Case of the Month #43 Refeeding Syndrome

Published 14/09/2023

How would you initiate feeding in a severely malnourished patient?

The British Dietetic Association (BDA) guidelines5 recommend that refeeding starts at 30-35Kcal/Kg/day (less if patient is clinically unwell or very low weight) which can be increased by 200-300kcal/day every 2-3 days. Weight starts increasing usually by seventh day. 

It is important to provide intravenous B vitamins and phosphate supplementation at the onset of feeding.