How to prevent or overcome this nutritional deficiency?
A large number of government schemes and programmes have been launched about which we have already studied in the Public Nutrition Course. Along with these programmes, new initiatives need to be put in place to deal with these conditions. Selective feeding programme should be initiated for PEM affected individuals and these include supplementary reading programmes, providing an extra 500-700 Kcal day from cooked food or by distribution of dry take home rations (1000-1200 Kcal day). Breast-feeding must be encouraged. Blanket supplementary feeding programmes should be needed only temporarily when the malnutrition rates (weight-for-height below median -2 SD) exceed 15% or 10% in the presence of other aggravating factors.
Targeted supplementary feeding (i.e. extra food given to the selected individuals), is indicated if the malnutrition rate exceeds 10% or 5% in presence of other aggravating factors e,g. high mortality and/or epidemic infectious diseases. Therapeutic feeding is required to reduce the death rate among infants and young children. A rehabilitative diet, with high-energy foods (providing 150-20 Kcal and 2-3 g of protein /kg body weight daily) should be served at frequent intervals. For the first few days, there should be a close medical supervision and feeding should be made at every 3 hours on a 24 hour basis. Mothers should feed their sick children themselves. Broad spectrum antibiotics for the treatment of emerging infections, immunization against measles and normal doses of vitamin A should be-made available.