5.4.3  Measuring the MUAC of children

A special tape is used for measuring the MUAC of a child (see Figure 5.7). The tape has three colours, with the red indicating severe acute malnutrition, the yellow indicating moderate acute malnutrition and the green indicating normal nutritional status. Figure 5.8 shows you how to use the tape to measure a child’s MUAC.

MUAC measuring tape
Figure 5.7  MUAC measuring tape.
Measuring MUAC
Figure 5.8  Measuring MUAC. (Source: UNICEF, 1986, How to weigh and measure children: assessing the nutrition status of young children)

Procedures for measuring MUAC

  1. Ask the mother to remove any clothing that may cover the child’s left arm. If possible, the child should stand erect and sideways to the measurer.
  2. Estimate the midpoint of the left upper arm (arrow 6).
  3. Straighten the child’s arm and wrap the tape around the arm at the midpoint. Make sure the numbers are right side up. Make sure the tape is flat around the skin (arrow 7).
  4. Inspect the tension of the tape on the child’s arm. Make sure the tape has the proper tension (arrow 7) and is not too tight or too loose (arrows 8 and 9). Repeat any step as necessary.
  5. When the tape is in the correct position on the arm with correct tension, read the measurement to the nearest 0.1 cm (arrow 10).
  6. Immediately record the measurement.

You can see the MUAC of a young child being measured in Figure 5.9.

Measuring MUAC of a young child
Figure 5.9  Measuring MUAC of a young child in Ethiopia. (Photo: AMREF Ethiopia)

Table 5.3 sets out the cut-off values using the MUAC measurement and how these relate to the level of malnutrition in children and adults.

Table 5.3  Cut-off points for screening in the community for SAM and MAM using MUAC

Target GroupsMUAC (in cm)Malnutrition
Children under five11-11.9Moderate acute malnutrition (MAM)
<11 cmSevere acute malnutrition (SAM)
Pregnant women/adults17-21 cmModerate malnutrition
18-21 cm with recent weight lossModerate malnutrition
<17 cmSevere malnutrition
<18 cm with recent weight lossSevere malnutrition
  • Why is MUAC a useful measurement tool?

  • There are a number of reasons. For pregnant women it is the only anthropometric measure that can give an accurate reading of their malnutrition status. Also, because MUAC can be measured quickly and easily, it is also used when screening large numbers of children and adults.

5.4.2 Measuring fat-free mass (muscle mass)

5.5 Clinical methods of assessing nutritional status