The hallmark of refeeding syndrome after first week of staing a refeed is:

The hallmark of refeeding syndrome is the development of severe hypophosphatemia after the cellular uptake of phosphate during the 1st week of staing to refeed. Refeeding syndrome is a complication of the acute nutritional rehabilitation odf children who are undernourished from any cause, and it may follow overly aggressive eneteral or parenteral alimentation. When excessive carbohydrates are administered, the resultant increase in serum insulin levels may produce the following: Hypophosphatemia Hypokalemia Hypomagnesemia A controlled transition over 3 days is recommended by the WHO for treating malnutrition, to prevent refeeding syndrome Ref: Nelson textbook of pediatrics 21st edition Pgno: 342