Management of Malnutrition in Children Under Five Years
Management of Severe Acute Malnutrition in Children Under Five Years
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).
MUAC Resources - Sources for MUAC Straps
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:
- The following criteria should be present for admission:
Children aged 6 months to 18 years:
- 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
- Identification bracelet
- Milk cards
RUTF for appetite test
- Summary Admission Criteria Table for in-patient or out-patient
- NCHS/WHO W/H and W/L reference table
A short training video on the RUTF appetite test (following the WHO guidelines) is also available here.
16 December, 2017