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Treatment of MAM for pregant and lactating women

This question was posted the Management of wasting/acute malnutrition forum area and has 4 replies.

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Anonymous 118

Nutrition Advisor

Normal user

2 Jun 2011, 14:06

Is there an internationally accepted standard protocol for treating pregnant and lactating women with MAM? Which is more widely accepted for women who do not respond to treatment for MAM: should the program be time-bound – say for 4 months – or is the woman best kept in the program until she her MUAC is <210 or the baby is 6 months old regardless of whether her condition improves?

Emily Hockenhull


Normal user

12 Apr 2021, 12:21

Hoping to reopen this topic, does a standardised protocol exist? I've seen it nestled within CMAM guidelines, however is there an internationally recognised protocol that can be used and adapted according to context? 

Philip James

Senior Technical Associate, ENN

Frequent user

19 Apr 2021, 18:28

Hi Emily, I don't think there is a standard protocol for treating PLW with MAM. Different agencies still use different MUAC cut-offs to define SAM and MAM with PLW, as well as different discharge criteria. It would be great to hear from practitioners on their experiences of programme implementation for PLW. 

At ENN we're currently updating our maternal nutrition brief, and so if we find up-to-date resources on this we'll update you! It does seem to be a big gap...

Doris Mwendwa


Normal user

20 Apr 2021, 08:05

Based on my past field experience in different contexts this is clearly defined in the country CMAM guidelines. Some countries include MUAC less than 21cm while others include MUAC less than 23 cm.

Length of stay: Lactating women are discharged when baby is 6 months despite the MUAC measurements while a pregant mother is discharged upon reaching MUAC above 21cm.

Mogadam Nazal

Nutrition officer

Normal user

20 Apr 2021, 09:15

Hi dear, hope you are doing well. According to Sudan MAM guideline 2020 for PLWs the admission criteria is as follows:

-the pregnant woman should be in second/third trimester and her MUAC is less than 21 cm

-lactating woman also her MUAC is less than 21cm and the child is less than six months old (exclusively breastfed).

and for the two (PLWs) length of the stay (duration in the program) is 3 months 

for the discharge criteria when the PLWs MUAC reach <=23 cm (greater than or equal) for two consuctive visit (cured).

for the non-responders PLWs stayed  the whole three months in the program and not reach the discharge criteria.

for the defaulters PLWs absent for three consecutive visits, and they are discharged as death while she dead during the program (during the three months)

wish you all the best

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