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Refeeding Syndrome in Children Aged 6 to 59 Months with Severe Acute Malnutrition

Abdul Salam Memon1, Muhammad Rafique1,2, Amanullah Lail1,2

  • 1Department of Paediatric Medicine, Civil Hospital, Karachi, Pakistan.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|July 3, 2025
PubMed

Insights

Refeeding syndrome affects 12.4% of children with severe acute malnutrition (SAM). Younger age, shorter height, and specific feeding methods are associated factors, highlighting the need for careful nutritional rehabilitation.

Area of Science:

  • Pediatric Nutrition
  • Clinical Medicine
  • Public Health

Background:

  • Refeeding syndrome is a critical concern in managing severe acute malnutrition (SAM).
  • Electrolyte imbalances can arise during nutritional rehabilitation.
  • Understanding risk factors is crucial for preventing adverse outcomes in malnourished children.

Purpose of the Study:

  • To determine the incidence of refeeding syndrome in children aged 6 to 59 months with SAM.
  • To identify factors associated with the development of refeeding syndrome in this population.
  • To inform clinical practice regarding nutritional support for SAM.

Main Methods:

  • A descriptive, cross-sectional study was conducted in Karachi, Pakistan.
  • 185 children aged 6-59 months with SAM were assessed for refeeding syndrome within 72 hours of nutritional rehabilitation.
  • Statistical analyses included Chi-square/Fisher's exact tests and paired t-tests (p ≤0.05 significant).

Main Results:

  • Refeeding syndrome was observed in 12.4% of the 185 children studied.
  • Significant declines in serum phosphate, potassium, and magnesium were noted in affected children.
  • Younger age, shorter height, and nasogastric/intravenous feeding were significantly associated with refeeding syndrome (p <0.05).
  • Cardiac irregularities were more frequent in children with refeeding syndrome.

Conclusions:

  • Refeeding syndrome occurs in a notable proportion of children with SAM.
  • Risk factors include younger age, shorter stature, and specific routes of nutritional support.
  • Close monitoring of electrolytes and cardiac function is essential during nutritional rehabilitation.
Abstract

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