title: [Nutritional support for malnourished hospitalized children: experience of a referral center, São Paulo, Brazil].
abstract: OBJECTIVE
  To study anthropometric development, nutritional support and mortality rate of malnourished children hospitalized in a referral center.
  
  
  METHODS
  In a retrospective study we surveyed 98 hospitalized malnourished children (ZW<--2) with no chronic disease. Data collected was: birth weight, gestational age, length of exclusive breast feeding, diagnosis at admission, formula used (type, delivery route and feeding tolerance) and length of stay. Weight and height were controlled at admission and discharge. To classify and evaluate nutritional rehabilitation we used the Z-score: weight-for-age (ZW), height-for-age (ZH), weight-for-height (ZW/H). The nutritional therapy used was based on the World Health Organization (WHO) guidelines, with minor modifications. All chosen formulas were industrialized: lactose-free polymeric formula (PLF) for children with diarrhea, low lactose polymeric formula (PLL) for children without diarrhea and cow's milk hydrolysate (CMH) for sepsis or chronic diarrhea. At the rehabilitation phase, all children were given the PLL formula.
  
  
  METHODS
  Student's t and chi-square tests.
  
  
  RESULTS
  The median of age and length of stay were 9.8 months and 17 days, respectively and the mortality rate was of 2%. Diarrhea and/or pneumonia were diagnosed at admission in 81.6% of the children. An improvement of 17.3 % ZW, 82.7 % ZH and 92.2 % ZW/H was observed. PLF was more frequently given at admission (47.4%) while CMH was given to only 7.4% of the children. Twenty-four percent of the children were tube fed and 5.1 % received parenteral nutrition. Tolerance of the initial formula was considered good in 66.7% of cases.
  
  
  CONCLUSIONS
  The WHO guidelines were effective in the nutritional therapy of severely malnourished hospitalized children, resulting in good nutritional rehabilitation with low mortality rates.
authors.affiliation: Centro de Referência de Saúde da Mulher, Nutrição, Alimentação e Desenvolvimento Infantil, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP. rssarni@uol.com.br
authors.forename: Roseli Oselka Saccardo
authors.initials: RO
authors.lastname: Sarni
authors.forename: Fabíola Isabel Suano de
authors.initials: FI
authors.lastname: Souza
authors.forename: Priscila
authors.initials: P
authors.lastname: Catherino
authors.forename: Cristiane
authors.initials: C
authors.lastname: Kochi
authors.forename: Fernanda Luisa Ceragioli
authors.initials: FL
authors.lastname: Oliveira
authors.forename: Fernando José de
authors.initials: FJ
authors.lastname: Nóbrega
mesh_terms: D000886:Anthropometry; D001938:Brazil; D015362:Child Nutrition Disorders / Q000628:therapy*; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D017408:Guidelines as Topic; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D018529:Nutritional Support / Q000379:methods*; D012189:Retrospective Studies