Acute Malnutrition - Follow-Up
IMCI - Child (Age 2 months up to 5 years)
Care for the child who returns for follow-up using ALL the boxes that match the child’s previous classifications
If the child has a new problem, assess, classify and treat the new problem as on the ASSESS AND CLASSIFY Chart
Severe Acute Malnutrition (SAM) without Medical Complication or Moderate Acute Malnutrition (Including SAM patients discharged from inpatient care)
After 7 days:
Ask:
- Is the child feeding well?Is the child finishing the weekly amount of RUTF? Are there any new problems?
Look for:
- General danger signs, medical complications, fever and fast breathing. If present or there is a new problem, assess and classify accordingly
- Weight, MUAC, oedema and anaemia
- If the child is well and gaining weight , there is no need to repeat the appetite test
- If the child is not gaining weight or you are concerned for any reason, repeat the appetite test
Treatment:
If any one of the following are present, refer:
- Any danger sign, red or yellow classification or other problem
- Poor response as indicated by:
- oedema
- weight loss of more than 5% of body weight at any visit or for 2 consecutive visits
- static weight for 3 consecutive visits
- failure to reach the discharge criteria after 2 months of outpatient treatment.
- Child fails the appetite test
If there is no indication for referral:
- Assess for possible HIV and TB infection
- Give a weekly supply of RUTF
- Counsel the caregiver on feeding her child
- Give immunisations and routine treatments when due
- Follow-up weekly until stable
- Continue to see the child monthly for at least two months until the child is feeding well and gaining weight regularly or until the child is classified as growing well
Moderate Acute Malnutrition
Routinely providing supplementary foods (RUTF/RUSF) to moderately acute malnutrition to infants and children presenting to primary health-care facilities is not recommended
Supplementary foods are recommended in the following situations:
- Areas with a high prevalence (new and old cases) of moderate acute malnutrition
- Children/family who are food and nutrient insecure and/ or where food based approach is not feasible. (no or very little food)
- For this group of children special attention to nutrition counselling, interventions to address food security and follow-up care to assess response is crucial
Integrated Management of Childhood Illness 2022; Child (Age 2 months up to 5 years); Give Follow-up Care; Acute Malnutrition
Last checked for updates: June 2023