Nutrition Management In Children with Chronic Diarrhea, Vitamin D Deficiency, Iron Deficiency Anemia, And Stunting: A Case Study

Asmaliah Hidayanti; Nursalim Nursalim; Agustian  Ipa

Authors

Asmaliah Hidayanti Department of Nutrition, Poltekkes Kemenkes, Makassar, Indonesia
Nursalim Nursalim Department of Nutrition, Poltekkes Kemenkes, Makassar, Indonesia
Agustian Ipa Department of Nutrition, Poltekkes Kemenkes, Makassar, Indonesia

Keywords:

Chronic Diarrhea, Iron Deficiency, Anemia

Abstract

Indonesia is a country that continues to face the problem of stunting. Out of 148.1 million (22.3%) worldwide, 19.8% in Indonesia suffer from stunting, according to the 2024 SSGI results. This study aims to assess nutritional management in children with Chronic Diarrhea, Vitamin D Deficiency, Iron-Deficiency Anemia, and Stunting in the PICU through an observational case study involving one respondent. The results of the nutritional assessment identified nutritional issues, leading to the establishment of dietary diagnoses: NI 2.1, NI 5.1, and NB 1.7. The nutritional intervention plan provided aligns with the established nutritional diagnoses, consisting of a malnutrition management diet in the rehabilitation phase, with a liquid consistency administered orally via the enteral route. Education/counseling and monitoring of the child's condition were also provided. Physical data related to nutrition were monitored and evaluated at each visit using direct observation methods. Monitoring and evaluation of intake were conducted daily using a 24-hour recall, while monitoring and evaluation of biochemical values were conducted according to the latest laboratory tests. The results of the nutritional screening of the respondent indicated the presence of malnutrition and other conditions related to nutrient deficiencies. Standardized nutritional care was provided over 9 days of intervention in the PICU. Anthropometric measurements were taken before the intervention and on the last day of the intervention, showing no changes in LLA and PB measurements in the respondents, thus maintaining their nutritional status in the category of malnutrition. Monitoring and evaluation results also showed significant improvements in physical conditions related to nutrition. The monitoring and evaluation results for patient intake showed that the respondents' intake continued to increase gradually. Meanwhile, the monitoring and evaluation results for nutrition education and counseling for the patients' mothers showed an increase in understanding of nutrition. This case study concludes that the standardized individualized nutrition care process has been proven to increase the respondents' intake, thereby preventing the deterioration of their condition and improving the mothers' understanding of the nutrition management provided.

Downloads

Download data is not yet available.

References

World Health Organization (WHO), 2023. Stunting at a Glance.

UNICEF & WHO, 2023. Global Nutrition Report: Stunting in Children Under Five Years of Age. Geneva: United Nations Children's Fund and World Health Organization.

Ministry of Health of the Republic of Indonesia, 2023. Indonesian Nutrition Status Survey (SSGI) 2023. Jakarta: Ministry of Health of the Republic of Indonesia.

Damaris, R., Nugroho, H.S., and Rahayu, M., 2022. Evaluation of nutritional interventions on the anthropometric status of stunted infants in densely populated areas. Indonesian Journal of Nutrition, 11(1), pp. 15–24.

Oktaviani, R., and Nirmala, S., 2020. The effectiveness of supplementary feeding on improving the nutritional status of stunted children. Community Health Journal, 6(1), pp. 47–55.

Ayele, B.A., Tadele, H., Wubayehu, T., Shiferaw, W.S., and Bekele, S., 2021. Electrolyte imbalance in children under five years of age with diarrhea. Pediatric Health, Medicine and Therapeutics, 12, pp. 273–280.

Rahman, M.M., Abe, S.K., Kanda, M., Narita, S., Rahman, M.S., Bilano, V., Ota, E., Gilmour, S., and Shibuya, K., 2020. Maternal anemia and the risk of poor birth outcomes and health in low- and middle-income countries. The American Journal of Clinical Nutrition, 112(6), pp. 1503– 1512.

Alemayehu, A., Mekonnen, H., Alemu, K., and Belete, H., 2022. Prevalence of hypoglycemia and associated factors among children with severe malnutrition. Child Health, Medicine, and Therapy, 13,

pp. 29–38.

Shanka, M., Lemma, G., and Adugna, M., 2022. The impact of therapeutic foods on recovery and weight gain in malnourished children. Journal of Pediatric Gastroenterology and Nutrition, 74(4), pp. 567–574.

Ahmed, T., Hossain, M., Mahfuz, M., Chisti, M.J., Ahmed, A.M.S., and Bhandari, N., 2021. Malnutrition and gastrointestinal diseases: synergies and potential interventions. Journal of Health, Population and Nutrition, 40(1), pp. 1–9.

Wondmieneh, A., Yesuf, E.A., Belachew, T., and Tewabe, T., 2020. Micronutrient supplementation and nutritional recovery in malnourished children: A systematic review. Nutrition and Health, 26(2),

pp. 123–130.

Bahwere, P., Sadler, K., and Collins, S., 2020. Acceptance and effectiveness of WHO F100 formula in the treatment of severe acute malnutrition in various settings. Nutrition Journal, 19(1), pp. 1– 9.

Tadesse, E., Berhane, M., and Desta, H., 2021. Outcomes of using WHO F-100 formula during the rehabilitation phase of children with severe malnutrition. Pan-African Journal of Medicine, 38(20), pp. 110–117.

Fatima, R., Putri, R.D., and Nurhayati, T., 2020. Improving mothers' knowledge through nutrition education in the prevention of stunting. Journal of Nutrition and Food, 15(2), pp. 83–90.

Kurniawan, A., Widodo, A., and Lestari, E., 2021. The relationship between mothers' understanding after nutrition education and feeding practices for stunted infants. Indonesian Journal of Public Health, 16(3), pp. 172–179.

Neri LD, Guglielmetti M, Fiorini S, Quintiero F, Tagliabue A, Ferraris C. Nutritional counseling in childhood and adolescence: a systematic review. Frontiers in Nutrition. 2024 Feb 1;11:1270048.

Olloqui-Mundet MJ, Cavia MD, Alonso-Torre SR, Carrillo C. Dietary habits and nutritional knowledge of pregnant women: the importance of nutrition education. Foods. 2024 Oct 8;13(19):3189.

Hanai T, Nishimura K, Unome S, Miwa T, Nakahata Y, Imai K, Suetsugu A, Takai K, Shimizu M. Nutritional counseling improves mortality and prevents hepatic encephalopathy in patients with alcohol‐associated liver disease. Hepatology Research. 2024 Nov;54(11):1089-98.

Aminah S, Mahmudiono T, Nadhiroh SR. Policy, intervention, and management in addressing stunting in children: A systematic review. African journal of reproductive health. 2024 Dec 6;28(10):348-57.

Erika KA, Fadilah N, Latif AI, Hasbiah N, Juliaty A, Achmad H, Bustamin A. Stunting Super App as an Effort Toward Stunting Management in Indonesia: Delphi and Pilot Study. JMIR Human Factors. 2024 Dec 17;11:e54862.