Facility ased Management of Early Growth Failure
Transcript of Facility ased Management of Early Growth Failure
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Facility Based Management of Early Growth Failure (In first 6 months of life)
• Period of high velocity of somatic and neural growth.
• Growth failure identified by regular growth monitoring as sub normal anthropometry.
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Criteria for admission in facility
Too weak to suckle effectively
Weight static or gain subnormal
Weight loss
W/L <-3SD
W/A <-3SD
Bilateral pedal pitting nutritional edema
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Compartments of facility
SNCU/Postnatal/Pediatric ward/HBNC
Should be continuum of care since birth
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Approach to a case U6mo
Triage
History
Examination
Test/Imaging
Identify medical complication
Anthropometry/review of growth charts
Assessment of nutritional risk
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Counsel Mother
Address her Medical/social/nutritional problems
Correct position, attachment
SST with EBM/Donor mother milk/infnatformula/F75/F100dil
Prospects of BF
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Management of children less than 6 months of age
• WHO 10 steps and management of complications are same
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Algorithm for deciding level of care of infants U6M
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Cont..
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Medical management and micronutrient supplementation
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Medical management and micronutrient supplementation
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Management of SAM < 6 months with prospect of breastfeeding
• Correct positioning and attachment
• SST with F100 diluted
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Factors affecting milk production
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Good and Poor Attachment
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Position of the mother
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Supplementary Suckling Technique (SST)
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Regulating quantity of catch up diluted (F-100 d)
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Management of SAM < 6 months without prospect of breastfeeding
• Stabilization phase (medical complication and edema): Start F75
• Rehabilitation phase ( if no complication and edema): Start
F100 diluted
• Initially 2 and then 3 hourly feed
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Outcome
• Good weight gain ≥ 10g/kg/day
• Moderate weight gain 5g to 10g/kg/day
• Poor weight gain >5g/kg/day
• Failure to respond
– Failure to regain appetite after 4 days of admission
– Failure to begin to lose odema from 4th day
– Edema still present after 10 days
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THANK YOU