ABSTRACT
Child malnutrition is a major global problem, but in many high-burden countries, screening and treatment of acute malnutrition called wasting (weight-for-length z-score < −2SD) only begins at age 6 months. Infants under 6 months ‘at risk of poor growth and development’ are, however, increasingly recognised. Latest 2023 WHO guidelines describe anthropometric, feeding and maternal/infant clinical criteria for early detection and treatment. We aimed to explore the value of these criteria to early detect infants at risk of wasting at 6 months. We conducted a secondary analysis of a prospective observational cohort of 789 mother-infant pairs in Senegal. Several WHO detection criteria were applied to examine the dyads and risk factors for wasting at 6 months, the current malnutrition programme enrolment criterion. Descriptive statistics, Alluvial plots and logistic regression analysis were employed. At birth, 6.8% of infants had low birth weight (weight < 2500 g) and most (99.7%) were breastfed. At age 3 months, 9.4% were underweight (weight-for-age z-score < −2SD) and 10% were wasted; 66% were exclusively breastfed. Many infants transitioned between being malnourished and having normal weight over time. Wasting prevalence at 6 months was 9.5%; risk factors included low birth weight (adjusted odds ratio [aOR] 3.16, 95% CI:1.39, 7.19) and underweight at 3 months (aOR 6.62, 95% CI 2.96, 14.8). Infant feeding and maternal factors were not associated. Applying the 2023 WHO guidelines could detect infants at risk of poor growth and development early. Programme enrolment criteria need further refinement to identify infants requiring follow-up or treatment.
Maternal &Child Nutrition, Volume 22, Issue 4, October 2026. Read More