The main diagnostic features are:
- weight-for-length/height < -3SD (wasted) or
- mid-upper arm circumference < 115 mm or
- oedema of both feet (kwashiorkor with or without severe wasting).
Children with severe acute malnutrition with loss of appetite or any medical complication have complicated severe acute malnutrition and should be admitted for inpatient care. Children who have a good appetite and no medical complications can be managed as outpatients.