Children who now have severe acute malnutrition

million

Children who now have moderate acute malnutrition

million

Children who are now chronically undernourished

million

Girl with severe acute malnutrition before and after treatment with Plumpy'Nut.

An example of a young child with severe acute malnutrition who, with the interventions of a community health system and Plumpy'Nut, recovered her health in about 7 weeks. 

What is malnutrition?
How is malnutrition measured?
What is severe acute malnutrition (SAM)?
What is moderate acute malnutrition (MAM)?
How can malnutrition be prevented?
What is malnutrition?

Childhood malnutrition, or the state of being poorly nourished, is not always the result of hunger or too little food available. Complicating factors may include: unsuitable foods given to children that do not provide sufficient protein, energy, or micronutrients; inadequate care or feeding practices; frequent infections or disease from inaccessible or poor health services; and unsafe water or insufficient sanitation systems.

Adequate nutrition, especially in the first 1,000 days of life, can have a lasting impact on a child's future. Edesia's range of ready-to-use foods (RUFs) target various stages of malnutrition in children under the age of five years, including prevention of malnutrition. The different types of malnutrition that Edesia's products target are: severe acute malnutrition (SAM), moderate acute malnutrition (MAM), and the prevention of stunting.

Because malnutrition can have many different contributing factors, the problem of malnutrition must also be solved through interdisciplinary activities. It is often not enough to provide nutrition supplementation, and other program activities should always be combined with this strategy to improve impact on nutrition status.

How is malnutrition measured?

muac-300x200-square

Anthropometry is the measurement of the human body; these measurements can tell us if an individual is malnourished (either overnourished or undernourished), and about the nutritional status of populations.

In the field, malnutrition (in this case, undernutrition) is most commonly measured through weight, height, and mid-upper arm circumference (MUAC). Some of these measurements are presented as indices, such as height-for-age (HFA) which measures chronic malnutrition (stunting) and weight-for-height (WFH) which measures acute malnutrition. MUAC measurements allow health workers to quickly determine if a patient is acutely malnourished by comparing results to recommended cut-offs for children 6-59 months. Health workers also look for edema (on both feet/legs) to indicate acute malnutrition.

What is severe acute malnutrition (SAM)?

Severe Acute Malnutrition (SAM) is a serious, life-threatening condition — characterized by severe wasting (thinness) or bilateral edema — that results from illness, lack of appropriate foods, or other underlying causes. SAM affects millions of children under the age of five years worldwide, in both emergency and non-emergency settings.

SAM is diagnosed by confirming that a child’s weight (6-59 months) is much too low, relative to their height (weight-for-height z-score < -3), their mid-upper arm circumference is too small (MUAC <115mm), or they have edema (or swelling) in both feet.

With the invention of Ready-to-Use Therapeutic Foods (RUTFs), the care of children with SAM has moved from in-patient, facility-based treatment to decentralized community and home-based care. Children with uncomplicated SAM are now, preferably, treated in highly effective community-based programs — often referred to as Community-based Management of Acute Malnutrition (CMAM). This change in programming has taken some of the burden of treatment away from families by bringing care to communities — caretakers no longer have to travel far distances and stay in a hospital with their malnourished child, leaving the rest of their family and their livelihood behind.

CMAM programs have a much higher coverage rate than facility-based programs because they use an active case-finding approach to find children who need treatment. This means that children can be identified sooner and treated with appropriate medication and RUTF and weekly or bi-monthly visits to a local health center. Children who are found to be unable to eat or have a co-morbidity — such as severe diarrhea, TB, or another infection — are referred for in-patient care until they stabilize enough to be treated at home.

What is moderate acute malnutrition (MAM)?

Moderate acute malnutrition (MAM) is a state of moderate wasting (thinness) that makes children at risk for deteriorating into severe malnutrition and more susceptible to life-threatening illnesses. MAM results from illness, lack of appropriate foods, or other underlying causes. MAM affects millions of children under the age of five years worldwide, in both emergency and non-emergency settings.

MAM is diagnosed by confirming that a child’s weight (6-59 months) is too low, relative to their height (weight-for-height z-score ≤-2 & >-3) or the child’s mid-upper arm circumference is too small (MUAC ≤125 & >115mm).

Children who are identified with MAM are often admitted to supplemental feeding programs (SFP), where they are provided additional food to supplement their normal home diet. Objectives of supplementary feeding programs are to rehabilitate children, prevent deterioration to severe acute malnutrition, and reduce mortality.

How can malnutrition be prevented?

Adequate nutrition during childhood can save lives and have a lasting economic impact on the future of a child, community, and country. Research provides strong evidence that adequate nutrition in the first 1,000 days of life (from conception to age two) builds up the necessary human capital for healthy and productive societies.

Evidence shows that focusing on providing the right nutrition during the 1,000 day window can have large impacts in global health, including saving more than one million lives each year; significantly reducing the human and economic burden of diseases such as tuberculosis, malaria, and HIV/AIDS; reducing the future risk for developing various non-communicable diseases such as diabetes; and increasing a country’s GDP by 2-3 percent or more annually.

Preventing malnutrition must include various multi-sectoral, nutrition-sensitive initiatives, such as poverty reduction; improvements in basic healthcare, infrastructure, and sanitation; food insecurity reduction; better response during and after emergencies; and many others. But some of the most important initiatives focus on promoting appropriate caregiver feeding and caring practices, such as exclusive and continued breastfeeding, and providing nutrient-dense, complementary foods for children starting at the age of six months.

Provision of LNS products for young children and pregnant and lactating women is one nutrition-specific intervention that may help prevent forms of undernutrition, such as micronutrient deficiencies and stunting.

Are you a humanitarian organization with a nutrition program?

If you are (or are interested in starting one) and would like to learn more about which products would fit best into your programming, please contact our nutritionist.