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What first? Medical treatment or Nutritional treatment.

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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Suhail

Normal user

12 Aug 2015, 17:19

If a child does not recover from SAM due to illness, what should be done in that case? He should be treated for illness first? Will the medical treatment be effective in absence of nutritional treatment?

Veronika

International Health Consultant

Normal user

13 Aug 2015, 08:40

I see in clinical practice that undernourished patients recover much slower from their illness even when they receive proper medical treatment. In contrary when patients receive proper nutritional treatment we see that medical treatment has more effect and leads to faster and more pleasant recovery. For optimal and fast recovery from illness medical and nutrition treatment should therefore run parallel to each other. Ideally nutritional anamneses and treatment should start the same day as the medical treatment and continue in accordance with medical indications. Medical treatment always has priority in case of indications that significantly influence nutritional advice or indicate nutrition intake limitations. Therefore nutritional treatment should be adapted conform medical indication. Mind! Adapted not terminated!!! In most cases in practice I see however that those two treatments can run next to each other very well and provide most health gain when used together. An important notice is that nutritional treatment has to support medical treatment and anticipate on medical treatment change; therefor those two should be seen as equal parts of treatment process where nutritional indications anticipate on medical indications.

Suhail

Normal user

17 Aug 2015, 11:22

Thanks Veronika Polozkova for your opinion. Unfortunately both options together are not available at many places. Clinicians do not consider nutritional treatment important. Therefore children died even medical treatment given to them for acute illness.

Rosemary Atieno

Nutritionist- MOH

Normal user

18 Aug 2015, 16:08

Hi Suhail,
From practice l would consider the status of the child if the child can take orally you initiate F75 or sugar water while the child awaits treatment to reduce hypoglycemia. l agree that a patient takes long without nutritional support due to the fact that drug binders and transporters are protein in nature. My advice is start nutrition therapy and initiate drugs as soon as possible it gives good results

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