Counselling for Malnourished Child

Counseling for Malnourished Child

Nutrition:  Caloric requirement

Following is the caloric requirement of children at various ages:

AGE	CALORIES/KG/ DAY
Infants	110
1-3 years	100
4-6 years	90
7-9 years	80
10-12 years	70
13-15 years	60

Sources of caloric supply:

1.       Carbohydrates                                      50-55%

2.       Fat                                                        30-35%

3.       Protein                                                  10-15%

Malnutrition in children:

·         Malnutrition can be defined as the insufficient, excessive or imbalanced consumption of nutrients

·         Mortality is highest in children who are suffering from malnutrition. Malnutrition in infants and preschool children may have a permanent effect on physical and mental growth and development.  

·         Every year millions of death are caused by malnutrition.

·         Malnutrition can be primary when there is deficiency of food availability or secondary when food is available but body benefit from it because of some cause.

Primary malnutrition:

Can be because of:

·         Failure of lactation: Breast milk may become insufficient for the requirement of the child e.g if mother becomes pregnant again or she is suffering from some illness

·         Ignorance of weaning: Weaning not started at proper age or right kind of weaning foods not given

·         Poverty: Parents may be unable to buy high calorie foods. In addition, they lack adequate housing, clean water supply and sanitation.

·         Cultural patterns and food facts: Mothers instead of giving nourishing food to the child may be giving sweets, tea, pappar etc. Concept of “hot food” usually results in withdrawal of banana from a child’s diet, similarly banana, citrus food, rice are considered as cold foods and may not be given to the child. In our male dominated society best foods are first served to the adult male memembers and left over’s are consumed women and children

·         Lack of immunization and primary care: lack of immunization against common infection like whooping cough, measles, and tuberculosis may result in malnutrition.

·         Lack of family planning: Malnutrition is common in large, poor families where family planning is not practiced. Multiple pregnancies leads to malnourished mothers which in turn give birth to low birth weight babies who become malnourished later on.

Secondary malnutrition:

Can be caused by following:

·         Infection: Acute, chronic or recurrent infection of major body systems like gastrointestinal tract, respiratory tract and urinary tract

·         Parasitic infection like worms, parasites

·         PICA disorder: eating of non-nutritious substances like dirt, chalk, clay, sand, paint.

·         Congenital disorders of heart, lungs, urinary tract.

·         Malabsorption: lactose intolerance, celiac disease, cystic fibrosis.

·         Metabolic disorders: Diabetes Mellitus, Diabetes insipidus, glycogen storage disease.

Micronutrient Deficiency:

What are micronutrients?
Micronutrients comprise of vitamins and minerals. These are essential for normal growth and development. They must be taken in the diet as body can produce it in very little amounts or not produce it at all.
Different types of vitamins:
Vitamin A; B; C; D; E; K
 Important Vitamins: Vitamin A and Vitamin D

 Vitamin A:
 Sources: Found in liver, beef, yellow and green vegetables especially carrots, eggs and whole milk.
Clinical affects of Vitamin A deficiency:

·         Visual problems (night blindness)

·         Recurrent episodes of diarrhea and respiratory infections

·         Retardation of mental and physical growth

·         Increased frequency and severity of infections

Who needs Vitamin A supplements?

·         Any child suffering from severe malnutrition, recurrent gastro-enteritis and measles, should be given 200,000 IU of vitamin A as a single dose. Children 6-12 months of age should be given 100,000 IU. Infants less than 6 months usually don’t need vitamin A supplementation unless the child has measles, in which case 50,000 IU of vitamin A should be given.

·         Food rich in vitamin A should be given in abundant quantities to all the children with clinical deficiency or are at risk, along with Vitamin A supplements.

Vitamin D:
Source: Exposure to sunlight, Oily fishes, Vitamin D fortified food.
Clinical affects of Vitamin D deficiency:


Rickets: Vitamin D regulates absorption of calcium and phosphorus in bones and teeth, deficiency of vitamin D and cause weak and deformed bones.

·         Poor growth

·         Infantile tetany

Treatment of Vitamin D Deficiency: Treated with Vitamin D3 injections or Vitamin D drops along with a diet rich in Vitamin D and calcium.


SOURCE pervaiz akber