Malnutrition in children is a significant concern that can have severe and long-term consequences on a child’s growth, development, and long-term health. As carers and community nurses, it is essential to recognise the symptoms of malnutrition in children to provide timely intervention, treatment and support.
According to a 2024 study published in BMJ Nutrition, Prevention & Health, which looked at 30 countries around the world, children with disabilities were more likely to be underweight compared to children without, which was also in line with previous research findings that children with disabilities were three times more likely to be underweight and two times more likely to be stunted or wasted.
The importance of proper nutrition in children with disabilities cannot be overstated. This article aims to educate and inform carers about the symptoms of malnutrition in children, the causes of malnutrition in children, diagnosis of malnutrition and most importantly how to prevent malnutrition in the future.
Key Symptoms of Poor Nutrition in Children
While weight can be a significant and recognisable characteristic of malnutrition in children, there are several other key symptoms to be aware of that indicate trouble with nutritional intake. A child may be eating a lot of a single type of food, but that food type isn’t giving them the nutritional value that they need leading to nutrient deficiency.
In another context, a child may have feeding difficulties that prevent them from eating or digesting a variety of food - in which case a carer should look at options such as nutritional supplements (such as meal replacement shakes), nutritional products or alternative feeding.
Some key symptoms of poor nutrition in children are as follows:
- Faltering Growth (i.e. not growing or putting on weight at the expected rate)
- Changes In Behaviour (such as being unusually irritable, slow or anxious)
- Reduced Appetite or Decreased Interest in Food
- Weight Loss or Poor Weight Gain (either sudden or gradual)
- Regression of Safe Food and Fluid Levels
- Decline in Swallow/Feeding Function
- Frequent Illnesses (such as recurring urinary tract infections)
- Delayed Wound Healing (such as with pressure sores)
- Hair Loss / Thinning
- Poor Skin Turgor (loose, fragile or cool skin that loses its elasticity)
- Constant Feeling of Cold
- Fatigue, Weakness and Low Energy Levels
- Tooth Decay
- Constipation or Changes in Bowel Habits
Understanding What Causes Malnutrition in Children
This relationship between children with disability and malnutrition isn’t a surprising one due to several factors that can affect a child’s nutrient absorption relating directly to disability. These, include unbalanced diets, digestive issues, gastrointestinal issues (such as constipation and coeliac disease), gastroesophageal reflux, as well as other physical impairments that cause feeding difficulties (i.e. feeding difficulties and lack of energy intake are key factors that can cause malnutrition in children with cerebral palsy).
Understanding what causes malnutrition can occur in children with disabilities is crucial to identifying, treating and preventing it.
Feeding / Swallowing Difficulties
As mentioned, feeding and swallowing difficulties can be a large factor for children who have various medical conditions including Cerebral Palsy, Huntington’s Disease, Multiple Sclerosis, Motor Neurone Disease, Down Syndrome, Intellectual disability, and Autism Spectrum Disorder (ASD).
Sensory Impairments
When a child’s senses are impacted (such as with Sensory Processing Disorder and ASD), it may also affect their nutrition as the child may have specific food preferences and aversions directly related to their sensory input.
Increased Nutrition Needs
Often seen in children with degenerative neurological disease such as Parkinson’s disease, Huntington’s disease or periodic issues such as managing pressure sores and wound care and healing.
Access To Proper Nutrition
Sometimes external factors such as financial, mental, mobility limitations, transport access, social isolation and/or geography plays a part in access to proper nutrition and food types.
Surgery
Children who suffer from gastroesophageal reflux, gastrointestinal issues, skeletal deformities or even neurological, and cardiological comorbidities may require surgery. Research has shown that 40% of neurologically impaired (NI) children undergoing surgery displayed signs of poor nutrition. This is important because malnutrition has also been identified as a key contributor to worse surgery outcomes.
Medication
Different medications can have different effects on appetite and nutrient absorption, which can lead to nutritional deficiencies.
Effective Approaches to Addressing Childhood Malnutrition
When it comes to the diagnosis of malnutrition, what’s known as anthropomorphic status indicators can be used as an objective measurement. This involves looking at the height compared to age, weight compared to height and weight compared to age. However, a comprehensive nutritional assessment should always be sought.
The treatment of malnutrition will always depend on the cause of the nutrition deficiency as well as the severity of the case. Incorporating nutritional supplement such as an Energy Mango Shake into a child’s diet can help ensure they’re receiving the right nutrients in their diet.
Always check with a dietitian or healthcare professional on appropriate treatments for your situation, however common suggestions are products like oral nutritional supplements. They will advise you on:
- Dietary Changes
- Nutritional Supplements
- Nutrition Products
- Feeding Tubes
It’s important that all treatment is monitored regularly.
Ensuring Better Nutrition for a Healthier Future
For home or community carers, there are a few malnutrition prevention strategies that can be adopted to ensure proper nutrition intake is being achieved. These are as follows:
- Understanding exact disability conditions and being aware of changed eating behaviours when they happen
- Recognising signs of swallowing/feeding difficulties when it’s in the early stages (these can present themselves through coughing, choking and sudden changes in food preferences)
As carers and community nurses, it is crucial to be aware of these signs and symptoms and to refer children who exhibit them to a healthcare professional for further assessment and intervention. Early detection and treatment can significantly improve outcomes and prevent long-term consequences of malnutrition.
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