Recovering from Malnutrition: A Step-by-Step Guide

Ever since we were told that Theodore is suffering from severe malnutrition due to his infections and malabsorption syndrome, I have scoured the Internet to know what I can do to help him. I have read articles from WHO and while they may have been very informative, they were not able to satisfy my one answer: how long does it take for the child to recover?

The following is a summary of Theo's progress. It may be different from yours.

Theodore at 3months and 12 days.

27 May 2014

It's been more than a month of no infections for Theodore but on the morning of 27 May, he vomited yellow liquid twice. We brought him to the pedia and were informed that it was stomach acid. We also found out that despite the absence of infections, he is still not gaining weight. At 5 months and 23 days, he was still at 4.7kgs.

At that point, we were referred to a pediatric gastroenterologist at Makati Med.

28 May 2014

We got an appointment with Dra. Sophia Calixto-Mercado for 11:30AM. She checked Theo and noted the distention in his tummy. She also asked for his history and plotted his growth in a growth chart. Theo, she said, is severely malnourished but the problem began when he was a month old, around the same time his health problems started.

Dra. Mercado ordered tests to be done. She ordered for a complete abdominal ultrasound and a stool exam. The stool exam is to check for fat globules, which would signify a malabsorption syndrome.

In the meantime, she recommended that we begin giving Theo Metronidazole and probiotics (Protexin Restore). There was another probiotics, which is to be given after the 7-day Protexin treatment but I forget the name. About two days into the treatment, we noticed that the size of his tummy has decreased. The distention is no longer obvious and he seems to be gaining weight.

Protexin is given as management to acute gastroenteritis in babies 2 months old to 2 years old. It contains 7 strains of good bacteria to help fight the bad bacteria and improve gut function. The other probiotic contains one good bacteria that is not present in Protexin.

Also, she advised to start giving him solids to boost his growth. Theo was only 5 months old but since he can already hold his head steady and he has started to show interest to solids, that should be okay. She said we can try the baby cereal available in the market. We did but it didn't help because after eating, Theo would poop fatty and watery stool. That's why we shifted to giving him indigenous foods, instead.

Taken on 4 June 2014

5 June 2014
Weight: 4.9kls

We had the test results. The abdominal ultrasound showed distention in Theo's large intestine until the sigmoid colon. His stool exam was positive of fat globules. It is confirmed: Theo has malabsorption syndrome.

I should note that after Theo got discharged last April, his pedia recommended giving him Similac Neosure in addition to breastfeeding. Her intention was pure, and that is to promote his growth. Apparently, Theo is lactose intolerant so that was one factor for the malabsorption syndrome. Dra. Mercado told us to stop giving him Neosure and to give Nutramigen, instead.

In addition, I have been drinking cow's milk and dairy was an active part of my diet. Since he's breastfeeding, he's getting the lactose from my diet too so I needed to eliminate dairy altogether.

We were also advised to continue the Probiotics and the Metronidazole for another week.

We were also told to be back for a weekly checkup to monitor his weight gain.

14 June 2014
Weight: 4.7kls

Theo's weight dropped again but Dra. Mercado said that's to be expected in patients recovering from malnutrition. However, clinically, he looked better. His cheeks were fuller, his color was better and his tummy is smaller.

21 June 2014
Weight: 5.08kls

His weight improved. Dra. Mercado told us to add olive oil and Spirulina to his diet. Theo did not like eating very much so it's best to make every spoonful count.

28 June 2014
Weight: 5.3kls

He gained weight again. Dra. Mercado told us to continue everything, except the probiotics and the Metronidazole. On top of that, she also gave e-Zinc, which was given at night for seven days.

We were also told that since the weight gain has been going up steadily, we no longer need to go to the clinic every week. Hooray! Instead, we will just have him weighed at the local health center and call the clinic to report. Should his weight drop again, we will need to go back.

The final diagnosis was: SIBO and Malabsorption Syndrome.

Today, Theo is 5.7kls. He continues to gain weight every week. He is still small for his age (now 7 months old) but he is recovering. He is happier and more active than before.

Taken last 7 July 2014

There is no magic pill that can make Theo or any child recover from malnutrition over night. It takes tons of patience and lots of love to help a child get better. It is also important to followup with your doctor to make sure everything is on track. A good support group is also needed. I'm lucky I have Ate Joy and Tita Tessie to help me take care of Theo and Nathan while Mommy and Daddy are at work.

Why Popeye Loves Olive Oyl

I'd like to believe that the cartoon show I used to love as a kid greatly influenced my desire for healthy food. Popeye, the hero in a popular cartoon series, gets his super strength by eating spinach. His heart beats for Olive Oyl (named after the nutrient-rich Olive Oil).

Both spinach and olive oil are considered super foods. Spinach, for example, is rich with nutrients but packs only a few calories. It helps lower the blood glucose level of diabetic patients and it lowers the risk of cancer. In addition, it helps in maintaining a healthy blood pressure while at the same time, improving bone health. With the host of benefits it provides, there's no wonder Popeye gets super fast and super strong every time he eats a can of the "good old green."

On the other hand, cardiologists recommend the intake of at least two tablespoons of extra virgin olive oil per day in order to reap its benefits to your general health and well-being. This is because extra virgin olive oil aids in boosting your immunity against viruses, and in fighting potentially-fatal diseases like cancer, diabetes, heart disease, obesity, rheumatoid arthritis, osteoporosis, oxidative stress and systolic and diastolic blood pressure.

Additional studies are currently underway wherein olive oil is being tested for its ability to prevent stroke, reduce the risk for Type 2 diabetes, and depression.

Is it safe to give olive oil to your baby?

As long as your infant is at least 6 months old, then it is safe to add olive oil to his diet. Per the guidelines set by WHO and UNICEF, babies less than 6 months old should get their nourishment solely from breast milk or formula (although it's best if it's the former than the latter).

Theodore's doctor recommended that we add extra virgin olive oil to his diet to help him gain weight, among others. This is because this very nutrient-rich oil is also a good source of fatty acid, something that Theo really needs.

Although olive oil rarely causes allergic reactions, you must still only introduce a little of it at a time. When introducing it to your baby, add it to the food that he has no negative reactions to. This will help you in properly gauging his reaction to it.

A word of caution: don't overdo on the olive oil. For every 2 oz of food served, add only about 1/4 to 1/2 tsp.

Is it safe to add olive oil to infant's milk?

It's rather pointless to add olive oil to your baby's milk because the oil and the milk won't mix. Do you remember that science experiment you've had when you were in school? When you add oil and water, they won't mix because the oil is lighter than water. Hence, if you add it to your baby's milk, the oil will just stick to the side of the bottle.

****LIKE ANYTHING ELSE, PLEASE DISCUSS WITH YOUR CHILD'S PEDIATRICIAN OR NUTRITIONIST BEFORE INTRODUCING ANYTHING TO YOUR LITTLE ONE.****