The problem of malnutrition affects both developed and developing countries. The disease-related malnutrition in hospitalised patients is well-described and the treatment recommendations reflect the health care conditions of developed countries. However the diagnosis and treatment of children with severe acute malnutrition (SAM) is inconsistent both in the international and in the developing countries' guidelines. The aim of this article is to start a discussion about the guidelines for the treatment and nutrition of malnourished infants and children in developing countries. The differences appear primarily in the hydration and nutritional status assessment, treatment of hypoglycaemia, additional supplementation and partly in nutrition itself. In general, we do know how to treat children with SAM, however the differences in the guidelines can cause a lot of difficulty in making decisions in emergencies, particularly for infants under 6 months.