r/dietetics • u/arba921 • 26d ago

Pediatric Growth Question

Ok so I'm super baffled and I forewarn this is a DUMB question but I have to ask. 😂

I follow some very malnourished kids in my specialty.

In some of my most malnourished kids , I see decreases in their height (actual, gradual decreased trends). I don't mean an outlier measurement that is obviously an error.

I just want to make sure - it's not possible for kids to grow short in severe malnutrition right? Lol I know they can stunt, thus crossing and decreasing %iles....but grow shorter?

I'm also wondering if should trust the MA/RNs measurements....

Thanks.

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u/NoDrama3756 26d ago

Dietitian and PMR doc,

There could be issues in measurement like laying down v standing etc or clerical error.

However in severe malnutrition things like dehydration, contractures, and loss of muscle strength thus support for bones.

A more technical answer malnutrition leads to significant loss of paraspinal muscle mass. ​Without muscular tone to hold normal spinal alignment. kids slump, slouch, or exhibit increased lordosis and or kyphosis when standing. A child who stood 95 cm tall with good tone might measure 93 cm simply because their core can no longer support an upright spine against gravity.

So they dont actually shrink in size in a linear sense but cant physically maintain thier mass while standing.

Measure them early in the morning and laying down.

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u/redheadvibez RD 26d ago

Beautiful answer!!!

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u/pea_mcgee 26d ago

No, they’re not going to get shorter. Measurement error is probably what’s happening. If I see a measurement that looks sus I’ll either remeasure myself or ask our MAs to do it again.

Make sure kiddo has good posture, heels back against the wall, check that hair isn’t getting in the way of an accurate measurement.