After performing the assessment of sick child for malnutrition and anaemia, the next step is deciding the classification of the child's illness based on the presence or absence of specific signs.

There Are Five Possible Classifications for Malnutrition:

  1. Severe complicated malnutrition:

    If the child's age is below six months and the child has:

    If the child's age is six months or above and the child has

  2. Severe uncomplicated malnutrition

    If the child's age is six months or above and the child has:

  3. Moderate acute malnutrition

    If the child's age is six months or above and the child has:

  4. Underweight in an infant less than 6months age

    Weight for age below the underweight line in the growth chart.

  5. No acute malnutrition in both infant less than 6months or 6months and above

    A child or an infant will be classified as having no acute malnutrition in the following cases:


Assessment and Classification of Malnutrition in Children < 6 Months

Signs Classify Treatment
  • Visible severe wasting OR
  • Pitting Edema of both feet.
    		•  SEVERE COMPLICATED MULNUTRITION
  • Give first of Amoxicillin.
  • Give the first dose of Vitamin A to all except to those with oedema or those who received a dose within the past 6 months.
  • Treat the child to prevent low blood sugar.
  • Advise the mother on the need of a referral.
  • Refer URGENTLY to a health facility ( where there is a stabilisation centre).
    		•
  • Weight for age below underweight line in the growth chart.
    		•  UNDERWEIGHT
  • Assess child's feeding and counsel the mother on according to the FOOD box on the COUNSEL THE MOTHER chart
  • If feeding problem, follow up in 5 days
  • if no feeding problem, follow-up in 30 days
    		•
  • No visible severe wasting AND
  • No oedema of both feet.
    		•  NO ACUTE MULNUTRITION
  • If the child is less than 2 years assess child's feeding and counsel the mother on feeding according to the FOOD box on the COUNSEL THE MOTHER chart.

    • - if feeding problem, follow up in 5 days.
    - if no feeding problem, praises the mother.

    Assessment and Classification of Malnutrition in Children > 6 Months

    Sgns Classify Treatment
  • MUAC less than 11cm OR
  • Pitting oedema of both feet AND
  • Any medical complication: Pneumonia OR Watery diarrhoea OR Dysentery OR Fever/low temperature OR Fail appetite test.
    		•  SEVERE COMPLICATED MULNUTRITION
  • Give the first dose of Amoxicillin.
  • Give the first dose of Vitamin A for all except those with oedema or those who received a dose in the past 6 months.
  • Treat the child to prevent low blood sugar.
  • Advise the mother on the need of referral.
  • Refer URGENTLY to a health facility ( where there is a stabilisation centre).
    		•
  • MUAC less than 11cm or Pitting Oedema of both feet AND
  • No Medical complication: Pneumonia OR watery diarrhoea OR Dysentery OR Fever/low temperature AND Pass appetite test.
    		•  SEVERE UNCOMPLICATED MALNUTRITION
  • Register in OTP and proceed as follows:
  • Give RUTF and counsel the on how to feed a child with RUTF.
  • Give the first dose of vitamin A for all except for those with oedema or those who received a dose in the past 6 months.
  • Give amoxicillin for 7 doses.
  • Give a single dose of 5mg folic acid for those with anemia.
  • Give Mebendazole (If child> 2 years & above).
  • Advise the mother when to return immediately.
  • Follow-up in 7 days
    		•
  • MUAC 11cm to <12 cm AND
  • No oedema of both feet.
    		•  MODERATE ACUTE MALNUTRITION
  • Refer to supplementary feeding program if available.
  • Assess the child's feeding and counsel the mother on feeding according to the FOOD box on the COUNSEL THE MOTHER chart.

    • If feeding problem, follow-up in 5 days.
    If no feeding problem, follow-up in 30 days.
  • Advise mother when to return immediately.
    		•
  • MUAC >12.5 cm or more, AND No oedema of both feet
    		•  NO ACUTE MALNUTRITION
  • If the child is less than 2 years assess child's feeding and counsel the mother on feeding according to the FOOD box on the COUNSEL THE MOTHER chart.

    • If feeding problem, follow-up in 5 days.
    If no feeding problem, praises the mother.