Treatment of hypothermia in severely malnourished children
In children who are 6–59 months of age, severe acute malnutrition is defined by a very low weight-for-height/weight-for-length, or clinical signs of bilateral pitting oedema, or a very low mid-upper arm circumference. Severe acute malnutrition affects an estimated 19 million children under 5 years of age worldwide and is estimated to account for approximately 400,000 child deaths each year.
Severely malnourished children are particularly vulnerable to hypothermia, where the body’s core temperature drops below the required temperature for normal functions. Hypothermia in malnourished children often suggests coexisting hypoglycaemia or serious infection.
The treatment or prevention of hypoglycaemia and hypothermia should be included in the initial treatment a severely malnourished child receives when first admitted to hospital.
WHO recommends re-warming the child by:
- clothing the child (especially the head), covering with a warmed blanket, and placing the child near a heater (not pointing directly at the child) or incandescent lamp; or
- putting the child in skin-to-skin contact on the mother’s bare chest or abdomen and covering them with a warmed blanket and/or warm clothing.
All malnourished children with hypothermia should also be treated for hypoglycaemia and receive broad-spectrum antimicrobials for serious systemic infection.
This is a summary of WHO recommendations on the treatment of hypothermia in severely malnourished children. The full set of recommendations can be found in the documents, Pocket book of hospital care for children (second edition): guidelines for the management of common childhood illnesses and Management of severe malnutrition: a manual for physicians and other senior health workers under ‘WHO documents’ below.
Updates on the management of severe acute malnutrition in infants and children
Pocket book of hospital care for children: second edition. Guidelines for the management of common illnesses with limited resources