A wasted 2-year-old with severe acute malnutrition (SAM) is admitted. After ruling out medical complications, what is the MOST appropriate initial dietary approach?
- A Begin F-75 formula (75 kcal/100 mL) to correct deficits gradually ✓
- B Start high-protein, high-calorie diet immediately (150-200 kcal/kg/day)
- C Give only oral rehydration solution for 48 hours
- D Introduce RUTF immediately from day 1
Correct answer: A. Begin F-75 formula (75 kcal/100 mL) to correct deficits gradually
Explanation
WHO protocol for SAM management involves two phases. In the stabilization phase (days 1-7), F-75 diet (75 kcal and 0.9 g protein per 100 mL) is given at 100 mL/kg/day to gently restore metabolic homeostasis and avoid refeeding syndrome. High-calorie feeding too early risks electrolyte imbalance, cardiac failure, and hypoglycemia. The rehabilitation phase uses F-100 or RUTF once the child is stable and has appetite. Refeeding syndrome is a life-threatening risk in SAM.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.