A 2-year-old child has severe acute malnutrition (MUAC 10.2 cm, bilateral pitting edema grade 2). The child has no medical complications (no shock, no altered consciousness, no severe vomiting or respiratory distress). According to the WHO/UNICEF SAM management protocol, what is the CORRECT treatment approach?
- A Hospitalization with F-75 formula, antibiotics, and micronutrients
- B High-calorie F-100 formula from day 1 to achieve rapid weight gain
- C IV albumin infusion to correct hypoalbuminemia and edema
- D Outpatient management with ready-to-use therapeutic food (RUTF) and antibiotics if no complications ✓
Explanation
WHO/UNICEF protocols (2007, updated guidelines) recommend Community-Based Management of Acute Malnutrition (CMAM) for children with SAM who have no medical complications. These children can be managed as outpatients with ready-to-use therapeutic food (RUTF — Plumpy'Nut), routine antibiotics (amoxicillin), and micronutrients. Inpatient management (with F-75 stabilization formula) is reserved for children with SAM who have medical complications (shock, severe dehydration, altered consciousness, severe anemia, respiratory distress). F-100 (high calorie) is used only in the rehabilitation phase after stabilization on F-75, not from day 1, to avoid refeeding syndrome.
Reference: Ghai Essential Pediatrics, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.