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SHARING

SITI YUYUN RAHAYU FITRI

Pediatric Nutrition Care


Identification of potential problem &
nutritional assesment
Estimating nutrient requirement
Determine route of delivery
Formula selection
Monitoring
Communication with patient and families

NUTRITION
ASSESMENT

ADULT VERSUS
CHILDREN

General Systems
Three different system :
Z-score (standard deviation

scores)
Percentiles
Percent of median

Z-score

The best system because of its


advantages compared to the other
methods

oLinear
oSex independent
oFurther computation

Contd
The formula : Z score (or SD score) =
(observed value median value of the
reference population) / SD value of
reference population
Its reffered for children under 5 age
The international reference population
same age and sex
Its adopted from NCHS by WHO

CHARTS (who.int/childgrowth/standard)
..\..\..\Z score\cht_wfl_girls_z_0_2.pdf
..\..\..\Z score\cht_wfh_girls_z_2_5.pdf
..\..\..\Z score\CDC Growth chart girls 2-20 th
P3-97.pdf
..\..\..\Z score\BMI girls.pdf
..\..\..\Z score\cht_wfl_boys_z_0_2.pdf
..\..\..\Z score\cht_wfh_boys_z_2_5.pdf
..\..\..\Z score\CDC Growth chart boys 2-20
th P3-97.pdf

Classification
Z score

Growth indicators
Length/heig
ht-for-age

Weight-forage

Weight-forlength/heigh
t

BMI-for-age

Above 3

obese

Obese

Above 2

Overwight

Overweight

Above 1

Possible risk Possible risk


of overwight of
overweight

0 (median)
Below - 1
Below 2

Stunted

Underweight wasted

Wasted

Below 3

Severity
stunted

Severity
Severity
underweight wasted

Severity
wasted

Interpretasi hasil
Kombinasi

3 indikator

Weight for age ( kurang berat, normal, BB


lebih)Length for age (pendek, normal, tinggi)
Weight for length (kurus, normal, gemuk)

Kategorisasi

status gizi

Normal ( - 2 SD sampai + 2 SD)


Diatas normal ( lebih dari 2 SD diatas median)
Dibawah normal (lebih dari 2 SD dibawah median

Contd
BB - U

TB - U

BB - TB

Interpretasi

Dibawah

Dibawah

Normal

Riwayat kurang gizi, normal

Normal

Normal

Normal

Normal

Di atas

Di atas

Normal

Tinggi, normal

Dibawah

Di atas

Di bawah

Kurang gizi akut

Di bawah

Normal

Di bawah

Kurang gizi akut

Normal

Di atas

Di bawah

Kurang gizi akut

Diatas

Di bawah

Di atas

Gemuk

Normal

Di bawah

Di atas

Gemuk, riwayat kurang gizi

Diatas

Normal

Diatas

Tidak gemuk

BMI / IMT

Body Mass Index (BMI) is a number


calculated from a child's weight and height.

BMI is a reliable indicator of body fatness


for most children and teens.

BMI percentile
(CDC-Center for Desease Control)
Weight Status Category

Percentile Range

Underweight

Less than the 5th percentile

Healthy weight

Overweight

Obese

5th percentile to less than the


85th percentile
85th to less than the 95th
percentile
Equal to or greater than the 95th
percentile

WHO\WHO AnthroPlus\WHO AnthroPlus.exe

Energy Requirement

RDA

Simplest
method
Indirect
calorimetri
Harris-Benedict
(REE)

Age
(Year)

RDA
(Kcal/Kg Wt)

01

100 120

13

100

46

90

79

80

10 12

M : 60 70
F : 50 60

12 18

M : 50 60
F : 40 50

Contoh

Seorang anak laki-laki usia 36 bulan,


dengan TB 96 cm dan BB 15 kg

TERIMAKASI
H