“MAMI” workshop at MSF Paediatric Days 2024: Improving care for malnourished children under six months of age
Historically, programming and advocacy for undernutrition has focused on children between six months and five years of age, whereas children under six months have not received the same attention. One reason for this is a misconception that these children are breastfed and hence will receive the necessary nutrition from their mothers. In reality, young infants are a vulnerable group for malnutrition and its consequences, and there are a number of reasons why an infant may be malnourished or be at risk for malnourishment. Improving care and support for these children, and their mothers, is the aim of the MAMI Global Network.
During this year’s MSF Paediatric Days in Nairobi, Kenya, the MSF Sweden Innovation Unit and MSF UK’s Manson Unit Innovation in collaboration with the MSF Nutrition Working Group organised a workshop focused on exploring ways in which the MAMI concept can be more extensively integrated into MSF projects.
In this article, we look at the MAMI concept and provide a glimpse into how the workshop can be a step towards integrating this concept into more MSF projects.
The workshop aimed at exploring ways to implement MAMI concepts into MSF projects, focusing on ways to improve screening for malnourished and at-risk infants and their mothers.Malnutrition in children under six months of age
There are a number of reasons why small children under six months of age may be malnourished or at risk for malnutrition. To start with, children who are born prematurely, with low birth weight, or with existing health conditions are more vulnerable. Malnutrition in small children can also be related to poor breastfeeding practices or be a result of the mother being undernourished, having health issues, and/or having mental health concerns.
In many contexts, cultural beliefs and stigmatisation of breastfeeding can result in mothers deciding to give their children infant formula instead of breastfeeding. In some places, such as the Middle East, where the use of infant formula is common, economic, and political instability in recent years have resulted in many populations who could previously afford infant formula no longer being able to access it, leading to increasing numbers of malnourished infants.
“Addressing malnutrition in infants and children is not just about access to food, it is more than that. We must talk about maternal mental health, domestic violence and other factors that can have a subsequent impact on the issue of infant malnutrition,” says Dr. Kerstin Hanson, MSF Nutrition Working Leader and MAMI workshop facilitator.
“Addressing malnutrition in infants and children is not just about access to food, it is more than that. We must talk about maternal mental health, domestic violence and other factors that can have a subsequent impact on the issue of infant malnutrition.”
What is included in the MAMI concept?
The MAMI Global Network supports infant and maternal nutrition, health and maternal mental health to reduce the risk of adverse outcomes among infants under six months. The network works to promote the inclusion of care and support for these children and their caregivers in programs and policy work focusing on undernutrition.
A key pillar of the MAMI concept is the promotion of methods for providing care to infants with malnutrition outside of hospitals, as these are stressful environments for people of all ages. Another important aspect of the MAMI concept is to improve methods and systems for identification of malnourishment in children under six months. While it is relatively easy to identify malnutrition in older children, it is not as straightforward in younger children. A baby can be small and have a low weight if they were born prematurely for example. This may or may or not mean that the child is malnourished. Regardless, they are at risk of malnutrition and thus warrant particular attention and care to avoid becoming malnourished.
The “MAMI” workshop during MSF Paediatric Days 2024
In total, 15 participants from across MSF participated in the MAMI-themed workshop during this year’s Paediatric Days. The workshop aimed at exploring ways to implement MAMI concepts into MSF projects, focusing on ways to improve screening for malnourished and at-risk infants and their mothers.
The workshop also aimed to improve the participants’ understanding of the MAMI concept and equip them to share information about MAMI with their colleagues and collaborators. Building on the discussions held during the workshop, the hope is to identify one or more specific ideas for implementing MAMI into MSF projects and piloting them in the near future.
“Something that came out strongly during the workshops was the need to engage with and involve communities in efforts to identify ways for improving identification of and care for infants with malnutrition. This issue is not strictly medical, so it cannot be solved within the hospital walls,” says Dr. Kerstin Hanson.
A participant commented about the workshop: “The sessions were really interesting and educative. They covered realities we face in our various contexts. MAMI is a beautiful initiative which should be adopted in both communities and health facilities.”
“The sessions were really interesting and educative. They covered realities we face in our various contexts. MAMI is a beautiful initiative which should be adopted in both communities and health facilities”
The need to engage with and involve communities in efforts to improve the identification and treatment of young infants that may be malnourished or at risk for malnutrition came out strongly during the workshop. 
In total, 15 MSF staff from seven countries (Nigeria, Kenya, Niger, DRC, Yemen, Syria, and Tanzania) participated in the workshop.