Malnutrisyonlu Çocuğa Yaklaşım

Abstract

Gelişmekte olan ülkelerde önemli bir halk sağlığı sorunu olan malnutrisyon çocuklarda artmış mortalite ve morbidite ile ilişkilidir. Günümüzde ek besinlere erken ya da geç olarak başlanması başlıca nedenini oluşturur. Özellikle 5 yaş altı çocuklarda motor ve mental bozukluklara neden olan malnutrisyon doğru bir şekilde tedavi edilmeli, gelişebilecek komplikasyonlardan çocuklar olabildiğince korunmalıdır. Bu derlemenin amacı malnutrisyonlu hastaya yaklaşım ve tedavi ile ilgili güncel verileri sunmaktır.

Keywords

• Malnutrisyon, çocuk, tedavi

APPROACH TO CHILDREN WITH MALNUTRITION

Abstract

Malnutrition is a significant health problem of children in developing countries which is related to high mortality and morbidity. Today; main reason of malnutrition is improper feeding where additional foods are given early or late. It causes motor and mental deficits especially under 5 years of age. Because of this, malnutrition should be treated carefully and children must be protected from its complications. The aim of this review is to approach children with malnutrition and present current datas about treatment

Keywords

• Malnutrition, child, treatment

References

1. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: global and reigonal expo- sures and health consequences. Lancet 2008;371(9608):243-60.
2. Brook CG, Hindmarsh PC, Healy MJ. A better way to detect growth failure. Br Med J (Clin Res Ed) 1986;293(6556):1186.
3. Schofield C, Ashworth A. Why have mortality rates for severe malnutrition remained so high? Bull World Health Organ 1996;74(2):223-29.
4. Brewster DR. Critical appraisal of the management of severe malnutrition: 1. Epidemiology and treatment guideliness. J Paediatr Child Health 2006;42(74):568-74.
5. Unicef. State of the world’s children 2008: child survival. New York: Unicef, 2007. www.unicef.org/sowc08/report/report.php
6. World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children’s Fund. Community-based man- agement of severe acute malnutrition. May 2007. www.who.int/ nutrition/topics/Statement_community_based_man_sev_acute_ mal_eng.pdf
7. Kumar S, Olson DL, Schwenk WF. Part I. Malnutrition in the pedi- atric population. Dis Mon 2002;48(11):703-12.
8. Karlberg P, Angstrom I, Karlberg J. Evaluation of growth during the first two years of life. In: Kristiansson B, edi- tor. Low rate of weight gain in infncy and early childhood. Goteborg, Sweeden: Department of Paediatrics, University of Goteborg;1980.

9. Prost MA. Postnatal origins of undernutrition. Nestle Nutr Workshop Ser Pediatr Program 2009;63:79-92.
10. Linnemayr S, Alderman H, Ka A. Determinants of malnutri- tion in Senagal: individual, hausehold, community variables, and their interaction. Econ Hum Biol 2008;6(2):252-63.
11. Kar BR, Rao SL, Chandramouli BA. Cognitive development in children with chronic protein energy malnutirition. Behav Brain Funct 2008;24:4-31.
12. World Health Organization. Management of Severe Malnutri- tion: A Manual for Physicians and Other Senior Health Work- ers. Geneva: WHO, 1999.
13. Jelliffe DB. The assesment of the nutritional status of the community (with special reference to field surveys in develop- ing regions of the world). Monogr Ser WHO 1966;53:3-271.
14. Behrman A.N. Severe Childhood Undernutrition. Kliegman R.M, Behrman R.E, Jenson H.B, Stanton B.F. Nelson Textbook of Pediatrics. 18th ed. Philadelphia Saunders 2008:229-232.
15. McLaren DS, Read WW. Weight/length classification of nutri- tional status. Lancet 1975;2(7927):219-21.
16. Briend A, Zimicki S. Validation of arm circumference as an indicator of risk of death in one to four year old children. Nutr Res 1986;6:249-61.
17. Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ 1995;311(6998):158-61.
18. Collins S. Treating severe acute malnutrition seriously. Arch Dis Child 2007; 92(5):453-61.
19. Bhatnagar S, Lodha R, Choudhury P, Scahdev H, Shah N, Narayan N, et al. IAP Guidelines 2006 on hospital based man- agement of severely malnourished children. Indian pediatrics 2007;44(6):443-61.
20. Manary MJ, Sandige HL. Management of acute moderate and severe childhood malnutrititon. BMJ 2008;337:a2180.
21. Brewster DR. Critical appraisal of the management of severe malnutrition: 2. Dietary management. J Paediatr Child Health 2006;42(10):568-74.
22. Christie CD, Heikens GT, McFarlane DE. Nasokomial and community-acquired infections in malnourished children. J Trop Med Hyg 1988;91(4):173-80.
23. Bhaskaram P. Measles & malnutrition. The Indian Journal of Medical Research. 1995;102:195-99.
24. Solomon SM, Kirby DF. The refeeding syndrome: a review. JPEN J Parenter Enteral Nutr 1990;14(1):90-7.
25. Trumbo P, Yates AA, Schlicker S, et al. Dietary reference intakes: vitamin A, vitamin K, arsenic, chromium, copper, io- dine, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc. J Am Diet Assoc 2001;101(3):294-301.
26. Ashworth A, Chopra M, Mccoy D et al. WHO guidelines for management of severe malnutrition in rural South African hos- pitals: effect on case fatality and the influence of operational factors. Lancet 2004;363(9415):1110-5.
27. Manary MJ, Ndkeha MJ, Ashorn P, Maleta K, Briend A. Home based therapy for severe malnutrition with ready to use food. Arch Dis Child 2004;89(6)557-61.
28. UNICEF. Strategy for improved nutrition of children and women in developing countries. New York: UNICEF, 1990.