A 2-year-old child with severe acute malnutrition (SAM) is admitted to a facility. Weight for height is -4 SD. The child has no pedal edema and a good appetite. According to WHO/IAP SAM management protocol, this child is BEST managed with:

• A Community-based management with ready-to-use therapeutic food (RUTF) at home, with follow-up visits ✓
• B Inpatient F-75 therapeutic milk for stabilization followed by F-100
• C Inpatient IV glucose infusion followed by transition to solid foods at 72 hours
• D High-energy formula (150 kcal/kg/day) and multivitamins as outpatient

Explanation

Children with SAM who have a good appetite (pass the appetite test), are alert, and have no medical complications (including no edema, vomiting, hypothermia, or severe infection) qualify for community-based management (CMAM/IMAM). RUTF (ready-to-use therapeutic food, such as Plumpy'Nut) is provided for home consumption at 200 kcal/kg/day with weekly or biweekly follow-up. Inpatient (F-75 followed by F-100) management is indicated for complicated SAM (edematous malnutrition/kwashiorkor, failed appetite test, medical complications). This approach reduces inpatient burden while achieving equivalent outcomes per WHO 2013 guidelines.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.