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Weight Gaining

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Moses Cowan

Nutrition Officer

Normal user

31 Aug 2014, 02:34

1. what is the average weight gain per child on RUTF when given correctly per week? in the treatment of severe acute malnutrition?

Mark Myatt

Consultant Epideomiologist

Frequent user

1 Sep 2014, 09:00

Response to treatment might be measured as:

Weight velocity ... This is usually 4 to 5 g/kg/day (median)

MUAC velocity ... we might expect a MUAC gain of about 0.3 mm to 0.4 mm / day (median). Detail of calculations are shown in most CMAM guidelines and in MSF's Nutrition Guidelines.

The velocity measures are usually expressed "per day" rather than "per week". You can multiply by 7 to get a "per week" expectation but this is almost never done.

Velocity measures are usually taken over an entire treatment episode. Growth / recovery often follows a "logistic" curve. Here is an example:

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The same pattern is often seen with MUAC response. With this response we have different velocities over time (fast then slowing to normal growth). This means that the velocity figure means different things at different times in the treatment episode. Usually we just monitor weight or MUAC at each contact and hope for a gain between contacts (individuals) and calculate a median velocity for all cases as a program performance statistic.

Children requiring phase I stabilisation may exhibit only small gains in the first few days of treatment.

Children with oedema will exhibit weight loss (or slow weight gain) as oedema is lost.

Note that it is not just RUTF. Standards are bases on the full CTC protocol which includes a antimicrobial. Weight or MUAC gain in a child with untreated infection will likely be slow, absent, or negative.

I hope this is of some use.

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