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Malnutrition is estimated to contribute to more than one third of all child deaths, although it is rarely listed as the direct cause. Lack of access to highly nutritious foods, especially in the present context of rising food prices, is a common cause of malnutrition. Poor feeding practices, such as inadequate breastfeeding, offering the wrong foods, and not ensuring that the child gets enough nutritious food, contribute to malnutrition. Infection – particularly frequent or persistent diarrhoea, pneumonia, measles and malaria – also undermines a child's nutritional status.

A recently developed home-based treatment for severe acute malnutrition is improving the lives of hundreds of thousands of children a year. Ready-to-use Therapeutic Food (RUTF) has revolutionized the treatment of severe malnutrition – providing foods that are safe to use at home and ensure rapid weight gain in severely malnourished children.

The advantage of RUTF is that it is a ready-to-use paste which does not need to be mixed with water, thereby avoiding the risk of bacterial proliferation in case of accidental contamination. The product, which is based on peanut butter mixed with dried skimmed milk and vitamins and minerals, can be consumed directly by the child and provides sufficient nutrient intake for complete recovery. It can be stored for three to four months without refrigeration, even at tropical temperatures. Local production of RUTF paste is already under way in several countries including Congo, Ethiopia, Malawi and Niger. Following the consensus on community-based management for severe malnutrition reached in a informal consultation in 2005, WHO has worked with UNICEF on the development of a field manual on community-based management of severe malnutrition, and the IMCI guidelines have been revised to take account of the new home-based treatment.

 

Globally over 200 million children do not reach their developmental potential in the first 5 years because they live in poverty, and have poor health services, nutrition and psycho­social care. These disadvantaged children do poorly in school and subsequently have low incomes, high fertility, high criminality, and provide poor care for their own children. These materials guide health workers and other counsellors as they help families build stronger relationships with their children and solve prob­lems in caring for their children at home.

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