Malnutrition Ward

I moved to cover the Protein-Energy-Malnutrition ward, approximately 11 children from 6-18 months age who are severely malnourished.  As I mentioned previously malnutrition is a common cause of death among children here in Zambia. Children come in with swollen extremities and belly’s. The goals are to prevent hypoglycemia, hypothermia, dehydration, infection as well as gradually reintroduce nutrition. Feeding too much protein or sodium too quickly can result in worsening of the childs status, potentially leading to death. Many of the children have concommitant HIV and/or TB. So these illnesses must also be addressed or their nutritionl status will never stabilize. The nurses and the nutritionist here are extremely patient with the mothers. Guiding them through the long process of recovery. Children must be maintsined on a low protein, low sodium formula until their edema resolves. While this is occuring they usually are losing weight. This diuresis can take up to 2-3 weeks. Once their edema has resolved their feeds they can then be switched to a heavier formular and then to free feeds (formula plus, either breast milk or porrige).

Wilison, is a 18 month old patient who is particulalry grumpy because he has to be kept on the lighter formula because of his edema. Everyday on rounds he keeps saying he wants “more”. He really is a cute child, with a lot of spunk, despite his severe illness.

Dan stayed on the maternal-child ward, managing post-partum and the NICU. He was called to the bedside of one of the 28 weekers who was having respiratory distress. Concerned that the infant was about to die he ran to the bedside to perform his assessment. Running through all the possibilities and treatment options, which are pretty sparse, he was thinking that this could possibly be the end for this infant…then all of a sudden the baby sneezed in Dan’s face. The infant perked up and has been doing much better.

Wilison

Wilison's puffy feet



Peds II, Malnutrition Ward





Wilison