Definition:

It is a severe form of protein malnutrition. It is not seen in breast fed infants.

Causes

(1) The factors which predispose to marasmus are a rapid succession of pregnancies and early/often abrupt weaning, followed by dirty artificial feeding of the infants with very dilute milk given in inadequate amounts to avoid expense.

(2) Mo less infant.

(3) Lack of food in a family,

(4) Prolonged starvation as a part of treatment of diarrhoea.

(5) Unsterilized feeding bottles leading to infective diarrhoea.

(6) Failure of lactation with no suitable alternative to breast feeding.

Signs and Symptoms

(I) Retardation which is much more marked than that of length.

(2) wasting and subcutaneous fat

(3) In severe cases, emaciati0

(4) Skin, esp. around the buttocks, loose & wrinkled,

(5) Abdomen protuberant.

(6)Face drawn and monkey like

(7) Appetite normal or increased.

(8) Patient is quite, calm and quiet but crying all the time.

(9) Eyes are sunken, anterior fontanelle may be depressed

(10) Limbs are 00ia & body temperature is subnormal.

(11) Intercurrent infection is common.

(12) Features of the underlying disease may be present.

Treatment

(I) Diet should contain adequate calorie, high protein.carbohydrates, minerals, vitamins etc..

(2) Prevention is a complex arid difficult problem. Education of mothers that they Will continue breast feeding for as long as possible is of the greatest importap

(3) Weight,should be recorded after every fortnight. Gradually solid foods bake boiled rice, fish, vegetables etc. are to be added

(4) Treatment of intercurrent infection, if present.

(5) Treatment of identifying cause.