8.3.2  Follow-up care for moderate acute malnutrition

If a child was classified with moderate acute malnutrition and referred to a supplementary feeding centre, or the mother has been given counselling to help her improve feeding and care of her child, she should be advised to return for a follow-up visit after 30 days. If there was a feeding problem as judged by the feeding recommendations in your chart booklet, the mother should be advised to return with the child earlier than 30 days.

You may have specially scheduled sessions for nutritional counselling, and mothers with a malnourished child can be asked to come for a follow-up visit at this time. A special session allows you to devote the necessary time to discuss feeding with several mothers and perhaps demonstrate some good foods for young children.

When the mother attends your health post for a follow-up visit after 30 days for a child with moderate acute malnutrition, you should take the steps set out in Box 8.4. As you read above, you should praise the mother and encourage her to continue good home care for her child. This will ensure that she feels supported by you.

Box 8.4  Follow-up care for moderate acute malnutrition

After 30 days

• Measure the child’s MUAC and determine if the child still has moderate acute malnutrition
• Reassess feeding.

Treatment

• If the child no longer has moderate acute malnutrition, praise the mother and encourage her to continue her good care of the child
• If the child still has moderate acute malnutrition, counsel the mother about any feeding problems you have identified. Ask the mother to return again in one month. Continue to see the child monthly until the child is feeding well and no longer has moderate acute malnutrition.

Exception

A child for whom you do not think that feeding will improve, or whose MUAC is not improving, must always be referred to a health centre or hospital for better management.

Box 8.5 below sets out the steps you need to follow to assess the child’s feeding. It will help you judge what advice and support you can give the mother or caregiver of the child.

Box 8.5  Checklist for feeding assessment

Assess the child’s feeding

Ask questions about the child’s usual feeding behaviour. Compare the mother’s answers against the feeding recommendation for the child’s age.

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