The Child Welfare League of America estimates that 15,000 children worldwide die each day from malnutrition-related problems. Infants are at particular risk, because they are completely dependent on other people to feed them. Malnutrition occurs for a number of reasons, including lack of access to appropriate food or medical problems, such as chronic diarrhea, that can lead to malabsorption. Malnutrition in infants has serious consequences, potentially leading to failure to thrive, stunted growth or even death. Malnutrition can be determined in an infant in a number of ways; if detected early enough, the condition can be remedied before serious damage is done.
Anthropometric Data
Mid-upper arm circumference, head circumference, weight and length can be used to detect malnutrition. These measurements can be compared with charts for normal growth to determine if the child is exhibiting signs of failure to thrive; this indicates that the infant's growth is abnormal and can often be traced back to malnutrition. One indication of failure to thrive is when the infant's weight falls below the third percentile or when her weight for height falls below the 20th percentile.
Visual Signs
Signs of malnutrition include dry, dull or thinning skin and hair, darker skin pigmentation, weight loss and fatigue. You also might see prominent bones on an infant, such as ribs or knees, or her skin might appear to be loose. A last, important symptom to check for is pitting edema, a type of swelling. Apply slight pressure to your infant's feet for a few seconds. If the impression of your finger lasts for a few seconds after you let go, your child has edema. The presence of edema is a sign of severe malnutrition.
Laboratory Data
In serious cases, a malnourished infant will be admitted to the hospital, where she can be monitored and treated. After admission, certain laboratory tests can confirm malnutrition or evaluate its severity; refeeding and treatment likely will begin slowly, pending results of the lab work. The doctor and/or dietitian will look for levels of pre-albumin -- a marker for malnutrition -- in the blood. They also might look for levels of vitamins and minerals in order to determine the best treatment option.
Treatment
Treatment usually includes hospitalization and intravenous nutrition. Nutritional repletion must start slowly, otherwise the patient's condition can become unstable. However, once the patient is stabilized, full nutritional requirements can be given through an IV inserted into the arm or chest; this includes all calories, protein, fats, carbohydrates, water, vitamins and minerals. Once the patient is stable and on the path for normal growth, he can be released from the hospital. If treated quickly, no permanent damage is usually done. However, chronic malnutrition can lead to delayed physical and mental development or even death.
