The "10 Steps of Malnutrition" refers to a standardized approach for the inpatient management of severe acute malnutrition (SAM), particularly in children. It isn't a "who" but rather a "what" - a set of guidelines.
Understanding the 10 Steps
The 10 steps are crucial for effectively treating and managing severely malnourished individuals. They are designed to address the immediate life-threatening issues and then gradually rehabilitate the patient towards recovery. Here's a breakdown of these steps:
- Treat/Prevent Hypoglycaemia: Rapidly address low blood sugar levels with glucose.
- Treat/Prevent Hypothermia: Ensure the patient is kept warm to prevent and treat low body temperature.
- Treat/Prevent Dehydration: Carefully rehydrate the patient, often using a special rehydration solution like ReSoMal, to avoid fluid overload.
- Correct Electrolyte Imbalance: Address imbalances in electrolytes like potassium and sodium, which are common in malnutrition.
- Treat/Prevent Infection: Malnourished individuals are highly susceptible to infections, so prompt treatment with broad-spectrum antibiotics is often necessary.
- Correct Micronutrient Deficiencies: Replenish essential vitamins and minerals, such as iron, zinc, and vitamin A.
- Start Cautious Feeding: Initiate feeding gradually, often with a therapeutic milk formula (F-75), to avoid refeeding syndrome.
- Achieve Catch-Up Growth: Transition to a more energy-dense formula (F-100) to promote rapid weight gain and growth.
- Provide Sensory Stimulation and Emotional Support: Offer a nurturing environment that includes play, interaction, and emotional support to stimulate development.
- Prepare for Follow-Up After Recovery: Plan for ongoing monitoring, nutritional support, and preventative care after discharge to prevent relapse.
Importance and Application
These steps are essential for healthcare professionals working in settings where severe acute malnutrition is prevalent. Organizations like UNICEF and the World Health Organization (WHO) advocate for and support the implementation of these guidelines globally. Successfully applying these 10 steps significantly improves the survival and recovery rates of children suffering from SAM.
