Protein energy malnutrition (PEM) is the commonest health problem in preschool children of developing countries, associated with significant morbidity and mortality. Children are more vulnerable to Protein energy malnutrition due to relatively higher caloric and protein requirements for growth and physical activity. Even subclinical under nutrition in this age group may lead to long-term growth [...]
Continue reading …PEM Management: Depending on the severity, PEM may be managed at home, nutritional rehabilitation centers, or hospital. Hospitalization is indicated in cases with severe PEM, life-threatening complications, severe anorexia and refusal to accept oral feeds, emotionally deprived or neglected child, and failure of domiciliary treatment. PEM Management aims towards diagnosis & treatment of complications, dietary [...]
Continue reading …Kwashiorkor and Marasmus - Clinical spectrum of Protein energy malnutrition is a continuum, ranging from borderline growth delay to well-defined syndromes of Kwashiorkor and Marasmus. Within this spectrum, many other terms are used to denote clinical variations of Kwashiorkor and Marasmus e.g. Prekwashiorkor, Marasmic kwashiorkor (MK), Nutritional dwarfism etc. Broadly, clinical presentations of Protein energy malnutrition may be [...]
Continue reading …Breast feeding in Special situations: There are no absolute contraindications for Breast feeding except when mother is on certain drugs, which are unavoidable, excreted in breast milk and can cause serious problems in baby. However, Following situations are common in clinical practice, which require a considered review of Breast feeding advisability, sustainability and modifications. Maternal [...]
Continue reading …Balanced diet for children is the ‘diet containing variety of foods in such quantities and proportions, which fulfills the needs for all essential nutrients, necessary to maintain optimal health and growth. Principles: General characteristics of a balanced diet for children, based on dietary goals from various sources (Prudent diet; WHO) are as follows — a) [...]
Continue reading …Weaning (Complementary feeding) may be defined as “gradual introduction of semi-solids and solids in baby’s diet apart from breast milk, to meet their growing demands, usually at 4-6 months.” Note that weaning is a complementary process and not the discontinuation of Breast feeding, which should continue as long as possible. Aims: BM is all that [...]
Continue reading …Top feeding means feeding of milks other than the breast milk in early infancy, should be strictly discouraged. However, it may be necessary in rare instances of true lactation failure, maternal death/serious sickness, or any absolute/relative contraindication for Breast feeding. Top feeding may be loosely classified as exclusive top-feeding, or supplementary top-feeding along with Breast [...]
Continue reading …Common Breast feeding problems may be broadly divided into three categories — I) breast and nipple problems, II) partial or complete lactation failure, and III) Breast feeding problems in special situations like sick mother, sick baby or working mother. I) Breast feeding problems & nipple problems are very common and often used as an excuse [...]
Continue reading …Physiology of lactation – Anatomically, the breast is made up of glandular tissue, supporting tissue and fat. There are 20-25 alveoli in each breast, each lined by epithelial cells and surrounded by myoepithelial cells. Milk is secreted in alveoli by epithelial cells and pushed forward by contraction of myoepithelial cells. Each alveoli drains its output [...]
Continue reading …Advantages of breast feeding – BM is species-spec jfic i.e. quantitatively and qualitatively most appropriate for human baby. Apart from nutritional superiority, Advantages of breast feeding have many other advantages to baby, mother, family and even to the community, Nutritional superiority in advantages of breast feeding: BM is easily digestible and contains all essential nutrients [...]
Continue reading …