Undernutrition, which includes stunting and underweight
THE IMPORTANCE OF NUTRITIONAL ASSESSMENT
AND INTERVENTION FOR THE CLINICAL OUTCOMES OF PAEDIATRIC PATIENTS
Malnutrition refers to deficiencies, excesses, or imbalances in the intake of energy and/or nutrients.1
Malnutrition can occur in both under and overweight patients. The term malnutrition addresses1:
Undernutrition, which includes stunting and underweight
Micronutrient-related malnutrition, which includes micronutrient deficiency or micronutrient excess
Overweight, obesity and diet-related non-communicable diseases
There are many clinical and socio-economic causes of malnutrition in children, including2-3:
Chronic illness
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Medication / treatment
Food insecurity
Behavioural or psychological conditions
Food refusal and ARFID
Neglect and abuse
Malnutrition is common in children and it can be costly:
1 in 3 children
are not growing well due to
malnutrition4
Up to 15%
of children in the UK are
malnourished5*
This costs the NHS in England
up to an additional
£1.2BN per year6
*Children already accessing healthcare services
This can have devastating consequences for paediatric patient outcomes7-9:
In 2023 more than 400,000 children are reported to be waiting to see paediatric specialists within the UK, with 18,000 waiting over 1 year for treatment.10
Identifying malnutrition early is vital to provide timely and appropriate nutritional intervention.11 Nutritional assessment and screening is a quick and simple way to identify malnutrition12 and is advocated by The World Health Organisation (WHO)13, Care Quality Commission (CQC)14 and NHS England.15
Studies show that identifying malnutrition early can16:
Improve patient
outcomes
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Help save costs
Reduce length of
hospital stays
Despite the importance of screening for malnutrition, there are often systematic barriers, which can make screening difficult, including:17
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QUICK AND SIMPLE NUTRITIONAL AWARENESS AND SCREENING TOOLS
Pedi R-MAPP is a validated, easy-to-use digital nutritional awareness tool that supports HCPs in completing a nutrition-focussed consultation. It can be used by any healthcare professional, on any part of the patient pathway, either during remote consultations, or as part of a face-to-face appointment.
With just 8 simple steps, it can be completed in as little as 2 minutes and is easy-to-use as part of routine clinical appointments.
STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics) is a validated nutrition screening tool for use in hospitalised children from 2 weeks to 16 years of age. It is quick and easy-to-use, with just 5 simple steps to follow.
It has been developed to aid the early identification and treatment of malnutrition in hospitalised children and is intended for use by all healthcare professionals as part of patients’ routine treatment.
MUAC Z-score tapes are a simple, inexpensive and easy way to measure malnutrition risk in children. It is a helpful nutritional assessment for all children as changes over time, particularly for very large or very small children, are easier to understand in order to track the progress of nutritional intervention.
MUAC Z-score tapes are available to support screening in both primary and secondary care settings and can be obtained via your Abbott representative.
The management of malnutrition in paediatrics is shown to have significant benefits, particularly for children with underlying medical conditions:
Nutritional interventions should always be tailored to the child. Oral routes should be tried initially but if oral intake is not possible due to underlying disease or treatment, enteral tube feeding should be considered.19
Similac High Energy is a nutritionally complete formula for infants and young children aged 0-18 months or weighing up to 8kg. It is scientifically developed to promote catch-up growth through optimal levels of energy, vitamins and minerals compared to standard formula for infants and young children.22 Additionally it supports brain development and provides excellent tolerance.23-26
IMPORTANT NOTICE: Breastfeeding is best for babies, and is recommended for as long as possible during infancy. Similac High Energy is a Food for Special Medical Purposes and should be used under the supervision of a healthcare professional.
The PaediaSure range of oral and tube nutritional supplements provide complete and balanced nutrition for children with disease-related malnutrition and faltering growth.
Footnotes:
*Similac High Energy is suitable as sole source of nutrition for oral and enteral feeding of infants and children up to 8kg in weight (or 18 months of
age).
‡ Based on UK DRVs, Department of Health, excluding electrolytes chloride, potassium and sodium.
^Claim pertains to both palm oil and palm olein oil
**Oral Nutritional Supplements
†Independent, head-to-head testing for PaediaSure, PaediaSure Plus, PaediaSure Fibre, PaediaSure Plus Fibre, PaediaSure Peptide vs Fortini or Frebini Energy or Peptamen Junior Powder and PaediaSure Compact.
***Medium Chain Triglycerides.
ARFID - Avoidant Restrictive Food Intake Disorder
HCPs - Healthcare Professionals
References:
1. WHO, 2021: Malnutrition. Available online: https://www.who.int/news-room/fact-sheets/detail/malnutrition. Last accessed February 2023.
2. Larson-Nath C et al. Nutr Clin Pract 2019;34(3):349–358.
3. NHS, 2020: Malnutrition. Available online: https://www.nhs.uk/conditions/malnutrition/causes/ #:~:text=Some%20children%20may%20become%20malnourished,in%20poverty%20or%20being%20abused. Last accessed February 2023.
4. UNICEF, 2019: The changing face of malnutrition. Available online: https://features.unicef.org/state-of-the-worlds-children-2019-nutrition/. Last accessed February 2023.
5. BAPEN, 2015: The cost of malnutrition in England and potential cost savings from nutritional interventions (short version). Available online: https:// www.bapen.org.uk/pdfs/economic-report-short.pdf. Last accessed February 2023.
6. BAPEN, 2015: The cost of malnutrition in England and potential cost savings from nutritional interventions (full report). Available online: https:// www.bapen.org.uk/pdfs/economic-report-full.pdf. Last accessed February 2023.
7. Tette E et al. BMC pediatrics 2015;15:189.
8. Martins V et al. Int J Environ Res Public Health 2011; 8(6):1817–1846.
9. Stanga Z et al. Clin Nutr 2007; 26(3):379-382.
10. RCPCH, 2023. Record high: Over 400,000 children waiting for treatment amidst child health crisis. Available online: https://www.rcpch.ac.uk/news-events/news/record-high-over-400000-children-waiting-treatment-amidst-child-health-crisis#:~:text=Record%20high%3A%20Over%20400%2C000%20children%20waiting%20for%20treatment%20amidst%20child%20health%20crisis,-11
%20May%202023&text=Startling%20new%20data%20reveals%20that,currently%20on%20the%20waiting%20list. Last accessed August 2023..
11. Reber E et al. J Clin Med 2019;8(7):1065.
12. McCarthy H et al. Journal of Human Nutrition and Dietetics 2012;25(4):311–318.
13. WHO, 2017: Assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition. Available online:https://apps.who.int/iris/bitstream/handle/10665/259133/9789241550123-eng.pdf. Last accessed February 2023.
14. CQC, 2022: Regulation 14: Meeting nutritional and hydration needs. Available online: https://www.cqc.org.uk/guidance-providers/regulations- enforcement/regulation-14-meeting-nutritional-hydration-needs. Last accessed February 2023.
15. NHS England, 2015: Nutrition and Hydration. Available online: https://www.england.nhs.uk/commissioning/nut-hyd/. Last accessed February 2023.
16. Agostoni C et al. Journal of Pediatric Gastroenterology and Nutrition 2005; 41(1):8–11.
17. Browne SI et al. Clin Nutr ESPEN 2021;44:415–423.
18. WHO, 2020. WHO report on cancer: setting priorities, investing wisely and providing care for all. Available online: https://www.who.int/publications/ i/item/9789240001299 Accessed July 2022.
19. Bauer J, Jurgens H, Fruhwald M. Adv. Nutr 2011;2:67-77 2011.
20. Penagini F, et al. Nutrients 2015;7:9400-9415
21. Selimoglu MA, et al. Front. Pediatr. 2021;9:610275.
22. Clarke S. E. et al. J Hum Nutr Diet. 2007;20(4):329-39.
23. Auestad N et al. Pediatrics. 2001;108(2):372-81.
24. Auestad N et al. Pediatrics. 2003;112(3):177-83.
25. Auestad N et al. Pediatric Research. 1997;41(1):1-10.
26. Williams T et al. JPNG. 2014;59(5):653-658.
27. Based on June 2022 community prescribing data.
28. Data on file. Abbott Laboratories Ltd., 2007 (PaediaSure Plus & PaediaSure Plus Fibre taste testing).
29. Abbott Laboratories Ltd., 2017 (Sensory research and evaluation: PaediaSure Plus vs. PaediaSure Compact).
30. Data on file. Abbott Laboratories Ltd., 2013 (PaediaSure & PaediaSure Peptide vs. Peptamen Junior Powder).
31. MIMS, July 2023
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Added to Bag
ENSURE PLUS
1 x 220 ml
Flavor: Apple
1,5 kcal / ml
Nutrition Information
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| Unit | Per {ml-col-1} ml | Per {ml-col-2} ml |
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