{"id":2447,"date":"2010-07-20T08:00:00","date_gmt":"2010-07-20T08:00:00","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/malnutrition\/"},"modified":"2025-05-14T19:08:31","modified_gmt":"2025-05-14T19:08:31","slug":"malnutrition","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/malnutrition\/","title":{"rendered":"Classification of Malnutrition in Children"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The World Health Organization (WHO) defines malnutrition as the cellular imbalance between the supply of nutrients and energy and the body\u2019s demand for them to ensure growth, maintenance, and specific functions.<\/p>\n<p>Malnutrition generally implies undernutrition and refers to all deviations from adequate and optimal nutritional status in infants, children and in adults. In children, undernutrition manifests as underweight and stunting (short stature), while severely undernourished children present with the symptoms and signs that characterize conditions known as kwashiorkor, marasmus or marasmic-kwashiorkor.<\/p>\n<p><!--more--><br \/>\n<script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script><br \/>\n<ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-0127150553352455\" data-ad-slot=\"7834404329\"><\/ins><br \/>\n<script>\n     (adsbygoogle = window.adsbygoogle || []).push({});\n<\/script><br \/>\n<strong>Definitions of malnutrition<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td><strong> Classification <\/strong><\/td>\n<td><strong> Definition<\/strong><\/td>\n<td colspan=\"2\" align=\"center\"><strong> Grading<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Gomez<\/td>\n<td>Weight below %<br \/>\nmedian WFA<\/td>\n<td>Mild (grade 1)<br \/>\nModerate (grade 2)<br \/>\nSevere (grade 3)<\/td>\n<td>75%\u201390% WFA<br \/>\n60%\u201374% WFA<br \/>\n&lt;60% WFA<\/td>\n<\/tr>\n<tr>\n<td>Waterlow<\/td>\n<td>z-scores (SD) below<br \/>\nmedian WFH<\/td>\n<td>Mild<br \/>\nModerate<br \/>\nSevere<\/td>\n<td>80%\u201390% WFH<br \/>\n70%\u201380% WFH<br \/>\n&lt;70% WFH<\/td>\n<\/tr>\n<tr>\n<td>WHO (wasting)<\/td>\n<td>z-scores (SD) below<br \/>\nmedian WFH<\/td>\n<td>Moderate<br \/>\nSevere<\/td>\n<td>-3%&lt;\/= z-score &lt; -2<br \/>\nz-score &lt; -3<\/td>\n<\/tr>\n<tr>\n<td>WHO (stunting)<\/td>\n<td>z-scores (SD) below<br \/>\nmedian HFA<\/td>\n<td>Moderate<br \/>\nSevere<\/td>\n<td>-3%&lt;\/= z-score &lt; -2<br \/>\nz-score &lt; -3<\/td>\n<\/tr>\n<tr>\n<td>Kanawati<\/td>\n<td>MUAC divided by<br \/>\noccipitofrontal head<br \/>\ncircumference<\/td>\n<td>Mild<br \/>\nModerate<br \/>\nSevere<\/td>\n<td>&lt;0.31<br \/>\n&lt;0.28<br \/>\n&lt;0.25<\/td>\n<\/tr>\n<tr>\n<td>Cole<\/td>\n<td>z-scores of BMI for age<\/td>\n<td>Grade 1<br \/>\nGrade 2<br \/>\nGrade 3<\/td>\n<td>BMI for age z-score &lt; -1<br \/>\nBMI for age z-score &lt; -2<br \/>\nBMI for age z-score &lt; -3<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Abbreviations: BMI, body mass index; HFA, height for age; MUAC, mid-upper arm circumference; SD, standard deviation; WFA, weight for age; WFH, weight for height; WHO, World Health Organization.<br \/>\n<script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script><br \/>\n<ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-0127150553352455\" data-ad-slot=\"7834404329\"><\/ins><br \/>\n<script>\n     (adsbygoogle = window.adsbygoogle || []).push({});\n<\/script><br \/>\n<strong>Gomez Classification:<\/strong> The child&#8217;s weight is compared to that of a normal child (50th percentile) of the same age. It is useful for population screening and public health evaluations.<\/p>\n<ul>\n<li>Percent of reference weight for age = [(patient weight) \/ (weight of normal child of same age)] * 100<\/li>\n<\/ul>\n<p><strong>Waterlow Classification:<\/strong> Chronic malnutrition results in stunting.\u00a0 Malnutrition also affects the child&#8217;s body proportions eventually resulting in body wastage.<\/p>\n<ul>\n<li>Percent weight for height = [(weight of patient) \/ (weight of a normal child of the same height)] * 100<\/li>\n<li>Percent height for age = [(height of patient) \/ (height of a normal child of the same age)] * 100<\/li>\n<\/ul>\n<p><strong>Classification of Malnutrition in Children<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td><\/td>\n<td align=\"center\">Mild Malnutrition<\/td>\n<td align=\"center\">Moderate Malnutrition<\/td>\n<td align=\"center\">Severe Malnutrition<\/td>\n<\/tr>\n<tr>\n<td>Percent Ideal Body Weight<\/td>\n<td align=\"center\">80-90%<\/td>\n<td align=\"center\">70-79%<\/td>\n<td align=\"center\">&lt; 70%<\/td>\n<\/tr>\n<tr>\n<td>Percent of Usual Body Weight<\/td>\n<td align=\"center\">90-95%<\/td>\n<td align=\"center\">80-89%<\/td>\n<td align=\"center\">&lt; 80%<\/td>\n<\/tr>\n<tr>\n<td>Albumin (g\/dL)<\/td>\n<td align=\"center\">2.8-3.4<\/td>\n<td align=\"center\">2.1-2.7<\/td>\n<td align=\"center\">&lt; 2.1<\/td>\n<\/tr>\n<tr>\n<td>Transferrin (mg\/dL)<\/td>\n<td align=\"center\">150 &#8211; 200<\/td>\n<td align=\"center\">100 &#8211; 149<\/td>\n<td align=\"center\">&lt; 100<\/td>\n<\/tr>\n<tr>\n<td>Total Lymphocyte Count (per \u00b5L)<\/td>\n<td align=\"center\">1200 &#8211; 2000<\/td>\n<td align=\"center\">800 &#8211; 1199<\/td>\n<td align=\"center\">&lt; 800<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script><br \/>\n<ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-0127150553352455\" data-ad-slot=\"7834404329\"><\/ins><br \/>\n<script>\n     (adsbygoogle = window.adsbygoogle || []).push({});\n<\/script><br \/>\n<strong>Wellcome Classification:<\/strong> evaluates the child for edema and with the Gomez classification system.<\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td>Weight for Age (Gomez)<\/td>\n<td style=\"text-align: center;\">With Edema<\/td>\n<td style=\"text-align: center;\">Without Edema<\/td>\n<\/tr>\n<tr>\n<td>60-80%<\/td>\n<td style=\"text-align: center;\">kwashiorkor<\/td>\n<td style=\"text-align: center;\">undernutrition<\/td>\n<\/tr>\n<tr>\n<td>&lt; 60%<\/td>\n<td style=\"text-align: center;\">marasmic-kwashiorkor<\/td>\n<td style=\"text-align: center;\">marasmus<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Gomez F, Galvan RR, Cravioto J, Frenk S. Malnutrition in infancy and childhood, with special reference to kwashiorkor. Adv Pediatr. 1955;7:131\u2013169. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/14349775\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Waterlow JC. Classification and definition of protein-calorie malnutrition. Br Med J. 1972 Sep 2;3(5826):566-9.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4627051\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Waterlow JC, Buzina R, Keller W, Lane JM, Nichaman MZ, Tanner JM. The presentation and use of height and weight data for comparing the nutritional status of groups of children under the age of 10 years. Bull World Health Organ. 1977;55(4):489\u2013498. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/304391\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Grover Z, Ee LC. Protein energy malnutrition. Pediatr Clin North Am. 2009 Oct;56(5):1055-68. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19931063\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Management of Severe Acute Malnutrition in Infants and Children <a href=\"https:\/\/medicalcriteria.com\/web\/es\/severe-malnutrition\/\" target=\"_blank\" rel=\"noopener noreferrer\">[MedicalCriteria.com]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: 28 Jul, 2010<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[98],"tags":[181,166,167,185,186,183,392,667],"class_list":["post-2447","post","type-post","status-publish","format-standard","hentry","category-nutrition","tag-children","tag-clasificacion","tag-classification","tag-desnutricion","tag-malnutrition","tag-ninos","tag-nutrition","tag-pediatrics"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2447","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2447"}],"version-history":[{"count":2,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2447\/revisions"}],"predecessor-version":[{"id":8732,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2447\/revisions\/8732"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2447"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2447"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2447"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}