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CONTENTS
Preface = ⅴ
Acknowledgements = ⅵ
1. Introduction = 1
2. Treatment facilities = 3
3. Evaluation of the malnourished child = 4
 3.1 Assessment of nutritional status and criteria for admission = 4
 3.2 History and physical examination = 5
 3.3 Laboratory tests = 5
4. Initial treatment = 7
 4.1 Principles of management = 7
 4.2 Hypoglycaemia = 7
 4.3 Hypothermia = 8
 4.4 Dehydration and septic shock = 8
  Diagnosis = 8
  Treatment of dehydration = 9
  Treatment of septic shock = 12
 4.5 Dietary treatment = 12
  Formula diets for severely malnourished children = 13
  Feeding on admission = 13
  Nasogastric feeding = 14
  Feeding after the appetite improves = 15
  Milk intolerance = 16
  Recording food intake = 16
 4.6 Infections = 16
  Bacterial infections = 16
  Measles and other viral infections = 17
 4.7 Vitamin deficiencies = 17
  Vitamin A deficiency = 17
  Other vitamin deficiencies = 18
 4.8 Very severe anaemia = 18
 4.9 Congestive heart failure = 18
 4.10 Dermatosis of kwashiorkor = 19
5. Rehabilitation = 20
 5.1 Principles of management = 20
 5.2 Nutritional rehabilitation = 20
  Feeding children under 24 months = 20
  Feeding children over 24 months = 21
  Folic acid and iron = 21
  Assessing progress = 22
 5.3 Emotional and physical stimulation = 22
  The environment = 23
  Play activities = 23
  Physical activities = 23
 5.4 Teaching parents how to prevent malnutrition from recurring = 24
 5.5 Preparation for discharge = 24
  Criteria for discharge = 24
  Appropriate diets = 24
  Immunization = 25
  Planning follow-up = 25
6. Follow-up = 26
7. Failure to respond to treatment = 27
 7.1 General principles = 27
 7.2 Problems with the treatment facility = 27
  Type of facility = 27
  Staff = 28
  Inaccurate weighing machines = 28
  Problems with preparing or giving food = 28
 7.3 Problems with individual children = 29
  Feeding = 29
  Infection = 30
  Serious underlying disease = 33
 7.4 Learning from failure = 34
8. Management of malnutrition in disaster situations and refugee camps = 35
 8.1 General considerations = 35
 8.2 Establishing a therapeutic feeding centre = 35
  Location and capacity = 35
  Water supply and sanitation = 35
  Cooking facilities and supplies = 35
  Staff = 35
 8.3 Criteria for enrolment and discharge = 35
 8.4 Principles of management = 36
 8.5 Evaluation of the therapeutic feeding centre = 36
9. Malnutrition in adolescents and adults = 37
 9.1 Principles of management = 37
 9.2 Classification of malnutrition = 37
  Adults(over 18 years) = 37
  Adolescents(10-18 years) = 38
 9.3 History and physical examination = 38
 9.4 Initial treatment = 38
 9.5 Rehabilitation = 39
 9.6 Criteria for discharge = 39
 9.7 Failure to respond to treatment = 39
References = 40
Appendices = 41
 1. NCHS／WHO normalized reference values for weight-for-height and weight-for-length = 41
 2. Sample recording form = 43
 3. Physiological basis for treatment of severe malnutrition = 50
 4. Composition of mineral and vitamin mixes = 53
 5. Desirable daily nutrient intake during initial phase of treatment = 54
 6. Drug dosages for treatment of infections = 55
 7. Toys for severely malnourished children = 58
 8. Sample curriculum for play therapy = 59