SAM
Severe acute malnutrition (SAM) or severe wasting is defined by very low weight-for-height (below -3 z-scores of the median WHO child growth standards), a mid-upper arm circumference < 115 mm, or by the presence of nutritional edema. Acutely malnourished children lack growth nutrients that are required to build new tissues. These nutrients aid weight gain after illness, repair damaged tissues and help replace the rapid turn-over of cells (intestine and immune cells). SAM remains one of the major killers of children under five; it contributes to approximately 5 million child deaths every year in India. Most of the deaths caused by SAM can be averted through timely treatment.
MANAGEMENT OF SAM CHILDREN
Ready-to-Use-Therapeutic Foods (RUTFS)
Ready-to-Use-Therapeutic Foods (RUTFs) and Lipid-based Nutrient Supplements (LNS) are created from simple ingredients, but the nutritional science behind them is highly sophisticated and constantly evolving. Children with SAM need safe, palatable foods with high energy content and adequate amounts of vitamins and minerals. The most widely used RUTF spread is a mixture of milk powder, sugar, vegetable oil, peanut butter, vitamins and minerals. RUTF spread can be safely and easily produced in small or large quantities in most settings worldwide. Several countries in Africa such as Niger, Congo, Malawi and Ethiopia are manufacturing RUTF following appropriate technology transfer. Presently there is no indigenously available RUTF in India.
Community Based Management of SAM
Until recently, treatment of severe acute malnutrition was restricted to facility-based approaches, greatly limiting its coverage and impact. All children suffering from SAM had to be admitted as inpatients to Therapeutic Feeding Centers (TFCs) and there therapeutic milk powders reconstituted with clean water. Children were required to stay in hospital for weeks with the caregivers, until their target weigt was reached.This in addion to few and centralised locations of TFC’s made it difficult to adhere to the treatment and reach children suffering in remote locations.

New evidence suggests, however, that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility and therapeutic feeding centers. The community-based approach involves timely detection of severe acute malnutrition in the community and provision of treatment for those without medical complications with ready-to-use therapeutic foods or other nutrient-dense foods at home. If properly combined with a facility-based approach for those malnourished children with medical complications and implemented on a large scale, community-based management of severe acute malnutrition could prevent the deaths of hundreds of thousands of children.
Transformation in the child because of RUTF. (Source http://hetv.org/)
RESEARCH
Several reports and papers are available for viewing and downloading. Please visit the author and main organization sites for more information. Thanks to all the people whose work has been listed here.

Unicef - Progress for Children. A Report Card On Nutrition
http://www.unicef.org/progressforchildren/2006n4/

WHO - World Health Statistics
http://www.who.int/whosis/whostat/2009/en/index.html

How Should India Approach The Management Of Severe Acute Malnutrition? A Position Paper
http://www.samchild.com/recommendations/how.pdf

Supplementary Feeding with Fortified Spreads Results in Higher Recovery Rates Than with a Corn/Soy Blend in Moderately Wasted Children1,2
Danielle K. Matilsky3, Kenneth Maleta
http://jn.nutrition.org/cgi/content/abstract/139/4/773

Management of severe acute malnutrition in children
Steve Collins, Nicky Dent
http://wwwnew.mc.vanderbilt.edu/medschool/globalhealth/Documents/SevereMalnutrition.pdf

Treating Malnutrition: We can do it, but where is the will to act?
AccessNewNutrition.pdf
FACE OF MALNUTRITION IN INDIA
WEBLINKS
An Urgent Call for Action: Undernourished Children of INDIA
http://www.youtube.com/watch?v=EoWmbd-Nx6U




Management of Severe Acute Malnutrition
http://www.youtube.com/watch?v=tVOL2Sz2Cx4




UNICEF: Food crisis ravages India's poorest children
http://www.youtube.com/watch?v=aFxrOugLtxE

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