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In e na ional Jou nal o Toxicological and Pha macological Resea ch 2024; 14 (12); 190-193
Meena e al. In e na ional Jou nal o Toxicological and Pha macological Resea ch
190
O iginal Resea ch A icle
S udy E ec o F-75 Die on Weigh o Se e e Acu e Malnou ished
Child en in Wes e n Rajas han
Anisha Meena1, Mahend a Jou wal2, Nidhi Kaushal3, Khushboo Singh4, R. K. Bishnoi5
1Assis an P o esso , Depa men o Paedia ics, GMC, Pali
2Assis an P o esso , Depa men o O hopaedics, GMC, Pali
3Assis an P o esso , Depa men o Paedia ics, GMC, Pali
4Medical Consul an (Communi y Medicine), WHO, Jodhpu
5HOD & P o esso , Depa men o Paedia ics, GMC, Pali
Recei ed: 18-09-2024 / Re ised: 21-10-2024 / Accep ed: 26-11-2024
Co esponding au ho : D . Anisha Meena
Con lic o in e es : Nil
Abs ac :
Backg ound: Malnu i ion is ampan in paedia ic age g oup globally. O e he las wo decades, se e e acu e
malnu i ion (SAM) has been inc easing in India despi e o a ou able na ional – le el economic g ow h.
P e alence o SAM has inc eased om 6.6% in 2005 – 2006 as pe NFHS-3 o 7.5% in 2015 – 2016 as pe
NFHS-4, and as pe NFHS-5 p e alence con inues o be 7.7%. Child en wi h SAM a e a 9-11 imes highe isk
o mo ali y and mo bidi y han well-nou ished child en. This is an unp eceden ed public heal h eme gency
equi ing policy a en ion, c i ical ca e, nu i ional he apy as well as nu i ional ehabili a ion.
Aims and Objec i e: To s udy e ec o F-75 die on weigh o SAM child en admi ed in malnu i ion
ea men cen e.
Ma e ial and Me hods: This is P ospec i e obse a ional s udy done on SAM Child en (wi hou bila e al pedal
oedema) aged 6mon hs o 60 mon hs hospi alized in Malnu i ion T ea men Cen e , in Go e nmen Medical
College Pali and a ached Bangu hospi al, du ing s udy pe iod om Ap il 2022 o Ap il 2024. F-75 die was
gi en o 387 SAM child en ha we e en olled in s udy o ini ial 3days acco ding o MTC guidelines. Daily
weigh gain is eco ded. A e age daily weigh gain (gm/kg/day) calcula ed on day ou h as well as on
discha ge.
Resul s: Ou o 387 child en a e age daily weigh gain on day ou h was ollowing: <5gm/kg/day in 35(9%),
5-10 gm/kg/day in 83(21.5%), >10 gm/kg /day in 269(69.5%). This sugges s good weigh gain on F-75 die in
maximum child en due o a ailabili y o ood in adequa e quan i y & quali y.
Conclusion: Al hough F-75 is no in ended o weigh gain, s ill child en gained good weigh on s a e die .
High quali y in an and young child eeding counselling is needed o p e en se e e acu e malnu i ion as
in oduc ion o complemen a y eeding a 6 mon hs age can lessen bu den o malnu i ion.
Keywo ds: Se e e Acu e Malnu i ion, F-75 die .
This is an Open Access a icle ha uses a unding model which does no cha ge eade s o hei ins i u ions o access and dis ibu ed unde
he e ms o he C ea i e Commons A ibu ion License (h p://c ea i ecommons.o g/licenses/by/4.0) and he Budapes Open Access
Ini ia i e (h p://www.budapes openaccessini ia i e.o g/ ead), which pe mi un es ic ed use, dis ibu ion, and ep oduc ion in any medium,
p o ided o iginal wo k is p ope ly c edi ed.
In oduc ion
Malnu i ion is one o he majo public heal h
p oblems h oughou he de eloping wo ld and is
an unde lying ac o in o e 50% o child en's
dea h unde 5 yea s who die each yea o
p e en able causes [6-9]. Se e e Acu e
Malnu i ion is de ined as se e e was ing and/o
bila e al oedema. Se e e was ing is ex eme
hinness diagnosed by weigh o leng h/heigh < -
3SD o WHO Child G ow h S anda ds, o mid
uppe a m ci cum e ence < 115mm (measu ed by
Shaki 's ape). Bila e al oedema is diagnosed by
g asping bo h ee , placing a humb on op o each,
and gen ly p essing o 10 seconds. A pi (den )
emaining unde each humb indica es bila e al
oedema [10].
I is es ima ed ha app oxima ely 16% o bi hs
wo ldwide in 2013 we e low bi h weigh (LBW).
Ra es o LBW a e highes (28%) in sou he n Asia,
which a e wice hose o Sub-Saha an A ica [5].
App oxima ely 9% o sub-Saha an A ican and
16% Sou h Asian child en su e om mode a e
acu e malnu i ion and app oxima ely 2% o
child en li ing in de eloping coun ies su e om
se e e acu e malnu i ion [11,12].
In e na ional Jou nal o Toxicological and Pha macological Resea ch e-ISSN: 0975-5160, p-ISSN: 2820-2651
Meena e al. In e na ional Jou nal o Toxicological and Pha macological Resea ch
191
Asia ca ies mos o global bu den because o
combina ion o la ge popula ion size and high
p e alence [10]. In India app oxima ely 20% o
child en unde i e yea s, a e se e ely was ed [13].
Es ima es om mos ecen na ionally
ep esen a i e su ey indica e ha 6.4% o child en
below 60 mon hs o age ha e weigh - o -heigh
below hi d s anda d de ia ion. A p esen , Indian
popula ion o 1.2 billion, he e a e abou 132
million child en unde i e yea s (12% o
popula ion), o which 6.4% o oughly 8 million a e
assumed o be su e ing om se e e acu e
malnu i ion. To p e en dea hs among se e ely
malnou ished child en, he Go e nmen o India
ha e s a ed he Nu i ion Rehabili a ion Cen e s
(NRCs) wi h suppo o UNICEF. The objec i es o
he p og amme a e o con ol malnu i ion among
he child en aged 1–5 yea s in he coun y and o
b ing down he pe cen o se e ely malnou ished
child en o less han 1% [14].
Ma e ials and Me hods
This was a p ospec i e obse a ional s udy done
om Ap il 2022 o Ap il 2024 in 10 bedded
Malnu i ion T ea men Cen e in Go e nmen
medical college Pali, Rajas han, and a ached
Bangu Hospi al.
The s udy pa icipan s we e 387 child en who me
c i e ia o se e e acu e malnu i ion, bu wi hou
bila e al oedema, be ween 6 and 60 mon hs o age.
WHO c i e ia o se e e acu e malnu i ion, which
included child en wi h weigh - o -heigh (W/H) o
leng h (W/L) wi h Z sco e less han 3 s anda d
de ia ion om mean, and/o mid-uppe a m
ci cum e ence (MUAC) <115 mm, and/o p esence
o bila e al pi ing pedal oedema. These child en
admi ed in MTC we e gi en special he apeu ic
die including F 75 and F 100 as pe
WHO/UNICEF p o ocol o managemen o se e e
acu e malnu i ion (WHO 1999). F 75 die we e
gi en o ini ial 3 days and hen shi ed o F 100
die .
These child en we e obse ed o daily weigh
gain. A e uling ou he acu e complica ions and
hei ini ial s abiliza ion, hese child en we e
subjec ed o he ac ual MTC p o ocol. Child en
we e gi en die as pe WHO/UNICEF p o ocol
daily along wi h o he supplemen s. WHO weigh
o heigh e e ence cha s we e used o hei
assessmen . Daily weigh measu emen s we e done
a ixed ime using a single s anda dized weighing
scale. A e age daily weigh gain was calcula ed on
day ou h and on discha ge.
Resul s
Among 387 child en, 205 (52.9%) we e males
while 182 (47.1%) child en we e emales. This pie
cha sugges s ha emale child en a e less a ec ed
as compa ed o male child en, p obably due o
mo e awa eness o Female educa ion & heal h by
go e nmen o India.
Figu e 1:
Acco ding o age dis ibu ion, mos o he child en
251 (64.85%) belonged o 6-18 mon hs o age, 89
(22.99%) child en we e o 19 -36 mon hs o age
and 47 (12.16%) child en we e o 37-60 mon hs o
age. This ba cha sugges s maximum child en
being a ec ed a 6 – 18 mon hs, which is he ime
o in oduc ion o complemen a y eeds.
Hence, awa eness and educa ion ega ding
complemen a y eeding a e equi ed o ackle his.
205
182
Male Female
In e na ional Jou nal o Toxicological and Pha macological Resea ch e-ISSN: 0975-5160, p-ISSN: 2820-2651
Meena e al. In e na ional Jou nal o Toxicological and Pha macological Resea ch
192
Figu e 2:
Among 387 child en, 22 (5.7%) belong o Gene al ca ego y, 175 (45.2%) belong o OBC ca ego y, 92 (23.7%)
belong o Scheduled Cas e ca ego y and 98(25.4%) belong o Scheduled T ibe ca ego y. This doughnu pie cha
sugges s child en belonging o Scheduled cas e & Scheduled ibe ca ego y a e less a ec ed, p obably due o
in ensi e go e nmen policies o educa ing backwa d classes.
Figu e 3:
On day ou h a e age daily weigh gain was <5gm/kg/day in 35 (9%) child en, 5-10 gm/kg/day in 83 (21.5%),
>10 gm/kg /day in 269 (69.5%).
Table 1:
Weigh gain on 4 h day o admission
No. o child en
Pe cen age
< 5 g/kg/day
35
9%
5 – 10 g/kg/day
83
21.5%
> 10 g/kg/day
269
69.5%
To al
387
On discha ge a e age daily weigh gain a e was <5gm/kg/day in 95 (26.61%), 5-10 gm/kg/day in 81(22.68%),
>10gm/kg/day in 181 (50.70%) child en.
Table 2:
Weigh gain on Discha ge
No. o child en
Pe cen age
< 5 g/kg/day
41
10.6%
5 – 10 g/kg/day
109
28.2%
> 10 g/kg/day
237
61.2%
To al
387
0
50
100
150
200
250
300
6 - 18 mon hs 19 - 36
mon hs
37 - 60
mon hs
Gene al
OBC
SC
ST
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193
Discussion
As i is well known ac ha F-75 is used only o
biochemical and me abolic, we do no expec any
weigh gain in child.
In ac , due o loss o oedema, weigh loss can be
seen in such child en. Bu in p esen s udy we
clea ly saw ha child en gained good weigh on
s a e die .
So, his gi es an in e ence ha child en who a e
malnou ished, can eco e e y well in ini ial days
o ea men also i hey a e ea ing he igh oods
in igh quan i y & igh quali y and a e no
su e ing om diseases o in ec ions.
To p e en se e e acu e malnu i ion he e is need
o
Ø P omo ing Exclusi e B eas eeding ill 6
mon hs
Ø Success ul in oduc ion o Complemen a y
eeding
Ø High quali y in an and young child eeding
counselling
Ø Awa eness ega ding a ious diseases
Ø Adequa e heal h ca e acili ies o disease
managemen
As in p esen s udy, mos a ec ed age g oup was
6mon hs o 18 mon hs, he e is need o counselling
ega ding Complemen a y eeding so as o dec ease
magni ude o malnu i ion.
Re e ences
1. NFHS-3. Na ional Family Heal h Su ey.
Go e nmen o India, Minis y o Heal h and
Family Wel a e 2005.
2. NFHS-4. Na ional Family Heal h Su ey.
Go e nmen o India, Minis y o Heal h and
Family Wel a e 2015.
3. NFHS-5. Na ional Family Heal h Su ey.
Go e nmen o India, Minis y o Heal h and
Family Wel a e 2020.
4. “Ma e nal and Child unde nu i ion and
o e weigh in low-income and middle-income
coun ies” Black RE, Vic o ia CG, Walke SP,
e al. Lance Aug2013; olume 382, issue
9890; pages 427-451.
5. T ea men o se e e and mode a e acu e
malnu i ion in low and middle-income
se ings” Len e s LM, Wany K, Webb P, e al:
Sys ema ic e iew, Me a-analysis and Delphi
p ocess. BMC Public Heal h, Sep embe 2013 -
Sp inge ; Volume 13; a icle numbe S23,1 –
15.
6. Whe e and why a e 10 million child en dying
e e y yea ?” Robe E Black e al. The Lance
2003.
7. “Unde nu i ion as an unde lying cause o
child dea hs associa ed wi h dia hea,
pneumonia, mala ia, and measles,” Lau a E
Caul ield e al. The Ame ican Jou nal o
Clinical Nu i ion, ol. 80, issue 1, July 2004,
pages 193– 198.
8. Malnu i ion as an unde lying cause o
childhood dea hs associa ed wi h in ec ious
diseases in de eloping coun ies, Amy L. Rice
e al. Bulle in o he Wo ld Heal h
O ganiza ion 2000, ol. 78, issue 10, pages
1207–1221.
9. Changes in child su i al a e s ongly
associa ed wi h changes in malnu i ion in
de eloping coun ies, Da id L Pelle ie e al.
Jou nal o Nu i ion Jan 2003, ol. 133, issue
1, pages 107–119.
10. NELSON 22nd Edi ion Pa V chap e 62
11. Unice , “Nu i ional S a us,” h p://www. Chil
din o.o g/malnu i ion nu i ional s a us. php.
12. Wo ld Heal h O ganiza ion, Global Da abase
on Child G ow h and Malnu i ion,
h p://www.who.in /nu g ow hdb/es ima es201
2/en/.
13. In e na ional Ins i u e o Popula ion Sciences
(IIPS) and Mac o In e na ional, Na ional
Family Heal h Su ey (NFHS-3), 2005-06:
India, ol. I, IIPS, Mumbai, India, 2007.
14. Wo ld Heal h O ganiza ion, Managemen o
Se e e Malnu i ion: A Manual o Physicians
11 and O he Senio Heal h Wo ke s, Wo ld
Heal h O ganiza ion, Gene a, Swi ze land,
1999,
h p://whqlibdoc.who.in /hq/1999/a5736.pd .
