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New definition of paediatric malnutrition to improve treatment

Posted:  Thursday, September 10, 2015

Malnutrition is a big problem among chronically ill hospitalised infants with prevalence rates ranging between 24 to 50%. However, only about 4% of infants get diagnosed. This disparity could be due to faulty diagnostic parameters. In order to address this issue, the definition of paediatric malnutrition has now been revised to include both the acute clinical population and the more traditional ambulatory populations.

The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently defined paediatric malnutrition in the clinical setting as "an imbalance between nutrient requirements and intake that results in cumulative deficits of energy, protein or micronutrients that may negatively affect growth, development and other relevant outcomes." This definition covers 5 aspects of diagnosis, namely anthropometrics, growth, chronicity, aetiology, and impact on functional status. A new study, published in the journal Nutrition in Clinical Practice (NCP), reviewed the new definition with respect to issues in its application in problematic populations.

Generally, the identification of paediatric malnutrition has focused solely on assessing traditional anthropometric measurements of head circumference, height/length and weight. This could be difficult to monitor in hospitalised children. In addition to this, many illness related factors such as inflammation, nutrient losses, increased energy expenditure, decreased nutrient intake, or altered nutrient use could also contribute to malnutrition. Hence, the experts feel that these confounding variables need to be considered while assessing paediatric malnutrition.

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