Underweight in Children

Underweight in Children

Maternal and child malnutrition account for more than 10% of the worldwide illness burden and over a third of all child mortality (Kumar et al., 2019). Poor nutritional quality in infants and parents has protracted health implications and multigenerational low productivity and economic perpetuation.

Despite a rising priority on parental and infant nutrition improvement via different policies, strategies, and programs, the United States has not achieved the desired progress in reducing maternal and child undernutrition, leading to underweight.

According to global research, undernutrition contributes to 45% of under-five fatalities because malnourished and underweight children are more vulnerable to childhood illnesses (Kumar et al., 2019). As a result, lowering underweight can be a significant milestone toward decreasing childhood morbidity and death in the United States. This paper aims to review a case scenario of a 2-year-old who is underweight and has underweight parents and grandparents and come up with the causes, potential risks, and long-term consequences of underweight children.

Numerous variables influence children’s nutritional and developmental milestones, including family socioeconomic status, infant feeding behavior, external conditions, accessibility to health services, and cleanliness practices at the domestic level.

Childhood diseases, such as diarrhea and respiratory illnesses, are significant causes of malnourishment and underweight and are linked to inadequate cleanliness and access to sanitation. Nutritional initiatives and health and sanitation methods such as access to safe drinking water, waste disposal, and clean home fuels, according to Adhikari et al. (2018), can reduce juvenile underweight and child mortality by 14-31%.

Evaluating body mass compared to chronological age is the way to assess underweight in children.  Govender et al. (2021) state that underweight in children below the age of five is classified as a low weight-for-age with a Z-score of -2 s.d. from the standard population’s median.

This disorder is a combination of stunting and wasting, which means that an underweight child may be stunted, wasted, or both. Low weight-for-age indicates being underweight for a given age. Considering weight-for-age is impacted simultaneously by the child’s height and weight, the indicator represents both chronic and acute undernutrition (Measure Evaluation, 2022).

This also measures a population’s health and nutritional risk. Underweight, based on weight-for-age, is the preferred criterion to analyze alterations in the magnitude of malnourishment over time. The proportion of children that have low weight for age can mirror wasting, which is low weight for height, indicating acute weight loss and stunting.

Additional information needed to determine underweight includes the parents’ source of income, the number of meals eaten each day, if proteins, carbs, fats, and oils, as well as fluids, are consumed daily, and their surroundings. To determine underweight, however, there may be considerable inconsistency between weighing scales. For weight, the highest allowable variation between repeated measures is 0.5 kg (Measure Evaluation, 2022). The precision of the weighing tools and the parents’ ability to report the precise age of the kid also contribute to the validity of this indicator.

The underweight health risks overall in children include malnutrition, vitamin deficiencies, anemia, osteoporosis from a lack of vitamin D and calcium, a weakened immune system that makes infection more likely, and growth and development concerns. To acquire a complete knowledge of the child’s health, I will need to collect the patient’s and her family’s body mass index (BMI) to determine if they are healthy or underweight.

Adult BMI is calculated by taking the parents’ weight and dividing it by their height. If the value is less than 18.5, the patient is considered to be malnourished and affirming the child’s diagnosis (CDC, 2020). Concerning the additional information needed, I can sensitively gather the information by looking asking the parents open-ended questions and probing where I need clarification.

I will also avoid culturally sensitive and one-gender-sided questions involving the mother/the females in caring for the child. The health provider needs to ask questions relating to drug abuse, misuse, and overdose as it directly relates to being underweight (Govender et al., 2021).

The following are the specific questions that the clinician should ask the patient’s parents: Does the infant have any underlying health concerns that might cause them to be underweight? (CDC, 2020). How would you characterize your weight (parents)? (CDC, 2020). This inquiry allows the clinician to evaluate the parents’ mental health and rule out eating problems. Are your close relative also really slender? This inquiry will elicit information on genetics as a potential factor for the provider. What do you consume in a regular 24-hour period?

Strategies to employ to encourage the parents to be proactive about their child’s health and weight include promoting a child’s health is to educate the parents about their health and child management. If the parents are unaware of the risk factors linked with their health history, family history, and behaviors, they will not achieve favorable health results. Nutrition education is required in this situation.

The provider must be aware of the patient’s health literacy and work with that knowledge in mind. The second technique involves considering environmental health and sanitation. Children from homes that drink water without any treatment, such as boiling or filtering, were found to be underweight, according to Adhikari et al. (2018).

Poor hygiene and sanitation practices are mostly to blame for child diseases worldwide. Furthermore, poor child care methods and poor hygiene increase vulnerability to childhood illnesses such as diarrhea and worm infestations, which also lead to being underweight.


Poor food quality, inefficient child-care practices, and recurring childhood illnesses are the most common predictors of child malnutrition. According to WHO child development guidelines, all babies and children below the age of five who report to primary health care facilities must be weighed and measured for length/height for their age at each visit to determine their nutritional condition.

Immunization against infectious illnesses in children can help avoid recurrent sicknesses and increase nutritional status. Guardians and relatives of children under the age of five who appear in primary health care institutions should be counseled on the general dietary needs of childhood, as well as basic health and sanitation. Access to basic health, water, hygiene, and sanitation services and opportunities for safe physical exercise are all part of a community-based malnutrition prevention strategy.


Adhikari, D., Khatri, R. B., Paudel, Y. R., & Poudyal, A. K. (2018). Factors associated with underweight among under-five children in eastern Nepal: Community-based cross-sectional study. Frontiers in Public Health5, 350. https://doi.org/10.3389/fpubh.2017.00350

CDC. (2020). Prevalence of Underweight Among Children and Adolescents Aged 2–19 Years: United States, 1963–1965 through 2017–2018. Cdc.gov. https://www.cdc.gov/nchs/data/hestat/underweight-child-17-18/underweight-child.htm

Govender, I., Rangiah, S., Kaswa, R., & Nzaumvila, D. (2021). Malnutrition in children under the age of 5 years in a primary health care setting. South African Family Practice63(1), e1–e6. https://doi.org/10.4102/safp.v63i1.5337

Kumar, R., Abbas, F., Mahmood, T., & Somrongthong, R. (2019). Prevalence and factors associated with underweight children: a population-based subnational analysis from Pakistan. BMJ Open9(7), e028972. https://doi.org/10.1136/bmjopen-2019-028972

Measure Evaluation. (2022). Children aged under 5 years who are underweight. Measureevaluation.org. https://www.measureevaluation.org/rbf/indicator-collections/health-outcome-impact-indicators/children-aged-under-5-years-who-are-underweight.html

Underweight in Children Assignment Instructions


During Week 2 you analyzed diversity considerations in health assessments and applied concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment.

This week, you will explore various assessment tools and diagnostic tests that are used to gather information about patients’ conditions. You will examine the validity and reliability of these tests and tools. You will also examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition.

Learning Objectives


Students will:

  • Evaluate validity and reliability of assessment tools and diagnostic tests
  • Analyze diversity considerations in health assessments
  • Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment
  • Apply assessment skills to collect patient health histories

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.


To Prepare

  • Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
  • By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2).
  •  Based on the Assignment option assigned to you, your Instructor will also assign you assessment tools or diagnostic tests to apply to either an adult or the child health example assigned to you. Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
  • Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
  • Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
  • If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
    • Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
    • Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

Assignment (3–4 pages, not including title and reference pages):


Assignment Option 2: Child Health Issue

Assigned based on letter of last name

Case #2:

  • 2 year old underweight female with underweight parents who are live with elderly grandparents

Last name ( N-T)

Include the following:

This is for Option 2

An explanation of the health issues and risks that are relevant to the child you were assigned.

  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.