Prepare for discharge and follow up

The average stay in a hospital setting varies between 10 to 15 days (but can be longer), depending on each child’s medical recovery. However the child requires follow up for another 4-6 months for full recovery, depending upon the child’s progress at home. Therefore parent/caregivers must be prepared for discharge and follow up.

  • Before being discharged from the facility, child must become accustomed to eating family meals. While the child is in the ward, gradually reduce and eventually stop the feeds of Catch-up diet, while adding or increasing the mixed diet of home foods, until the child is eating as s/he will eat at home.
  • Ensure that parent/caregiver understands the causes of malnutrition and how to prevent its recurrence by following correct breastfeeding and feeding practices (frequent feeding with energy and nutrient dense foods).
  • Treatment for helminthic infections should be given to all children before discharge. Give a single dose of any one of the following antihelminthics orally:
    200 mg. albendazole for children aged 12–23 months, 400 mg albendazole for children aged 24 months or more.
    100 mg mebendazole twice daily for 3 days for children aged 24 months or more.
  • Before discharge, inform the ANM posted at the nearest PHC or sub-centre in order to ensure follow up. ASHAs and AWWs are an important link in community based follow up of the child till full recovery takes place. All SAM children should be followed up by health providers in the program till s/he reaches weight-for-height of – 1SD.
  • Make a plan with the parent for follow-up visits. Regular check-ups should be made at 2 weeks in first month and then monthly thereafter until weight for height reaches -1 SD or above. If a problem is detected or suspected, visit/s can be made earlier or more frequently until the problem is resolved.