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Pediatric Malnutrition Assessment & Diet Planning System — Pakistan

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WHO Classification Reference

StatusMUACWHZEdema
SAM < 11.5 cm< −3 SD Bilateral +
MAM 11.5 – 12.5 cm−3 to −2 SD Absent
Normal > 12.5 cm> −2 SD Absent

SAM Treatment Phases

1
Stabilization

F-75 formula • 80–100 kcal/kg/day • Treat complications

2
Transition

F-100 formula • 100–130 kcal/kg/day • Appetite improving

3
Rehabilitation

Local foods • 150–220 kcal/kg/day • Rapid weight gain

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Clinical Reminder:

Always check for medical complications before starting nutritional rehabilitation. SAM patients with complications require inpatient care. This tool is a clinical aid — not a replacement for professional medical judgment.

Child Assessment

Enter child details for WHO-based malnutrition classification

Child Details

kg
cm
cm
Appetite test: Offer RUTF — Good ≥50% eaten, Poor <50%

Diet Planner

Build a customized diet plan for the assessed child

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Target: — kcal/day

Food Library

Nutrition Summary

Calories0 kcal
Target: —
Protein0 g
Target: —
Fat0 g
Target: —
Carbohydrates0 g

Diet Chart

Tap food cards to add them to the diet chart

Food Database

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Local Pakistani Foods (Pre-loaded)

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Custom Foods (Firebase)

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Patient Records

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F-75 / F-100 Therapeutic Formulas

WHO standard therapeutic milk formulas for SAM management

F-75 — Stabilization Phase

STABILIZATION
75 kcal
per 100 ml
0.9 g
Protein / 100 ml
2.6 g
Fat / 100 ml

WHO Standard Recipe (per 1000 ml)

IngredientAmount
Dried skimmed milk25 g
Sugar70 g
Cereal flour35 g
Vegetable oil30 g
Mineral mix20 ml
Vitamin mix140 mg
Water to1000 ml

Feeding Schedule: 8 feeds/day (every 3 hours). Starting volume: 80–100 ml/kg/day.

When to Use F-75

SAM with acute complications
Bilateral pitting edema present
Poor appetite (failed appetite test)
Diarrhea / infection / hypothermia
Do NOT use if appetite is good — use F-100 or RUTF
Never overfeed in stabilization phase.

Risk of refeeding syndrome, cardiac failure, and death.

F-100 — Rehabilitation Phase

REHABILITATION
100 kcal
per 100 ml
2.9 g
Protein / 100 ml
5.4 g
Fat / 100 ml

WHO Standard Recipe (per 1000 ml)

IngredientAmount
Dried skimmed milk80 g
Sugar50 g
Vegetable oil60 g
Mineral mix20 ml
Vitamin mix140 mg
Water to1000 ml

Transition Steps (F-75 → F-100)

1
Check Criteria

Edema subsiding, appetite returning, no acute complications

2
Appetite Test

Offer RUTF — child must eat ≥50% of daily portion

3
Gradual Switch

Transition over 2–3 days to prevent metabolic complications

4
Weight Target

Gain of 10–15 g/kg/day during rehabilitation phase

Local F-75 Alternative — Pakistan

Use only when commercial formula unavailable

Use WHO commercial F-75 whenever possible. This local alternative lacks mineral/vitamin mix — supplement separately.

Ingredients (per 1000 ml) — Adjustable

🥛 Full-fat cow's milk
ml
🍬 Sugar
g
🌾 Cereal flour (wheat/rice)
g
🫙 Vegetable oil / ghee
ml
💧 Water To make up to 1000 ml

Preparation Method

  1. Cook cereal flour in a little water to a smooth paste
  2. Add milk and oil, mix thoroughly
  3. Stir in sugar until dissolved
  4. Add boiled water to reach 1000 ml total
  5. Cool to body temperature before serving
  6. Store in clean covered container; use within 12 hours
Safety Rules:
  • Always use clean boiled water
  • Prepare fresh daily — no reheating
  • Never add salt or sodium
  • Add vitamin/mineral supplement if available

F-75 / F-100 Volume Calculator

Enter weight to calculate