Question

What are the characteristics and management of marasmus?

Answer 1

Marasmus is a condition caused by severe deficiency of proteins and calories in the diet leads to the wasting or loss of body fat and muscles.

Characteristics of marasmus includes

• Severe wasting of muscles
• Grossly underweight
• Stunded body growth
• Loss of subcutaneous fat
• Dry skin, wrinkled skin and brittle hair
• Anaemia
• Eye lesions due to Vitamin A deficiency
• Dehydration
• Sub-normal body temperature.
• Failure to thrive
• Sevierly malnourished children may look older

Management

Management of marasmus would be hosptal based and dietary management. It is based on correction of specific deficiencies and metabolic abnormalities. Hospital based management is required for severe dehydration, infection, hypoglycemia,and hypothermia. Dehydration can be treated with IV, oral or nasogastric administration of fluid. Infection can be treated with broad sprectrum antibiotics. In hypoglycemic patient intravenous administration of dextrose or glucose through NG tube or oral. The child should be properly covered with a blanket to manage hypothermia. The state of shock should be treated with intravenous injection of glucose saline or blood transfusion. The child should be given a diet providing sufficient quantities of calories and protein and gradually increase the amounts. The diet should be given frequently and in small amounts. It is best to begin with liquid formula because it is easy to feed and measure the intake. Initially the child may refuse the feeds, as the appetite improves and child starts to take solid supplements. Fresh milk or skimmed milk based formula can be used for feeding child suffering from marasmus. Sugar and vegetable oil are added to increase the energy content. A mixed cereal based diet can be given with added oil to increase energy density. Vitamins and mineral suppliments should be added to improve malnutrition. Once a child starts to recover, the child can start to take a more balanced diet that meets their nutritional needs.

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