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Plant protein rehabilitation diets and iron supplementation of the protein-energy malnourished child.

Thirty-eight children admitted to the paediatric ward of Obafemi Awolowo University Teaching Hospital, Ile-Ife, were treated using a local therapeutic regimen for protein-energy malnutrition (PEM). Serum transferrin concentration was measured at weekly intervals to determine the response to and nutritional adequacy of the dietary component of this therapeutic regimen. At discharge, weight for height measurements in the children showed a significant (P less than 0.001) increase in growth although the expected weight for height was not attained. Serum transferrin concentration rose significantly from a mean basal level of 132.1 +/- 17.2 mg/dl to 222.0 +/- 24.6 mg/dl at the end of the first week of hospitalization and at discharge was 403.2 +/- 27.8 mg/dl. Although not statistically significant, mortality was highest amongst children for whom iron supplementation started early on admission. Earlier studies on the aetiology and treatment of anaemia in PEM have argued in favour of routine treatment with iron to prevent the development of anaemia during the recovery phase, but data from this study suggest that iron therapy should not be instituted during the first week of treatment.