OBJECTIVE: Therapeutic Feeding Center (TFC) was focused on collaborating  parents and medical staff to manage malnutrition and prepare the readiness to continue the nutritional program at home. We have a hospital-based TFC managed malnutrition since 2013. This report represented our program and importancy of TFC in hospital especially in rural and limited resouces area like Malinau.
CASE: Since three weeks before admission, a 13 month boy had gradually been oedema anasarca, otorrhea, with pallor, pustulated, itchy, and exfoliated skin. One week lately he had diarrhea. The laboratory finding showed anemia, leucocytosis, hypoalbuminemia, hypoproteinemia, and urine with leucocyte esterase ±15, and leucocytosis. He was  diagnosed with kwashiorkor malnutrition (8,87 kg) with severely stunted (63.5 cm), diarrhea, otitis media, impetigo, and urinary tract infection. We followed the ten steps of severe malnourished children management according to WHO guideline and treated the comorbidity. After reached rehabilitation phase, the comorbid had partially resolved, and no need more special care in ward, he transferred to TFC room. Previously, we built a team consisted of doctor, nurse, dietitian, and the parent. We trained the parent about hygiene, preparing meal as programmed, and stimulating growth and development. At the last days diet recall, he got enough energy and protein from F-100 milk and food (412 kcal/kgBW/day energy and 15,6 g/kgBW/day protein). In nineteenth day of care, he had better clinical conditions, no oedema, complication resolved, BW/H more than -2 SD (7,58 kg), and had better appetite. The team discussed the progress and discharged plan with dietitians and doctor from asscotiated public health center. Coordination was built for further follow up at home.
CONCLUSION: Hospital based-TFC  is effective to manage severe malnourished children in scattered services area. Hospital based-TFC maintained nutrition program from hospital to community.