How is undernutrition-type malnutrition diagnosed and managed in children?

Undernutrition-type malnutrition in children can be severe and have many long term health effects. The diagnosis of malnutrition is based on the circumference of the mid-upper arm and the weight and height of the child. Variations on the diagnostic criteria exist, but most use these measures to define malnutrition in a child.^[1]

Two other syndromes of malnutrition have been described in children. Marasmus, which means “wasting”, is the physiological effects of insufficient calories over a period of months or years. Children with this syndrome are extremely underweight, have little muscle tissue, and are lethargic. The second syndrome is kwashiorkor, which means “the sickness of weaning”. Children with kwashiorkor are not energy deficient but are protein deficient. As a result, they lose muscle, develop skin conditions, and have edema (fluid retention) that causes them to have swollen feet and abdomens. A combination of the two is also possible, resulting in severe muscle loss and edema.^[1][2]

Children with moderate malnutrition can be treated at home with calorie-rich foods like peanut butter, milk powders, and vegetable oils. They may be given vitamin supplements to drink at home as well. Counseling on nutrition for the caretakers is important in these cases, and regular follow up at the doctor is advisable. In severe cases, the child may need to be treated in a hospital, especially to monitor blood glucose levels, body temperature, and hydration status. Monitoring is important because severely malnourished children are at risk for infections like pneumonia and urinary tract infections.^[1][3]