 


    In marasmic kwashiorkor the signs of kwashiorkor and marasmus appear at the same time, while kwashiorkor occurs at the second year of the child’s life, marasmus is most common during first year of life, especially during the period between the latter half of the first year and the first half of the second year.



    Causes of Protein energy malnutrition

    Although PEM is caused primarily by an inadequate food intake, it may be caused secondarily by diseases which may lead to


    •  low food ingestion
    • inadequate nutrient absorption or utilization
    • increased nutritional requirements
    • increased nutrient losses.
    • vomiting
    • abdominal pains
    • diarrhoea
    • watery,  greenish, fatty and foamy stool. (Stool pH is generally below 5.5) .    
    • Prevent or treat depletion occurring due to loss of body fluid, sugar and electrolyte by supplying food (high in protein) and fruits (like pawpaw) 
    • Regulate body temperature
    • Treat any disease infection
    • Monitor type of food and amount consumed
    • Ingestion of approved Nutrient complements
    • Provide psychological support for such children 
    • Continue dietary checks even after recovery.





    Metabolic changes caused by protein energy malnutrition include;


    This results in a defective absorption of carbohydrate, fats, proteins, some minerals and vitamins.

    During the condition of PEM, intake of foods (disaccharides) can trigger metabolic disturbances referred to as disaccharide malabsorption. Some of the disturbances include;



    Cure and management of protein energy malnutrition.


    The following are the specific, self-evident measures that can be taken to combat or treat malnutrition in children;