27-11-14 Slide 2 Severe Acute Malnutrition (SAM) is defined as
Bipedal pitting oedema of nutritional origin And/or Severe wasting
indicated by weight for height < -3SD or Slide 3 SAM is
increasingly being recognized in infants who are < 6 months of
age(1) In addition to aetiologies such as low birth weight,
persistent diarrhoea and recurring sepsis or chronic underlying
diseases or disability, the development of SAM in this age group
commonly reflects suboptimal feeding practices, especially
breastfeeding practices. Slide 4 Infants who are < 6 months of
age should be exclusively breastfed to gain optimal nutrition Yet,
rates of exclusive breastfeeding worldwide remain disappointingly
low, with only an estimated 2531% of infants who are 25 months of
age being exclusively breastfed (2) Slide 5 Risk factors for
increased mortality are likely to include recent weight loss,
failure to gain weight, failure to feed effectively and the
presence of bilateral oedema (3) To date, management of SAM in this
age group has focused on establishing, or re- establishing
exclusive breastfeeding, and, use of formula feeds and early
introduction of complementary foods to treat these infants, when
breastfeeding is not possible(3) Slide 6 Poor feeding practices
Poor breastfeeding counselling and support Wrong advice concerning
PMTCT- stop breastfeeding and supplement with formula Formula that
is; Wrongly constituted Constituted with poor hygiene Diarrhoea
Slide 7 Early weaning Mother unwell Mother pregnant (poor child
spacing) Introduction of Cow`s milk, supershake, maheu, water,tea
Co-morbidities CP Hydrocephalus HIV, trisomy 21 with cardiac
complications Slide 8 Manual for Management of Severe malnutrition
was published in 1999 and 2000 However, these were not developed
with active consideration to infants
