De-worming Guidelines

1. De-worming should be done at least one week prior to the first feeding
session.
2. The following are NOT eligible for de-worming:
a. Children who were de-wormed in the last six months
b. Children who are sick during the day of de-worming (with fever, colds,
flu or other illness)
c. Children below two years old
3. Informed consent must be secured from the parents of the children who will
undergo de-worming.
4. Give diphenhydramine syrup prior to the administration of the antihelmintic
drug (Albendazole 400 mg). This is best given just before leaving the
community. Inform the parents about the purpose of giving this drug.
a. Diphenhydramine is given to prevent erratic behaviour of the worms
(or to calm, or to weaken the worms) once the antihelmintic takes
effect.
5. The parents are the one who will administer the antihelmintic drug to their
children at home. Give them the following instructions and reminders:
a. Explain the purpose of the antihelmintic drug. This drug is given to
eradicate the worms present in the gastrointestinal tract of the child or
as a preventive measure against helminth infestation. This will ensure
that the child will benefit from the nutrients that he/she gets from the
food he/she eats.
b. Before giving the antihelmintic drug, give 1 teaspoon of
diphenhydramine twice a day for two days. During the last dose of
diphenhydramine, give the antihelmintic drug before the child goes to
sleep. Tell the parent that the diphenhydramine will make the child
sleepy so it is not best to give it during school days.
c. Do not give the antihelmintic drug if the child is sick or had been given
antihelmintic in the last six months
d. Dead helminths may be expected in the feces of the child the following
day. In extreme cases, helminths can be emitted through vomiting.
Guidelines in Vitamin A supplementation
1. Vitamin A (200,000 IU) is given during the first feeding session.
2. It should NOT be given to the following:
a. Children who received Vitamin A supplementation in the past six
months.
b. Children below two years old.
3. Explain the purpose of Vitamin A to the parents:
a. Vitamin A is important in eyesight development.
b. Other sources of Vitamin A are vegetables like carrots, squash and
others.
c. Vitamin A deficiency can lead to blindness
d. It should only be given (supplement) once every six months.

4. Secure informed consent.

5. Vitamin A capsules are administered by cutting the tip of the capsule and
squeezing its full content to the mouth of the child.