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Mother, Infant and Young Child Nutrition and Malnutrition |
Management of Malnutrition in Children Under Five Years
Management of Severe Acute Malnutrition in Children Under Five Years
Admission
Every opportunity should be taken to identify and refer severely malnourished patients at all available contact points within the
health system, including Out-Patient Departments (OPD), mobile clinics and community-based services. Malnutrition screening would be made using
Mid-Upper Arm Circumference (MUAC) tape and
by checking for oedema (see Early
Detection and Referral). Check Admission Procedures Summary of key steps for admission (in-patient - out-patient treatment):
- On arrival, patients should be given sugar water immediately - 10 gr of sugar per 100 ml of water. Patients in clear need of medical attention should be "fast tracked" to have their anthropometric measurements checked so that they can start treatment as soon as possible.
- The following anthropometric measurements should be taken before admission:
and/or
- The following criteria should be present for admission:
Children aged 6 months to 18 years:
or
or
- Patients that have been referred by the community or by peripherals health units but do not fulfil the criteria for SAM should be referred to supplementary feeding programs (if available) or counselled on available nutritional support programs. It is important that caregivers receive some tangible benefit - like a "protection ration" - from coming to the treatment-centre.
- Patients that do fulfil the criteria for SAM and do not require "fast tracking" should perform the appetite test so that further decisions can be made if they will need to commence in-patient or the out-patient treatment.
Check the Summary of Criteria for admission to in-patient or out-patient care
- At admission, it is crucial to explain to the mother/caregiver about the nutrition status of their child and the implications for his/her life.
Admission Room - what you need at a glance Anthropometric equipment (Oxfam Kit 1):
- Infant/child length-height measuring board
- Scale, infant spring-type 25 kg x 100g
- Weighing trousers
- Mid-Upper Arm Circumference (MUAC) tape
- Scale, infant, clinic beam type, 16kg x 10g
- W/H wall-chart
Registration and recording equipment (Oxfam Kit A4):
- Record book
- Multichart
- Identification bracelet
- Milk cards
- Stationary
RUTF for appetite test
Job aids:
- Summary Admission Criteria Table for in-patient or out-patient
- NCHS/WHO W/H and W/L reference table
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02 January, 2009
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