A malnourished Afghan child being treated by a medical team. A Somali boy receiving treatment for malnourishment at a health facility. Improving nutrition Efforts to improve nutrition are some of the common forms of development aid. Interventions often promote breastfeeding in order to reduce rates of malnutrition and death in children. Some of these interventions have been successful. In young children, outcomes improve when children between six months and two years of age receive complementary food (in addition to breast milk). There is also good evidence that supports giving supplemental micronutrients to pregnant women and young children in the developing world. Sending food and money is a common form of development aid, aimed at feeding hungry people. Some strategies help people buy food within local markets. Simply feeding students at school is insufficient. Longer-term measures include improving agricultural practices, reducing poverty, and improving sanitation. Identifying malnourishment Measuring children is crucial to identifying malnourishment. In 2000, the United States Centers for Disease Control and Prevention (CDC) established the International Micronutrient Malnutrition Prevention and Control (IMMPaCt) program. It tested children for malnutrition by conducting a three-dimensional scan, using an iPad or a tablet. Its objective was to help doctors provide more efficient treatments. There may be some chance of error when using this method. A systematic review of 42 studies found that many approaches to mitigating acute malnutrition are equally effective; thus, intervention decisions can be based on cost-related factors. Overall, evidence for the effectiveness of acute malnutrition interventions is not robust. The limited evidence related to cost indicates that community and outpatient management of children with uncomplicated malnutrition may be the most cost-effective strategy. Medical management It is often possible to manage severe malnutrition within a person's home, using ready-to-use therapeutic foods. In people with severe malnutrition complicated by other health problems, treatment in a hospital setting is recommended. In-hospital treatment often involves managing low blood sugar, maintaining adequate body temperature, addressing dehydration, and gradual feeding. Routine antibiotics are usually recommended because malnutrition weakens the immune system, causing a high<unk> of infection. Additionally, broad spectrum antibiotics are recommended in all severely undernourished children with diarrhea requiring admission to hospital. A severely malnourished child who appears to have dehydration, but has not had diarrhea, should be treated as if they have an infection. Among malnourished people who are hospitalized, nutritional support improves protein intake, calorie intake, and weight. Bangladeshi model Baby suffering from protein malnutrition due to insufficient amount of nutrients In response to child malnutrition, the Bangladeshi government recommends ten steps for treating severe malnutrition: # Prevent or treat dehydration # Prevent or treat low blood sugar # Prevent or treat low body temperature # Prevent or treat infection; # Correct electrolyte imbalances # Correct micronutrient deficiencies # Start feeding cautiously # Achieve catch-up growth # Provide psychological support # Prepare for discharge and follow-up after recovery Therapeutic foods Due in part to limited research on supplementary feeding, there is little evidence that this strategy is beneficial. A 2015 systematic review of 32 studies found that there are limited benefits when children under 5 receive supplementary feeding, especially among younger, poorer, and more undernourished children. However, specially formulated foods do appear to be useful in treating moderate acute malnutrition in the developing world. These foods may have additional benefits in humanitarian emergencies, since they can be stored for years, can be eaten directly from the packet, and do not have to be mixed with clean water or refrigerated. In young children with severe acute malnutrition, it is unclear if ready-to-use therapeutic food differs from a normal diet. Severely malnourished individuals can experience refeeding syndrome if fed too quickly. Refeeding syndrome can result regardless of whether food is taken orally or parenterally. It can present several days after eating with potentially fatal heart failure, dysrhythmias, and confusion. Some manufacturers have fortified everyday foods with micronutrients before selling them to consumers. For example, flour has been fortified with iron, zinc, folic acid, and other B vitamins like thiamine, riboflavin, niacin and vitamin B12. Baladi bread (Egyptian flatbread) is made with fortified wheat flour. Other fortified products include fish sauce in Vietnam and iodized salt. Micronutrient supplementation According to the World Bank, treating malnutrition - mostly by fortifying foods with micronutrients - improves lives more quickly than other forms of aid, and at a lower cost. After reviewing a variety of development proposals, The Copenhagen Consensus, a group of economists who reviewed a variety of development proposals, ranked micronutrient supplementation as its number-one treatment strategy. In malnourished people with diarrhea, zinc supplementation is recommended following an initial four-hour rehydration period. Daily zinc supplementation can help reduce the severity and duration of the diarrhea. Additionally, continuing daily zinc supplementation for ten to fourteen days makes diarrhea less likely to recur in the next two to three months. Malnourished children also need both potassium and magnesium. Within two to three hours of starting rehydration, children should be encouraged to take food, particularly foods rich in potassium like bananas, green coconut water, and unsweetened fresh fruit juice.Along with continued eating, many homemade products can also help restore normal electrolyte levels. For example, early during the course of a child's diarrhea, it can be beneficial to provide cereal water (salted or unsalted) or vegetable broth (salted or unsalted). If available, vitamin A, potassium, magnesium, and zinc supplements should be added, along with other vitamins and minerals. Giving base (as in Ringer's lactate) to treat acidosis without simultaneously supplementing potassium worsens low blood potassium. Treating diarrhea Preventing dehydration Food and drink can help prevent dehydration in malnourished people with diarrhea. Eating (or breastfeeding, among infants) should resume as soon as possible. Sugary beverages like soft drinks, fruit juices, and sweetened teas are not recommended as they may worsen diarrhea. Malnourished people with diarrhea (especially children) should be encouraged to drink fluids; the best choices are fluids with modest amounts of sugar and salt, like vegetable broth or salted rice water. If clean water is available, they should be encouraged to drink that too. Malnourished people should be allowed to drink as much as they want, unless signs of swelling emerge. Babies can be given small amounts of fluids via an eyedropper or a syringe without the needle. Children under two should receive a teaspoon of fluid every one to two minutes; older children and adults should take frequent sips of fluids directly from a cup. After the first two hours, fluids and foods should be alternated, rehydration should be continued at the same rate or more slowly, depending on how much fluid the child wants and whether they are having ongoing diarrhea. Alternating between rehydration and food at this point is After the first two hours of rehydration it is recommended that to alternate between rehydration and food. If vomiting occurs, fluids can be paused for 5–10 minutes and then restarted more slowly. Vomiting rarely prevents rehydration, since fluids are still absorbed and vomiting is usually short-term. Oral rehydration therapy If prevention has failed and dehydration develops, the preferred treatment is rehydration through oral rehydration therapy (ORT). In severely undernourished children with diarrhea, rehydration should be done slowly, according to the World Health Organization. Oral rehydration solutions consist of clean water mixed with small amounts of sugars and salts. These solutions help restore normal electrolyte levels, provide a source of carbohydrates, and help with fluid replacement. Reduced-osmolarity ORS is the current standard of care for oral rehydration therapy, with reasonably wide availability. Introduced in 2003 by WHO and UNICEF, reduced-osmolarity solutions contain lower concentrations of sodium and glucose than original ORS preparations. Reduced-osmolarity ORS has the added benefit of reducing stool volume and vomiting while simultaneously preventing dehydration. Packets of reduced-osmolarity ORS include glucose, table salt, potassium chloride, and trisodium citrate. For general use, each packet should be mixed with a liter of water. However, for malnourished children, experts recommend adding a packet of ORS to two liters of water, along with an extra 50 grams of sucrose and some stock potassium solution. People who have no access to commercially available ORS can make a homemade version using water, sugar, and table salt. Experts agree that homemade ORS preparations should include one liter (34 oz.) of clean water and 6 teaspoons of sugar; however, they disagree about whether they should contain half a teaspoon of table salt or a full teaspoon. Most sources recommend using half a teaspoon of salt per liter of water. However, people with malnutrition have an excess of body sodium.. To avoid worsening this symptom, ORS for people with severe undernutrition should contain half the usual amount of sodium and more potassium. Patients who do not drink may require fluids by nasogastric tube. Intravenous fluids are recommended only in those who have significant dehydration due to their potential complications, including congestive heart failure. Examples of commercially available oral rehydration salts (Nepal on left, Peru on right). Low blood sugar Hypoglycemia, whether known or suspected, can be treated with a mixture of sugar and water.
risks of Obstructed labour
risks of Postpartum infections
complications of Abnormal uterine bleeding
complications of Obstructed labour
symptom of Postpartum infections
complications of Heavy menstrual bleeding
complications of Miscarriage
complications of Mastitis