Implementing WHO feeding guidelines for inpatient management of malnourished children
Saba Ahmed1, Kiran Ejaz2, Aisha Mehnaz3
1Department of Pediatrics, Indus Medical Hospital, Karachi.
Insights
Adopting World Health Organization (WHO) feeding guidelines improved weight gain in severely malnourished children. However, the case fatality rate remained high, indicating a need for enhanced healthcare services at therapeutic feeding centers.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Severe malnutrition in children is a critical global health issue.
- Effective nutritional rehabilitation strategies are essential for improving outcomes.
- World Health Organization (WHO) feeding guidelines provide a framework for managing malnourished children.
Purpose of the Study:
- To assess the impact of WHO feeding guidelines on weight gain in malnourished children.
- To evaluate the case fatality rate among children treated with WHO feeding protocols.
- To identify factors associated with successful weight gain and mortality in this population.
Main Methods:
- A cross-sectional, observational study was conducted.
- 131 severely malnourished children (6 months to 5 years) were included.
- Nutritional rehabilitation followed WHO feeding formulae, with analysis of demographic, clinical, and mortality data.
Main Results:
- Mean weight gain was 5.25 ± 4.57 g/kg/day.
- Weight gain exceeding 5 gm/kg/day correlated with longer hospital stays and feed acceptability.
- The case fatality rate was 13%.
Conclusions:
- WHO feeding guidelines promote adequate weight gain in hospitalized malnourished children.
- The study highlights the importance of accessible and effective healthcare services within therapeutic feeding centers.
- Further improvements in care are needed to reduce the case fatality rate.
Objective:
To evaluate the efficacy of adopting WHO feeding guidelines on weight gain and case fatality rate in malnourished children.
Study Design:
Cross-sectional, observational study.
Place And Duration Of Study:
Department of Pediatrics, Dow University of Health Sciences, Karachi, from 2009 to 2010.
Methodology:
Patients above 6 months and less than 5 years of age with severe malnutrition were included during the study period, acute complications were treated and nutritional rehabilitation by WHO feeding formulae was done. Demographic details, clinical features, reasons for weight gain and risk factors of mortality were analyzed.
Results:
A total of 131 children were included. Mean age of children was 22 ± 18 months. There were 78% marasmic, 4% kwashiorkor and marasmic kwashiorkor 18% children. Resolution of edema took 8 ± 4 days, dermatosis cleared in 11 ± 3 days. Mean hospital stay was 10 ± 8 days. Case fatality rate was 13%. Mean weight gain was 5.25 ± 4.57 g/kg/day. Weight gain of > 5 gm/kg/day was associated with hospital stay of more than 7 days, acceptability and palatability of feed by the children and mothers and early clearance of infections.
Conclusion:
Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however, adequate healthcare services are available at the therapeutic feeding centers.
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