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Therapeutic Feeding Programs .

Therapeutic Feeding Programs. Therapeutic Feeding Programs. Therapeutic Feeding Programs: Entry and Discharge Criteria. Entry: <-3 Z scores (<70% reference median) WFH and/or edema Other anthropometric or clinical signs or lack of appetite Discharge:

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Therapeutic Feeding Programs .

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  1. Therapeutic Feeding Programs.

  2. Therapeutic Feeding Programs

  3. Therapeutic Feeding Programs: Entry and Discharge Criteria • Entry: • <-3 Z scores (<70% reference median) WFH and/or edema • Other anthropometric or clinical signs or lack of appetite • Discharge: • Discharge: >=-2.5 Z scores or >=75% reference median WFH for 2 successive weeks • Good appetite • Free of illness • Dealt with causes at household level to prevent relapse

  4. Therapeutic Feeding Programs • Severe PEM is a medical emergency! Major causes of death: starvation, hypoglycemia, hypothermia. • In cases of kwashiorkor: other medical complications including congestive cardiac failure • Phase 1: Intensive Care Phase (24 hr care – 1 week) • Objectives: control infection, rehydrate, treat malaria, intestinal parasites, septic shock, dermatitis of kwashiorkor, measles immunization and Vit A • Feeding: 10-12 feeds/day with therapeutic milk (F75, F100) • Aiming for 80-100 kcals/kg body weight/day, micronutrients • Continued breastfeeding for infants whenever possible • Phase 2: Rehabilitation Phase (daily care – 5 weeks) • Objectives: Weight gain, train caretaker • Feeding: 6 meals/day with mixture of therapeutic milk and cereal-based porridge based on fortified blended foods, transition to a local diet. Feed as much as the child will eat – aiming for at least 150 kcals/kg body weight/day

  5. Therapeutic Feeding Programs: Program Monitoring

  6. Therapeutic Feeding Programs:Phasing Out • TFP should be phased out as soon as existing health facilities are adequate to care for severely malnourished individuals with appropriate services, follow-up and sensitization are implemented in cases of malnutrition, and no large-scale nutritional deterioration is expected.

  7. Key references • WHO. The Management of Nutrition in Major Emergencies (2000). • Mason, J. Lessons on the Nutrition of Displaced People. J Nutr. 132: 2096S-2103S, 2002 • ACC/SCN. Fourth Report on the World Nutrition Situation (2000). • WHO. Field Guide on Rapid Nutritional Assessment in Emergencies (1995). • ACC/SCN. Assessment of Nutritional Status in Emergency-Affected Populations: Adolescents (2000). • ACC/SCN. Assessment of Nutritional Status in Emergency-Affected Populations: Adults (2000). • Emergency Nutrition Network. Infant Feeding in Emergencies: Policy, Strategy and Practice (1999). • WHO. Management of Severe Malnutrition: A Manual for Physicians and Other Senior Health Workers (1999). • MSF. Refugee Health (1997). • ACC/SCN. Report on the Nutrition Situation of Refugees and Displaced Populations (2001).

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