MANAGEMENT OF UNCOMPLICATED SEVERE ACUTE MALNUTRITION

TREATMENT

  • Give oral antibiotics: amoxicillin DT 40 mg/kg twice a day 40 mg/kg for 5 days
  • Give ready-to-use therapeutic food (RUTF) for a child aged ≥ 6 months (for doses, see next
    section)
  • Counsel the mother on how to feed the child
  • Assess for possible TB infection
  • Advise mother when to return immediately (danger signs)

FOLLOW-UP CARE

After 7 days

  • Reassess child and feeding. If no new problem, review again in 7 days

After 14 days or during regular follow up:

  • Do a full reassessment of the child: check WFH/L, MUAC, oedema of both feet and do another
    appetite test

If the child has complicated SAM

  • Refer URGENTLY to hospital

If the child has uncomplicated SAM

  • Counsel the mother and encourage her to continue with appropriate RUTF feeding. Ask
    mother to return again in 14 days

If the child has moderate acute malnutrition:

  • Advise the mother to continue RUTF. Counsel her to start other foods according to the age
    appropriate feeding recommendations
  • Tell her to return in 14 days. Continue to see the child every 14 days until the child has no more
    acute malnutrition

If the child has no acute malnutrition (WFH/L is -2 z-scores or more, or MUAC is 125 mm or more)

  • Praise the mother, STOP RUTF and counsel her about age appropriate feeding recommendations