Malnutrition And Growth Faltering ✅ Flashcards
What % of children in hospital are malnourished?
20-40%
What does the rate of malnutrition in hospitalised children depend on?
- Population
- Type of hospital
What problems can malnutrition in hospitalised children cause?
- Longer hospital stays
- Poorer clinical outcomes
- Significant cost implications for health services
What often happens to nutritional status during hospital stays?
It deteriorates
Why does nutritional status often deteriorate during hospital stays?
Due to effects of treatment or surgery
How is the problem of malnutrition in hospitalised children being addressed?
Increasing emphasis on identifying children who are either malnourished on admission or who may become so whilst in hospital
How are children who are malnourished or at risk of it identified?
Number of screening tools have been developed
Give 3 screening tools for the identification of malnourishment/risk of
- PYMS
- STAMP
- STRONGkids
How do screening tools identify children who are/are at risk of malnourishment?
Combine simple antropometric mesures with other parameters in order to score and categorise children
Give 3 parameters that may be considered in nutritional screening tools
- Subjective observations of ‘wasting’
- Underlying disease
- Likely impact of planned treatments on nutritional status
What is done with children identified as being high risk on nutritional screening tools?
Targeted for additional dietetic or nutritional input
What is the limitation of existing nutritional screening tools?
Have not been shown to improve patient outcome or reduce hospital stay in children
What can malnutrition in sick children arise from?
- Inadequate intake
- Increased requirements
- Excessive losses
What is required in the management of a malnourished child?
- Assessment to identify main factors
- Plan appropriate mangement
What is nutritional management currently largely based on?
Monitoring weight
What is the limitation of using weight monitoring to guide nutritional management?
Can be misleading, as recognised that in children with a variety of chronic diseases, aiming to promote weight gain may result in incrased fat mass rather than promoting linear growth or lean mass, which might be clinically more favourable
What is the limitation of the definition of growth faltering or malnutrition in high-income settings?
Inconsistent and depends on context
What does growth faltering generally refer to?
Infants who are not growing as expected
What should growth faltering be diagnosed on the basis of?
A pattern of growth (rather than single measurement)
What is mild growth faltering often described as?
A fall in weight across 2 centile lines
What is severe growth faltering often described as?
A fall in weight across 3 centile lines
What is the aim of defining faltering growth in terms of crossing centile lines?
Identiying extremes of the population
What % of children will cross 2 centile lines between 6 weeks and 1 year of age?
5%
What % of children will cross 3 centile lines between 6 months and 3 years of age?
1%
