Supplementary foods for the management of moderate acute malnutrition in children aged 6

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Supplementary foods for the management of moderate acute malnutrition in children aged 6–59 months

Intervention | Last updated: 19 May 2023

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.

The dietary management of children with moderate acute malnutrition 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.

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 noncommunicable 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.

Currently there are no evidence-informed recommendations on the composition of supplementary foods used to treat children with moderate acute malnutrition. WHO has published a technical note that summarizes existing knowledge and presents principles on the dietary management of children with moderate acute malnutrition. The technical note also proposes a nutrient composition profile for supplementary foods.

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) presenting to primary health-care facilities is not recommended.*

* 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.

** Indicators for assessing food insecurity are available in the following publication: The Integrated Food Security Phase Classification (IPC) Global Partners. Integrated Food Security Phase Classification. Technical manual version 1.1. Rome: The Food and Agriculture Organization of the United Nations; 2008 (http://www.fao.org/docrep/010/i0275e/i0275e.pdf)