All severely malnourished children have vitamin and mineral deficiencies. As giving iron in acute phase can make infections worse, although anaemia is common, do NOT give iron initially but wait until the infection is controlled, child has a good appetite and starts gaining weight (usually by the second week)
Treatment
Give:
Vitamin A orally on Day 1 unless there is definite evidence that a dose has been given in the last month (for age >12 months, give
200,000 IU; for age 6-12 months, give 100,000 IU; for age 0-5 months, give 50,000 IU)
Give daily for at least 2 weeks:
Multivitamin supplement (without iron)
Folic acid 1 mg/d (give 5 mg on Day 1)
Zinc 2 mg/kg/d
Copper 0.3 mg/kg/d (if available)
Elemental iron 3 mg/kg/d but only when gaining weight (start in rehabilitation phase when gaining weight)
