Clinical Approach to a Child with Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM)

Definition and Classification of Malnutrition in Children

Malnutrition in children is a significant public health concern characterized by inadequate nutrient intake, leading to deficiencies in essential vitamins and minerals. It is classified into two main categories:

• Severe Acute Malnutrition (SAM): Defined by extreme weight loss, visible wasting, or nutritional edema due to prolonged insufficient nutrition.
• Moderate Acute Malnutrition (MAM): A less critical condition than SAM, but still requires intervention to prevent progression.

Clinical Approach to SAM and MAM

Diagnosis and Assessment

The World Health Organization (WHO) recommends assessing malnutrition using anthropometric measurements such as mid-upper arm circumference (MUAC), weight-for-height Z-score (WHZ), and clinical signs.

Management Protocol

• Initial Stabilization: Address hypoglycemia, hypothermia, and dehydration.
• Nutritional Support: Gradual refeeding with Ready-to-Use Therapeutic Foods (RUTF) or fortified milk formulas.
• Medical Treatment: Antibiotic therapy, micronutrient supplementation, and monitoring of infections.

Preventive Strategies

Prevention involves improving maternal nutrition, promoting exclusive breastfeeding, ensuring balanced dietary intake, and implementing community-based nutrition programs.