Protein-energy malnutrition is one of the most serious forms of malnutrition. It occurs in infants because breastfeeding or weaning diets are inadequate. As a part of routine child care, a doctor asks the parent or child about the child's diet and food intolerances and examines the child for signs of a nutritional deficiency or disorders that interfere with nutrition, such as malabsorption, kidney disease, diarrhea, and metabolic or genetic diseases. A doctor evaluates the child's growth by observing changes in height and weight and comparing them to normal growth curves. If malnutrition is suspected, the diagnosis may be confirmed by performing blood or urine tests to measure nutrient levels.
Most vitamin deficiencies are rare among infants and children in industrialized countries.
A formula high in polyunsaturated fatty acids increases the vitamin E requirement, particularly for premature infants who absorb vitamin E poorly. Vitamin E deficiency may also occur in children who have disorders that interfere with fat absorption, such as cystic fibrosis and certain genetic abnormalities. Administering excessive amounts of iron may also aggravate vitamin E deficiency. These problems can be corrected by giving vitamin E supplements. Children with intestinal malabsorption may develop severe vitamin E deficiency, which produces a variety of neurologic symptoms, such as reduced reflexes, difficulty in walking, double vision, loss of position sense, and muscle weakness.