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Request for information on the MAMI approach

This question was posted the Management of small and nutritionally at risk infants under six months and their mothers (MAMI) forum area and has 1 replies.

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Andrianarivo Andriamisaina Toky Tsilavina


Normal user

12 May 2021, 16:45

Hello, I would like to ask in the event that Community care for malnourished infants is impossible, and therefore the project will address all the other factors that could hinder the good growth of these infants and will also ensure the psychological support of the households during treatment in hospital. Does this change the vision of the approach which aims to combine both care and prevention? In this case can we still move forward in this direction or what would be your recommendations?

Is there a difference between C-MAMI and MAMI?

Alice Burrell

Save the Children

Technical expert

17 May 2021, 13:18


This is the sitaution we face in a number of countries due to national guidance still recommending inpatient care for all infants <6 months identified as wasted.

However, this does not change the approach of MAMI. Even if infants <6 months who meet the crtieria for wasting must be admitted to inpatient care to adhere with national guidance, the MAMI Approach can still manage other 'small or nutritionally at-risk' infants <6months through outpatient interventions. For example, if we look at infants who have a WLZ > -3.0, but are born low birthweight, or have a moderate feeding difficulty or who are not gaining adequate weight (according to growth monitoring charts), these infants would not be admitted to inpatient wasting trearment BUT they are nutritionally at-risk and will benefit from additional support. This is the preventative aspect which is so critical in the approach for MAMI. We are not just focusing on wasting, but 'small and nutritionally at risk' which includes a much larger group of infants, many of which can be supported through the MAMI outpatient intervention package of care (please refer to recently released MAMI Care Pathway). 

For those infants who must be admitted to inpatient care due to adherence to national protocols, you can still focus on improving the support provided in the inpatient facility - looking beyond just providing feeding support, as is often the case. Firslty, by doing a full MAMI assessment of mother/caregiver and infant when they are admitted will help to identify all risk factors and challenges. Then providing a package of care to address these, which may include medical, IYCF, mental health among others. And importantly, trying to establish a pathway so that the mother and infant receive continued care after discharge. 

And lastly, there is no difference between C-MAMI and MAMI. C-MAMI is the old name. C-MAMI was changed to MAMI because it was being confused with CMAM. They both refer to the management of small and nutritionally at-risk infants <6months and their mothers through community-based interventions. 

I hope this has answered your questions!

Alice Burrell

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