Malnutrition: trials and triumphs

Severe malnutrition is uncommon but often fatal, particularly in very young infants or when oedema is present. Another major contributor to mortality is undiagnosed infection. Three pilot studies have recently been performed in severely malnourished patients in therapeutic feeding centres in sub-Sah aran Africa. In each, a practical management problem was addressed and a po tential solution tested. Three conclusions were reached: young breastfeedin g infants were best managed using a supplemented suckling technique; routin e antibiotics from admission reduced mortality; and in adults with oedemato us malnutrition, therapeutic diets with a lower-than-usual protein:energy r atio were effective in reducing mortality and permitting catch-up weight ga in.