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Chapter-34 Management of Severely Malnourished Children

BOOK TITLE: Principles of Pediatric & Neonatal Emergencies

Author
1. Lodha Rakesh
2. Bhatnagar Shinjini
3. Sachdev HPS
4. Choudhury Panna
ISBN
9788184489507
DOI
10.5005/jp/books/11182_34
Edition
3/e
Publishing Year
2011
Pages
15
Author Affiliations
1. AIIMS, New Delhi, India, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, All India Institute of Medical Sciences, New Delhi, e-mail: rakesh_lodha@hotmail.com, AIIMS, Ansari Nagar, New Delhi, All India Institutes of Medical Sciences (AIIMS), New Delhi, India, All India Institute of Medical Sciences, New Delhi, India
2. All India Institute of Medical Sciences, New Delhi, Biology Center, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Gurugram, Haryana, India, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana, India, Center for Diarrheal Diseases and Nutrition Research; All India Institute of Medical Sciences, New Delhi, India, Translational Health Science and Technology Institute, Faridabad, Haryana, India, Biology Center, Translational Health Science and Technology Institute, Gurgaon, Haryana, India, Pediatric Biology Center, Translational Health Science and Technology Institute, Gurgaon, Haryana, India, All India Institute of Medical Sciences, New Delhi, e-mail: shinjini_bhatnagar@rediffmail.com, All India Institute of Medical Sciences, New Delhi, India, All India Institute of Medical Sciences New Delhi
3. Pediatrics and Clinical Epidemiology, Sita Ram Bhartia Institute of Science and Research, New Delhi, Sitaram Bhartia Institute of Science and Research, New Delhi, India, Maulana Azad Medical College, New Delhi, India, e-mail: hpssachdev@hotmail.com, Maulana Azad Medical College, New Delhi, Sita Ram Bhartia Institute of Science and Research, B-16, Qutab Institutional Area, New Delhi, India, Senior Consultant Pediatrics and Clinical Epidemiology, B-16, Qutab Institutional Area, New Delhi, India
4. Lok Nayak Hospital, New Delhi, India, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, New Delhi, India, DII/M 2753, New Delhi, India, Lok Nayak Hospital, New Delhi, Lok Nayak Jai Prakash Narayan (LNJP) Hospital, New Delhi, India, Child Health Foundation; Indian Academy of Pediatrics, New Delhi, India, C5/262, Sector 31, Noida, Gautam Budh Nagar, Uttar Pradesh, India, Lok Nayak Hospital; Indian Academy of Pediatrics, New Delhi, India, Lok Nayak Jai Prakash Narayan Hospital, New Delhi, India, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, D-11/M/2753, Netaji Nagar, New Delhi 110023
Chapter keywords

Abstract

Malnutrition in children is widely prevalent in India. It is estimated that 57 million children are under-weight (moderate and severe). More than 50% of deaths in 0-4 years are associated with malnutrition. The median case fatality rate is approximately 23.5% in severe malnutrition, reaching 50% in edematous malnutrition. There is a need for standardized protocol-based management to improve the outcome of severely malnourished children. In 2006, Indian Academy of Pediatrics undertook the task of developing guidelines for the management of severely malnourished children based on adaptation from the World Health Organization guidelines. The current guidelines recommend in-patient management of all severely malnourished children. The treatment guidelines are divided into ten essential steps: 1. Treat/prevent hypoglycemia. 2. Treat/prevent hypothermia. 3. Treat/prevent dehydration. 4. Correct electrolyte imbalance. 5. Treat/prevent infection. 6. Correct micronutrient deficiencies. 7. Initiate re-feeding. 8. Achieve catch-up growth. 9. Provide sensory stimulation and emotional support. 10. Prepare for follow-up after recovery.

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