Prognostic factors affecting outcome of hospitalised infants 1-6 months with severe acute malnutrition in North India

Abstract

Background: Emerging evidences show that severe acute malnutrition is prevalent in infants below 6 months of age. This study is focused on the prognostic factors which decide the outcome of management of these infants in a hospital.Methods: Admitted patient for severe acute malnutrition and related complications were observed during their stay in the hospital. Detailed history to find out contributing factors that cause severer acute malnutrition in this age group was taken. Anthropometry, related morbidities were recorded and outcome was assessed.Results: A total of 115 infants of 1 to 6months of age were enrolled to study. Birth characteristics such as birth weight (p-value 0.0133), prematurity (p-value 0.023), birth spacing (p-value 0.0064), infant feeding characteristics as giving pre-lacteal feed(p-value 0.011), exclusive breast feeding (p-value 0.0473), deprivation of colostrum (p-value 0.003), maternal characteristics as age at first conception (p-value <0.0001), maternal literacy status ( p-value 0.0453); presence of sepsis, incomplete immunization, presence of bilateral pedal edema, visible severe wasting, all these variables were found to affect the recovery of an infant during hospital stay.Conclusions: The present study helps to identify significant risk factors associated with severe acute malnutrition in less than 6 months old infants which can be included in management, prevention and policy making in future.

Management outcome and risk factor in children with severe acute malnutrition in <6 months of age and role of supplementary suckling technique in re-establishing breastfeeding

“…This finding is consistent with the study of Lalit Kumar et al [12] in which 68.69% were cured, 27.82% were no responders, and 0.8% expired. In a study by Vygen et al [15], Recovery was 85% whereas mortality was 6%.…”

“…In the present study, 72% of the cases of SAM were preterm and only 28% were term. This is consistent with the findings of Kumar et al, (2018) [12] study which described that preterm babies were more prone to be non-responder as compared to term babies.…”

“…A total of 29.33% cases of SAM received colostrum in our study, which is much low than compared of Diksha Sharma et al, (2017) [13] study in which 59% of SAM infants received colostrum. Similarly in Lalit Kumar et al, (2018) [12] study, infants who received colostrum were only 18.30% (13/68) non-responders as compared to 54.54% (19/47) in infants who were not given colostrum and were significant (p=0.003).…”

“…Similarly, Kavita Choudhary et al [7] study also found a strong association between exclusive breastfeeding up to 6 months with malnutrition. Furthermore, in Lalit Kumar et al, (2018) [12] study, among the exclusive breastfed infants only 16.27% (7/43) were non-responders which was very low as compared to 34.72% (25/72) who were top fed which was statistically significant (p=0.0473). Partial breastfeeding was positive in 145 (70.7%) of the study cases and no breast feeding was noted in 60 (29.3%) in the study done by Saadia et al [14] study.…”

“…This was consistent with the findings of Diksha Sharma et al, (2017) [13] study in which only 46.3% of the control group and 71% of the severe malnutrition group received pre-lacteal feed which was statistically significant. The effect of pre-lacteal feeds can be appreciated by the findings of Lalit Kumar et al, (2018) [12] study in which out of the total infants who were given pre-lacteal feeds 47.4% were non-responders which was much higher than compared to the ones who were not given prelacteal feeds (18.2%). In the study done by Sharma et al [16] The most common presenting complaint in our study was inappropriate weight gain (61.33%) followed by loose stools (17.33%) whereas in Singh et al [15] study acute diarrhea (21%) was most common followed by failure to gain weight.…”