Malnutrition and its effects amongst under 5 years old children

Introduction

Globally, the health of children has been of great importance in any nation, the child in many of the nation’s homes is the source of joy and when the health of the child is at risk, it calls for so many reasons for instability in home.

Most African homes also do not take some certain diseases condition serious in the child and one of this is malnutrition which has been termed “emergency” by Edukugho (2004). Malnutrition results from food insufficiency as well as poor social and economic condition. Malnutrition has been identified as a big problem affecting developing centuries especially in school children from poor homes. He further states that majority of school children lack the food they need hereby leading to malnutrition, now posing a serious threat to education particularly in developing counties including Nigeria the condition affect over one third of children globally and it is a majority concern to all nation to fight the disease condition. Therefore step must be taken to educate mothers who are expecting another new baby as this children surfer a lot of malnutrition deficiency in the Africa context, they receive that the pregnancy is what affecting child and make the child sickly.

According to Steven (2003), malnutrition is the insufficient, excessive or unbalanced consumption of nutrients. Behram (1996), malnutrition is a term used to describe the condition cause by diet that conditions or contain all the essential nutrients but in sub option amount. Benton and Sergeant (1992), sees malnutrition as a result of prolonged nutritional defect e.g. malnutrition is a disorder concerning nutrition. It may result to a form of poor diet or form impaired utilization of foods ingested (Mosby’s Dental Dictionary, 2008).

Malnutrition in children

According to Ziegler (2008), mortality due to malnutrition accounted for 58% of the total morbidity in 2006. ln the world, approximately 62 million people, all causes of death combined, die each year. One in twelve people worldwide is malnourished. In 2006 more than 36 million died of hunger or diseases due to deficiencies in nutrition (malnutrition).

According to Gordon (2003) malnutrition leads failing health as a result of long standing dietary practices that do not coincide with nutritional needs. The condition also commonly referred to as Protein – Energy Malnutrition especially when experienced by children and adult.

Gordon and Paul (1993) explained that protein energy malnutrition is a form of under-nutrition caused by an extremely or accompany illness. The typically dramatic results of Protein-Energy Malnutrition are kwashiorkor and marasmus.

As noted by World Health Organization (WHO, 2006) malnutrition is by far the biggest contributor to child mortality present in half all causes. Six million children die of hunger every year. Underweight birth and inter-uterine growth restrictions; causes 2.2 million child deaths a year. Poor or nonexistent breast feeding causes another 1-4 million other deficiencies, such as a lack of vitamin A, or zinc, for example, account for 1 million malnutrition in the first two years is irreversible malnourished children growth.

Causes of malnutrition

According to Agidi (2011), causes of malnutrition are;

Poverty
Agricultural production
Dietary practice.
Poor transportation and communication.
ignorance of nutrition value of food
Lack of Time
War

Poverty: Poverty may be described as the scarcity of human basic needs or the inability of an individual or society to acquire human basic needs. Many people do not have enough money to buy the right kinds of food. Many families find it difficult to eat balanced diet and this has resulted to malnutrition of various degrees. Some families cannot afford three meals a day according to Food and Agriculture Organization (FAO).

Agricultural productivity: Food shortage can be caused by a lack of farming skills such as crop rotation, or by a lack of technology or resources needed for the higher yields found in modern agriculture, such as nitrogen fertilizers, pesticides and irrigation.

As a result of widespread poverty, farmers or government cannot provide the technology. The World Bank and some wealthy donor countries also press nations that depend on aid to cut or eliminate subsidized agricultural inputs such as fertilizer, in the name of free market policies even as the United States and Europe extensively subsidized their own farmers. Many if not most farmers cannot afford fertilizer at market prices, leading to low agricultural production and ways and highly unaffordable prices.

Dietary practices: According to the World Health Organization (WHO, 2007) lack of breast feeding can lead to malnutrition in infants and children possible reasons for the lack in the developing world may be that the average family thinks bottle feeding is better, but WHO went further to say that mother abandon it because they don’t know how to get their baby to latch on properly or suffer pain and discomfort. Deriving too much of ones’ diet from a single source, such as eating almost exclusively corn or rice, can lead to malnutrition. This may either be from a lack of education about proper nutrition or from only having access to a single food source.

Poor transportation and communication: There is no good transportation system to convey goods or foods from rural areas to urban areas. Majority of the road are bad and this result in high cost of transportation of food items. This also leads to high rate of in transit damage of good products

Ignorance of nutritional value of food: This is as a result of ignorance to the relation of foods to health is another reason for the prevalence of malnutrition. For example, sometimes protein rich food such as milk, egg and fish are not free to the child, on the assumption that they are harmful to the child, even though, the family may be producers of milk or catching fish themselves.

Lack of time: A secondary cause of inadequate nutrition may be lack of time. Proper nutrition demands time bi the preparation of meals and for their consumption. The house wife who is doing a full day work outside the home may lack time for shopping and for preparation of meals.

War: War has always been potent cause of nutritional disease. It acts by interfering with food distribution by taking away many young men from their normal task of agriculture, and sometimes by destruction of crops and livestock on large scale. When there are food shortages, women the children and old people are seriously affected.

Types of malnutrition

According to Mike (2010) stated that malnutrition may be considered in different ways such as;

Under-nutrition.
Starvation
Over-nutrition.
Nutritional disorder.
Kwashiorkor
Marasmus
Marasmic kwashiorkor.

Under-nutrition: Is the consumption of inadequate of food nutrients over an extended period time.
Starvation: This refers to the total elimination of food or lack of food.
Over-nutrition: Is the consumption or ingestion of excessive quantity of food over an extended period of time.
Nutritional disorder: Protein-joules deficiency disease includes kwashiorkor, marasmus and marasmic kwashiorkor.
Kwashiorkor: a term used by Cicely-Williams in 1934 to describe this while working in West Africa kwashiorkor means a sickness a child develop when another baby is born; in the language spoken in Ghana. Kwashiorkor occurs when there is not enough protein in the diet but calories or energy in the form of carbohydrates rates is available in sufficient quantity. It affects children from 1-5 years old. This disease also affects pregnant and lactating mother and it mainly occur in children during weaning period.

Signs and symptoms/physical changes of kwashiorkor

Growth failure.
Swelling of legs and feet (oedema) due to present of fluid in the tissue.
Wasted hair changes to a light colour and become soft fat it can easily pull out; the skin develops washes and also becomes lighter in colour.
Diarrhoea and pre-anaemia due to lack of protein and synthesis blood cells.

Marasmus

Marasmus is a deficiency of both protein and energy in sufficient prolong periods, it occur in children under one year. The mother includes stopping breast feeding for various reasons, including the infections in her or in the infant. A frequent reason of stopping breast feeding is the beginning of the pregnancy, this is a wider spread reason among poor, uneducated woman that the milk of a pregnant woman is bad for the child due to necessity or desire to return back to the work.

Signs and symptoms of marasmus

They are usually hungry.
The age is below the standard for the age.
The child is wizard (he looks like a wizard old man).
There are little or no subcutaneous fat (muscle wasting).
There is oedema.
There is hypothermia (low body temperature).
Diarrhoea is usually frequent.
The infant is usually irritable, fretful and apathy.

Marasmic kwashiorkor

The Marasmic kwashiorkor child shows symptoms of both marasmus and kwashiorkor with oedema. Both kwashiorkor and marasmus can be complicated with other infections due to intestinal infections and bacteria (William, 1934).

Marasmic kwashiorkor

This has to do with both features.

Growth failure.
Wasted muscles.
They are usually very hungry.
There is oedema.
Diarrhoea is usually frequent.
There is hypothermia (low body temperature).

Importance of nutrition

Watchtower Bible and Tracts Society (2003) states that;

Good nutrition means getting enough macronutrients and micronutrient.
Micronutrients contain calories (energy) protein, carbohydrates and fats they help you to main your body weight while micronutrients include vitamins and minerals. They keep the cell working properly, but will not prevent weight loss.
Good nutrition help people with malnutrition in that when one’s body fights any infection, it uses more energy and eat more than normal but when you feel sick you eat less than normal.
It is essential to improve the diet of the mother. Pregnant and nursing woman need to consume more calories and protein in particular help in the production of mother’s milk. So when there is little foods, give protein to woman of child bearing age and to little children.
In almost all cases, the best possible food for a baby is its mother’s milk this is especially so during the first days after birth because mother milk contain antibodies that protect body from infection. During the first four month grow and develop properly.
The greatest possible variety of food in different combination provides nutrient that protect your baby. The mother should focus on providing the child with good quality food, neither focusing the child to eat after it is full or with holding food from the child when it appears toward more.

Diagnosis of malnutrition

A diagnosis of malnutrition is made based on the following factors:

Your body mass index (BMI), which is your weight in kilograms divided by your height in meters squared.
Whether you have unintentionally lost weight in recent months.
Your ability to feed yourself.
Whether something such as a health condition, has meant that you are no longer able to absorb nutrient from your diet.
Generally diagnosing malnutrition in children involve taking a measurement of their weight and height and then comparing it against what would be the expected average height and weight for a child of that age.
Although some children growth is slower than expected, that may be a sign of malnutrition.
A child who is growing less than 5cm a year could be malnourished.
Blood test can also be used to measure levels of protein in the blood. Low level of protein would suggest that a child is malnourished.

Prevention/dietary management

Sumation (2001) stated the following;

Prolong breast feeding as much as possible but at the right stage start feeding supplementary food.
Make use of locally available vegetables and animals’ protein foods for feeding the child.
Protecting drinking water supply and keeping the surroundings clean.
Educate the mother and other members of the family about the correct diet for children.
Sponsoring vaccination campaigns and watching over the growth and development of children.
Sponsoring vaccination campaigns and watching over the growth and development of children.

Treatment of malnutrition

Watchtower Bible and Tracts Society (2003) states that:

If the child suffers from serious under-nourishment hospitalization may be best for initial treatment. According to a manual for physicians published by the world Health Organization the doctors will evaluate the child’s condition and treat any infections or dehydration. Feeding many begin gradually often starting with a tube. This is initial phase may take as long as a week.
A rehabilitation phase follows: the child is reintroduced to mother’s milk and is encouraged to eat as much as possible.
Emotional and physical stimulation are important during this phase. Care and affection can do surprising amount of good for the child’s development. This is when the mother may be given education on how to care for her child with a proper diet and hygiene so as to avoid a relapse.
The child is released from the hospital after applying all this steps, but it is important that the child be taken to the hospital or clinic for follow up visits.

References

Agidi, E.K. (2001). Human Nutrition. Lecture Note for Nutrition and Dietetics. Delta State College of Health Technology, Ofuoma-Ughelli (Unpublished).

Behrman, J.R. (1996). Hunger and Malnutrition. Global Crises, Global Solutions. Cambridge, UK: Cambridge University Press p. 363-420.

Benton, D. & Sergeant, J. (1992). Breakfast Blood Glucose and Memory. Journal of Biological Physiology 33(2) 207-10.

Edukugho, E. (2004). Malnutrition: On a Silent Rampage in Schools in

Nigeria. Vanguard Newspaper.

Gordon, M.W. (2003). The Challenge of Hunger and Malnutrition. Copenhagen Consensus Challenge Paper, London.

Gordon, M. W. & Paul, K (1993). Synergism of nutrition, infection, and immunity: an overview. American Journal of Clinical Nutrition. 66(2):464–477

Mike, F.J. (2010). Nutrition and Undernutrition. London. Elsevier Inc.

Mosby’s Dental Dictionary (2008) 2nd edition Elsevier, Inc.

Steven, C. (2003). Community Therapeutic Care. Presentation on Behalf of Valid International to USAID.

Sumation, B. (2001). Dietary Management of Malnutrition. Dublin. Gayle & Co.

Watchtower Bible and Tract Society (2003). Nutritious Foods Within Your Reach. Pennsylvania. Awake.

William, R.M. (1934). Marasmus; Causes & Infection. Edinburgh. Backhouse Press.