What nutritional rehabilitation is required?

This phase of treatment starts when the appetite improves and the child is looking better:

  1. Once the appetite has returned and any oedema has improved, a weaning (follow-on) formula with a higher protein content can be started in infants. As the older child improves, porridge and mixed foods, especially maize, beans and dried peas, can be started. Vegetable oils can be added for energy. A high energy and protein diet is needed. Start introducing solid foods slowly. During this phase, children are often very hungry and take a lot of food. The first sign of recovery is when the child starts to smile.
  2. Continue folic acid 5 mg daily for 5 days.
  3. Continue multivitamin syrup 10 ml daily.
  4. Treat for worms with mebendazole 100 mg twice daily for 3 days and metronidazole (Flagyl) 7.5 mg/kg 8 hourly for 7 days for Giardia.
  5. Oral iron 6 mg elemental iron/kg/day for 12 weeks, starting ONLY when the child is gaining weight and any oedema has disappeared.
  6. Monitor daily weight gain.

A blood transfusion is only used for severe anaemia with associated cardiac failure. Extra magnesium is often added to feeds.

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