Marasmus is a serious underweight as a result of malnutrition. It is not the same as kwashiorkor. What is marasmus? Causes of marasmus, the signs and symptoms; treatment of Marasmus, difference between marasmus and kwashiorkor and other important notes on marasmus.
What is Marasmus?
Marasmus means undernourishment causing a child's weight to be significantly low for their age. It is any wasting disease, especially a severe loss of body weight, mostly in children, caused by malnutrition or the inability to digest protein and calories.
Marasmus is a form of severe malnutrition characterized by energy deficiency mostly occurring in children. Though, marasmus can occur in anyone with severe malnutrition but the significant percentage is manifested in toddlers.
A child with marasmus looks extremely thin and wasted that might be confused for kwashiorkor. Body weight is reduced to less than 62% of the normal (expected) body weight for the age.
Marasmus occurrence increases prior to age 1, whereas kwashiorkor occurrence increases after a year and six months(18 months equivalent). One other distinguished fact from kwashiorkor is that, kwashiorkor is protein deficiency with adequate energy intake whereas marasmus is inadequate energy intake in all forms, including protein.
This clear-cut separation of marasmus and kwashiorkor is however not always clinically evident as kwashiorkor is often seen in a context of insufficient caloric intake, and mixed clinical pictures, called marasmic kwashiorkor, are possible.
Protein wasting in kwashiorkor generally leads to edema and ascites , while muscular wasting and loss of subcutaneous fat are the main clinical signs of marasmus.
Marasmus is commonly represented by a shrunken, wasted appearance or underweight, loss of muscle mass and subcutaneous fat mass, affected buttocks and upper limb muscle groups.
Other symptoms of marasmus include:
- unusual body temperature,
- uneven dehydration,
- hypovolemic shock,
- heart failure,
- abdominal manifestations,
- ocular manifestations,
- dermal manifestations,
- chronic diarrhea,
- respiratory infections,
- intellectual retardation,
- distorted growth.
Dry skin and brittle hair are also symptoms of marasmus. Marasmus can also make children short-tempered and irritable.
Causes of Marasmus
Marasmus is caused by a severe deficiency of nearly all nutrients, especially protein, carbohydrates and lipids, usually due to poverty, famine, food insecurity and scarcity of food.
Viral, bacterial and parasitic infections can cause children to absorb few nutrients, even when consumption is adequate. Among the more common types of malnutrition are serious deficiencies in: iron, iodine, zinc, vitamin A.
Marasmus can develop in children who have weakening conditions such as chronic diarrhea as highlighted above.
The body needs calories, protein, and overall general nutrients to function. Without adequate nutrition, muscles waste away, bones become brittle, and thinking become foggy.
Meanwhile, not only the causes, but also the complications of the disorder must be treated, including infections, dehydration, and circulation disorders, which are frequently lethal and lead to high mortality if ignored.
Initially, the child is given dried skim milk powder mixed with boiled water which is then followed by mixing it with vegetable oils and finally sugar. Once children start to recover, they should have more balanced diets which meet their nutritional needs.
Infections are also common in children with marasmus. So, they are also treated with antibiotics. Ultimately, marasmus can progress to the point of no return when the body's ability for protein synthesis is lost.
At this point, attempts to correct the disorder by giving food or protein are futile. With proper nutrition and medical care, the result can be a positive one.
However, the best outcomes occur when a child’s parents or guardians know about the importance of nutrition and how to prepare foods properly.
Healthy weight gain and growth can resume fairly quickly once a child with marasmus starts consuming more: calories, protein, carbohydrates, and other nutrients.