A catch up growth chart.

Abstract

Severely malnourished children should stay in hospital for as short a time as possible to minimize the harmful effects of separation from their families and institutionalization and to ensure that scarce hospital beds are used efficiently. Repletion of wasting, that is, attainment of ideal or expected weight-for-height (EWH) has been recommended as the criterion for recovery from PEM. As it may be impractical to measure length, a simple visual means of monitoring the progress of children recovering from PEM is needed. A “catch up” growth chart was devised, based on the mean deficit in weight-forheight of 2–3 kg of 827 children admitted to the ward of the Tropical Metabolism Research Unit (TMRU) in 1958–1976. This deficit was restored in 10.3 (±3.95 SD) weeks by a subsample of 52 recent admissions, a rate of recovery similar to previous reports from the TMRU. In 1972/1973 a similar treatment regime using oil-fortified milk (“high energy feeding”) was instituted in 4 rural hospitals in Jamaica. As the majority (72%) of the children who were measured attained 90% of EWH, the chart proposed will be practicable in any hospital.