Implementation

What is a Stabilisation Centre?

A Stabilisation Centre is a place where inpatient treatment for complicated cases of severe acute malnutrition is provided in lieu of hospital admission. Stabilisation Centres are often set up in emergency situations.

What do we do when supplies of ‘Nutriset’ sachets of F75 and F100 run out?

F75 and F100 can be made using local ingredients. Use one of the following recipes, depending on the type of milk that is available locally:

F75 formula

  • If using full-cream cow’s milk (fresh or long life): 300ml cow’s milk, 100g sugar, 20g (or ml) oil, 20ml electrolyte/mineral solution and make up to 1000ml with boiled and cooled water
  • If using full-cream dried milk: 35g milk powder, 20g (or ml) oil, 20 ml electrolyte/ mineral solution, and make up to 1000ml with boiled and cooled water
  • If using dried skimmed milk: 25g milk powder, 100g sugar, 30g (or 35ml) vegetable oil, 20ml electrolyte/mineral solution and make up to 1000ml with boiled and cooled water

F100 formula

  • If using full-cream cow’s milk (fresh or long life): 880ml cow’s milk, 75g sugar, 20g (or ml) oil, 20ml electrolyte/mineral solution and make up to 1000ml with boiled and cooled water
  • If using full-cream dried milk: 100g milk powder, 50g sugar, 30g (or ml) vegetable oil, 20ml electrolyte/mineral solution, and make up to 1000ml with boiled and cooled water
  • If using dried skimmed milk: 80g milk powder, 50g sugar, 60g (or 70ml) vegetable oil, 20ml electrolyte/mineral solution and make up to 1000ml with boiled and cooled water

As an alternative to electrolyte/mineral solution, add 3g (½ red scoop) of Combined Mineral and Vitamin mix (CMV) to 1000ml of feed. CMV comes in tins from ‘Nutriset’.

What do we do if there is no CMV?

It is essential to find a source of potassium. If no CMV is available, add 10% KCl solution to feeds (22.5ml per 1000ml feed). If KCl is not available, give each child ½ crushed Slow K tablet/kg body weight per day. Slow K tablets are often given for people with hypertension, and so should be available from the pharmacy.

Magnesium helps potassium get back into the cells so try and find a source of this too. You should find 50% magnesium sulphate solution for injection in your pharmacy or on the obstetric ward (given for eclampsia). Give 0.3ml/kg body weight intramuscularly once (maximum 2ml).

Also try to find a source of zinc. Zinc tablets may be available in your country for children with diarrhoea.