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• Malnutrition in hospitalized children
  Peter Cartledge
  Published on: 22 March 2016

• Published on: 22 March 2016

  Malnutrition in hospitalized children

  • Peter Cartledge, Specialist Trainee in Paediatrics
  • Other Contributors:
    • Tom Lissauer, Linda Vaccari

  Dear Sir:

  We read with interest Marko Kerac's excellent article on wasting amongst under 6-month old infants in developing countries (1). There is a considerable amount of excellent research on how to identify malnutrition. We also have comprehensive, effective, evidence on how to manage malnutrition and reduce mortality (2). However, we and others have audited the identification of malnutrition in children...

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  Dear Sir:

  We read with interest Marko Kerac's excellent article on wasting amongst under 6-month old infants in developing countries (1). There is a considerable amount of excellent research on how to identify malnutrition. We also have comprehensive, effective, evidence on how to manage malnutrition and reduce mortality (2). However, we and others have audited the identification of malnutrition in children admitted to hospital and found that it is often unrecognized and so the appropriate management is not instituted. Unfortunately there is a paucity of good quality research on why many health professionals in developing countries fail to identify malnutrition in hospitalized children and even if they do why they are not instigating the published and widely disseminated guidelines. Failure to recognize malnutrition can have catastrophic consequences, as mortality rates can be reduced from as high as 50% to 5% by simply using the WHO "10-step" guidance (2).

  Our audit and literature review suggested potential barriers to the identification of malnutrition included: that the focus of attention was an infective illness or other co-morbidities, low staff to patient ratio, lack of supplies, poor health care infrastructures (leading to poor conditions on wards), inadequate or non-existent undergraduate and in- service training and a lack of successful dynamics within the work-force.

  With malnutrition contributing to 53% of child deaths (3), it is imperative that we address the failure to identify malnutrition and the implementation of management guidelines.

  References

  1. Kerac, M., Blencowe, H., Grijalva-Eternod, C., McGrath, M., Shoham, J., Cole, T., Seal, T. Prevalence of wasting among under 6-month- old infants in developing countries and implications of new case definitions using WHO growth standards: a secondary data analysis, Archives of diseases in childhood. 2011 ;96:1008-1013 Published Online First: 2 February 2011 doi:10.1136/adc.2010.191882

  2. WHO. Guidelines for the in-patient treatment of severely malnourished children, 2003.

  3. Caulfield, L.E., de Onis, M., Bl?ssner, M., Black, R.E. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. The American Journal of Clinical Nutrition. 2004 July 1, 2004;80(1):193-8.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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