A catch up growth chart

Severely malnourished children should stay in hospital for as short a time as possible to minimize the harmful effects of separation from their families and institutionalization and to ensure that scarce hospital beds are used efficiently. Repletion of wasting, that is, attainment of ideal or expected weight-for-height (EWH) has been recommended as the criterion for recovery from PEM. As it may be impractical to measure length, a simple visual means of monitoring the progress of children recovering from PEM is needed. A "catch up" growth chart was devised, based on the mean deficit in weight-for-height of 2-3 kg of 827 children admitted to the ward of the Tropical Metabolism Research Unit (TMRU) in 1958-1976. This deficit was restored in 10.3 (ñ3.95 SD) weeks by a subsample of 52 recent admissions, a rate of recovery similar to previous reports from the TMRU. In 1972/1973 a similar treatment regime using oil-fortified milk ("high energy feeding") was instituted in 4 rural hospitals in Jamaica. As the majority (72 percent) of the children who were measured attained 90 percent of EWH, the chart proposed will be practicable in any hospital. (Summary)

High energy feeding in protein-energy malnutrition

The use of high-fat diet in malnourished children produced accelerated growth of lean tissues as well as adipose tissue, and resulted in rapid nutrition rehabilitation in 25 seriously malnourished babies. Such diets are easy to prepare and relatively cheap, and they offer important advantages over conventional feeding in the hospital treatment of malnourished children.(AU)

Accelerated recovery from infant malnutrition with high calorie feeding

Rapid recovery from infant malnutrition with associated weight deficit can be expected if the calorie density of the milk formula is doubled by adding oil. An intake of 200 kcal per kg should result in a rate of weight gain 15 times that of a normal one year old. Nearly complete recovery of weight deficit can be expected in severe cases in around six weeks, on the average. Approximately 100 kcal per kg are required to maintain constant weight plus six excess kcal for each gm of weight gain. Of these six kcal, approximately 0.6 are oxidized, 0.9 wasted, and the remainder retained as stored energy, mostly fat. These observations are of considerable practical importance for efficient treatment of infant malnutrition. If the amount of diet offered is sufficent for rapid recovery (200 kcal/kg/day) the most likely cause of failure to gain weight is infection. These generally beneficial results tend to minimize the significance of many apparent functional abnormalities observed in acutely malnourished children (AU)