Being underweight in children can have serious consequences

Being underweight in children can have serious consequences

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Underweight in children - an underestimated problem

Research has shown that more and more people in Germany are overweight or obese. Many children are too fat. But some are too thin or too small for their age. Unfortunately, too little attention is still paid to the problem of underweight in children.

Underweight among children is a frequently underestimated risk in Germany. It is usually associated with considerable health risks, since then the supply of essential nutrients and / or trace elements is usually not guaranteed. In a recent statement, the Child Health Foundation provides information about a neglected problem with sometimes serious consequences.

An accompanying symptom of long-term or chronic illnesses

The so-called "generation fries" has been dealing with medical professionals and the public for years. And for good reason: The alarming increase in overweight due to fast food and sweet drinks threatens the health of more and more children and adolescents.

On the other hand, children who are too thin or too small for their age receive much less attention. There are still major deficits in the care of these children in Germany: Their problems are often not recognized and not dealt with consistently, complains the Child Health Foundation in its statement, which can be downloaded from its website.

“When we talk about underweight, the first thing we automatically think of is the many children in developing countries who suffer from hunger and poor living conditions,” says Prof. Dr. Berthold Koletzko, Head of the Metabolic and Nutritional Medicine Department at the University Children's Hospital in Munich and Chairman of the Child Health Foundation.

"Underweight among children and adolescents is also more common in Germany than most people think. With one big difference: The underweight of children in the Third World is usually a result of poverty and malnutrition. In contrast, in the children in this country it often has nothing to do with a lack of food: it is often an accompanying symptom of long-term or chronic illnesses. "

According to the foundation, the extent of the problem is really visible in children who need hospital treatment. An example was recently provided by an examination of 475 children in the children's clinic at the University of Munich. Every fourth child in the Dr. had to be admitted to Haunersche Children's Hospital was underweight.

"Data from the past twenty years shows that every third to fourth child in European hospitals is moderately to severely malnourished," explains Professor Koletzko. "This is a condition that we doctors are not allowed to accept."

Premature babies are particularly at risk

According to the experts, premature babies and chronically ill children and adolescents have a particularly high risk of poor nutritional status. Children with congenital heart defects, cystic fibrosis and various gastrointestinal disorders are also often affected.

"The effects of malnutrition are even more serious in children than in adults," says Prof. Berthold Koletzko. Because malnutrition in the first two years of life can hinder brain development and thus intellectual development. In the first five years of life, it can also weaken the immune system and thus lead to an increased susceptibility to infections.

Other consequences of malnutrition include growth disorders, delayed sexual maturity, delayed wound healing, reduced bone density and muscle mass, and short stature.

"The possible consequences of malnutrition also include significant delays in development, increased mortality and a severe reduction in the quality of life of the affected children and adolescents," explains Professor Koletzko.

Deficits in medical practices and children's hospitals

But why is the problem of malnutrition being neglected by many doctors? The Child Health Foundation identifies the following deficits in medical practices and children's hospitals:

  • The height and weight of children and adolescents are often not consistently measured and evaluated. As a result, the child's nutritional status is not correctly assessed.
  • Malnutrition and the necessary handling of it are usually not adequately taken into account in the training of health professionals.
  • There is a shortage of staff and a lack of time in the children's clinics in Germany. Even if there is sufficient data for the children's deficiency, knowledge does not always lead to the correct diagnostic and therapeutic steps.

Therapy of the causal disease

And how do you get the linnets up again? The prerequisite here is the therapy of the disease, which is causally involved in the child's underweight.

If underweight is the result of inadequate, incorrect or one-sided nutrition, loss of appetite or eating disorder, a change in diet to a high-calorie diet can help. To eliminate the deficit, foods are then allowed that are actually considered to be real fattening foods.

“In infants, the concentration of the amount of food powder can be increased as a simple method. However, this leads to an unbalanced diet and stresses the kidneys. So-called balanced therapeutic baby foods with a high energy content are more suitable. The food of toddlers and schoolchildren can be enriched with cream, margarine, butter, vegetable oils and maltrodextrin, ”explains Professor Koletzko.

Thickeners medically recommended

The Foundation for Child Health recommends the following procedure for domestic use:

  • The food should be attractive and tasty and may contain plenty of butter or oil.
  • Meals should preferably be taken with the family in a positive atmosphere. Conversations during meals should include children.
  • Special treatment of the sick child towards his siblings and constant admonition to eat should be avoided as far as possible.
  • For underweight young and school children, the addition of fats (cream, margarine or butter, vegetable oils) and carbohydrates (maltodextrin) is suitable for food enrichment. The frequent giving of high-energy snacks, for example homemade milkshakes, ice cream with cream, chocolate and muesli bars, almond or nut butter, potato chips and other high-energy bites, is particularly effective.

If adequate weight gain is not achieved with domestic measures alone, energy-rich drinking foods can be very helpful. The parents should be advised in detail by a nutritionist. According to the information, the often rather high costs for such foods are medically reimbursed by the statutory health insurers.

Children should be weighed and measured at regular intervals

In view of the inadequate knowledge of nutritional medicine among doctors and other members of the health professions, the Foundation for Child Health demands funding for training and further education in the field of nutritional medicine in order to increase the competence of medical students, doctors and nurses.

All children and adolescents should be weighed and measured at regular intervals in pediatric practices and clinics. In addition, the course of the disease should be documented and information on the child's nutritional status should be given in each discharge letter from the clinic.

"It is crucial that not only measurements are made, but that conclusions are also drawn from the measured values," says Prof. "If malnutrition actually exists, its causes must be clarified as precisely as possible so that the affected child can also be treated adequately. "(Ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Children's Health Foundation: Underweight in children - an underestimated risk, (accessed: January 13, 2020), Children's Health Foundation

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