Diet plays a crucial role in the management of a case of proteinenergy malnutrition. Severe malnutrition is best managed in the hospital as such cases usually have lifethreatening complications. When the child is critically ill, a cautious approach to feeding is vital. By the end of the first week the acute problems have usually been overcome and oral feeds should be introduced. In the rehabilitation phase, the emphasis is on weight gain and so a more vigorous approach is needed. Upto 200 kCal/kg/day has to be given for maximum ‘catchup growth’. Transfer to family type diet is an important final step in rehabilitation before the patient is discharged from the hospital.
Mild to moderate cases of malnutrition can be treated at home or in a nutrition rehabilitation centre. Important aspects of domiciliary treatment are nutritioneducation for the mother and feeding the child ‘from the family pot’ with close supervision and encouragement.
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