Childhood Diseases

Posted by: SIL | 2011/01/24



Hi there,

My SIL''s daughter is 2.5 months is severely malnourished. She has got a big head, big tummy, big eyes, and the rest of the body parts are skinny.
She is currently living with my family so that we can help her get well. We can''t afford to take her to a peaditrian because she does not have medical aid. I have however come across information on the internet that says that her condition might not be reversable if its long terms. She has been like this for over 1 yr.
Is this true? I am worried that she will grow up looking different. If it is reversable, how long does it take?

Expert's Reply



This little baby does not have kwashiorkor but appears to have another illness also caused by malnutrition which is known as MARASMUS.Your baby niece must be seen immediately at your nearest public hospital with a paediatric department. This is very urgent.

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user comments


Posted by: SIL | 2011/01/25

Thanks very much. I will give the above to the nanny who takes care of the during the day, to make sure she gives her enough protein.
I really appreciate your help.

Reply to SIL
Posted by: Purple | 2011/01/25

Sorry, I thought you had typed two and a half months not two and a half years - that does change things somewhat.

No, there is no need to suddenly start giving her formula if she is not still drinking formula now.

You are obviously feeding your child fine, so giving your niece the same food should help to rectify the problem. Protein is found in eggs and meat and fish but also beans and chickpeas (but there is far less protein in that).

At two and a half years, you need to ensure that she is getting lots of small meals throughout the day - so for example, start with a nice breakfast of porridge or pronutro with milk and sugar, maybe slice some banana on top. A yogurt is also nice if she can fit that in.
A mid morning snack of a boiled egg and toast solders (egg is full of protein), or maybe some cheese cut up into blocks (protein) along with some fruit.
Lunch - perhaps a sandwhich with chicken mayo (chicken is protein) and some fruit cut up.
Afternoon snack - dried fruit or some biltong (protein) or some provitas with marmite or something like that.
Supper - what ever the famly usually eats - pap and wors, samp and beans or chicken, rice and two different coloured vegetables (all of these are protein filled meals).
You can also add a before bed snack of a cup of warm milk or a piece of fruit.

As she is not used to eating much she might not eat much at each meal, but get around this by offering her lots of small things often.
If you can, try to include protein at each of her meals, but definitely at atleast two of them per day.
If she won''t eat it as she isn''t used to it, try to disguise it in other foods.
However, if she sees your child eating, she should tuck into the food all right.

Try to avoid her getting diarrhea at all costs as this can worsen the situation, so insist on hands being washed before eating, try to give mostly cooled boiled water to drink. IF she does get a runny tummy, get her to the GP quickly and get her having rehydrate solution (you can make it at home, let your GP tell you how).

Good luck, she is a lucky little girl to have a caring aunt like you.

Reply to Purple
Posted by: SIL | 2011/01/25

I took her to a local GP yesterday and was told its marasmus. The GP said I must just give me protein and milk.

Purple, she is 2.5 yrs and therefor was weaned off breast milk a while back and as far as I know she is not on formula which I am prepared to buy for her today.

Its however difficult for us not to feed her anything else because I also have a baby who is 5 days older than her, so they eat the same things at the same time. Its not feasible for me to give my own daughter food and not give the other one food.

Reply to SIL
Posted by: Purple | 2011/01/24

Kwashiorkor is a lack of protein. She would also get orange hair with this. Kwashiorkor is unlikely in a baby this young who should not be on solid food anyway. However, I''m no expert, but I did grow up in a rural area where we often had to help feed people and teach people how to feed children who were in danger of developing kwashiorkor and marasmus.

Is she being fed breastfmilk every hour and a half to two hours? or if she is on formula is she being fed every 3 or four hours.
If she is not waking up for a feed, you need to wake her up - that means during the day time and the night time.
Do not ever let her go past 5 hours without a feed if she is bottle fed and 4 hours if she is breastfed. Preferably wake her well before then. Set an alarm clock during the night.

If formula fed, make sure that the bottles are prepared exactly according to the tin and that you use freshly boiled water each time. If the feeds aren''t prepared properly she will not get the nutrition she needs and if the water isn''t boiled or sits around after being boiled she could get diarhea which will just worsen the problem.

Don''t give her anything else except milk (breast or formula) otherwise she will be taking in too little milk and this will worsen the problem - so no water, no cereal, no rooibos tea and no other solid food - these will fill her tummy up but not provide any nutrition for her and could even give her tummy cramps.
Also, don''t give a dummy as she will be sucking and not taking in milk during that time and might go too long between feeds this way.

Make sure that you visit the clinic every single week to have her weighed and if she is not putting on at least 150g per week (though 300 or 400g is better) then you will have to take her to see a peadiatrician to get some advice - so start saving up now. Also, if she is in danger of dying the nurse will refer you to the hospital, though you should actually consider taking her through to a hospital emergency room now.

Yes, if baby is severely malnourished her little body and brain won''t grow as they should and that can''t be undone.

Reply to Purple

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