5 Characteristics of Child Malnutrition

Our five core characteristics for clinically judging child malnutrition are:—— Growth indicators lag behind the standards for the same age group for 3 consecutive months, prolonged course of repeated infections, abnormal appetite or eating behavior, delayed motor and cognitive development, pathological changes in skin, mucous membranes and hair。

Many people's impression of malnutrition is still that of "sallow complexion and thin skin", but now it is more common to see hidden malnutrition. A chubby person who can eat two large bowls at a time may also suffer from it, so don't take it seriously.

Let me first tell you about a 4-year-old boy who was admitted to the hospital last week. When grandma brought him in, he looked very energetic and said that he could eat 2 bowls of rice at a meal, but he was not growing. When looking at the growth curve, he was stuck at the 2nd percentile for boys of the same age for 6 consecutive months, which is often said to be 2 standard deviations below the median, which is equivalent to ranking in the bottom 3 of 100 babies of the same age in terms of height and weight. There is actually a controversy that has been quarreling in the parenting circle for many years: the old school always says that "babies grow late, and they still jump at twenty-three." However, according to the standards of evidence-based medicine, as long as the baby's growth curve drops by more than 2 percentiles within 3 months, or the baby's growth curve is lower than p3 for two consecutive times, the nutritional intake problem must be checked first. It will be too late to wait until puberty to make up for it.

Don’t think that only lack of height is a sign. I’ve met many parents who bring their children to get “immunity-boosting medicines.” They say that their children catch colds two or three times a month, and then have a fever just two days later. They took a lot of anti-inflammatory drugs and they don’t work. The last blood test showed that either vitamin A was only half of the normal level, or ferritin was as low as single digits. This kind of repeated infection and the duration of the disease is two or three days longer than that of ordinary children, which is actually a typical sign of malnutrition. I once had a 3-year-old girl who got herpetic angina every 20 days on average. Even the kindergarten teacher knew her well. She took iron and vitamin A supplements for 2 months. She only had one cold in the next six months, and she recovered without taking any medicine. Of course, it must be made clear here that not all recurrent infections are nutritional problems. They may also be immune deficiencies or congenital development problems. Don’t blindly supplement nutrients as soon as you catch a cold. It is more reliable to check the blood first.

There are also some signals that are more subtle, and you may even think they are your baby’s “bad habits.” A mother came here with her 5-year-old son before. She said that the child always gnawed the walls and ate pencil lead, and couldn't change it after several injections. The teacher thought it was ADHD, but a trace element check showed that zinc was only 60% of the normal level, and he also had moderate iron deficiency anemia. After a month and a half of supplementation, the pica disappeared. Of course, some colleagues in the child psychology department have mentioned that many left-behind children will also develop pica behaviors when they lack companionship. Don’t just supplement the baby with nutrients, but also check whether there is a problem of insufficient parent-child companionship. Oh, by the way, the abnormal eating behavior mentioned here is not just pica. Some babies eat less than half of their usual meals for half a month, or they eat a lot but their weight does not increase but decreases. This is also a warning sign.

Many parents always think that "elegant people speak late" and "it is normal for babies to develop slowly". However, if they find that their baby is two or three months later than other babies of the same age and can't crawl or walk, or that at the age of 2 he can only say repeated words and can't sit still and has poor attention span, don't rush to sign up for an early childhood education class that costs tens of thousands of dollars. First, check whether the protein, DHA or B vitamins are not taken in enough. I met a 2-year-old child before. His parents fed him plain porridge and pickles all year round, and he rarely even gave him eggs. He could only sit down when he was 1 and a half years old, and he couldn't even call his parents when he was 2 years old. After adjusting his diet for 3 months, he chased adults to call him mom and ran faster than anyone else.

There are also some details that are most easily overlooked, such as the baby's hair suddenly becoming withered and sparse, with handfuls falling out at a stroke, or the corners of the mouth always getting rotten, map-like patches on the surface of the tongue, white spots on the fingernails that turn up, or bruises on the legs without bumping or touching. Most of these are manifestations of B vitamins, vitamin C or zinc deficiency. My relative's baby had rotten lips for half a year. I always thought it was because of internal heat, so I applied a lot of lip balm and drank a lot of fire-clearing tea, but it didn't work. Finally, I took vitamin B complex supplements for a month, and everything was cured.

Finally, I have to remind everyone, don’t just stick to these characteristics. For example, if some children are born with yellow hair and follow their parents, it is definitely not malnutrition. If you really want to judge, at least 2-3 characteristics must appear at the same time, and combined with the changes in the growth curve, it will be reliable. By the way, don’t think that only skinny babies suffer from malnutrition. I have seen many chubby little ones who eat fried chicken and Coke with excess energy, but are completely lacking in vitamins, dietary fiber, and high-quality protein. This is a typical hidden malnutrition. They also suffer from the above-mentioned problems of recurring oral ulcers and being unable to sit still in class.

If you are really unsure, go to the nutrition clinic of the local regular hospital and don’t just buy those “Internet celebrity nutrition packs” that cost hundreds of dollars. In many cases, it is just a matter of adjusting your diet. There is no need to spend that wasted money.