Inclusion Criteria:

   - Parent or legal guardian is willing and able to provide written informed consent for
   the subject to take part in the trial and comply with an inpatient stay of at least 10
   days.

   - Children aged 2-24 months inclusive diagnosed with SAM (weight-for-length Z score <-3
   or bilateral pedal edema) admitted in the Dhaka Hospital of icddr,b, Dhaka, Bangladesh

   - Willing to suspend usual home skin care treatments for the duration of study

Exclusion Criteria:

   - Consent refusal

   - Life threatening health conditions such as septic shock and altered consciousness on
   admission; congenital problems (congenital heart disease or known metabolic disorders,
   chromosomal abnormalities, renal failure, etc.); any known chronic disease including
   tuberculosis, HIV infection

   - History of drug or other allergy or any condition that may complicate the
   interpretation of safety or efficacy such as dermatitis which, in the opinion of the
   investigator, contraindicates participation in the trial, or know hypersensitivity to
   SSO

   - The child is in care (no longer looked after by their parent or legal guardian)

   - Participation in another study