Treatment of malnutrition

·        Treat/prevent hypoglycemia; all severely malnourished children are at risk of developing hypoglycemia which is an important cause of death during the first 2 days of treatment. If the child is losing consciousness , cannot be aroused or has convulsion , give 5 ml/ kg of body weight of sterile 10% of  glucose intravenously(IV), followed by 50 ml of 10% glucose or sucrose by nasogastric (NG) tube.  

·        Treat/prevent hypothermia; if the rectal temperature is below 35.5 ͦc or under arm temperature is below 35 ͦc, the child should be warmed. Either use the “kangaroo care technique” by placing the child on the mother’s bare chest or abdomen and covering both of them, covered with a warmed blanket.

·        Treat/prevent dehydration and Correct electrolyte imbalance; whenever possible, a dehydrated chid with severe malnutrition should be rehydrated orally. IV infusion easily causes over-hydration and heart failure and should be used only when there are definite sign of shock.

·        Treat/prevent infection /deworming; all severely malnourished children should be given their treatment for bacterial infection, measles and viral infections etc.

·        Correct micronutrient deficiencies; different deficiency such as vitamins A, D, E, K and iron, zinc etc should be corrected.

·        Initiate refeeding; Breast feeding, extra diet supplementary foods are provided balanced diet, making food pyramid etc.

·        Facilitate catch up growth.

·        Provide sensory stimulation and emotional support; severely malnourished children have delayed mental and behavioral development, which, if not treated, can become the most serious long term result of malnutrition. Emotional and physical stimulation through playing game and other activities can substantially reduced the risk of permanent mental retardation and emotional impairment.

·        Prepare for follow up after recovery;  Suitable education is provided of their parent for follow up, child should be fulfill their criteria for discharge such as eating well, gaining weight, all infection were treated , able to talk and walk etc.