If a child was classified with moderate acute malnutrition and referred to a supplementary feeding centre, or the mother has been given counselling to help her improve feeding and care of her child, she should be advised to return for a follow-up visit after 30 days. If there was a feeding problem as judged by the feeding recommendations in your chart booklet, the mother should be advised to return with the child earlier than 30 days.
You may have specially scheduled sessions for nutritional counselling, and mothers with a malnourished child can be asked to come for a follow-up visit at this time. A special session allows you to devote the necessary time to discuss feeding with several mothers and perhaps demonstrate some good foods for young children.
When the mother attends your health facility for a follow-up visit after 30 days for a child with moderate acute malnutrition, you should take the steps set out below. As you read above, you should praise the mother and encourage her to continue good home care for her child. This will ensure that she feels supported by you.
After 30 days
Treatment
Exception
A child for whom you do not think that feeding will improve, or whose MUAC is not improving, must always be referred to a higher health facility or hospital for better management.
The figure below sets out the steps you need to follow to assess the child’s feeding. It will help you judge what advice and support you can give the mother or caregiver of the child.
Assess the child’s feeding
Ask questions about the child’s usual feeding behaviour. Compare the mother’s answers against the feeding recommendation for the child’s age.