Emergency treatment of large numbers of children with severe protein-calorie malnutrition

Abstract

Dried skimmed milk is the accepted food for the initial treatment of severe protein-calorie malnutrition. Major drawbacks of dried skimmed milk include tendency to provoke or aggravate severe diarrhea (presumably due to lactose intolerance) and its low caloric content predisposing to hypoglycemia and slow rate of weight gain. Kwashiorkor food mix, prepared from dried skimmed milk, calcium casinate, sucrose and reinforced with vegetable oil, was designed to overcome these handicaps with the dried skimmed milk. It was used in treating thousands of children with severe protein-calorie malnutrition during the Nigeria-Biafra War. The results of treatment show that compared with dried skimmed milk, kwashior food mix lowered the rate of severe diarrhea, hypoglycemia and case-fatality; and the patients thus treated showed a faster gain in weight. Furthermore, its combination with postkwashiorkor food mix at a later stage of treatment maintained the initial improvement.