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NEW RESEARCH CHALLENGES TRADITIONAL VIEWS ON WASTING TREATMENT
Kidlington, UK, 13 February 2025 – A groundbreaking research paper published in PLOS Global Public Health sheds new light on the category of "non-responders" in the treatment of child wasting. The study, titled “Re-thinking ‘non-response’ to wasting treatment: exploratory analysis from 14 studies,” authored by members of the Wasting and Stunting Technical Interest Group, challenges established notions and calls for a re-evaluation of therapeutic feeding protocols.
This comprehensive analysis pooled data from 14 studies involving nearly 16,000 children aged 6-59 months, offering new insights into the performance of these children during wasting treatment. To date, children who do not meet the recovery criteria after therapeutic feeding—typically within 12 to 16 weeks—have been labelled as ‘non-responders,’ often deemed treatment failures.
The research identified two distinct groups among non-responders: ‘high growth non-responders’ (those experiencing significant growth during treatment) and ‘low growth non-responders’ (those with minimal growth).
“The report found that 75% of non-responders were actually growing very well and should be viewed as successful in their treatment journeys, not as failures,” said Dr. Philip James, co-author and Senior Technical Associate at Emergency Nutrition Network (ENN).
Other key findings from the study include:
- High growth non-responders began with poorer anthropometric status but exhibited growth trajectories parallel to those who fully recovered. They may require longer under treatment to achieve standard recovery criteria.
- Low growth non-responders represented the true treatment failures, were more likely to have co-morbidities, and could be detected as early as between weeks 3 and 4 of treatment. This group require urgent early referral for other medical and social interventions that may support their growth.
In conclusion, the paper urges health professionals and program managers to re-think how they categorize and manage non-responders in wasting treatment, ultimately encouraging a more evidenced-based approach to child nutrition and health.
Press release by the Emergency Nutrition Network (ENN).
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For further information, please contact:
Willis Angira | Communications & Digital Manager | Emergency Nutrition Network (ENN)
Email: willis.angira@ennonline.net
Tel: +447506 125854
About ENN
The Emergency Nutrition Network (ENN) is an international non-governmental organisation, working with practitioners, policy makers and researchers to strengthen know-how and evidence to overcome malnutrition. We help practitioners better serve those most vulnerable to the causes and consequences of malnutrition.
Website: www.ennonline.net.
NOTES TO EDITORS:
The authors highlighted four key messages from the results.
1) Firstly, the high growth non-responders (NRs) group should be viewed as treatment successes since they are growing just as well as the children who recover. Indeed, 75% of ‘non responders’ seem to be responding to treatment very well and by regarding them as ‘non-responders’ we risk discharging them too early and underestimating the overall effectiveness of therapeutic feeding programmes.
2) Children who recovered started to slow their rate of growth after 3-4 weeks of treatment and began to plateau growth around the common thresholds of recovery. The high growth NR group may need to be kept longer under treatment to enable them to chance to reach a plateau in their growth.
3) The low growth NRs are the true ‘non-responders’. They had the highest proportion of children with reported co-morbidities.
4) It is not easy to predict which children will go on to recover, be in the high growth NR group or in the low growth NR group, given growth trajectories cross. However, the models suggest that children who are severely underweight have a higher risk of being in the low growth NR group.