The World Health Organization (WHO) has issued new guidelines to
treat children suffering from severe acute malnutrition (SAM). As
against the earlier approach of treating such children in hospitals, the
new approach recognises that treating SAM children at home is more
effective. The new guidelines have also made changes in recommendations
for infants under-six months suffering from SAM. The new recommendations
suggest that alternative methods of feeding the child, such as milk
banks, should be used in case the mother is unable to breast feed. The
guidelines emphasise on the use of antibiotics to treat these children.
The new guidelines supersede those issued by WHO in 1999, which
recommended that all severely malnourished children be hospitalised,
given fortified formula milk and appropriate treatment, including
antibiotics. In the light of new technologies, the new guidelines effect
a paradigm shift. SAM children, who have appetite and are not suffering
from any evident medical condition that requires hospitalisation, are
to be effectively treated at home with specially-formulated foods that
provide energy and nutrients. In addition, antibiotic medicines like
amoxicillin are also recommended to treat infection.
“It’s generally better for children and better for their families if
they’re treated as outpatients,” says Elizabeth Mason, director of WHO’s
Department of Maternal, Newborn, Child and Adolescent Health. “It can
be easier for families who need to continue providing and caring for
other children and it allows vulnerable, malnourished children to stay
home and avoid the risk of getting hospital infections.”
The guidelines say proactive use of antibiotics is important because
the immune system of a SAM child can virtually shut down. This lack of
immune response means two things—the body cannot fight off infection and
medical tests may not detect infection, even when one is present.
According to the guidelines, evidence suggests that giving a broad
spectrum antibiotic such as amoxicillin enables the child’s body to
fight off common infections like pneumonia and urinary tract infections
which can otherwise be fatal to this group of children.
