Tuesday, 17 October 2017

Malnutrition: A Global Problem & Ways to Get Rid of It

Malnutrition: A Global Problem & Ways to Get Rid of It

Weight Loss, Low Energy, Muscle Wasting, Increased Risk of Fractures, Infactions, Confusion, Reduced Independence, Increased of Fails, Reduced Mobility, Low Mood If you feeling these things around you, the child or person my be impacted of malnutrition, you can read this article to overcome from these problem. 

The text input is by Dr. Tarachand Saini, Junior Specialist (Pediatrics)
Department of Pediatrics
PBM Hospital & S.P. Medical College 
Bikaner Rajasthan

Malnutrition comprises both under nutrition & over nutrition (Obesity). Inadequate food ingestion| both in quantity & quality i.e. deficit in nutrients leads to under nutrition. Over eating and ingestion| of fast food & lack of exercise, watching TV for long time leads to overweight & obesity. 

Malnutrition is more prevalent in developing countries of the world, India is one of them. 33% deaths are due to malnutrition in age group 0 to 5 years age. In India 6.4% children and in Rajasthan 11.6% children are severely Acute malnourished  About 70% children are suffering from anemia. These children having less weight in comparison to height/length (z-score<-3SD), wasting, less mid arm circumference (<11.5cm)  &  edema.

Mostly the problem is due to not breast  feeding exclusively for 6 months, delay in starting complementary feed after 6 months, diluting cow’s milk, repeated infections of respiratory & gastrointestinal tract, broken family, negligence & poverty of parents.

Clinical Effects of MalnutritionMUAC (Mid-upper arm circumference) measurement is a simplest way to screen the SAM child at community level by ASHA workers in above 6 months to 5 years age children. Children having no complications & disease can be treated at the community level by using feed of local crops grown by farmers & supplementing nutrients, routine deworming of children every 3-6 months interval. Children with disease complications should referred by the health workers to hospitals in malnutrition treatment centers  for management.  Here the F-75 & F-100 diets & nutrients (minerals & multivitamins) are given to the children for at least 15 days to improve weight & treatment of Complications like hypoglycemia, hypothermia, dehydration, infection, electrolytes imbalance is done. Children are played with toys. Immunization of unvaccinated children  is done. Health education is given to mother by doctors & nurses. Wage compensation to parents of admitted children is also given (i.e. 165 Rs. Per day). ASHA worker is also paid for referral & follow up of cases.

To prevent malnutrition child should be given exclusively breastfed for 6 months, continuing till 2 years age & supplementary feeds after 6 months age according to age. Child should feed initially liquid feed, then semi solids & solids . Routine immunization is essential. Vitamin –A should be given every 6 months interval. Use of iodized salt, ghee or oil, green vegetables, fresh fruits is good for health. We can give sweet milk mixed with chapati, rice, sooji/ powdered murmure , or dal – roti/ rice, sattu, rabari- chhachh. Child can be fed 3 part cereal +1 part dal + ½ part  groundnut  or Till roasted & grinded & boiled in milk. Use of edible oil fortified with vitamin –A & D will help much to combat malnutrition. Sun exposure for vitamin-D synthesis is essential for at least 30 minutes period.