A question regarding making ‘your own’ F75, treatment of SAM under five children. You use one of the available recipes (from WHO) and than you add CMV, should a dose of folic acid (5 mg) be given on day 1? (as it is recommended in WHO guidelines from 2003). And if you do not have f.eks. Plumpy’Nut to use in phase 2, and use ‘homemade’ F100 (with CMV), is it than recommended to give iron after weight gain, in phase 2 (3 mg/kg/day) as is recommended in WHO guidelines from 2003?
Thank you!
Sunniva N.
Hi Sunniva,
If the CMV used conforms to the normal standard (e.g. from Nutriset) then additional supplementation of folic acid should not normally be required and is adequate to treat mild folate deficiency.
You may consider a single dose of Folic Acid 5mg on admission to be given only for children with clinical anaemia (do not give within 7 days of a dose of fansidar if it is used)
The addition of CMV to your home-made F100 should make it approximately the same as F100. You can therefore add iron as you suggest when there is weight gain.
I would suggest that you consult more recent guidelines (e.g. your national guidelines). There may be context specific differences in guidance. You might consider the following generic guidelines of interest. Remember they may be context specific:
http://www.cmamforum.org/Pool/Resources/Example-of-IMAM-protocol-West-Africa-Golden-Grellety-2012-eng.pdf
(in particular Annexes 18 & 26)
You might also find this thread interesting:
http://www.en-net.org/question/75.aspx
Note the differences in final volumes between the home-made and commercial formulae. Be careful to add the correct amount of iron or just give iron syrup.
I hope this helps,
Paul
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