Pediatric Nutrition in Practice

142 Shahrin  Chisti  Ahmed

Management

Management of malnutrition depends on the
type of malnutrition, identification of its cause,
if applicable, and its severity.
In primary moderate acute malnutrition,
management at home is recommended. This in-
cludes nutrition-specific interventions such as
counseling of parents on the proper diet to be
given to the child, with emphasis on continued
breastfeeding and appropriate complementary
feeding, micronutrient supplementation, period-

ic deworming, etc. Ideally, these children should

receive 25 kcal/kg per day of energy in excess of

what their healthy peers get, and their diets

should contain animal-source foods which are

rich in essential fatty acids and micronutrients

including vitamin A, iron and zinc [9]. Stunting

cannot be addressed by nutrition-specific inter-

ventions alone. For the control of stunting, nutri-

tion-sensitive interventions should be scaled up

at the national or regional level. These include en-

suring household food security, safe water, prop-

er sanitation and adequate hygiene, female edu-

Short-term consequences:

mortality, morbidity, disability

Intergenerational

consequences

Long-term consequences:

adult height, cognitive ability, economic

productivity, reproductive performance,

metabolic and cardiovascular disease

Maternal

and child

undernutrition

Inadequate dietary intake Disease

Household food insecurity Inadequate care andfeeding practices

Unhealthy household

environment and

inadequate health services

Household access to adequate quantity and quality of resources:

land, education, employment, income, technology

Inadequate financial, human,

physical and social capital

Sociocultural, economic and political context

Immediate

causes

Underlying

causes

Basic

causes

The bold arrows show that the consequences of undernutrition can feed back to the underlying and basic

causes of undernutrition, perpetuating the cycle of undernutrition, poverty and inequities.

Source: adapted from UNICEF, 1990

Fig. 1. Framework of the relations between poverty, food insecurity and other underlying and immediate causes of
maternal and child undernutrition and their short- and long-term consequences. From UNICEF [6].

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 139–146

DOI: 10.1159/000367880