A First Step Towards Eliminating Malnutrition: A Proposal for Universal Nutrition Screening in Pediatric Practice

Background: Childhood malnutrition remains far too common around the world today. In this paper, we discuss pediatric malnutrition in the context of protein-energy undernutrition and hidden hunger (single or multiple micronutrient deficiencies). Recent growth statistics show that nearly 150 million children under 5 years are stunted, and 50 million are wasted. At the same time, millions more children experience undernutrition of lesser severity but with negative effects on growth nonetheless. Beyond poor growth, such nutrient shortfalls can predispose children to impaired physical and mental development, which may have lifelong consequences. The World Health Organization recently set an aspirational goal "to end all forms of childhood malnutrition by 2030." Plan of Action: Our paper proposes a stepwise strategy to raise awareness of childhood malnutrition risk and to work toward building a consensus on pediatric malnutrition screening as a pathway to ending childhood malnutrition. In a full plan for action, we propose to convene an expert Working Consensus Group on Pediatric Nutrition Screening (WCG-PNS). We propose that this group will work to (1) identify malnutrition screening tools specific for universal screening of children in hospital and community settings, (2) plan and lead healthcare professional training on how to screen for malnutrition risk, then take appropriate follow-up steps, (3) guide and advise quality improvement programs (QIPs) to facilitate incorporation of nutrition screening and interventions into everyday practice, and (4) measure and communicate potential findings in terms of health and financial outcomes. Conclusion: We recognize an urgent need for universal screening of infants and children for nutritional risk--around the world and across the continuum of care. Such screening is expected to promote early identification of children who can benefit from nutrition interventions, then ensure that these children get needed nutritional support. In this way, we aim to prevent growth impairment, which has also been associated with adverse effects on mental and physical development. Keywords: malnutrition, pediatrics, nutrition screening, nutritional interventions, undernutrition, clinical outcomes