Kwashiorkor as a Edematous Malnutrition and Its Effect on Mental Health

Kwashiorkor, also known as “edematous malnutrition, is caused by an unbalanced diet to very low protein intake, or marasmus. Kwashiorkor is most often apparent in poverish regions experiencing food deprivation. “The diseases usually strikes after weaning, between 1 and 3 years of age. It is common in regions where children get just enough starchy foods but little protein” (Book p. 196). This causes the child’s body to break down protein reserves which results in physical deformities such as belly enlargement, swelling of the feet, hair loss, and rashes. Without proper nutrition in early childhood development, the child will have stunted growth resulting in smaller body dimensions as an adolescent. Kwashiorkor not only causes physical deformities, it also causes a decline in the child’s internal organs, such as the brain, heart, liver, and kidneys.

A report done by BioMed Central found that their patient, an 18 month-old boy with severe malnutrition, developed anuric acute kidney injury. At the time of admission, the patient presented weight loss of a 3 month’s duration and generalized body swelling for the previous 3 weeks. He also was diagnosed with watery diarrhea and fever. He had severe palmar pallor, puffy face, and pedal edema with peeling skin in the lower limbs (#5, p. 1). Kwashiorkor can be treated by adding protein to the child’s diet but with the severity in this case, the child’s health needed to be managed with peritoneal dialysis. Peritoneal dialysis is a treatment of intravenous fluids administered through a catheter to remove waste and toxins from your blood when your kidneys can no longer do this process effectively. “Children with severe acute malnutrition are treated in phases, with the first phase being stabilization with an emphasis on treating infections and replenishing the deficient micronutrients. In this phase, the patients are manily given a Formula 7 diet… after stabilization, patients are fed Formula 100 diet, which is rich in energy and protein for catch up growth” (#5, p.2). After 7 days of this treatment, the child’s condition improved and was able to be discharged after 2 weeks from showing normal kidney size and a balanced nourishment.

This disease also affects other organs as well, such as the brain. “Some argue that the time from early gestation to be the first six months of life is the most critical for brain development, implying that inadequate nutrition during this period would have much more severe effects on children’s cognitive development than would subsequent episodes of malnutrition” (#3, p. 82). Early childhood malnutrition is liable for attention-deficit/hyperactivity (ADHD) and the limited ability to retain knowledge lasting into adulthood. “Learning and behavior are also affected. In one long-term study of marasmic children… the malnutrition probably interfered with growth of neural fibers and mylination, causing a permanent loss in brain weight” (Book p. 197). Malnutrition and intelligence has a correlation with environmental factors as well. Studies show that these cases occur from underprivileged parts of the world where malnutrition has an effect on the mother, which could have negative influences onto her fetus and her newborn child. Under these environments, the mother may also have been affected by her own undernourishment, and the child is brought up in an environment that is not socially and economically stimulating. This impairment induces the child to have lower production of neurotransmitters in the brain leading to lower than standard IQ, intelligence quotient. Intelligence scores are related to the efficiency in the cortical areas of the brain located in the parietal, temporal, occipital, and frontal lobes and in the thalamus, amygdale, and hippocampus. (#4, p. 207). Children who suffer from famine during the critical and sensitive period, early childhood neurodevelopment, has a longitudinal impairment on the child’s analytical or information-processing skills, creative, the capacity to solve new problems, and practical intelligence, application of intellectual skills in everyday situations (Book p. 323-324).

Kwashiorkor is also linked to mental health issues that set out into adulthood. Early childhood malnutrition can result in depression and other behavioral problems in children. In a study done by Lozoff and Brittenham revealed that underweight children who were tested showed noncognitive behavior such as unhappiness and withdrawal in the presence of the examiner, and a lack of focus to the task (#4, p. 206). In another study from the Child Psychology and Psychiatry, a connection was found between poverty and malnutrition to children who portray depressive symptoms. The study addressed two key questions: (1) Is the prevalence of depression symptoms elevated among youth with histories of kwashiorkor and marasmus and (2) To what extent is the association between childhood malnutrition and youth depressive symptoms mediated and/or moderated by maternal depressive symptoms (#1, p. 790).