Moderate acute malnutrition

Recommendations for MAM

1. Moderate Acute Malnutrition Dr.Himanshu S Dave Department of Pediatrics NRCH, New Delhi

2. In children aged 6–59 months, moderate acute malnutrition is defined as moderate wasting (i.e. weight-for-height between –3 and –2 Z-scores of the WHO Child Growth Standards median) and/or mid-upper-arm circumference (MUAC) greater or equal to 115 mm and less than 125 mm.

3. The dietary management of MAM is based on the optimal use of locally available foods to improve nutritional status and prevent the condition from deteriorating to severe acute malnutrition. In situations of food shortage, or where some nutrients are not sufficiently available through local foods, supplementary foods have been used to treat children with moderate acute malnutrition.

4. Children with a history of low birth weight, or acute or chronic undernutrition , are at increased risk of morbidity and mortality during childhood. In addition, they may also be at increased risk of becoming overweight and obese, and developing non communicable diseases (NCDs) later in life if high-energy food supplements are given indiscriminately as part of efforts to treat or prevent moderate wasting, as doing so may promote unhealthy weight gain.

5. WHO Recommendations Infants and children aged 6–59 months with moderate acute malnutrition need to consume nutrient-dense foods to meet their extra needs for weight and height gain and functional recovery. However, routinely providing supplementary foods to moderately wasted infants and children (i.e. with acute undernutrition ) is not recommended.

6. There may be a role for the provision of supplementary foods in settings where there is a high prevalence of wasting or food insecurity at community or household level, and as part of the continuum of care for the individual child that includes appropriate treatment of clinical conditions and other modifiable factors, provision of nutritional counselling and subsequent follow-up to assess response.

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