Six hospitals in Israel are preparing to admit dozens of captives who will be released as part of the hostage release deal between Israel and Hamas. As part of the ongoing preparations, the Health Ministry has released a guide on “treating refeeding syndrome in returning captives," detailing what these individuals will eat based on age groups. Schneider Children's Medical Center is expected to treat the returning children, while Ichilov, Wolfson, Sheba, and Soroka hospitals will admit adults.
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The Health Ministry instructed all security personnel to provide the captives with the food and drink they will need until they reach the medical centers due to concerns about refeeding syndrome, which is characterized by increased food consumption after a period of malnourishment:
For infants up to one year: a ready-to-drink bottle with up to 120 ml of infant formula such as Materna, Similac or Nutrilon.
For children from one to three years: water, unsweetened applesauce in a personal portion, one sweet biscuit, sweetened tea with a teaspoon of sugar.
For adolescents and adults: water, a sweetened hot drink with a teaspoon of sugar, three units of sweet biscuits, and unsweetened applesauce in a personal portion.
A guide written under the leadership of the nutrition department managers at Sheba, Wolfson and Clalit HMO hospitals said that "prolonged malnutrition may lead to significant nutritional deficiencies that can adversely affect health and even pose a life-threatening risk.”
“Increased food consumption after a significant period of reduced eating may cause metabolic disorders as well as serious imbalances in fluids and electrolytes that can result in severe clinical conditions, including damage to the nervous and respiratory systems, cardiac function, muscular systems and blood. This condition is called refeeding syndrome. Therefore, uniform guidelines are important in every medical framework in accordance with the points specified in this document."
Refeeding syndrome is characterized by life-threatening fluctuations in electrolytes and fluids, and may occur within approximately 72 hours from the start of feeding in patients suffering from severe malnutrition, including prolonged starvation.
The source of this phenomenon is an increased intake of carbohydrates and calories in a short period of time. Clinical symptoms include fluid retention at the start of feeding, which may lead to heart failure and arrhythmia.
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Professor Hagai Levin, head of the medical department at the headquarters of the families of the hostages
(Photo: Motti Kimchi)
Professor Hagai Levin, head of the medical department at the headquarters of the families of the hostages, said that the families "requested attention to the issue of refeeding because it’s a complex matter that needs to be addressed professionally. What the Health Ministry has done is excellent because it emphasizes the three principles that should be present in the reception of the released captives: Professional work, based on up-to-date and good knowledge that we have. Sensitive and individually tailored treatment for each person nutritionally, as well as in each of the other areas, and gradually in the sense that not all deficiencies and issues can be corrected at once."
He adds that it is "necessary to maintain a calm approach and not rush to fix everything at once but rather gradually over time and in a proper manner. We see this in the dietary regimen, and I recommend, similarly to this regimen, to address other medical aspects. In terms of physical activity, one should act according to the same principles, as well as regarding mental health. In broader aspects, such as dental care, for example, conditions can’t always be addressed adequately in hospitals."