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Feeding of children after diarrheal epidemic

This question was posted the Infant and young child feeding interventions forum area and has 8 replies.

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Purna Chandra Wasti

Technical Officer at FAO

Normal user

16 Jul 2009, 08:10

Dear network members, Greetings from Nepal. Now, we have encountered with an epidemic of diarrhea in some of the districts of Nepal. Health, water, sanitation and hygiene as well as other humanitarian interventions are in operation. Of course nutrition intervention should also be in action. Now, may I receive any wealth of experience from the field from our network members. With regards, Yours Purna Chandra Wasti National Nutrition Consultant FAO- Nepal.

Tamsin Walters

en-net moderator

Forum moderator

16 Jul 2009, 11:31

From Basil Kransdorff: Good idea,is to make sure the kids get lots of natural fiber and ZINC in a bio-available for. Inorganic zinc supplements will have low benefit. A good source of zinc is pumpkin seeds added in a porridge. Here is an extract of the benefits of zinc. Zinc Supplements Reduce Diarrhea in Drug Users With HIV By C. Vidya Shankar, MD MEXICO CITY (Reuters Health) Aug 08 - Zinc supplements reduce episodes of diarrhea among drug users with HIV, researchers reported at the International AIDS Conference. Persistent diarrhea affects the great majority of patients with HIV/AIDS, resulting in malabsorption, weight loss and reduced survival, Dr. A. Campa from Florida International University, Miami, and colleagues mention in a poster presentation. In their trial, Dr. Campa's team randomized 231 HIV-positive drug users with diagnosed zinc deficiency, 62.3% of whom were on antiretroviral therapy, to receive either zinc supplements or a placebo. Men received 15 mg while women received 12 mg daily for a year. Zinc supplementation cut the episodes of diarrhea in half, Dr. Campa and colleagues found. Specifically, the prevalence of diarrhea was 14.1% and 29.3% in the zinc-supplemented patients and the controls, respectively. Zinc supplements produced a significant benefit even after accounting for confounding factors like HAART, viral load and CD4+ cell counts, the investigators add. Zinc supplementation is a safe and effective adjunct therapy for HIV-associated diarrhea, Dr. Campa and colleagues conclude.

Purna Chandra Wasti

Technical Officer at FAO

Normal user

16 Jul 2009, 11:53

Thanks Basil, I am impressed with pumpkin seeds in porridge idea. Can you share more information on this ( if available). Regards, Wasti

Anonymous 81

Public Health Nutritionist

Normal user

16 Jul 2009, 11:53

Dear Purna Chandra Wasti Sorry i am not yet clear on the question. Is it geting advice on treatment of diarrheal cases or is it know the reason why there is epidemic of diarrhea where health, water, sanitation and hygiene is fine?

Tamsin Walters

en-net moderator

Forum moderator

16 Jul 2009, 12:06

Dear Kiross, My question was regarding the nutritional management of children during the situation of diarrheal epidemic. Regards, Wasti

Anonymous 81

Public Health Nutritionist

Normal user

16 Jul 2009, 12:12

Dear Wasti, Thanks Kiross

Dr Basil Kransdorff - e'Pap Technologies - info@epap.co.za

CEO - e'Pap Technologies

Normal user

16 Jul 2009, 12:38

Hi Puma, - Zinc is important in over 200 enzymic processes in the body. In the case of gut condition - it is especialy important getting the enzymic and probiotic processes back to normality. A healthy gut enviroment will address many of the pathogen threaths that come through the food system. Where people are eating refined foods - the important fibre and cereal fat is normally removed and this contributes to the destruction of the health of the gut enviroment. The outer casing of rice is full of both fiber and cereal fat and in polished rice these important components are removed. In Africa where maize is the main source of carbohydrates, the millers remove the fiber and maize germ taking out many very important nutritional components. Many traditional foods have answers to many of the nutritional problems we are creating through the refining or processing of our food chain. Pumkin seeds is one such item and will send under seperate email directly to you a typical analysis of pumkin seeds. These seeds are a great source of zinc omega fatty acids and also fiber. I have been told but have not seen the clinical evidence that pumpin seeds also act as a natural de-wormer and helps shrink swollen prostrates.. I will also send you an excerlent article on the importance of zinc in the bodies nutritional proceses. The importance of trying to address the nutritional deficiencies through a food state form cannot be emphasised enough. Would be happy to share these issues with you seperatly directly to your email or also on the forum. . Most suppliments that are formulated around inorganic nutrients have little absorption to the body and therefore are not that effective in addressing nutrient defeciencies. Hope this helps.

Nina Berry

IFE Consultant

Normal user

16 Jul 2009, 23:04

Hi Wasti It is really important that families and communities understand that feeding infants less than 6 months old anything (other than breastfeeding) puts them at significantly increased risk of contracting diarrhoea and of developing the most serious complications. They need to be reassured that frequent breastfeeding is sufficient for the first six months of life. Health workers also need to understand this. I often tell them that the only source of potable water for an infant less than six months old is mothers' milk. If the mothers are malnourished or depleted, then the most effective solution is to feed the mothers so that they can feed the babies. If the mother is not available to breastfeed, the option of wet nursing should be explored. (It should also be understood that even when mothers are HIV+, there is good evidence that HIV-free survival rates are higher in babies who are breastfed than in those who are artificially fed.) After six months breastfeeding continues to protect infants and young children from diarrhoea and lower respiratory tract infection so should be encouraged until the child is at least two and for as long as possible after that. Breastmilk is also a really good rehydration solution. Many health workers and communities believe that breastfeeding should be witheld from babies and young children who have diarrhoea. In fact, frequent breastfeeding can both prevent and treat dehydration in most cases. Many infants and young children will tolerate breastmilk when they cannot seem to tolerate anything else. Feeding them frequently helps to maintain nutritional status while they are ill. Breastmilk contains bioavailable micro nutrients including zinc and will also recolonise the gut with natural flora. Hope that helps Nina

Dr Basil Kransdorff - e'Pap Technologies - info@epap.co.za

CEO - e'Pap Technologies

Normal user

17 Jul 2009, 07:21

Just want to support Nina's comments about mothers breast milk - the iron and zinc in breast milk is over 70 times more bio-available than inorganic nutrients such as ferrous suplhate because the iron is in a different form and has a bio-carrrier (food state form)

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