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.

7. THANK YOU