Adapted MSF nutrition guidelines on F75

Prompted by recent operational findings, MSF has decided to modify its Nutrition Guidelines to promote the use of F75 in Phase I treatment of severe malnutrition. Although nutrition academics and scientists have long advocated F75 as the safest therapeutic option, MSF has been reluctant to advocate the new protocol on the basis that there has been no proof of its efficiency in the field. The additional reduction in mortality by using F75 is not currently known, and it was felt that the use of two similar milks complicated the work and thus increased the risk of errors in milk prescription and administration.

Being compliant with many national and international guidelines, however, MSF increasingly used F75 in the first phase of treatment. Also, during the nutritional crisis in Angola (2002), MSF used F75 in its therapeutic feeding centre with positive results. National staff who were responsible for mixing and administering the therapeutic food were largely illiterate, however this had no effect on the efficiency and quality of their work. This experience proved to MSF that, provided staff are adequately trained and supervised, F75 can be implemented in an emergency situation. However, in case of an overwhelming situation and lack of human resources, lack of milk supply, or where simplification of the protocol is needed, MSF consider the use of F100 (diluted for particularly weak cases) instead of F75 an acceptable alternative.

For further information, contact Saskia van der Kam, MSF-Holland. Email: saskia.vd.kam@amsterdam.msf.org