Malnutrition Causes, Diagnosis & Ways to Tackle in 0-3 Years Child
Created by Vandana Chawla Updated on Sep 28, 2019
You would have heard about this term, Malnutrition. Somehow, whenever I have asked people about what do they visualize when they hear the term, Malnutrition, I have been given a visualization of thin and weak looking children in slums from a low-income background. And we forget children coming from middle or higher strata of society. The fact is way different though! Malnutrition can be a reality for any child, independent of their socio-economic type. Any child, who does not have access to a Balanced Healthy Diet can suffer from Malnutrition. Hence, understanding the key reasons related to Malnutrition is important for each parent.
What Is Malnutrition Disease?
Malnutrition is made up of 2 words, viz..' Mal' (meaning, ‘away from') & ‘Nutrition', hence, Malnutrition hence is a state which is away from Nutrition. Therefore, according to the WHO, Malnutrition refers to deficiencies, excesses or imbalances in the intake of energy and/or nutrients. The term Malnutrition covers 2 broad conditions
Undernutrition refers primarily to deficiencies of micro & macronutrients and can result in Stunting (low height for a particular age), Wasting (low weight for the standard height) & underweight (low weight for a particular age). On the contrary, Overnutrition may result in overweight, obesity and diet-related noncommunicable diseases, like, Diabetes, Cardiovascular diseases and more.
I am sharing mainly about undernutrition aspect in this blog. In this context, we will be dealing with undernutrition. Let’s look at its impact on growing children.
Impact of Undernutrition On A Young Child
Nutritional influences during early life can have a lasting impact on the physical growth, cognitive development, social development and the overall health of the child. Under-nutrition can lead to less energy for the child and as a result, less interest in learning. This affects the cognitive development and academic performance of the child. Under-nutrition affects physical growth, thus affecting body weight and height.
Moreover, undernutrition during early childhood years can lead to increased risk to infectious diseases, and also increased risk of non-communicable diseases in children. The impact of Undernutrition on a young child could be in various ways explained below:
As the name suggests, there is a poor increase in height, hence the child may appear short for his/her age. This is usually due to chronic or long-term Nutritional deficiencies/insufficiencies. Stunting is one of the major indicators of undernutrition in a child and is associated with increased risk of respiratory tract infections, diarrheal diseases, malaria, and measles. Stunting can also affect cognitive development and later the academic performance of the child. Research has indicated that the largest proportion of the stunting occurs during infancy and toddlerhood (6 - 23 months) and therefore adequate complementary feeding from infancy to toddler years plays an important role in achieving the right physical growth and brain development in a child.
Wasting & Underweight
Both are different but both are seen in children who fail to gain weight as per their height or age respectively. The child looks thin, lean, pale and weak and is at a higher risk of contracting infectious diseases.
Poor Cognitive Development
By 2 years, the child's brain has reached 80% of an adult’s brain size. Similarly, there is an overall physical growth in the child as well. This helps in the transfer of vital information to different areas of the brain. To reach full brain growth potential, nutrients in adequate amounts should be included in the child's diet. Research has indicated that undernutrition in children at an early age can result in lower IQ, less cognitive functioning and poor academic performance.
Undernutrition is the result of inadequate intake and/or absence of vital nutrients in the child's diet. Hence, the child may be exhibiting multi-nutritional deficiencies. There can be a deficiency of Macronutrients, like Proteins, Healthy Carbs or Healthy fats or of Micronutrients, like, Vitamins and minerals. The key micronutrients one should look out for deficiency are Iron, Zinc, Folate, Vitamin A & D.
Increased Risk of Non-communicable Diseases
Unhealthy eating habits lacking in vital nutrients affect the metabolic capacity of a growing child and can increase the risk of diabetes, heart disease, and other diseases.
How to Diagnose If Child Is Undernourished?
FAO (Food & Agricultural Organization) has categorized the signs and symptoms of Undernutrition under three broadheads.
This includes delayed achievement of developmental milestones, fatigue, tiredness, dizziness, lack of appetite, reduced interest in food, Poor or slow weight gain, swollen throat, poor eyesight, poor immunity(falling sick more often) and a longer healing time for wounds. Dry, patchy or irritable skin, tooth decay, and bleeding gums are also some physical signs.
In children more than 3 years of age, it includes poor or no concentration, poor attention span, slow learning pattern, difficulty in understanding, reading and writing. In infants and toddlers, there is a disinterest in playing games and activities, lack of energy, dullness, and poor eye contact.
Other Behavioral Signs
This includes, irritability, aggressiveness, crankiness, long hours of sleeping, weary, excessive crying, less interaction and the child appears to be almost always unhappy. Presence of these signs and symptoms, along with Growth monitoring and certain blood tests will help the physician to diagnose undernutrition.
The key concern actually is, what makes an infant or a toddler undernourished?
Causes of Undernutrition in Toddlers
Undernutrition results from an imbalance between the required amount of nutrients by the body and the actual amount of nutrients introduced and absorbed by the body. The reasons for this imbalance are given below -
Poor Quality of Diet - If the diet of the child is lacking in foods that provide the vital nutrients essential for growth then it may result in nutritional deficiencies and undernutrition. Growing children have increased nutritional needs, due to the rapid growth taking place in these early years; hence they are at high risk of becoming undernourished.
Unhealthy Eating Habits - Introducing the child to unhealthy foods, that is foods with no nutritional value from a very early age, can contribute to poor nutritional status. Foods and drinks with excessive added sugar, like soda drinks, juices, biscuits, candies, flavored yogurts or milk or rich in unhealthy fats, like, fried snacks, reduces the child's appetite for healthy foods and makes the child addicted to unhealthy foods. This sets in unhealthy eating habits, right from the start and can cause Undernutrition.
Irregular Eating Habits - Small frequent meals helps in meeting the increased nutritional needs of growing children. Eating at irregular hours, keeping long gaps and eating large amounts at one time may result in indigestion and poor absorption. Following the pattern on the long term can slowly set in nutritional deficiencies and if not corrected finally to undernutrition. [For More Read - How to Develop Healthy Food Habits in Your Child?]
Improper Breastfeeding & Weaning Practices - Early initiation of Top milk, that is before 6 months of age, replacing breastfeeding with unhealthy Complementary foods, mainly starch-based and lacking in other foods can set in Undernutrition at a very early age. So, as much as possible, please do try to breastfeed exclusively your child is 6 months, and continue to Breastfeed longer till at least 18 months along with semi-solids and solid after the child turns 6 months.
Frequent Illnesses & Infections - Baby's immune system is still developing and hence exposure to the unhealthy environment can easily result in infection and illness. This followed by medication reduces a child's appetite. Long periods of eating less can put the child at a very high risk of becoming undernourished. [Read - Urinary Tract Infection Symptoms, Causes & Tips to Care in Babies]
Inadequate Knowledge - With easy access to knowledge through the internet, one is not sure of the validity and authenticity of the information. This can be a misleading factor which can affect child-rearing practices. I advise you to speak to an Expert and avoid online search and general results.
Natural Traditional foods replaced with Processed Foods - Today's modern kitchen witnesses, the replacement of traditional superfoods like millets (ragi, jowar, bajra), dals, lentils, beans, nuts, seeds, colored fruits and veggies with processed foods, like, ready-to-eat foods, sauces, and drinks. Overconsumption of these packaged foods can be one of the contributors to Undernutrition in a child.
Ways to Tackle Undernutrition in Kids
Here are a few ways to deal with malnutrition (undernutrition) in your toddler:
- Introduce the Child to Variety of Foods - Make your child's plate colorful with different colored fruits and veggies. This will not only provide essential nutrients but will also help in boosting immunity. Try including these healthy foods in recipes, like smoothies, cereals, dals, omelets, pancakes, chapati atta, or home-made cakes.
- Avoid Monotony as this will make food boring and child may lose interest in eating. The variety will also ensure including foods from all 5 basic food groups, that is, carbs, dairy, dals, meat/eggs, fruits and veggies, and healthy fats.
- Offer Small Frequent Meals as this will ensure better digestion and increased intake of a variety of nutrients.
- Improve a Child's Appetite by attractively serving foods. Let the child experiment with different flavors and textures of food.
- Avoid Buying or Offering Sugary Drinks – water is the best drink for your child. Soda drinks, Fruit juices & some of the so-called health supplements are loaded with sugar and harmful additives. Read the label always!
- Ensure Healthy Breastfeeding and Weaning Practices - In case of any issues related to breastfeeding, do consult your doctor or a lactation Expert. Remember, exclusive breastfeeding for the first six months will not only help to meet the increased nutritional needs of the baby but will also help to boost the child’s immunity.
- Go for Regular Checkups, especially in the initial years, to identify the problem at an early stage.
Nutrition plays an important role in the growth and development of a child, with a healthy diet synergistically enhancing physical and mental abilities. Undernutrition in children is detrimental to the development of their physical, cognitive and psychosocial development. This will have both short-term and long-term implications. Understanding the importance of Nutrition and focusing on quality, portions, and frequency of food will go a long way in preventing Malnutrition, especially in the growing early years of your child.