Alternative methods of classifying severity of malnutrition in children younger than 2 years of age with poor weight gain in resource-abundant settings^[1]

Growth parameters	Mild malnutrition	Moderate malnutrition	Severe malnutrition
Weight-for-length Z-score*	–1 to –1.9	–2 to –2.9	≤–3
Mid-upper arm circumference Z-score	–1 to –1.9	–2 to –2.9	≤–3
Decline in weight-for-length Z-score	≥1	≥2	≥3

WHO: World Health Organization.

* The WHO weight-for-length percentiles for infants <24 months can be determined using the related UpToDate calculator.

¶ As an alternative, the WHO also defines wasting in children 6 to 59 months as mid-upper arm circumference 115 to 125 mm (moderate wasting) and <115 mm (severe wasting). These flat cutoffs can be used as field measures in place of Z-scores, particularly in low-resource settings^[2].

References:

Becker P, Carney LN, Corkins MR, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). Nutr Clin Pract 2015; 30:147.
Note on terminology of "wasting" and "acute malnutrition." World Health Organization 2023. https://fscluster.org/sites/default/files/documents/note_on_terminology_acute_malnutrition_and_wasting_who_feb_2023.pdf (Accessed on July 19, 2023).

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Alternative methods of classifying severity of malnutrition in children younger than 2 years of age with poor weight gain in resource-abundant settings[1]

Alternative methods of classifying severity of malnutrition in children younger than 2 years of age with poor weight gain in resource-abundant settings^[1]