Malnutrition in children is a weight and nutrition-related condition that has caused a significant morbidity and mortality both in the developing and developed countries. Underweight condition is defined by the body mass index (BMI) or body fat percentage that is too low for general sustainable health. According to the World Health Organization, weight is charted against the age of the child. The child is then considered underweight when their weight for age falls below negative two standard deviations (WHO, 2010).
Severe underweight in children is associated with nutritional and immunity deficiencies that place the individuals at risks of growth impairment presenting with stunting, osteoporosis, and recurrent infections. The body requires minerals and nutrients for growth, sustenance and immune system development.
Underweight individuals are also at risks of developing cardiovascular diseases. However, their risk of developing cardiovascular disease is less than that of the obese and overweight individuals (Park et al., 2017). In comparison, the risk in overweight individuals depends on coexisting comorbidities while that in underweight individual does not.
Being underweight has been recently associated with higher mortality than normal. The impact is worse in older populations than younger age groups (Lorem et al., 2017). Underweight individuals are also at risk of developing acute recurrent infections. Common infections include the upper respiratory tract infections (URTIs) and skin infections (Harpsøe et al., 2016). For this reason, comprehensive interventions are necessary to mitigate the effects of being underweight on long-term health outcomes.
The patient for this week’s case study is a twelve-year old Hispanic girl who is severely underweight. Her parents are underweight as well. She recently experienced bullying in school, probably due to her condition. Weight below the normal for age can be acute or chronic depending on the duration and onset of decline in weight.
Additional information required to assess her health would further include the family nutrition, health conditions during the pregnancy, birth, and postnatal life (Kumar et al., 2019); and presence of chronic familial illnesses (Tatsumi et al., 2016). The information acquired would determine the type of under-nutrition and the most appropriate management approach.
Since the girl’s parents are also underweight, it would be prudent to examine the history of genetic or familial chronic illnesses in the nuclear and extended families. The circumstances during pregnancy that are worth examining include the maternal nutritional knowledge level. The mother’s nutrition during the prenatal period and nutrition of the child in the postnatal life would be responsible for the weight status of the patient.
Information about sugar control and diabetes in the family is also important in assessing the weight status of the child. Type I diabetes, common in childhood, sometimes has a genetic component. Diabetes presents with weight loss that could be responsible for the child’s underweight status (Balcha et al., 2018). Other chronic illnesses too inhibit proper growth and weight increase.
The etio-pathogenesis of underweight status and malnutrition in not limited to nutritional causes. Therefore, specific questions will be necessary to gather more information to make more accurate diagnosis and build a more accurate health history. I would ask the child’s informant the following specific questions:
These three questions would assess the nutritional status of the family, inherited conditions, and the severity or developmental consequences of the low weight for age.
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