Abdul Salam Malik, Atta Ullah Mazhar.
Assessment of nutritional status of children under 48 months of age
Pak Paed J Mar 2006;30(1):38-47.
B V Hospital & Quaid_e_Azam Medical College, Bahawalpur

Objective: To assess the frequency and severity of malnutrition, and its association with mothers education, breast feeding duration, weaning age, family income and family size, in children under 48 months of age. Study design: Case- Control study. Place & duration: The study was conducted at E.P.I. Centre, Paediatrics out patient department B.V. Hospital, Bahawalpur, from March 1999 to September 2000. Subject & method: The weight for age, a direct anthropometric measurement, was used for assessment of malnutrition. Inclusion criteria were the children under 48 months of age attending E.P.I. Center B.V.H., Bahawalpur. Children loosing weight due to acute diarrhoea were excluded from the study. Results: The results indicate that 587 (58.7%) children were normal and 413 (41.3%) were suffering from malnutrition. Among malnourished children, 208 (20.8%) had first degree, 110 (11%) had second degree and 95 (9.5%) had third degree malnutrition at 95% confidence intervals (+ - 2SD). In the mother education group, the 462 illiterate mothers having 220 (47.6%) normal and 242 (52.4%) malnourished while 161 higher educated were having 123 (76.4%) normal and 38 ( 23.6%) malnourished children only. Odd Ratio is 3.56, showing that those children who were exposed to mother illiteracy were having 3.56 time more malnutrition as compared to educated mothers group. The 192 non breast feeding mothers had 100 (52%) normal and 92 (48%) malnourished children as compared to 409 mothers breast feeding their children for one year and above having 249 (61%) normal and 160 (39%) malnourished children. The Odd ratio is 1.43 showing that children exposed to non breast feeding factor are 1.43 times more malnourished as compared to breast fed children. Among the weaning variable, it has been found that 270 mothers, giving early weaning from 4th month, had 184 (68.2%) normal and 86 (31.8%) malnourished children. The 315 mothers beginning weaning after one year and above had 144 (45.7%) normal 171 (54.3%) malnourished among them. The Odd ratio is 2.54 showing that children exposed to late weaning after one year are having malnutrition 2.54 times more as compared to other children who received weaning earlier than 4th month. Similarly, the family size had shown that 235 mothers having only one child had 165 ( 70.2%) children normal and 70 (29.8%) malnourished but 255 mothers, having 4 or more children, had 120(47.1%) normal and 135 (52.9%) malnourished children. The Odd ratio is 2.65 showing that the children exposed to large family size of 4 or more than 4 children suffer from malnutrition 2.65 times more as compared to those who belong to a small family size. The family monthly income shows that 508 mothers from a low income group have 253 ( 49.8%) normal and 255 ( 50.2%) malnourished children but 207 mothers from families with a higher income, had 156 (75.3%) normal and 51 ( 24.7%) children malnourished. The Odd ratio is 3.08 showing that children exposed to poor socio-economic status are having 3.08 times more malnutrition among them as compared to children belonging to rich families. Conclusion: Malnutrition is more prevalent in illiterate sectors of the community where breast feeding is not practiced. The delayed weaning as well as large family size with poor socio-economic status is also associated with malnutrition. By removing these factors, we can reduce the malnutrition load among children.

Category: Pediatrics
Keywords: Malnutrition. Breast Feeding. Weaning.

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