When classifying nutritional status in children with WT, the utilisation of weight and height in isolation can lead to an underestimation of the prevalence of malnutrition. Nutritional assessment of children with WT should also include MUAC and TSFT. Early aggressive nutritional resuscitation is recommended.

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Background: Internationally, ready-to-eat breakfast cereals (RTEBC) make an important contribution to the nutritional intake of children. Significant differences have been found between the nutritional quality of children and non-children's RTEBC. South Africa has strict legislation regarding the use of nutrition claims to promote products. Objectives: To determine i) differences in nutritional quality between children's and non-children's RTEBC; and, ii) compliance of nutrition claims with current legislation. Outcome measures: An analysis of the nutrient content per 100 g and per recommended serving size; an audit of nutrient content claims. Design: This study examined the packages of 134 RTEBC that were categorised into children's cereal and six types of nonchildren's cereal. Results: Children's cereals formed 21% (n = 28) of the sample and were significantly more likely to have sugar as the first or second ingredient listed. Per 100 g, children's cereals contained significantly more carbohydrates, sugar and sodium than nonchildren's cereal collectively. Per 100 g and per serving, non-children's cereal was significantly higher in protein, fat and dietary fibre compared to children's cereal. Seventy-eight percent of all RTEBC (n = 104) had a nutrient content claim and 2% (n = 3) had a comparative claim. The most common claim was regarding dietary fibre (69 claims) followed by vitamins and minerals (65 claims). Ten nutrient claims were not compliant with legislation. Conclusion: Significant differences in nutritional quality exist between South African children's and non-children's RTEBC. Food manufacturers need to be more vigilant regarding nutrient claims and adhere to the labelling legislation.