Malnourished Children

* In the US: Fewer than 1% of all children in the United States have chronic malnutrition.

Incidence of malnutrition is less than 10%, even in the highest risk group (children in homeless shelters).

Some studies indicate that poor growth secondary to inadequate nutrition occurs in as many as 10% of children in rural areas.

Studies of hospitalized children suggest that as many as one fourth of patients had some form of acute PEM and 27% had chronic PEM.

* Internationally: The World Health Organization estimates that approximately 150 million children (26.7%) younger than 5 years in developing countries are malnourished based on their low weight in relation to their age. An additional 200 million children have stunted height secondary to poor nutrition.

More than half of young children in South Asia have PEM, which is 5 times the prevalence in the Western Hemisphere.

In sub-Saharan Africa, 30% of children have PEM.

Two thirds of all malnourished children in the world live in Asia, and another one fourth live in Africa.

Mortality/Morbidity:

* The adverse effects of malnutrition include physical and developmental manifestations. Poor weight gain and slowing of linear growth occur. Impairment of immunologic functions in these children mimics those observed in children with AIDS, predisposing them to opportunistic and other typical childhood infections.

* Children who are chronically malnourished exhibit behavioral changes, including irritability, apathy and decreased social responsiveness, anxiety, and attention deficits. In addition, infants and young children who have malnutrition frequently demonstrate developmental delay or permanent cognitive deficits. The degree of delay and deficit depends on the severity and duration of nutritional compromise and the age at which malnutrition occurs.

* Although death from malnutrition in the United States is rare, in developing countries, approximately 50% of the 10 million deaths each year are secondary to malnutrition in children younger than 5 years.

Age:

* Children are most vulnerable to the effects of malnutrition in infancy and early childhood. Premature infants have special nutritional needs that are not met with traditional feeding recommendations; they require fortified human milk or specially designed preterm formula until later