Child Health Case

Child Health Case

Severely underweight 12-year-old Hispanic girl with underweight parents who has been bullied in school just recently.

Body mass index (BMI) for age is used to classify weight as either underweight or overweight. Nurses and other healthcare professionals are well aware of this health assessment tool and routinely use the tool. Home scales are particularly set to calculate BMI by measuring both the height and weight of both adults and adults. BMI reduction is the focus of many programs that advocate for weight loss, and BMI measurement is carried out in several sporting activities, including annual school sports for children. BMI as a health assessment tool is well-versed with the American culture and widely used across the country for personal and clinical health assessment.

BMI and Its Validity

To calculate BMI, the height of an individual is measured in meters, and the weight is measured in kilograms. To get the BMI, weight in kilograms is then divided by height in meters squared. Paediatrics specifically uses BMI for age as opposed to BMI for adults using the CDC growth charts. BMI percentile growth charts are used to classify children as healthy, overweight, underweight, or obese, depending on the age and sex of the child. A child is classified as underweight when the BMI for the age percentile growth chart is less than the 5^th percentile, healthy if between the 5^th and 85^th percentile. Overweight children have a BMI for age percentile growth chart between 85 and 95, while obese children are above the 95^th percentile. However, BMI is not a diagnostic tool among children and teenagers but only a screening tool to show potential weight and health-related issues. The BMI for age growth chart tool is valid in the prediction of health among children and teenagers because of its high sensitivity, but the tool has low specificity(Gutin, 2018). BMI is a reliable tool for predicting the presence of risk factors for health, such as malnutrition among underweight children.

An Explanation of the Health Issues and Risks Relevant to the Child I was Assigned

In the case scenario given, the child is underweight, meaning that her BMI for age and sex growth chart percentile is below the 5^th percentile. Underweight children are at risk of several health issues because their bodies are less able to tolerate stress to the body, such as infections. Underweight children are at increased risk of developing chronic infections due to decreased immune function. There is a high risk of delayed development and growth among underweight children, including slowed cognitive development compared to children their age (Bourke et al., 2016). Underweight children have a high probability of developing mental illnesses because of low social interaction with fellow children due to chronic fatigue among these children. Children from minority groups such as Hispanics and Latinos are likely to be underweight compared to the general population due to environmental and socioeconomic factors. Children of underweight parents are at risk of becoming underweight because family influences their child’s dietary behavior through the availability and accessibility of foods, meal structure, adult food modelling, food socialization practices, and food-related parenting style (Williams et al., 2017).

Additional Information I Would Need to Further Assess His Or Her Weight-

To further assess the 12-year-old Hispanic girl, there is a need to get more personal and familial history. It is important to get additional information on the feeding habits of the child. Anorexia and bulimia nervosa are common conditions among teenagers, and therefore, acquiring a feeding history will help the clinician understand the feeding habits of the child. Additional information on the child’s overall health will be important to assess her weight-related health. Some chronic diseases impair the absorption of food, leading to being underweight, while some diseases are highly catabolic, causing increased energy demand. Nutritional history will be important to assess the caloric intake of the child. Nutritional history provides clinicians with information on the adequacy of food intake.

Risks

Risk of recurrent infections. There is a risk of recurrent infections among underweight children, and asking for additional information about the past medical history of the child will be important. There is a risk of slowed cognitive development among underweight children. To inquire about this, the clinician needs to ask about the child’s educational level in relation to her age mates (Bourke et al., 2016). Further information about the academic performance of the child will be important. The risk of malnutrition is high among underweight children, and therefore, it is important to do a 24-hour nutritional recall to establish the child’s feeding pattern and nutrition intake.

Three Specific Questions I Would ask about the Child to Gather More Information

1. How many times does the child eat in a day, and the quantity of food they eat?
2. Does the child have any recurrent health issues?
3. How is the performance of the child at school?

Strategies to Encourage the Parents or Caregivers be Proactive about their Child’s Health and Weight

Health education

Educating parents or caregivers on the benefits of maintaining their child’s weight within the normal BMI for age. Teaching the parents how to assess the BMI of their child and explaining the meaning of the obtained results makes them proactive about their child’s health and weight(Smith et al., 2020). When parents clearly understand the implication of the child’s weight on their health, parents become proactive in ensuring the child maintains a healthy weight.

Nutrition counseling

Educating the parents on their child’s nutritional requirements and the different food groups encourages parents to be proactive about their child’s health and weight. The clinician needs to understand the socioeconomic status of the parent or caregiver for them to give objective nutritional advice.

References

Bourke, C. D., Berkley, J. A., & Prendergast, A. J. (2016). Immune Dysfunction as a Cause and Consequence of Malnutrition. Trends in Immunology, 37(6), 386–398. https://doi.org/10.1016/j.it.2016.04.003

Gutin, I. (2018). In BMI We Trust: Reframing the Body Mass Index as a Measure of Health. Social Theory & Health : STH, 16(3), 256–271. https://doi.org/10.1057/s41285-017-0055-0

Smith, J. D., Fu, E., & Kobayashi, M. (2020). Prevention and Management of Childhood Obesity and its Psychological and Health Comorbidities. Annual Review of Clinical Psychology, 16, 351–378. https://doi.org/10.1146/annurev-clinpsy-100219-060201

Williams, J. E., Helsel, B., Griffin, S. F., & Liang, J. (2017). Associations Between Parental BMI and the Family Nutrition and Physical Activity Environment in a Community Sample. Journal of Community Health, 42(6), 1233–1239. https://doi.org/10.1007/s10900-017-0375-y

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