This is an interesting question, with limited information in the literature about using ReSoMal specifically in this age group. A few points from my previous clinical practice:

1. I generally avoid giving oral non-milk fluids to to infants. If they can tolerate anything orally I would prefer the usual - breast milk, or breast milk substitute if this is not possible.

2. If an infant is severely dehydrated and cannot tolerate oral fuids, I would start off with very gentle i.v. fluids (keeping an eye on that blood sugar) and re-establish feeds as soon as possible.

3. I would be very carefully about thinking of giving anything with lower sodium content (such as ReSomal) to an infant <6 months due to the risks of hyponatraemia / fitting.

So generally, the focus is on getting milk into the infant as soon as possible, following the usual guidelines, and adapting this according to vomiting / tolerance of feeds.

This is based on my experience, as I only found limited research on this!

Very nice question i usually withhold managing this age group with resamol.
1)We advocate for exclusive breastfeeding,in case where mother has enough breast milk I advice her to breastfeed the baby as many times as possible to capture dehydration and baby should be having a good breastfeeding reflexes.
2)of late have not yet seen the guidelines for managing this age group with resomal,the dehydration in this case is captured through I.V fluids

Thanks to all of you for your suggestions. In my work context, most cases of severe malnourished children less than 6 months with dehydration are maternal orphan. What is recommended to treat these cases (malnutrition<6 months) is the using of diluted therapeutic milk (F-100).
As Dr Sylvia Garry said, we don't have enougth information in the literature about using ReSoMal specifically in this age group.
In nutriset website, we can read that ReSoMal is forbidden for malnourished children under 6 months. Here is the link: http://www.nutriset.fr/fr/nos-produits/malnutrition-aigue-severe/resomal.html.
Thanks again for your help.

How is Resomol used in infants >6 months?

Dear Geraldine Fitzgerald ,
ReSoMal (Rehydration Solution for Malnutrition) is used to treat severe dehydraton in children with severe acute malnutrition through oral route. The first condition is to establish a correct diagnosis of the severe state of dehydration.
After preparing the solution (powder in a water), it may take 2 to 12 hours to rehydrate the patient.
For the first 2 hours start with 5ml x weight (kg) of the child every 30 minutes during the first 2 hours. After that it's important to evaluate the state of the child before continuing. For the 2nde phase , ReSoMal should be alternated every two hours with therapeutic milk F-75. At this stage, the quantity of ReSoMal is 10ml x weight of the child. In practice, patient monitoring is important because it is very easy to fluid overload in the malnourished.
There lot of guidelines about it though WHO website.

In orphaned children less than six months old, the priority would be to find breastmilk from another mother (donor milk or a wet nurse), if that is socially and culturally acceptable.
If all efforts to find a milk donor are fruitless, the option of last resort would be a breastmilk substitute (following IV rehydration, as suggested above), until a wet-nurse or carer willing to relactate can be found.
An artificially fed infant is in a very precarious position; likely to be readmitted soon after discharge.

Not posting a reply, rather revisiting the same question. There is nothing in the WHO or our country guidelines about not giving resomal to babies under 6 months. If it is to be avoided as suggested and the mother not having breastmilk due to her own poor nutrition (which is the commonest cause of malnutrition under 6 months in our setting) are our only options for rehydration substitute milk (F75 or dilute F100) or IV? When we are told so often to avoid IV in malnutrition and the substitute milk seems sometimes to worsen diarrhea what options do we have?

Using the IV route to rehydrate a child with severe acute malnutrition is dangerous, with a risk of haemodilution. The oral route through a nasogastric tube should be the prefered option especially if the child is vomiting everything or is too weak to feed orally.

Please, could you let me ask at the same context, What about the manufacture of Resomal in Therapeutic Feeding Centers? and What is the commercial alternative you recommend?

can RESOMAL be given to older children like above 6 months to 13 years

Resomal is a mixture of sugar, salt and water similar to sports/ rehydration drinks that is appropriate for SAM children who are genuinely dehydrated.  Breast serves as an excellent rehydration fluid as well.  Every thing in very young infants needs to be used in moderation, so try 10mL/kg at first and repeat as needed.  Be sure not to use pure water, but indeed an electrolyte solution.