Peer Reviewed
Feature Article Nutrition
Investigating the child with malnutrition
Abstract
Growth failure is the principal manifestation of malnutrition in children. Major organic disease is uncommon. A detailed dietary history and assessment for psychosocial deprivation are important.
Key Points
- Growth failure is the principal manifestation of malnutrition in children.
- Normal growth variations and errors in charting must be recognised and not labelled as malnutrition.
- Anthropometric assessment can differentiate wasting and stunting.
- In the primary care setting, major organic disease is uncommon (<5%) and can usually be suspected on clinical assessment.
- Routine hospital admission with an expensive laboratory work-up to exclude rare causes is considered inappropriate medical practice in the absence of other manifestations of illness.
- A detailed dietary history and assessment for psychosocial deprivation are important.
- Dietary improvement with home visits has been shown to increase growth in a fifth of children in a community study.
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