Complications of Malnutrition


(blood sugar <3 mmol/l or <54 mg/dl)


(axillary temperature < 35.0C)


(Differential diagnosis hypovolaemic- and or septic shock)

Definition: AVPU = ≤P, cold peripheries, capillary refill (>3 sec) AND a weak fast pulse


Use ReSoMal 5 ml/kg every 30 minutes for 2 hours (="ReSoMal challenge") in malnourished children (very thin evidence, if O/S: give ORS).
Than reasses, if the child is no longer dehydrated, give 5 ml/kg per loss. Monitor carefully. Be aware of volume overload. In case of emerging oedema around eyes, taper or stop fluids.

Anaemia (PCV<12%)

Only transfuse children with a PCV<12% (Hb <4 g/dl or <6 g/dl and respiratory distress), and then preferably with fresh whole blood.

Photophobia, Xerosis, Bitot’s spots, xerophtalmia and corneal ulceration

Multidisciplinary Teams

Malnourished children are also "mentally malnourished". Once stabilized, they should be engaged into social interaction and play therapy. Encourage parents to make use of the play therapy room across from Moyo Ward and to converse and play a lot with their children.

Involve physiotherapy early in children with CP.

Nutritionist(when available)
Get them to help to get a full history of the child’s/family’s feeding habits at home.