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Management of SAM cases

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 3 replies. You can also reply via email – be sure to leave the subject unchanged.

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Mumuni Abdul-Fataw

Health Coordinator, Plan International Ghana

Normal user

11 Nov 2014, 13:18

In a cluster of about 35 communities without an Inpatient Care center, how would you manage a severely malnourished child with a MUAC or 9.8cm at the community level? Considering the fact that, therapeutic feeds like F-75 and F-100 can not be used.

Anne Walsh

Normal user

13 Nov 2014, 06:52

Is the child able to eat RUTF?

Mumuni Abdul-Fataw

Health Coordinator, Plan International Ghana

Normal user

13 Nov 2014, 09:05

Yes please, the child eats RUTF but not much as expected. One thing I have observed is that, the motherly care is not there at all. The child also missed most of the vaccines or weighing sessions that might contributed to the current situation.

Anne Walsh

Normal user

13 Nov 2014, 10:03

Hi Mumuni,
Is there someone that could be assigned to work on a one to one basis with the mother and child each week to help her with feeding practices, lots of small but often meals of RUTF, giving plenty of fluids (breastmilk if she is still lactating, clean water if not), no other foods except the RUTF at this stage, talking about not sharing the RUTF with others, handwashing. Then monitor the weight of the child carefully. If the child has gained 200g or more after one week then she is doing well, but recovery will take longer than children that come in with a higher MUAC.
If no progress after a week then start discussions with the mother about any options for a short period in a stabilisation centre.
But if the child is taking some RUTF now, you have a good chance of increasing intake just by helping the mother with good RUTF feeding practices.
What discharge criteria are you using in your programme?

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