Here is a list of foods that are high in energy, although some of them are low in nutritional value.  The highlighted foods are the more nutritional foods:

• Severe malnutrition reduces the working of the heart, liver, kidneys and gastrointestinal tract.
• A significant weight loss of 10% (this could mean even a 1kg weight loss in children) can be dangerous to a child’s health.
• Rehabilitation of the malnourished child should take 5 weeks.
• If a child has not eaten properly for over 10 days and then starts to get his/her appetite back, introduce foods slowly by giving half the requirement needed for the child’s age and increase it over a few days.
• As the child’s appetite returns, increase the intake of foods that provide energy and protein.  Do not give too much protein in the beginning of rehabilitation.  Slowly increase it over a few days.
• Treatment is effective in severely malnourished children if they have a weight gain of more than 10g per kg of their weight per day.
• If the child is putting on less than 5g per kg of their weight per day, then the treatment is ineffective.
• Add as much variety as possible to the daily meal intake.
• A child that has HIV/AIDS may require 1-2 times the requirements or the RDA* requirements (i.e. 1-2 times more food than a child who is not infected).
• HIV/AIDS children need 3-5g protein per kg of their weight to allow for catch-up growth.
• HIV/AIDS children need 150-200k calories per kg of their weight per day.
• Children who are severely malnourished and / or have HIV/AIDS may battle to absorb fat so fatty foods will make them feel ill.
• Regularly check and record the child’s growth to detect early signs of growth failure.
• Lack of growth can be as a result of poor food choice rather than food not being absorbed into the child’s system.
• If a child is stunted but looks in proportion, it may be beneficial to see which age group the child fits into for his / her height and then increase the food intake to one and a half times,  allowing for catch-up growth.
• Supplementation may be necessary but not more than 2 times the RDA (Recommended Daily Allowance) for vitamins and minerals.
• Iron supplementation should not be given to children with severe malnutrition or severe infection.
• Malnourished children need Vitamin A supplementation every day.  Check to see if Vitamin A intake is up to date on his / her Road to Health card.
• Make sure food has been cleaned well before cooking, especially it is being eaten raw.
• Meat, chicken and fish should be cooked well.  Make sure eggs are never served runny.
• Store food off the floor in a clean place and keep well sealed.
• Avoid preservatives, artificial colours and artificial flavours.
• Reduce or stop giving the child table sugar if he/she has oral or vaginal thrush.
• Look for signs of worm infestation. General symptoms include irritability, sleeplessness, frequent coughing and abdominal cramps, itching around the anus and loss of appetite.
• Children who have been severely malnourished
• Feed 5 times per day with normal food and supplement with a good multi-vitamin  and minerals
• Eat high energy dense foods such as bananas, milkshakes/ hot chocolate, biscuits
• They need energy and protein dense recipes using local foods.
• Increase portion sizes over a period of time