Management of acute moderate and severe childhood malnutrition

Acute childhood malnutrition affects about a tenth of the world's children under 5 years of age, particularly those living in circumstances of extreme poverty in the developing world. 1 2 Malnutrition is typically the result of an inadequate diet and is one of the most common diagnoses in children in health facilities in sub-Saharan Africa and south Asia.Acute childhood malnutrition leads to greater risk of death or disability from common paediatric illnesses such as pneumonia and diarrhoeal disease, and it shapes long term health by compromising physical and intellectual development.3 The condition carries a case fatality rate of 5-60%.4 5 This review describes how best to manage cases of acute childhood malnutrition in light of recent changes in standard recommendations. What is acute malnutrition?In acute malnutrition, the amount of one or more macronutrients available to body tissues is inadequate to sustain optimal function.Macronutrient deficiency may result from inadequate diet, poor absorption of ingested nutrients, or the presence of a chronic inflammatory condition that increases requirements for nutrients while promoting a nutrient wasting, catabolic state.How is acute malnutrition diagnosed and categorised?Anthropometry Nutritional status is assessed with the weight for height z score, which compares a child's weight to that of a healthy reference population of children of the same height or length and is expressed in units of standard deviations from the mean of the reference population.