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Is there a special protocol and a special therapeutic food for mild malnutrition treatment?

This question was posted the Management of wasting/acute malnutrition forum area and has 4 replies.

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MOHAMMED AL-OTHMANI

Make Hope for Development

Normal user

5 Dec 2022, 18:10

Is there a special protocol and a special therapeutic food for mild malnutrition treatment?  

Mark Manary

Washington University School of Medicine

Technical expert

19 Dec 2022, 13:59

There is no protocol or specialized food for mild malnutriiton.

Unlike moderate or severe malnutriiton, I define mild malnutrition as acute weight loss.  Unless there is a conscious effort to lose weight, the most common causes have to do with an acute illness.  Could be an infection, or a thyroid problem or malabsorption. Taking an approach that does not assume food insecurity as the primary cause is a better approach.

A healthy diet, translated to a context appropriate, realistic diet, is what is recommended.  

MOHAMMED AL-OTHMANI

Make Hope for Development

Normal user

19 Dec 2022, 22:34

Thanks Dr Mark Manary for your response

Anonymous 40504

Normal user

20 Dec 2022, 02:46

Surely , answering MAM (Moderate Acute Malnutrition) through case management requires a multi factors approach.The one include: medical, psychological , family environmental background such as poverty, illiteracy. All mixed with a strong climate change pressure and less resillience communities. We should have a protocol in such context, to facilitate cost reduction, chance to increase volume of person to be treated and be able to have a integrated answer considering normal life constraints. Our children are malnourished because our communities are sick.

Spencer Rivadeneira Danies

pediatra Hospital Nuestra Señora de los Remedios

Normal user

25 Jan 2023, 16:38

Saludos. 

Excelente pregunta, a la cual me uno.

En La Guajira colombiana, donde murieron 85 niños por desnutrición aguda, durante 2022, frecuentemente encontramos niños con "riesgo de desnutrición", incluso cercanos a -2 DE del indicador peso para la talla/longitud; en un contexto de inseguridad alimentaria grave. Para ellos, no tenemos directrices claras y son sometidos a diversas intervenciones no estandarizadas. Muchos de estos niños, en corto plazo, están en desnutrición aguda moderada o, incluso, severa. Esto es lamentable.

Hemos propuesto lo siguiente:

1.- Cambiar la denominación "riesgo de desnutrición", por desnutrición aguda leve.

2.- No suspender el alimento terapéutico cuando el niño alcanza -2 DE, sino pasar de Plumpy nut a Plumpy doz, hasta que la puntuación Z del indicador P/T- L sea > de -1 DE. 

3.- Iniciar Plumpy doz, en todo niño con P/T - L con desnutrición aguda leve, así no venga de un tratamiento para desnutrición aguda moderada.

Hoy estamos en espera de las nuevas directrices del Ministerio de Salud, donde se aprueban estas sugerencias.

Espero sus valiodos comentarios al respecto.

Mil gracias.

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