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Diagnosing Pediatric Malnutrition
Author(s) -
Bouma Sandra
Publication year - 2017
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533616671861
Subject(s) - malnutrition , medicine , etiology , intensive care medicine , psychological intervention , failure to thrive , pediatrics , nursing , psychiatry , pathology
The publication of the landmark paper “Defining Pediatric Malnutrition: A Paradigm Shift Toward Etiology‐Related Definitions” launched a new era in diagnosing pediatric malnutrition. This work introduced the paradigm shift of etiology‐related definitions—nonillness and illness related—and the use of anthropometric z scores to help identify and describe children with malnutrition (undernutrition) in the developed world. Putting the new definition into practice resulted in some interesting observations: (1) Etiology‐related definitions result in etiology‐related interventions. (2) Illness‐related malnutrition cannot always be immediately “fixed.” (3) Using z scores in clinical practice often puts the burden of proof on the clinician to show that a child is not malnourished, rather than the other way around. (4) Children with growth failure severe enough to be admitted with “failure to thrive” should always be assessed for malnutrition, and when they meet the criteria, malnutrition should be documented and coded. The publication of the consensus statement came next, announcing the evidence‐informed, consensus‐derived pediatric malnutrition indicators. Since the indicators are a work in progress, clinicians are encouraged to use them and give feedback through an iterative process. This review attempts to respond to the consensus statement's call to action by thoughtfully appraising the indicators and making recommendations for future review. Coming together as a healthcare community to identify pediatric malnutrition will ensure that this vulnerable population is not overlooked. Outcomes research will validate the indicators and result in new discoveries of effective ways to prevent and treat pediatric malnutrition.

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