MALNUTRITION IN A CHILDRENS-HOSPITAL

Malnutrition may retard growth, increase the risk of infection and len gthen the duration of hospital admission, particularly in children wit h chronic disease. Several surveys have shown a significant but unreco gnized high prevalence of undernutrition in adults admitted to hospita l. However, there have been few studies of children in hospital. We ai med to measure the body weight, height and mid upper arm circumference (MUAC) of a sample of children seen at the Royal Hospital for Sick Ch ildren, Glasgow, UK. We studied 226 children (of which 93% were Caucas ian) aged 7 months to 16 years (140 male, 86 female) admitted to the m edical or surgical wards or out-patient clinics during a period of 9 w eeks in the winter of 1994-5. Body weight was measured using an electr onic balance, height with a stadiometer, and MUAC using a tape. We com pared our results with published standards. Sixteen percent of childre n were underweight-for-age (< 5th centile), 15% were stunted (< 5th ce ntile height-for-age) and 8% were wasted (< 80% weight-for-height). Si xteen percent were moderately undernourished or at risk of becoming so (between -1 SD and -2 SD for both weight-for-age and height-for-age) and 19% had a weight-for-height between 80% and 90% of standards. Only one-third of these malnourished children were previously recognized a s such. Children with diseases of the digestive system (inflammatory b owel disease, cystic fibrosis, coeliac disease) were most at risk of u ndernutrition. When children with these diseases were omitted from the analyses, 13% of the remaining children were < 5th centile weight-for -age and 12% were < 5th centile height-for-age. Our findings are compa rable with surveys of patients in children's hospitals elsewhere. A si gnificant proportion of children are malnourished and this study, in c ommon with others, indicates that undernutrition in children in hospit al remains largely unrecognized by the medical and nursing staff carin g for them. Body weight and height should be measured, plotted on appr opriate growth standard charts and the data used to ensure that approp riate action is taken to correct undernutrition.