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Administration of zinc tablets to severely malnourished children

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 1 replies. You can also reply via email – be sure to leave the subject unchanged.

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Kristyn

Normal user

26 Jun 2014, 08:39

I am a community nutritionist and would kindly ask for the forum to share with me if there any contra-indications in administration of zinc tablets to children with severe malnutrition and having waterly diarrhoea episodes if admitted in the stabilization center.
I would appreciate available guidelines shared with me.

André BRIEND

Frequent user

26 Jun 2014, 09:07

Dear Kristyn,

This issue is discussed in the 2013 update on SAM. See relevant section below:

“children with severe acute malnutrition who have diarrhoea should receive zinc, in the same
way as children who are not severely malnourished. However, children with severe acute
malnutrition who are receiving F-75, F-100 or ready-to-use therapeutic food that complies with the WHO specifications should not be given additional zinc supplements even if they have diarrhoea, as these therapeutic foods contain at least the recommended amounts of zinc for management of diarrhoea”.

http://www.who.int/nutrition/publications/guidelines/updates_management_SAM_infantandchildren/en/

Excessive Zn intake has been associated with increased mortality in a study in Bangladesh. This explains this WHO document prudent attitude in this regard. See:

Doherty CP1, Sarkar MA, Shakur MS, Ling SC, Elton RA, Cutting WA. Zinc and rehabilitation from severe protein-energy malnutrition: higher-dose regimens are associated with increased mortality. Am J Clin Nutr. 1998 Sep;68(3):742-8.

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