Prevent and treat PEM in village community

Protein energy malnutrition is the term given to a group of clinical condition which occur due to inadequate protein and calorie intake specially in children but is also observed as stars mission in adolscent and adult mostly lactating women specially during period of mine or other emergencies. 

PEM has serious consequences for the health of individual particle children and can result in death. 

PEM can be defined as a range of pathological condition arising from A deficiency of protein and energy and is commonly associated with infections. many disease result in adverse changes in the appearance and function of one or more body parts. For example a healthy person has clear eyes. but in a person with severe between A deficiency eyes lose their clarity and become muddy or cloudy. 

Clinical feature of PEM:-

1). Khwashiorker

Kwashiorkor comes from an African word meaning displaced child to the illness of older infant who is denied breast milk when the new baby is born. Kwashiorkor is common in children between 1 and 5 years. it is due to a protein deficiency which occurs after protein rich foods are discontinued during weaning and the child is given food low in protein and calories. 

Symptoms of kwashiorkor

• Children appear smaller than their age
• Skin is dry and flaky hair turns reddish
• Muscles limp and underdeveloped
• Children frequently have  digestive problem
• fluid retention in the body causes at the standard abdomen swelling in hands and ankles. This is called oedema.
• Very thin limps liver maybe enlarged
• Children lock enthusiasm and look unhappy.

2) Marasmus

This condition is generally seen in infants less than 1 year old. It occurs due to deficiency of protein carbohydrates and fats. measurements is the childhood equivalent for starvation in adult and is more serious than kwashiorkor.

Symptoms of marasmus

• Anar face cover a sunken body
• Eyes are sunken cheeks are hollow giving a prematurely is looked
• Odema is absent abdomen curv inward.
• skin is dry loose and wrinkle due to loss of fat below the skin.
• Hair may be normal or dry thin and light coloured.
• Muscle are waste and have poor tone.
• Bones are prominent due to absence of fat around them.

Causative factors of PEM are:

• Poverty: PEM orcurs in poor Indian communities. it is commonly seen in families of landless agricultural labourers and tribal communities without any regular earning among others.
• Maternal malnutrition:if the nutrition test status of mother is poor the chance of offspring being malnourished are hire. Maternal malnutrition result in low birth weight of offspring.
• Infection of poor hygiene: kwashiorkor follows attack of diarrhoea or an attack of Measles.
• Ingorance: both the form of pen occur as a result of importance of the mother in addition to proverty. dimag due to in gardens delete the introduction of supplementary food even up to age of 1 year. this has serious consequences because mother milk alone is not enough for the child by the age of 6 months. the infant should be given supplementary food in addition to breast milk. in addition mother restrict the date when the child is suffering from infection such as diarrhoea and common favour. this practice is not good syn such that re restriction lead to PEM in children who are fat
• Wrong child feeding practice,: supplementary food in addition to breast milk are introduced quite late. The child is usually given the same diet taken by adult. The typical Indian diet is based on cerals and is quite bulky for small child. this would mean that the child could consume only small amount of the food at one time. Consequently the child cannot get enough energy protein which is the major causes of PEM in India.

TREATMENT:

one of the major objective of the treatment is to feed the child energy and protein rich food so that is requirement are meet to there is adequate weight gain. The main principle in the treatment of several form PEM is a provide adequate energy and protein through dietary means. This can be provided through the food stuff usually consumed by the community at their homes like cerials pulses nuts and sugar and jaggery. addition of milk is not compulsory but if added will improve the quality of the diet.

PREVENTION,

• Prevention of pem should start with the mother of the child. Children with low birth weight often develop pem. The main reason of low weight is maternal malnutrition. pregnant women should consume extra food to meet the additional need of pregnancy.
• Mother's milk is best food for an infant. lactating mother should be encouraged to breastfeed their children as long as possible. Birthday age of about six months however mother milk is alone is not adequate for the child. supplementary food should be provided to the children by the age of 6 months in addition to breast milk. This can be cereal pulses and nuts mix wheat Bengal gram and groundnut mix and can be prepared at home by the mother.
• Children should be fed 5 to 6 times a day.
• infection like diarrhoea and respiratory infection increasing the risk of PEM. in addition during diarrhoea and any other infection food should be not be restricted. The child should be fed as usual.
• protection of children against disease like tuberclosis for whooping cough by immunization is another important aspect in prevention of pem.