Poor indicator to response during treatment of malnutrition includes –

Guidelines on Hospital based management of severely malnourished children The curent guidelines recommended in-patient (hospital) management of all severely malnourished children are divided into ten essential steps: Treat/prevent hypoglycemia Treat/prevent hypothermia Treat/prevent dehydration Correct electrolyte imbalance Treat/prevent infection Correct micronutrient deficiencies Start cautious feeding Achieve catch-up growth Provide sensory stimulation and emotional support Prepare for follow-up after recovery. Monitoring progress  during treatment Good weight gain is >10 g/kg/day and indicates a good response. It is recommended to continue with the same treatment. Moderate weight gain is 5-10 g/kg/day; food intake should be checked and the children should be screened for systemic infection. Poor weight gain is < 5g/kg/day, screening for inadequate feeding, untreated infection, tuberculosis and psycho-logical problems is recommended. Indicators of failure to respond Primary failure to respond is indicated by: Failure to regain appetite by day 4. Failure to start losing edema by day 4. Presence of edema on day 10. Failure to gain at least 5.g/kg/day by day 10. Secondary failure to respond is indicated by failure to gain at least 5g/kg/day for 3 consecutive days during the rehabilitation phase. Criteria for discharge Severely malnourished children are ready for discharge when the following criteria have been 'Wiled: The absence of infection. The child is eating at least 120-130 cal/lcg/day and receiving adequate micronutrients. There is consistent weight gain (or at least 5 g/kg/day for 3 consecutive days) on exclusive oral feeding. WFH is 90% of NCHS median; The child is still likely to have a low weight-for-age because of stunting. The absence of oedema. Completed immunization appropriate for age. Caretakers are sensitized to home care.