Tackling Malnutrition with Therapeutic Feeding
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© UNICEF Swaziland 2007 JKim |
Mbabane, September 2007 – Dr. Thembe fixes his gaze on 13-month-old Lisa. She is tiny, lost in the bright red jumper that bunches around her small frame. Despite her small size, her eyes are big and bright; she catches the doctor’s gaze and holds it.
“This is one of the cases that make you smile,” says Dr. Thembe, a pediatrician at Mbabane Government Hospital. “This is happening like it’s supposed to in the books on therapeutic feeding. Much of it is thanks to the mother, who really cares about this child’s welfare.”
Buhle, Lisa’s 19-year-old mother, stands nervously at Lisa’s bedside, stroking the fuzzy patches of hair on her daughter’s head. Buhle brought Lisa to the hospital nearly two weeks ago, after her daughter’s fever, diarrhea and vomiting would not stop. Lisa was admitted for severe malnutrition.
“I am thankful even now,” says Buhle. “There was little food at home and no one is working. I just wanted her to grow and now she is. She is okay.”
After she was admitted, Lisa was put on Mbabane Government Hospital’s new therapeutic feeding regiment. While the country is in the grips of the worst drought in 15 years, UNICEF, together with the Swaziland National Nutrition Council, have set up therapeutic feeding centres (TFC) throughout the country. Each of the nation’s five hospitals were equipped to serve as TFC sites. UNICEF and partners held trainings for hospital staff to sensitize them on the need for therapeutic food and its proper preparation.
“The training was invaluable, even for doctors who’ve been around awhile,” says Dr. Akingba, head of pediatrics at Mbabane Government Hospital. “We all know what we are supposed to do and why it is so important. Thanks to the training, everyone is doing their best to make these children better.”
Since the bodies of severely malnourished children are unable to process regular food, they cannot be fed thin porridge or other typical foods for infants. Instead, therapeutic food must be taken for up to one month, or until their bodies are able to process traditional foods.
Mbabane Government Hospital and the other TFC sites in Swaziland are using the powdered milk formulas of F-75 and F-100. Both are formulated specifically for severely malnourished children and should be used only under supervision. F-75 is a milk-based powder mixed with water and given to severely malnourished children when they first arrive for treatment. It is normally given for one to three days or up to a maximum of seven days. It is not intended to cause a child to gain weight, but only to condition the body to digest food.
F-100 is the phase 2 therapeutic milk. It is also a milk-based powder mixed with water. It contains more protein and calories than F-75 and is designed for rapid weight gain, so that the child’s body can rebuild and be able to handle normal foods.
Lisa responded beautifully to the therapeutic feeding, gaining more than half a kilo during her first two weeks. She has regained her appetite, eagerly drinking the milk that her mother administers. The listless little girl with the blank stare that was admitted 14 days ago is no more. Her eyes are clear and bright and she even manages to smile.
Lisa’s father is now working and promises to help support his daughter. If Lisa’s weight gain continues, she and Buhle will journey home soon. Buhle looks forward to the heaviness of her daughter against her back, happy to carry home a daughter who weighs so much.
