Treatment of malnutrition in refugee camps
Golden, M.H.; Briend, A.
Lancet 342(8867): 360
1993
ISSN/ISBN: 0140-6736 PMID: 8101595 Document Number: 328882
An overview of recommendations made at a meeting hosted by Medicins sans Frontieres, Epicentre and INSERM in Paris in May 1993 is presented. General agreement was reached on a formula suitable for the treatment of all stages of severe childhood malnutrition; 80 g dried skim milk, 50 g sugar, 60 g oil, minerals and vitamins per litre of feed (energy density 1 kcal/ml). This is sufficient for catch-up growth when fed to appetite. The same formula may be given orally or by nasogastric tube in the early stages of treatment, if diluted 3:1 with water. About 100 ml/kg per day should be given in the first few days when the children are anorexic and then about 200 ml/kg per day of the undiluted feed once appetite has returned. Concentrations of minerals and vitamins for use in these diets are tabulated. The same mineral-mix should be used in oral rehydration solution. In areas without refrigeration, culturing of the formula with Lactobacillus can be used to prevent contamination with pathogens. This also reduces the risk of lactose intolerance. Furthermore, all children should be treated with broad-spectrum antibiotics and should receive parenteral vitamin A and measles vaccine.