Background: Acute malnutrition in infants under six months (u6m) is increasingly recognized as a serious public health concern, as the evidence from developing countries suggests that acute malnutrition affects around 8.5 million u6m infants. Despite this, the current evidence base on the management of acute malnutrition in under six months infants is sparse. The objectives of this paper were to present the burden and underlying risk factors associated with acute malnutrition and synthesize current evidence on various assessment and management approaches currently in use for infants u6m.

Methods: Two electronic databases, PubMed and Cochrane Library were searched between April 2020 and May 2020. We systematically reviewed the literature and identified 33 papers that fulfilled the inclusion and exclusion criteria. Results: One third of the identified studies (n=10, 30.3%) were secondary data analysis. The studies were geographically diverse (LICs + LMICs), of which six were multi-country studies. The review identified that South Asian countries bear the highest burden of acute malnutrition in u6m infants. In order to identify the u6m infants at the risk of mortality, severe underweight at 6 weeks of age could be a potential indicator (requires further evidence from different contexts). Majority of the studies identified maternal related factors to be mainly associated with acute malnutrition in u6m infants. Among preventive interventions, one with maternal nutritional supplementation (MNS) in addition to breastfeeding support showed promising improvement in anthropometric outcomes.

Conclusion: Health programmes, particularly in South Asia region require to focus on maternal related factors to avert and/or manage growth faltering in u6m infants. Further research on context specific burden of acute malnutrition and identification of underlying risk factors, is urgently required for shaping new programs and/ or for incorporating u6m in the existing malnutrition management programs.