Malnutrition and the Family: Deprivation in Kwashiorkor

Abstract

The background to social and emotional deprivation is discussed and applied to a study of kwashiorkor in East African children. A group of 107 children with kwashiorkor was compared with 111 controls. Age, sex and tribe were all found to have significances of their own: fifty of each group were therefore matched for these three factors. Ten other factors were found to be significant in the background of children with kwashiorkor, all of which could be associated with social or emotional deprivation or both (see Table 14). It is concluded that, in childhood, sustained personal care and affection are essential to normal growth. Social and emotional deprivation has been linked with kwashiorkor. This study compares a group of 107 East African children will 11 well-nourished controls carefully selected to minimize possible bias. Unmatched comparison of kwashiorkor patients with controls revealed significant differences as to age, sex and tribe (Table 2). To eliminate these differences, 50 children in each group were matched as to age, sex and tribe. Results of the matching revealed 10 social factors significantly associated with kwashiorkor: 1) attendant not the mother; 2) attendant changed when child was ill; 3) mother pregnant; 4) parents separated; 5) only child of split liaison; 6) weaned; 7) reason for weaning; 8) child living away from parents; (9 child sent away at weaning, and; 10) poverty. The 1st 9 factors are associated with established/impending changes in the child's family structure while factors 6 to 9 affect the child more personally and often painfully. Factor 10 is seen as a continuous source of potential, though not essential, deprivation. Statistical significances were greatest for factors which affect the child's personal/emotional life. With these factors in mind, health educators may set them out as an acrostic, based on the 1st letters of a slogan which could be taught to attendants: A Child Needs Personal Love With Which To Enjoy Protein. This study supports Elsie Widdowson's classic study on deprivation dwarfism (1951) which showed that children's growth can be stunted if food is served without sustained loving care.