There are times when SAM patients with complications (not severe) will not have themselves admitted in the ITP because of financial concerns or as personal choice of the parents/caregiver. Is it okay to give the therapeutic milk it at the nearest health facility with constant supervision and monitoring from the Barangay Nutrition Scholar or health staff?
Dear anonymous, You raised an interesting question that needs however some clarifications : Does the " not severe" include malnourished with poor appetite? does the Barangay nutrition Scholar or the Health staff have the ability to administer and follow up adequately the routine medical treatment? do you include infants less than six month age in this question or not? I have not heard of any standard protocol on the use of therapeutic milk in ambulatory settings, let's share field related experiences. We faced this issue in Niger before 2005 but for a different reason. we were to recommed feeding strategies in IMCI training for nurses to deal with complicated SAM patient in their Pheripheral health center (PHC) when " immediate transfer to TFC is not feasible". we recommended frequent feeding with available milk product including F75 /F100. There was no evaluation ( was it so necessary?) of outcome for these special and few cases of complicated SAM patients treated in PHC. Niger has now placed trained physicians in PHCs, being able to treat complicated SAM at PHC is a growing demand from them. we may in the coming years learn more on operationalizing PHC stabilization units at national scale. Of course, I hope we find an immediate answer or interim guideline for you before !
Anonymous

Answered:

9 years ago
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