Therapeutic feeding of children 6–59 months of age with severe acute malnutrition and acute or persistent diarrhoea

In children who are 6–59 months of age, severe acute malnutrition is defined by a very low weight-for-height/weight-for-length, or clinical signs of bilateral pitting oedema, or a very low mid-upper arm circumference. Severe acute malnutrition affects an estimated 19 million children under 5 years of age worldwide and is estimated to account for approximately 400,000 child deaths each year.

Diarrhoea is common in malnourished children and can result in decreased absorption of nutrients and significant water loss which can lead to dehydration, shock and ultimately death. Both acute and persistent (i.e. three or more loose or watery stools in a day, for more than 14 days) diarrhoea can worsen the harmful effects of severe acute malnutrition if left untreated. Episodes of prolonged diarrhoea are also associated with increased morbidity and mortality from other diseases, adverse neurodevelopment and stunting.

Although treatment and prevention of dehydration are essential, care of severely malnourished children must focus on the most effective and safest therapeutic feeding approach to resolve diarrhoea while meeting their nutritional needs.