Results of nutrition regimens in patients with malnutrition

Aim: Malnutrition is a common phenomenon in childhood. Especially in socioeconomically and socioculturally disadvantaged societies, malnutrition due to inadequate nutrient intake without any accompanying disease is seen commonly. We aimed to evaluate malnutrition in patients who applied to our growth and development clinic and the benefits of administering enteral nutritional support to these patients. Method: The study involves 83 children whose age varies from 1 month of age to 18 years old and applied to Dicle University Medicine Faculty, Pediatrics Clinic between Jan 1st, 2017 and Nov 30th, 2017. The children whose complete blood count, biochemistry, urine analysis, ferritin, folate, vitamin B12 and thyroid function test results were not in normal ranges or children with additional diseases were excluded from the study. Moreover, children with incomplete vaccinations were excluded. Patients' age, gender, birth weight, delivery method, place of birth, vaccination history, additional diseases, first date of application, second date of application, follow up duration, place of residence, measured heights at the first and second application, measured weights at the first and second application, estimated ideal weights according to the age of application, prematurity and maturity conditions were recorded. Results: The 83 children whose age were varied from 1 month to 18 years were 36 girls (%43.4) and 47 boys (%56.6). In the study 55 cases (%66.3) had a history of mature birth and 28 cases (%33.7) had a history of premature birth. In the study %77.1 of the cases had a history of vaginal delivery and %22.9 of the cases had a history of c-section delivery. %34.9 of the cases were delivered at home and %65.1 of the cases were delivered at hospitals. In the study %69.9 of the patients were found to be living in rural areas and %20.1 were found to be living in urban areas. The average body weight of the girls in the study was 21.3 kg, with an average height of 120.1 cm at the time of first application. The average body weight of the boys in the study was 25.8 kg, and the average height was 127.4 cm at the first application. The ideal estimated weight in relation to age of the girls was measured as %66, with the boys' measured as %61 at the first application. According to the Waterlow classification, %8.4 of the cases had acute malnutrition, %38.6 of the cases had chronic malnutrition, and %53 of the cases had acute malnutrition on top of chronic malnutrition. According to the Gomez classification, %4.8 of the cases had mild malnutrition, %55.4 of the cases had moderate malnutrition, and %39.8 of the cases had severe malnutrition at the first application. In this study 10-18 years of age was the most common age bracket presenting with malnutrition. This group comprised %63.9 of our patients. The average body weight of the girls in the study was 23 kg, with an average height of 126 cm at the second application. The average body weight of the boys in the study was 30.5 kg, with an average height of 138.5 cm at the second application. The estimated ideal weight in relation to age of the girls was measured as 69 and the boys' was measured as 65 at the second application. According to the Gomez classification, %24.1 of the cases had mild malnutrition, %61.4 of the cases had moderate malnutrition, and %14.5 of the cases had severe malnutrition at the second application. Conclusion: In this study we evaluated the benefits of enteral nutritional support in case of inadequate nutrient intake without any accompanying disease. We concluded that enteral nutritional support regularly given to children with malnutrition without any additional diseases improves the children's health independent from age, gender, place of birth, method of birth, severity of malnutrition. This study also shows that inadequate nutrient intake commonly causes malnutrition in socioeconomically low areas and fixing these socioeconomical problems will help health problems. This is why inadequate nutrient intake must be considered as a child health problem. The wealth of the areas that are socioeconomically disadvantaged can be corrected by government interventions in order to decrease the amount of malnutrition related with inadequate nutrient intake. If malnutrition persists despite interventions, then enteral nutritional support can be effective at treating the affected group of children. Key Words: Malnutrition, child, high calorie nutritional support, Gomez, Waterlow