PEM protein Energy Malnutrition

All about PEM

1. MICRO TEACHING ON PROTEIN ENERGY MALNUTRITION

2. Introduction Protein-energy malnutrition or PEM is the condition of lack of energy due to the deficiency of all the macronutrients and many micronutrients. It can occur suddenly or gradually. It can be graded as mild, moderate or severe. It affects children who are not provided with calories and proteins.

3. PROTEIN ENERGY MALNUTRITION OR (PEM) Also called protein calorie malnulution. Protein deficiency in children causes protein energy malnutrition (PEM) which commonly found in India among the children of six months to three year of age. It occurs in poor children who do not take enough food or take food in deficient in protein or both the conditions may exists.

4. Which causes the following diseases in children, widely common in infant or pre school children. KWASHIORKOR: It is predominantly found in children between 1to 5 year of age. This is primarily due to insufficient intake of protein with adequate amount of colories. As the diet of weaning child mainly consist of carbohydrates.

5. SIGNS AND SYMPTOMS OF KWASHIORKOR It includes shunted growth, weakness Edema on face (moon face), legs or hands Diarrhea Discolouration of hair and skin Anemia Apathy Moonface Abdomen is distended (pot belly) The skin is dry, pigmented and flabby Liver Enlargement

6. 2. MARASMUS : Mainly occurs in children under one year of age. Marasmus is predominantly due to the deficiency of all macronutrients that the body requires to function, including carbohydrates, protein and fats. It occurs due to inappropriate weaning.

7. SIGNS AND SYMPTOMS OF MARASMUS Growth Retardation Old man face Muscle wasting Anemia Weakness Diarrhea Skin is dry there is loose folds presents on skin Abdomen is shrunkend Mental Retardation occurs

8. CAUSES OF PEM Poverty Poor hygienic conditions Limited food supply in large families Deficiency of macronutrients in diet Anemic mother Low birth weight baby Premature labour Serious infections such as septicemia, pneumonia, gastroenteritis, tuberculosis, measles and AIDS

9. TREATMENT OF PEM Nutritional Requirements: The diet should be digestible (liquid diet initially for a week) and should contain protein of high nutritive value eg milk protein and all essential nutrients in required amount. 3 to 4 gm protein /kg/day in Kwashiorkor 150 to 200 gm calorie/kg/day in Maramus

10. NURSES ROLE & PREVENTION FROM MALNUTRITION Nutritional education is the high priority to prevent this problem other preventive measures included the following. Health promotion Specific protection Early daignosis and treatment Rehabilitation

11. Health promotion: Promotion of exclusive breastfeeding up to 6 th month of age. Nutritional education and nutrition counseling to promote correct feeding practice, food habits, food hygiene and environment sanitation etc. Appropriate weaning practice.

12. 2. Specific protection: Provision of balanced diet. Immunization against vaccine preventable diseases. Promotion & maintenance of hygienic measures.

13. 3. Early Diagnosis & Treatment: Early daignosis and treatment of infections and common childhood illness (Diarrhea, Malaria) etc. Promotion of early rehydration therapy in child having diarrhea.

14. 4. Rehabilitation: To provide Nutritional rehabilitation services. To provide follow up care etc.

15. Questions? A three year old girl child was brought to the pediatric department with the chief complaints of failure to thrive, Diarrhea and respiratory tract infection. On Examination: We can see edema on knee and ankle joints, moon face and sparse hair, What is your daignosis on it ? An infant brought to the pediatric department with the chief complaints of failure to thrive, Diarrhea O/E: He looks like old man with shrunken abdomen and dry skin what is your daignosis ?

16. Thank you 😊 Thanks for your attention.