INTRODUCTION
Globally, pediatric malnutrition contributes to about half of child deaths. Historically, pediatric malnutrition has been associated with starvation only and was considered primarily to be a problem of the developing world. Identification of malnutrition has focused on the effects of malnutrition (e.g., protein-energy malnutrition, kwashiorkor, and marasmus), but failed to investigate the etiology of malnutrition. Lack of a standardized definition has hampered early identification of malnutrition, understanding of the prevalence of malnutrition, and its effect on clinical outcomes.
Recently, more attention has been paid to the non-starvation causes of malnutrition, including acute and chronic illness. Studies estimate between 6 and 51% of hospitalized children are under nourished, although the prevalence of disease related malnutrition has been difficult to determine due to a lack of a precise and consistent definition. Malnutrition in hospitalized children leads to worse outcomes including lean body mass depletion, muscle weakness and loss, cognitive and developmental delays, immune dysfunction, delayed wound healing, infections, more ventilator days, and increased length of both ICU and total hospital stay.
Although recent research has focused primarily on pediatric malnutrition in a hospital setting, malnutrition can also be identified in the community setting. Children with chronic illness and special health care needs have many risk factors for developing malnutrition and should be routinely screened in the primary care and outpatient clinic setting. Screening for malnutrition requires a team approach to address nutritional deficits that can predispose the patient to acute illness or exacerbate the underlying disease or condition.
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Pediatric Malnutrition – A Look at the New Guidelines
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