Energy compensation in young children who fail to thrive

Kasese-Hara, Mambwe; Wright, Charlotte; Drewett, Robert

doi:10.1111/1469-7610.00036

Cited by 33 publications

(17 citation statements)

References 48 publications

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“…Similarly, only between 5 and 10% will have any symptoms or signs of underlying disease (14) . Some evidence of differences in maternal feeding behaviour and appetite and eating behaviour as well as decreased energy intake at meals (31) have been found in the infant (27)(28)(29)(30) . Thus, the majority of children showing a weight faltering pattern have no observable disease or evidence of neglect.…”

Section: Failure To Thrive/weight Falteringmentioning

confidence: 99%

Child undernutrition in affluent societies: what are we talking about?

Wright

García

2012

Proc. Nutr. Soc.

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In this paper we set out to explore the prevalence of child undernutrition found in community studies in affluent societies, but a preliminary literature review revealed that, in the absence of a gold standard method of diagnosis, the prevalence largely depends on the measure, threshold and the growth reference used, as well as age. We thus go on to explore describe the common clinical 'syndromes' of child undernutrition: wasting, stunting and failure to thrive (weight faltering) and how we have used data from two population-based cohort studies, this paper to explore how much these different 'syndromes' overlap and the extent to which they reflect true undernutrition. This analysis revealed that when more than one definition is applied to the same children, a majority are below the lower threshold for only one measure. However, those with both weight faltering and low BMI in infancy, go on in later childhood to show growth and body composition patterns suggestive of previous undernutrition. In older children there is even less overlap and most children with either wasting or low fat seem to be simply growing at one extreme of the normal range. We conclude that in affluent societies the diagnosis of undernutrition is only robust when it relies on a combination of both, that is decline in weight or BMI centile and wasting. Undernutrition is an intrinsic hazard in pre-school children in all cultures because infants have such high-nutrient requirements due to high rates of morbidity, requirements for growth, relatively inefficient metabolism and dependence on adults for all food. Worldwide, undernutrition has been clearly linked to a substantial increased risk of mortality and morbidity (1) as well as long-term stunting (2) and probably also has metabolic effects stretching into adulthood (3,4) . Thus undernutrition in childhood is clearly an important risk factor. However, what is less clear is how common it actually is in more affluent societies and what causes it in those settings. Systematic review of the prevalence of undernutrition in affluent societiesWe undertook a systematic review of the literature on the recent prevalence of undernutrition in developed societies, searching Medline, Ovid and/or Web of Knowledge for studies published between 2000 and 2011. Countries listed as having a very high human development index as defined by the UN (5) were considered as 'developed or affluent societies'. Studies were included if published in English and if they included prevalence rates and data collection methodology.

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Section: Failure To Thrive/weight Falteringmentioning

confidence: 99%

Child undernutrition in affluent societies: what are we talking about?

Wright

García

2012

Proc. Nutr. Soc.

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“…On average, after a high energy preload, infants and preschool children reduce their meal intake by between 50% and 100% (Birch & Deysher, 1986;Johnson & Birch, 1994) of the energy content of that preload, but older children compensate much less (Cecil et al, 2005;Johnson & Taylor-Holloway, 2006). Only one previous study has examined energy regulation in a clinical group; this study (Kasese-Hara, Wright, & Drewett, 2002) found that weight-faltering children seemed not to compensate; they ate the same, smaller amount after both high and low energy preload. No studies have yet formally assessed energy regulation in enterally fed children.…”

Section: Introductionmentioning

confidence: 97%

Energy compensation in enterally fed children

et al. 2011

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“…Similarly, there are infants who are described as 'contented' after very small feeds, and who do not wake up for feeds, who also fail to thrive (Davies, 1979). These infants are similar to those who fail to show compensation in their energy intake when given a high-calorie preload before a meal (Kasese-Hara et al, 2002). Such children show poor appetite regulation and for this reason fail to take in sufficient calories to accord with growth requirements.…”

Section: Child Factorsmentioning

confidence: 99%