Guideline: Updates on the Management of Severe Acute Malnutrition in Infants and Children

Overview

This guideline provides global, evidence-informed recommendations on a number of specific issues related to the management of severe acute malnutrition in infants and children, including in the context of HIV.

The guideline will help Member States and their partners in their efforts to make informed decisions on the appropriate nutrition actions for severely malnourished children. It will also support Member States in their efforts to achieve global targets on the maternal, infant and young child nutrition comprehensive implementation plan, especially global target 1, which entails achieving 40% reduction by 2025 of the global number of children under 5 years who are stunted and global target 6 that aims to reduce and maintain childhood wasting to less than 5%.

The guideline is intended for a wide audience, including policy-makers, their expert advisers, and technical and programme staff in organizations involved in the design, implementation and scaling-up of nutrition actions for public health. The guideline will form the basis for a revised manual on the management of severe malnutrition for physicians and other senior health workers, and a training course on the management of severe malnutrition.

Contents

• Acknowledgements
• Abbreviations
• Executive summary
• Scope and purpose
• Background
• Recommendations
  • 1 Admission and discharge criteria for children who are 6–59 months of age with severe acute malnutrition
  • 2 Where to manage children with severe acute malnutrition who have oedema
  • 3 Use of antibiotics in the management of children with severe acute malnutrition in outpatient care
  • 4 Vitamin A supplementation in the treatment of children with severe acute malnutrition
  • 5 Therapeutic feeding approaches in the management of severe acute malnutrition in children who are 6–59 months of age
  • 6 Fluid management of children with severe acute malnutrition
  • 7 Management of HIV-infected children with severe acute malnutrition
  • 8 Identifying and managing infants who are less than 6 months of age with severe acute malnutrition
• Dissemination, adaptation and implementation
  • Dissemination
  • Adaptation and implementation
• Guideline development process
  • Formulation of recommendations, including future research priorities
  • Advisory groups
  • Scope of the guideline, evidence appraisal and decision-making
  • Management of conflicts of interest
• Plans for updating the guideline
• References
• Annex 1 GRADE summary of findings tables
• Annex 2 Members of the WHO Steering Committee for Nutrition Guidelines Development
• Annex 3 Members of the Nutrition Guidance Advisory Group – Subgroup on Nutrition in the Life Course and Undernutrition, external resource people, WHO Secretariat and WHO Regional Offices
• Annex 4 External experts and stakeholders
• Annex 5 Summary of considerations for determining the strength of the recommendations
• Annex 6 Questions on the management of severe acute malnutrition in population, intervention, control, outcomes (PICO) format
• Annex 7 Research priorities

Suggested citation:

WHO. Guideline: Updates on the management of severe acute malnutrition in infants and children. Geneva: World Health Organization; 2013.

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