SEE PROFILE

Objective To report a nutritional rehabilitation program in Niger for the management of severe acute malnutrition in infants aged <6 months. Study design This is a presentation of a case series (n = 632) of young infants who were admitted to a nutritionW/L Weight-for-lengthrehabilitation program in 2010-2011. The main characteristics of the inpatient treatment protocol where the use of diluted F-100 milk via a supplementary suckling technique until exclusive breastfeeding was reinitialized, coaching of mothers on infant feeding, and intensive antibiotic therapy as indicated during the stabilization phase. Semistruc-tured interviews were conducted with 103 mothers. Results Rates of recovery, mortality, and default were 85 % (537 of 632), 6 % (37 of 632), and 9 % (55 of 632), respectively. The majority of infants had an infectious disease at study entry (81%), particularly acute watery di-arrhea and respiratory tract infections. Infection on admission was a predictor of death during treatment (OR, 3.9; 95 % CI, 1.6-9.2). Anorexia at entry was a risk factor for treatment failure (OR, 4.4; 95 % CI, 1.71-11.1). Interviews revealed a very low rate of exclusive breastfeeding (3%), with delayed initiation in 68 % of cases. Traditional be-liefs, perceived insufficiency of breast milk, and psychological problems played important roles in feeding choices. Conclusion Severe acute malnutrition in infants aged <6 months can be successfully treated by managing cases as inpatients with an adapted protocol, intensive clinical supervision, and intensive drug treatment if indicated