A 2 year old child shows stunted growth and slow brain development. He has thin limbs and also shows wasting of muscles. There is great oedema and swelling present over his body parts. He has very less amount of fat present beneath his skin. Which of the following could be a reason for the development of this condition in him?

Options

A. Replacement of mother's milk by foods less in total proteins as well as calories at an early age
B. Replacement of mother's milk by foods less in total proteins, but having high calories at an early age
C. Replacement of mother's milk by foods less in total fats, but having high calories at an early age
D. Replacment of mother's milk by foods less in vitamins and minerals, but having high calories at an early age

Answer

To solve the question regarding the condition of the 2-year-old child, we can follow these steps:

### Step 1: Identify the Symptoms
The child exhibits several symptoms:
- Stunted growth
- Slow brain development
- Thin limbs
- Muscle wasting
- Oedema (swelling)
- Very little fat beneath the skin

### Step 2: Understand the Possible Conditions
Based on the symptoms, we need to consider conditions related to malnutrition, particularly protein-energy malnutrition. There are two main conditions:
1. **Merasmus**: Typically occurs in children under one year old, characterized by severe calorie and protein deficiency.
2. **Kwashiorkor**: Usually affects children aged 1 to 5 years, characterized by protein deficiency despite adequate calorie intake. Symptoms include stunted growth, muscle wasting, and oedema.

### Step 3: Analyze the Symptoms in Context
Given that the child is 2 years old and shows symptoms consistent with kwashiorkor (stunted growth, slow brain development, thin limbs, muscle wasting, and oedema), it is likely that he is suffering from kwashiorkor due to protein deficiency.

### Step 4: Evaluate the Options Provided
Now we need to evaluate the provided options to determine which one could lead to the development of kwashiorkor:
1. **Replacement of mother's milk by food less in total proteins as well as calories**: This is more indicative of marasmus, not kwashiorkor.
2. **Replacement of mother's milk by food less in total protein but having high calories**: This is consistent with kwashiorkor, as it involves inadequate protein intake despite sufficient calories.
3. **Replacement of mother's milk by food less in total fats but having high calories**: This does not directly relate to protein deficiency.
4. **Replacement of mother's milk by food less in vitamins and minerals but having high calories**: This does not address protein deficiency.

### Step 5: Conclusion
The most appropriate reason for the development of the child’s condition is the second option: **Replacement of mother's milk by food less in total protein but having high calories at an early age**.