NUTRITIONAL ASSESSMENT IN PEDIATRICS

Nutritional status affects every pediatric patient's response to illne ss. Good nutrition is important for achieving normal growth and develo pment. Nutritional assessment therefore should be an integral part of the care for every pediatric patient. Routine screening measures for a bnormalities of growth should be performed on all pediatric patients. Those patients with chronic illness and those at risk for malnutrition should have detailed nutritional assessments done. Components of a co mplete nutritional assessment include a medical history, nutritional h istory including dietary intake, physical examination, anthropometrics (weight, length or stature, head circumference, midarm circumference, and triceps skinfold thickness), pubertal staging, skeletal maturity staging, and biochemical tests of nutritional status. Alternative meas ures for linear growth assessment (e.g., lower leg and upper arm measu res) can be performed on patients unable to stand or who have musculos keletal deformities. Bone densitometry can be used to assess bone mine ralization and the risk of fracture. Nutritionally at risk patients ma y benefit from determination of resting energy expenditure by indirect calorimetry. The use of age, gender, and disease-specific growth char ts is essential in assessing nutritional status and monitoring nutriti on interventions. The importance of accurate measurements using traine d personnel and appropriate equipment cannot be overemphasized. (C) El sevier Science Inc. 1998.