New WHO guideline on the prevention and management of acute malnutrition in infants and young children: remaining challenges

Wasting and nutritional oedema, often referred to together as 'acute malnutrition,' are life-threatening nutritional disorders that affect infants and young children under 5 years.Over the last 25 years, significant advances have been made in managing acute malnutrition, including improving inpatient protocols for severely ill children and expanding opportunities for management beyond the inpatient setting to community-based programmes for children with severe acute malnutrition (SAM).More recent advances have included the incorporation of front-line workers into national and regional systems to detect and treat acute malnutrition; and greater recognition of the dynamic nature of growth faltering and weight loss, including relapse after treatment for SAM. 1 Despite these technical and clinical advances, global progress to eliminate acute malnutrition has been slow.In 2022, around 6.8% of all children under 5 years old (45 million children) experienced wasting, short of the global 2025 target of 5%. 2 Against this background, the WHO released new, updated guidelines on the management of wasting and nutritional oedema on 20 November 2023.The current version is a much-needed update and major expansion from the last edition published in 2013.Areas of expansion include guidelines for supportive care of infants with risk factors for poor growth and development, integrated care of both caregivers and children, management of