Prevention and follow up of
Malnutrition
What is follow up?
• After stabilization (2-3days) and rehabilitation
( 2-6wk) , every child should be followed up to
2.5 ...
Prepare to follow up
(1)Primary failure to respond is indicated by :-
• Failure to regain appetite by day 4
• Failure to s...
Reasons of failure to response
• Feed not prepared properly
• Inadequate foods
• Child does not take feed properly
• Psych...
Problems encountered during
treatment with high protein diet
• Pseudo tumor cerebri
• Encephalitis like picture
• Nutritio...
Criteria for discharge
• 6-8 wk time is taken to recover
• He should be alert and active
• He must regain 85% of his ideal...
Follow up children after
discharge
• Visiting the child at regular intervals
• Child rearing practices should be told to
m...
Long terms sequelae
1) Growth :-
• Weight and head cicumference decreased
2) Mental development :-
• Sub normality present...
3) All abdominal organs :-
Usually recover completely but in some cases
a) diabetes may develop (pancreas)
b)scarring may ...
Preventing measures
• There is no simple solution of to the
problem of PEM
• Many types of action are necessary
• Followin...
ii. Promotion of breastfeeding:-
( baby friendly hospital)
iii. Development of low cost weaning food:-child
should be made...
Specific protection
• Child diet must contain protein and energy
rich food(milk , egg, fresh foods if possible)
• Food for...
Early diagnosis and treatment
1. Periodic surveillance
2. Early diagnosis of any lag in growth
3. Infections and diarrhea
...
Rehabilitation
1. Nutritional rehabiltational services
2. Hospital treatment
3. Follow up care
Preventive and social measures
• Since malnutrition is the outcome of several
factors , the problem can be solved only by
...
Action at family level
1. Nutrition education
2. Both husband and wife need to be
educated about the selection of right ki...
4. Counter the misleading commercial
advertisements with regarding to baby foods
5. Planning a kitchen garden or keeping p...
Action at community level
1. Nutrition problem analysis in terms of :-
i. Extent ,distribution, and types of
nutritionals ...
2. Plan realistic and feasible approaches based on
local resources
3. Direct intervention measures such as ICDS,
Mid day s...
5. Applied nutrition programme :- production of
various type of protective foods by the community
for the community
6. ICD...
ii. Health check ups includes ANC of expectant
mothers, PNC of nursing mothers and health care
of children.
These services...
7. Safe water supply to prevent water born diseases.
In brief broad socioeconomic development of the
entire community .
At the national level
1. Rural development (NRHM ,RCH)
2. Increasing agriculture production:-application of
modern farming...
Action at international level
1. Establishment of multi lateral world food
program in 1963
2. International co-operation i...
THANKS
Presented by:-
Md. Aqueel Azhar
20th batch
Department of paediatrics
Katihar medical college katihar
• Prime Minister Manmohan Singh stated,
“The problem of malnutrition is a matter of
national shame.... I appeal to the nat...
of 26

Prevention and follow up of malnutrition

Published on: Mar 4, 2016
Published in: Health & Medicine      
Source: www.slideshare.net


Transcripts - Prevention and follow up of malnutrition

  • 1. Prevention and follow up of Malnutrition
  • 2. What is follow up? • After stabilization (2-3days) and rehabilitation ( 2-6wk) , every child should be followed up to 2.5 yr of age. • In case of older children up to 1yr from the time of discharge
  • 3. Prepare to follow up (1)Primary failure to respond is indicated by :- • Failure to regain appetite by day 4 • Failure to start loosing edema by day 4 • Presence of edema on day 10 • Failure to gain at least 5g /kg / day by day 10 (2) Secondary failure to response :- • Failure to gain at least 5g /kg /day for consecutive days during the rehabilitation phase.
  • 4. Reasons of failure to response • Feed not prepared properly • Inadequate foods • Child does not take feed properly • Psychological causes for e.g anorexia nervosa
  • 5. Problems encountered during treatment with high protein diet • Pseudo tumor cerebri • Encephalitis like picture • Nutritional recovery syndrome
  • 6. Criteria for discharge • 6-8 wk time is taken to recover • He should be alert and active • He must regain 85% of his ideal weight • Serum albumin must be minimum 3g
  • 7. Follow up children after discharge • Visiting the child at regular intervals • Child rearing practices should be told to mothers • Immunization should be completed
  • 8. Long terms sequelae 1) Growth :- • Weight and head cicumference decreased 2) Mental development :- • Sub normality present d/t decreased size of brain . • General reasoning and spatial perpetual abilities most severely affected d/t decrease of DNA and cholesterol content of brain
  • 9. 3) All abdominal organs :- Usually recover completely but in some cases a) diabetes may develop (pancreas) b)scarring may persisting kidney and pyelonephritis can progress 4) Endo myocardial fibrosis may occur
  • 10. Preventing measures • There is no simple solution of to the problem of PEM • Many types of action are necessary • Following is adapted from 8th FAO/WHO expert committee on nutrition • A) health promotion :- I. Measures directed to pregnant and lactating women(education , distribution of supplements)
  • 11. ii. Promotion of breastfeeding:- ( baby friendly hospital) iii. Development of low cost weaning food:-child should be made to eat more food at frequent intervals . iv. Measures to improve family diet v. Nutrition education:- promote correct feeding practices vi. Home economics vii.Family planning and spacing of birth viii.Family environment
  • 12. Specific protection • Child diet must contain protein and energy rich food(milk , egg, fresh foods if possible) • Food fortification
  • 13. Early diagnosis and treatment 1. Periodic surveillance 2. Early diagnosis of any lag in growth 3. Infections and diarrhea 4. Development of programs for early rehydration 5. Supplementary feeding programs during epidemics 6. Deworming of heavily infested children
  • 14. Rehabilitation 1. Nutritional rehabiltational services 2. Hospital treatment 3. Follow up care
  • 15. Preventive and social measures • Since malnutrition is the outcome of several factors , the problem can be solved only by taking action at various levels:- • Family ,community , national , international • It requiores a cordinated approach of many disciplines:- nutrition , food , technology health adminstration , health education , marketing etc.
  • 16. Action at family level 1. Nutrition education 2. Both husband and wife need to be educated about the selection of right kinds of local foods and in planning of nutritionally adequate diets within the limits of their purchasing power 3. Since food expenditureoften amounts to 50-70% of family budgets , nutrition management and planning should be a good investment
  • 17. 4. Counter the misleading commercial advertisements with regarding to baby foods 5. Planning a kitchen garden or keeping poultry 6. Combination of locally available and imported items
  • 18. Action at community level 1. Nutrition problem analysis in terms of :- i. Extent ,distribution, and types of nutritionals deficiency ii. The population group at risk iii. Dietary and non dietary factors contributing to malnutrition
  • 19. 2. Plan realistic and feasible approaches based on local resources 3. Direct intervention measures such as ICDS, Mid day school meals, nutritional anemia prophylaxis program , Vit A prophylaxis programme 4. Increasing the availability of foods both in quantity and quality, but much more important:- making sure that the people suffering or at risk ,can obtain them.
  • 20. 5. Applied nutrition programme :- production of various type of protective foods by the community for the community 6. ICDS:-an inter sectoral programme which seeks to directly reach the children below six yrs(specially from vulnerable groups and remote areas) i. Supplementary nutrition:- Beneficiaries Calories(kcal) Protein(g) Children upto 6yr 300 8-10 Severely malnourish Double of the above Double of the above Pregnant and lactating mother 500 20-25
  • 21. ii. Health check ups includes ANC of expectant mothers, PNC of nursing mothers and health care of children. These services are provided by ANM, medical officers under RCH program iii. Immunization iv. Non formal pre school education v. Referral services vi. Nutrition and health education utilization of these services is still poor.
  • 22. 7. Safe water supply to prevent water born diseases. In brief broad socioeconomic development of the entire community .
  • 23. At the national level 1. Rural development (NRHM ,RCH) 2. Increasing agriculture production:-application of modern farming practices, expansion of cultivated areas ,use of fertilizers ,better seeds. Accompanied by effective marketing , land tenure ,food price policies and food distribution system 3. Stabilisation of population 4. Nutrition related health activities
  • 24. Action at international level 1. Establishment of multi lateral world food program in 1963 2. International co-operation in the situations of natural calamities 3. Some organs of UNO like FAO, UNICEF, WHO, World Bank, IMF, UNDP and CAR working in close collaboration.
  • 25. THANKS Presented by:- Md. Aqueel Azhar 20th batch Department of paediatrics Katihar medical college katihar
  • 26. • Prime Minister Manmohan Singh stated, “The problem of malnutrition is a matter of national shame.... I appeal to the nation to resolve and work hard to eradicate malnutrition in five years.”

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