Plumpy Nuts: Delivering malnourished children out of the jaws of death

Tema, March 22, GNA – The rib cage visibly out, pale skin, tinny and tightly curled hair with swollen feet and skinny or bloated body; these are some of the symptoms of Severe Acute Malnutrition (SAM) child.

SAM has been a worrying issue for nutritionists across the country with Tema not being an exception. The harbour cum industrial city, in 2020 lost seven children to the condition.

Some children who suffered the condition in the Metropolis were however lucky to have survived after being put on treatment. Four of them were declared cured at the Tema Manhean Polyclinic between December 2020 and February 2021.

Survivors’ story

Ms Lydia Adjeiteh, mother of two-year old SAM child called Apostle could not hide her joy as she talked to the Ghana News Agency (GNA) about her son’s survival story.

Apostle who is the second child of his Mother was healthy until he hit eight months old and one day he started vomiting every food that entered his tiny stomach.

Gradually, he started losing weight and his growth became stagnant as he could not transcend from sitting to walking.

Her quest to save her ailing child took her to many places including prayer camps based on people’s recommendations, “I spent a lot going round with him seeking a cure, but he was rather getting worse until I was referred to the Nutrition Unit at the Tema Manhean Polyclinic”.

She added that after six weeks of treatment and the usage of alternative ways to feed him, Apostle gained weight and started walking, “I will urge every mother with a malnourished child to take advantage of the services of the child welfare clinics (weighing centres) and the nutritionists to save them”.

The story of Julia is not different, her mum Ms Rebecca Aba Annan, was devastated when the baby became frail, stunted and not walking compared to her twin sister Juliet who was healthy and walking, “people even thought she was the back born of her twin sister, it was that bad”.

She said Julia loved the plumpy nut (treatment food) right from day one which aided her early recovery with visible improvement within one week. It took three weeks for her to be taken off the treatment.

Plumpy Nut
Plumpy nut is a Ready-to-Use Therapeutic Food (RUTF), it is a paste of groundnut composed of vegetable fat, peanut butter, skimmed milk powder, lactoserum, maltodextrin, sugar and combined mineral and vitamin mix (CMV).

A child can take between 11 to 25 of the 92 grams packet per week depending on the weight, which range from 3.5kg to 9.4, such children consume between 1.5 and 3.5 packets a day.

According to Mr Samuel Atuahene Antwi, Tema Metropolitan Nutritionist, the Health Directorate often received the plumpy nuts from the Regional Medical Stores which is supplied by the United Nations Children’s Fund (UNICEF).

Mr Antwi expressed worry at the malnutrition cases in the Metro saying, the Manhean nutrition rehabilitation centre which used to feed moderate malnourished children for free to prevent them from getting severe was dying out.

He explained that a corn mill that used to generate some funds with which the malnourished were fed was no longer working, therefore the facility could not sustain the provision of the handouts for food demonstration and free cereal blends to parents leading to officials only doing counselling for such children’s parents.

Saving Malnourished Children

Ms Irene Baka, Manhean Polyclinic Nutritionist is one of the people working hard to save children from SAM. It starts with the observation of the weight for three consecutive weeks to see if it is below three standard deviation (3sd). The Mid Arm Circumference is also measured, anything below 11.5 centimeters means the child needs treatment.

When put on the treatment, weekly visits to the facility for the plumpy nut package are required until the weight improves and the Mid Arm Circumference rises above 12.5cm three consecutive weeks. “Once a child is seen for 16 weeks continuously without improvement, he or she is classified as None Recovery Child who would need further probe to check for other medical conditions that may necessitate hospitalization”.

Touching on their challenges, she said children reject the RUTF, while some parents refuse to corporate with them leading to defaulters and relapses. In addition, others prefer seeking alternative treatment and only report to the hospital when the situation had deteriorated.

Ms Baka shared her experience on how her outfit was able to successfully treat a SAM child who was also HIV positive like her mum, noting that it was one of the challenging cases they handled as the mother was also mentally challenged, and therefore found it difficult to fulfil her part of going to the facility to collect the food and feeding the baby accordingly.

Health officials in her area had to be identified and tasked to ensure the child got the treatment as the mother sometimes ended up eating the plumpy nuts.

All stakeholders especially traditional and opinion leaders, religious establishments, community members, Ministry of Health and the Ghana Health Service.

Others must work together to save children from dying from Severe Acute Malnutrition by helping to identify children with symptoms early to be put on treatment. All must encourage parents of such children to take the treatment serious without defaulting.

Philanthropists and corporate organizations can also help provide the needed logistics to such treatment centres as part of their corporate social responsibility to reduce the numbers and save more children from dying from Severe Acute Malnutrition.

Such deaths are unacceptable and everything must be done to give life to children who certainly are the future of Ghana.