Moderate Acute Malnutrition

Moderate acute malnutrition (MAM) is a level of undernutrition in children less severe than severe acute malnutrition, but which still increases the risk of illness and death and requires nutritional support to prevent progression to a more severe state.

• Visible mild to moderate wasting
• Mid-upper arm circumference (MUAC) in the moderate malnutrition range for children 6–59 months (between the severe and normal thresholds)
• Weight-for-height/length between -2 and -3 standard deviations on growth charts
• Reduced energy and activity level compared to a well-nourished child
• No bilateral pitting oedema (which would instead indicate severe acute malnutrition)

• Inadequate dietary intake relative to the child's needs.
• Repeated or prolonged illness, such as diarrhoea or respiratory infections, which increase nutrient needs and reduce appetite.
• Poor infant and young child feeding practices and household food insecurity are common underlying contributors.

• Identified through routine growth monitoring using mid-upper arm circumference measurement and weight-for-height/length assessment against WHO growth standards.
• Checked for the absence of bilateral pitting oedema and other complications that would instead classify the child as having severe acute malnutrition, which requires more intensive management.
• Assessment for underlying illness contributing to poor growth is part of a complete evaluation.

Children with moderate acute malnutrition are generally managed as outpatients with a supplementary nutritious food specifically formulated to support catch-up growth, along with nutrition counselling for caregivers.

Underlying illness, if present, is identified and treated, as ongoing infection can prevent nutritional recovery.

Routine follow-up, including regular growth monitoring, tracks the child's response to feeding support and identifies any need for escalation of care.

Children who do not respond to outpatient management, or whose condition worsens toward severe acute malnutrition, are reassessed for more intensive treatment.

• Promote exclusive breastfeeding for the first six months, with appropriate, nutrient-dense complementary feeding thereafter.
• Attend regular growth monitoring so that moderate malnutrition is identified and addressed before it progresses.
• Ensure prompt treatment of childhood illnesses that can worsen nutritional status.
• Support household food security and nutrition education for caregivers.