Document Detail

Critical appraisal of the management of severe malnutrition: 2. Dietary management.
MedLine Citation:
PMID:  16972962     Owner:  NLM     Status:  MEDLINE    
In the dietary management of severe acute malnutrition in children, there is evidence to support the WHO Manual's protocol of cautious feeding of a low energy and protein formula with small frequent feeds in the initial phase of treatment, particularly in kwashiorkor. However, this initial milk diet (WHO F-75) might benefit from increasing the sulphur amino acid, phosphorus and potassium content and reducing the lactose content, but further studies are needed. Careful tube-feeding results in faster initial recovery and weight gain, but has a significant risk of aspiration in poorly supervised settings. Ready-to-use therapeutic food is an important recent advance in the dietary management of malnutrition in ambulatory settings, allowing more effective prevention programmes and earlier discharge from hospital where community follow-up is available. It should be included in future protocols. There is very good evidence on the use of micronutrients such as zinc, and preliminary evidence suggests that smaller doses of daily vitamin A are preferable to a single large dose on admission for severe malnutrition.
David R Brewster
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  42     ISSN:  1034-4810     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-15     Completed Date:  2007-04-06     Revised Date:  2007-09-24    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  575-82     Citation Subset:  IM    
Fiji School of Medicine, Suva, Fiji.
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MeSH Terms
Food, Fortified
Malnutrition / diet therapy*
Micronutrients / therapeutic use
Severity of Illness Index
Reg. No./Substance:
Comment In:
J Paediatr Child Health. 2007 Apr;43(4):320   [PMID:  17444841 ]

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