Response on F-75 and use of measuring scoops

By Mamane Zeilani, Nutriset

Mamane Zeilani is Director for International Development and Nutritional Strategies at Nutriset, including product Research and Development Before joining the team in August 2006, he implemented and oversaw emergency nutrition and food security programmes in west and southern Africa (Malawi, Burundi, Eritrea, Zimbabwe, Niger), and Asia (DPRK, Afghanistan and Tajikistan) for several international NGOs.

Since 1986, Nutriset has been very involved in seeking practical solutions for the development of quality nutritional products. These products are today widely used by humanitarian actors in the developing countries. Among them are two formulae utilised in the dietetic treatment of severe malnutrition, mostly in children aged under 5 years of age. These therapeutic milks, named F-75 and F-100, are used for the initial treatment (or stabilisation phase) and for nutritional rehabilitation of severely acutely malnourished children, under medical supervision and according to internationally recognised guidelines and protocols.

From large scale to individual solutions (using scoops)

The F-100 formula was designed in 1993 and F- 75 in 1994. They were first used in large emergencies. As is the case for the majority of products developed by Nutriset, packaging and instructions were initially created to reflect the situation on the ground. The need of the international community was to rapidly treat hundreds of children in any given therapeutic feeding centre (TFC). Thus, at the request of non-governmental organisations (NGOs), each sachet contained the quantity of milk powder required to make up 2.4 litres of formula. This was considered to be the most pragmatic solution. The sachet had to be manufactured in such a way so as to withstand tough transport and storage conditions. The quantity of F-75 and F- 100 added to 2 litres of boiled water is 410g and 456g, respectively. NGOs did not request any measuring instrument for smaller quantities.

With the progressive and extensive implementation of the WHO manual for the management of severe malnutrition , Nutriset adapted its supply in terms of products and packaging. Smaller size TFCs were set up in countries facing nutrition emergencies. However, the lack of refrigeration facility and the resulting wastage of therapeutic milk then became a serious issue. To satisfy a special request from one of its partner working in such a context (treating small number of children at any one time in a TFC), Nutriset developed red measuring scoops. This enabled field workers, and particularly local staff, to easily measure the exact quantity of milk powder needed to prepare small quantities of F-75, as well as F-100. These red scoops are also used to make up ReSoMal (Rehydration Solution for the Severely Malnourished).

Ongoing research and development

These red scoops are currently packed in every box of F-75 therapeutic milk manufactured by Nutriset in Malaunay, France. Further technical solutions, including the development of smaller sachets, have been sought and are reaching final technical validation stages. Moreover, sachets that contain the equivalent of either a quarter or a half of the original F-75 sachet have successfully passed the final validation process in 2006.

As can be seen, Nutriset is constantly seeking to develop products and related packaging solutions best adapted to the context of humanitarian nutrition interventions. Having read Chloe Angood's article in this issue of Field Exchange it is clear that further work needs to be done in order to facilitate the use of F- 75 and F-100 therapeutic milk by nutritionists in the field. Nutriset would like to acknowledge the great value of the work done by this research group.

Nutriset would like to invite organisations and individuals that train and/or manage therapeutic feeding programmes within health structures in the developing world to contact us, as we would be very pleased to explore new means of improvement. Nutriset will welcome solutions to improve packaging of F-75 and F-100, as well as its other products for the treatment/ prevention of malnutrition. Our team will work to clarify instructions accompanying red scoops to enable everyone to comprehend the quantities of scoops needed per quantity of water to make up the different volumes of feed.

For more information, contact: Mamane Zeilani, Nutriset, email:mzeilani@nutriset.fr or nutriset@nutriset.fr