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MUAC is a simple, rapid, and reliable screening tool for detecting acute malnutrition in children aged 6–59 months. A MUAC <11.5 cm indicates severe acute malnutrition (SAM), while 11.5–12.5 cm indicates moderate acute malnutrition (MAM). MUAC is especially useful in field settings because it requires minimal equipment, training, and cooperation from the child. It is not used to assess obesity or head growth, and it is less effective for identifying chronic malnutrition (stunting).

The best initial feeding strategy for preterm infants is expressed breast milk, preferably fortified with additional protein, calcium, and phosphorus to meet their high nutritional needs. Breast milk provides immunological protection and is better tolerated than formula. If mother’s milk is unavailable, donor milk or preterm formula may be used. Cow’s milk and soy formulas are not appropriate due to poor digestibility and risk of complications. Fortified human milk remains the gold standard for preterm nutrition.

In high-resource settings where safe formula feeding is available, maternal HIV infection is considered an absolute contraindication to breastfeeding due to risk of HIV transmission. In low-resource settings, however, breastfeeding with ART is often recommended because the benefits outweigh the risks. Maternal TB is not a contraindication if treatment is underway; infants may receive prophylaxis. Preterm infants particularly benefit from breast milk, often fortified for additional nutrients.

Zinc deficiency impairs both innate and adaptive immunity, increasing susceptibility to infections such as diarrhea and pneumonia. It is particularly common in children with malnutrition. Zinc supplementation reduces morbidity and mortality in children with diarrheal disease. Vitamin D also modulates immunity but zinc deficiency is more directly associated with immune impairment. Calcium and vitamin E play supportive roles but are not primary immune regulators.

Excessive screen time is a well-documented risk factor for obesity in children. It reduces physical activity and is often associated with mindless snacking, exposure to unhealthy food advertising, and disrupted sleep. Guidelines recommend limiting recreational screen time to less than 2 hours per day for school-aged children. Reducing screen time is therefore an important strategy in preventing and managing childhood obesity.