Management of Poor Nutrition in Child

In each phase of life, human beings have specific dietary needs. During the first six months of life an infant acquires all its dietary needs from either breast milk or formula milk (Department of Health, 2005, p2). However after the age of six months it is important that the infant begins to complimentary feed in the form of a well-balanced diet that has the correct macro/micronutrients for optimum growth and development (Morgan & Dickerson, 2003, p234). This part of the assignment will critically discuss the benefits of a well-balanced diet for the growing and developing infant. This will be undertaken with regards to the scenario given.

The scenario is about a ten month old infant girl called Jasmine. She has been admitted to hospital for initial management of poor growth and malnutrition. The term malnutrition refers to both under-nutrition and over-nutrition. However, for the purposes of this essay the term malnutrition will be used for the term under-nutrition. Malnutrition can result from too little or the wrong kinds of food, or can be secondary to an underlying illness. Signs of malnutrition include short stature, thin arms and legs, skin and hair in poor condition, clearly visible vertebrae and rib cage, wasted buttocks, and in extreme cases, oedema, wasted facial appearance and lethargy (RCN, 2006, p30). Jasmine is still being fed on formula milk; however she has not be successfully weaned onto a solid diet. Delayed weaning can lead to slower growth and deficiencies in nutrients such as iron, zinc, fat soluble vitamins and fatty acids (EUFIC, 2000, p2).

Adequate calorific intake is required for the infant’s growth, digestion, physical activity and maintenance of organ metabolic function. Carbohydrates are very important in the diet of a young infant as babies have only small hepatic glycogen stores and have a limited ability to carry out both gluconeogenesis and ketogenesis. It is recommended that carbohydrates should make up at least forty-forty-five percent of the infant’s total calorific intake (Turner, 2001, p572). Similarly, fat should make up around fifteen percent of an infants calorific intake. It is needed to provide energy and essential fatty acids, required for growth and tissue maintenance.

As mentioned dietary fat is an important part of an infant’s diet. Infants need energy to enable the enormous growth of the first year and also facilitate high activity levels. Therefore, it is suggested that they require an energy-dense diet. Although this can be provided by carbohydrates, fat has almost twice as many joules of energy for weight than carbohydrate. As well as the energy component of fat in the diet, the infant requires the essential fatty acids for correct development of the nervous system (Livingstone, 1997, p9). It has been suggested that the lack of essential fatty acids may explain why malnourished children consistently achieve lower intellectual level, compared with their well nourished counterparts (Walker et al., 2007, p146). It is important to note however, that studies into this issue have methodical limitations that affect the results of the studies. The research had only a very small cohort of children, who had other psychosocial problems apart from being under-nourished. It is argued therefore that the findings can not be generalisable to al under-nourished children. Essential fatty acids can only be obtained from lipids (oils and fats) in the diet. Fat is also a source of the fat-soluble vitamins A, D, E and K, each of which is needed by the infant to some degree. In very young infants the lack of vitamin D may produce hypercalcaemia and or hypocalcaemia convulsions alongside poor quality bone growth, resulting in rickets. Dietary vitamin D can be obtained through fish, cream and cheese (Morgan & Dickerson, 2003, p315).

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