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Guidelines)
deepak ugra
email: deepakugra@hotmail.com
The Academy shall strive for the achievement of the optimum growth, development and health in the physical, emotional, mental, social and spiritual realms of all children irrespective of diversities of their backgrounds
MUAC is a simple measure - Good quality, non-stretchable, long lasting MUAC tapes to be available at every health facility.
Rehabilitation
Weeks 2-6
Hypoglycemia
Hypothermia Dehydration
Electrolytes
Infection Micronutrients
no iron with iron
Cautious feeding
Catch-up growth Sensory stimulation
F-75 can be used as an initial starting formula in the acute phase, F-100 in the rehabilitation phase.
If the childs appetite is poor, nasogastric/ gavage feeding should be given initially
IAP recommends F-75 and F-100 equivalents both milk and cereal based
Indian Pediatr 2007; 44: 443-461
NB: Full cream cows milk can be also be used
* To be added to diet Use water to make up to 2500 ml. If available, also add selenium (0.028 g of sodium selenate, NaSe4.10H20) and iodine (0.012 g of potassium iodide, KI) per 2500 ml. Add 20 ml of the solution to a litre of diet
Feeding below 6 mo
Breastfeeding should be encouraged if there is prospect of continuing/reinitiating BF. Supplemental suckling technique can be used to support and enhance breastfeeding. F-75 if there is no prospect of continuing or re-initiating breastfeeding
Outpatient Care
Before
After
Consistent weight gain on oral feeds and has no medical complications. Babies on breastfeeding should be showing this weight gain Training and involvement of the mother/ caretaker is an important aspect of inpatient care After discharge the child should be referred for further care to the appropriate OTP center
In- & Out patient care: One Integrated Program Integrated with other existing health programs Trial in high-risk areas; scaling up the program Monitor no. of beneficiaries, mortality reduction It is necessary to encourage indigenous commercial production of RUTF/F75/F100 with strict quality control
Research Priorities
Appropriate starter diet, catch-up diet and ready-to-use therapeutic food need to be encouraged Programmatic Research for assessing the cost-effectiveness of various interventions used in the program
Role of IAP
Providing technical advice to the government regarding appropriate interventions and in formulating management guidelines and training modules Assisting by conducting training programs Public awareness and media participation Recommend MCI/Universities to include management of SAM in the medical curriculum