ABSTRACT

This project was conducted with the primary objective of knowing the dietary management of children with protein energy Malnutrition (PEB) in 44 Nigerian Army Reference Hospital, Kaduna State, Nigeria. The research was adopted using the questionnaire method. The questionnaire was used as an instrument for data collection with the population of 50 respondents. The questionnaire contained two major sections include section (A) child personal data while section (B) parents personal data the Data collected from the questionnaires was analyzed in simple percentage method. It was discovered that protein energy malnutrition accounted for (50%) kwashiorkor. Marasmus accounted for (30%) and Marasmic Kwashiorkor (20%) respectively. The highest number of the respondents that exclusively breast fed from 3 -6 months is 22 (44%) followed by 7 -9 months 18 (36%) 10 and above with 10 (20%) each.

Majority of the respondents were bares hand fed 16(32%) cup and spoons fed had 14 (28%) bottle feeding 14 (28%) and force feeding 8 (16%) respectively the findings shows that enriched cereals and legumes have great importance in the management of malnutrition among children and above also the practice of nutrition education in child welfare clinic has greatly reduced the incidence of the diseases among infants.

CHAPTER ONE

INTRODUCTION

1. 0    Background of the Study

The World Health Organization estimated in 2008 that globally, half of all cases of under nutrition in children under five were caused by unsafe water, inadequate sanitation or insufficient hygiene. This link is often due to repeated diarrhea and intestinal worm infections as a result of inadequate sanitation. However, the relative contribution of diarrhea to under nutrition and in turn stunting remains controversial.(WHO, 2008)

Malnutrition is a globally known term, which refers to both under-nutrition and over- nutrition. Individuals are malnourished or suffer from under nutrition if their diets do not contain the required or adequate calories. It can lead to serious health issues, including stunted growth, eye problems, diabetes and heart disease. (UNICEF, 2016)

 Children throughout the world can reach their growth potential if they are nurtured in healthy environments and their caregivers follow recommended health, nutrition and care practices. Stunting indicates a failure to achieve one’s genetic potential for height (Golden 2009).

A child is considered ‘stunted’ or malnourished if his or her height is more than two standard deviations below the World Health Organization standard (WHO Multicentre Growth Reference Study Group, 2006).

Although a child may not be classified as ‘stunted’ until 2–3 years of age, the process of becoming stunted typically begins in utero. The result – a very short height – usually reflects the persistent, cumulative effects of poor nutrition and other deficits that often span across several generations. This review summarizes the impact of stunting, highlighting research findings published in the past 5 years.

Diet plays a crucial role in the management of a case of protein energy malnutrition. Severe malnutrition is best managed in the hospital as such cases usually have life threatening complications. When the child is critically ill, a cautious approach to feeding is vital. By the end of the first week the acute problems have usually been overcome and oral feeds should be introduced. In the rehabilitation phase, the emphasis is on weight gain and so a more vigorous approach is needed. Up to 200 kcal/kg/day has to be given for maximum ‘catch up growth’. Transfer to family type diet is an important final step in rehabilitation before the patient is discharged from the hospital (Mayer, 2013).

1.2     Statement of the Problem

According to the United Nations Children’s Fund (UNICEF), PEM is an invisible emergency much like the tip of an iceberg, where its deadly consequences are hidden from view. In 2005, 20% of children younger than 5 years in low-to-middle income countries were estimated to be underweight (weight for age <2), while 32% (178 million) children younger than 5 years in developing countries were estimated to be stunted (height for age <2).

Worldwide, only 36 countries account for 90% of all stunted children when countries with stunting prevalence of at least 20% were considered. Nigeria alone has 34% of the world’s stunted children because of its large population, although there is significant variation between its states.

There is considerable evidence indicating food child malnutrition occurs in Nigeria. However, not a lot of information exists on the energy deficiency effects on children’s diets.  Given the potential negative effects of food scarcity on young children’s nutrition and health, it is important to assess if and when food stress occurs. is on this note that the study seeks to evaluate dietary management of children with energy malnutrition in 44 Nigerian army reference hospital, Kaduna.

1.3     Significance of the Study

This research project will be found most useful by health workers, Government and its institutions, hospitals, schools and fellow students because it will chart the course for the identification of children suffering from energy protein malnutrition and the care they should receive. Based on the aforementioned we intend with this study to:

•          Help to identify the major challenges of growth in children fewer than five years of age.

•          Provide additional literature and data for health workers, Nutrition experts, private organizations and the government who are working hard to battle this clinical condition.

•          Orientate mothers on the super importance of breastfeeding and equip them with better nutritional skills on child diet and growth monitoring.

•          Serve as an invaluable source and referral literary material to other allied students.

1.4.    Aims and Objectives of the Study

1.                 To determine the protein energy malnutrition among children attending 44 Army Reference Hospital 

2.                 To assess nutritional adequacy of the diet served to children with protein energy malnutrition

3.                 To counsel mothers on the importance of exclusive breastfeeding for good health of infants.

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