Screening and management of acute malnutrition in children 6 to 59 months old

MUAC: mid-upper arm circumference; WHZ: weight-for-height Z-score (standard deviation score); RUTF: ready-to-use therapeutic food; IV: intravenous.
* This algorithm applies to children with acute malnutrition, with or without underlying chronic malnutrition. Acute malnutrition is defined by wasting (determined by MUAC or WHZ) and/or pitting edema. Chronic malnutrition is generally manifested as stunting (impaired linear growth) and/or underweight for age.
¶ Indications for inpatient treatment include poor appetite, medical complications (sepsis, diarrhea with dehydration, significant skin breakdown with open ulceration), untreated HIV or tuberculosis infection, challenging psychosocial situations that preclude effective outpatient care, or failure of a prior trial of outpatient treatment.
Δ Selection and progression of feeds depends on the results of serial appetite tests using RUTF. For details on inpatient management, refer to UpToDate content on management of complicated severe acute malnutrition.
◊ Oral antibiotics are not needed if the child has completed a course of empiric IV antibiotics as an inpatient.