Early detection and nurturing of malnourished children
Published date 27/01/2021
According to the Ministry of Health | Department of Preventive Medicine
Malnutrition is a lack of energy and essential nutrients that affects the normal life, functioning and growth of the body. Underweight malnutrition is low weight for age (based on Z-Score of weight-for-age indices).
A healthy, normal child when properly nourished will gain weight steadily every month, if the child does not gain weight or gain weight, it is due to improper nutrition. Properly nourished baby means that the child is eating the right amount of food, complete with nutrients. To accurately assess whether a child is regularly “full” or not, it is necessary to monitor the weight once a month, because in the first years of life, the child’s body develops very quickly.
Usually, there are two ways to detect and assess whether a child is malnourished or not. How to detect malnourished children based on growth charts used in the community or at home for early detection of children at risk of malnutrition and how to assess underweight malnutrition according to the Z-index -Score based on weight for age used by experts and nutritionists, which is published annually by the Institute of Nutrition.
To assess the nutritional status, we need to know the normal growth of the child’s weight as follows:
The weight of a full-term, healthy newborn at birth averages about 3,000g (3kg), if the baby weighs less than 2,500g (2.5kg), it is usually a premature baby (premature birth) or malnourished. fetus (born at full term but weighing less than 2,500g). One-year-old babies weigh three times as much at birth (about 9-10kg). Children from 2 to 10 years old gain an average weight of 2.4 kg/year and can calculate their weight according to the following formula:
Xn = 9.5kg + 2.4kg x (N-1).
– Xn is the child’s current weight (kg).
– 9.5 is the baby’s weight at 1 year old.
– 2.4 is the average weight gain in 1 year.
– N is the age of the child (in years).
How to early detect children at risk of malnutrition at home (community)?
A simple way to identify a child who is developing normally or at risk of malnutrition is by: weighing the child regularly every month to monitor the weight development of the child, after each weighing dot on the growth chart grow one point corresponding to the weight and age of the child, this month’s score is connected to the previous month’s score and so on, we will have the “Health Path” of the child.
– Monthly weight gain (the chart goes up) steadily, which is an important sign of a healthy, normally developing baby.
– If the child does not gain weight (horizontal chart) is a warning sign of poor health and nutrition, it should be considered. Causes may be: not eating enough, lack of nutrients (insufficient breast-feeding, eating less meals, poor children’s food,…); eat well, but play too hard and become deficient, need to eat more; the child is suffering from an unrecognized disease; due to previous weight loss has not recovered.
If the child does not gain weight for 3 consecutive months, the child must be examined at a medical facility.
– If the child loses weight (the chart goes down) is a dangerous sign, it is necessary to find the cause to have the right, timely and quick treatment. Often children will recover and gain weight when they are better nourished, cared for, treated right away, or are well nourished after an illness.
Nurturing malnourished children
Malnourished children often have poor appetite, or have digestive disorders or diseases. Therefore, children must eat many meals a day, each meal a little to ensure the necessary amount of food for the child, and provide more energy than normal children.
– Children under 6 months: strengthen breastfeeding, children who are lazy to breastfeed should express breast milk with a spoon. If there is not enough breast milk, give high-energy formula (1ml of milk provides 1 kcal).
– Children 6 – 12 months: in addition to breastfeeding, need to eat 2-3 more solid meals, if there is not enough breast milk, give high-energy formula. Children should drink 400-500ml of milk every day, if breast milk is not available, use high-energy milk.
– For children from 1-2 years of age, in addition to breast-feeding, they need to eat 4 more meals/day, drink 400-500ml of milk per day, if breast milk is not available, use high-energy milk.
– For children from 3 to 5 years old, they need to eat 5-6 meals/day and 500ml of milk.
Need to let the baby out to sunbathe 15-20 minutes in the morning
In the diet, in addition to rice to cook flour, porridge or rice, it is necessary to add meat or fish, eggs, beans, green vegetables and fat or oil. Add more ripe fruit to the snacks in between the main meals.
Some children have low-energy diets. Therefore, it is advisable to add oil and grease to porridge or to add fat to broth, stir-fried vegetables for children to eat… to increase the temperature of children’s meals. In addition, food can be liquefied with enzymes in germinated seeds (bean sprouts, malt) to increase the energy density in the meal, reducing the number of meals in a meal.
For children over 6 months, it is advisable to give yogurt with a moderate amount (from 1/2 to 1 box) every day after regular main meals.
The way to prepare meals must be suitable for the child’s taste, always change the food for the child to eat deliciously.
Children need to be out in the sun for 15-20 minutes in the morning (about 8-9am) on sunny days. Clothing for children choose cotton, absorbent and not tight. Your baby’s place should be clean, cool, and bright.