Energy needs in the treatment of uncomplicated severe acute malnutrition: Secondary analysis to optimize delivery of ready-to-use therapeutic foods

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  • Sheila Isanaka
  • Christopher T Andersen
  • Kerstin E Hanson
  • Fatou Berthé
  • Rebecca F Grais
  • André Briend

Outpatient therapeutic feeding protocols for the treatment of uncomplicated severe acute malnutrition in children were initially based on weight gain data from inpatient settings and expert knowledge of the physiological requirements during recovery. However, weight gain and energy requirements from historic inpatient settings may differ from modern outpatient settings and therefore may not be appropriate to guide current therapeutic feeding protocols. We calculated the weight gain and average estimated total daily energy requirement of children successfully treated for uncomplicated severe acute malnutrition as outpatients in Niger (n = 790). Mean energy provided by six therapeutic feeding protocols was calculated and compared with average estimated energy requirements in the study population. Overall weight gain was 5.5 g·kg-1 ·day-1 among recovered children. Average energy requirements ranged from 92 to 110 kcal·kg-1 ·day-1 depending on the estimation approach. Two current therapeutic feeding protocols were found to provide an excess of energy after the first week of treatment in our study population, whereas four research protocols tended to provide less energy than the estimated requirement after the first week of treatment. Alternative feeding protocols have the potential to simplify and lead to important savings for programmes but should be evaluated to show adequacy to meet the energy needs of children under treatment, as well as feasibility and cost efficiency. Our findings rely on theoretical calculations based on several assumptions and should be confirmed in field studies.

Original languageEnglish
Article numbere12989
JournalMaternal and Child Nutrition
Volume16
Issue number4
Number of pages9
ISSN1740-8695
DOIs
Publication statusPublished - 2020

Bibliographical note

© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

    Research areas

  • Faculty of Science - Community-based management of acute malnutrition, Energy requirement, Niger, Ready-to-use therapeutic food, Severe acute malnutrition, Weight gain

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