Important things NOT to doin the management of SAM cases is "Don't give iron during initial feeding (Stabilization ) phase. Iron can be given only after the child has been on F-100 for 2 days (usually during week 2). So why it is not given during early (stabilization) phase of the management for SAM cases?
It is not advisable to give iron during the initial phase of feeding.Giving iron early in treatment can have toxic effects and interfere with the body's ability to resist infection.More to the point, there is no need to add iron when the child is on RUTF. Too much protein in the first days of treatment may be dangerous because the child is unable to deal with the extra metabolic stress involved .Too much protein could overload the liver, heart, kidneys and may cause death.
There is some evidence that iron supplementation can increase the mortality risk of children with SAM in the initial phase of treatment, and it is thought that this is related to the risk of free radical damage and infection.
Increased risk of infection also through alteration of gut flora resulting in diarrhoeas. In fact, we hold off iron in most acute infections till stabilisation is achieved with antibiotics etc.
Foods rich in iron can be given at the acute stage of malnutrition to avoid progression.In Severe acute malnutrition, all nutrients are low.So protein, iron, zinc and other nutrients are needed but not in excess.
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