Preparing for the next round: convalescent care after acute infection

Abstract

Infections pose a nutritional stress on the growing child. No therapeutic goal is as important as the rapid recovery of preillness weight after acute infections. Successful convalescence, with supernormal growth rates, can be achieved with relatively brief periods of intensive refeeding, offsetting any tendency toward reduced immune defenses or other nutritionally determined susceptibilities to further infection. Since the mother is the only person who can effectively manage convalescent care, she must be given specific tasks with measurable targets in order to reliably oversee the child's rehabilitation. Not generally considered in the realm of preventive medicine, effective home-based convalencent care is the first crucial step in preventing the next round of illness. An approach to the widespread mobilization of mothers to monitor and sustain their children's growth is proposed in this paper. Rather than a passive recipient of health services, the mother becomes the basic health worker, providing diagnostic and therapeutic primary care for her child. Only the mother can break the malnutrition-infection cycle.

PIP: The interactions between infection, nutrition, and malnutrition are discussed in detail. Relevant data from various developing countries is tabulated. It is the job of the health care system to intervene in this cycle with specific programs. Only mothers can break the infection-malnutrition cycle, since they are the ones who provide postinfection convalescent care for their children. Indonesia with the help of the World Bank and UNICEF, has recently organized a program to educate mothers in basic health care, thus making them the main personnel in preventive, primary health care. Supervision should be provided along with the proper diagnostic tools for the mothers to evaluate their own success. Mass media campaigns can be used to publicize the program. Such an approach seems to be the only cost-effective means of intervening in the malnutrition-infection cycle in these countries.