Dépister la dénutrition de l'enfant en pratique courante

Protein energy malnutrition (PEM) occurs when energy and protein intakes do not meet requirements. It has functional and structural impact and increases both morbidity and mortality of a given disease. The Nutrition Committee of the French Pediatric Society recommands to weigh and measure any child when hospitalized or seen in consultation. Body mass index (BMI) must be calculated and analysed according to references anytime growth kinetics cannot be analysed. Any child with a BMI below the third centile or −2 standard deviations for age and sex (1) needs to be examined looking for clinical signs of malnutrition and signs orienting toward an etiology, (2) requires to have his BMI and height dynamics ploted on a chart. PEM warrants to draw a nutritional strategy along with the global care plan. A target weight needs to be determined as well as the quantitative, qualitative and modality of nutritional care. This plan must be evaluated afterwards in order to adapt nutritional therapy.