Understanding the Purpose of F-75
F-75 is not a standard formula but a specific therapeutic diet used in a hospital or clinical setting for patients with Severe Acute Malnutrition (SAM). It is the cornerstone of the initial 'stabilization' phase of treatment, also known as Phase 1, as defined by the World Health Organization (WHO) protocols. The key characteristics of F-75 are its low levels of protein, fat, and sodium, combined with a higher carbohydrate content.
During this phase, malnourished patients, especially children, often have compromised organ function, electrolyte imbalances, and medical complications like infections. A typical, high-calorie diet would overwhelm their weakened systems. F-75 is designed to address these metabolic needs gently, supporting rehydration and correcting electrolyte levels without causing further stress. It is crucial to remember that F-75 is not intended for weight gain, which is addressed in the subsequent treatment phase with a different formula, F-100.
Critical Safety and Preparation Notes
Medical Supervision is Paramount: F-75 should only be prepared and administered under the strict supervision of trained medical personnel. It is not for at-home use or for feeding well-nourished children. Strict Hygiene: All equipment must be clean and sterilized. Hands should be washed thoroughly before and after preparation. This prevents the introduction of bacteria, which can be life-threatening for a compromised patient. Use Cooled, Boiled Water: Never use water directly from the tap. All water must be boiled and then cooled to a safe temperature (around 70°C, but not boiling) before mixing. This prevents contamination and avoids creating lumps when mixing with milk powder. Accurate Measurements: Precision is non-negotiable. Using a marked 1-litre measuring jug is essential to ensure the correct final volume and concentration. The final volume is crucial; adding too much water will dilute the formula, while adding too little will make it too concentrated.
How to Make F-75 with Cooking Facilities
If a healthcare facility has cooking equipment, a more traditional F-75 recipe can be prepared using cereal flour.
Ingredients for 1,000 ml of F-75
- Dried skimmed milk
- Sugar
- Cereal flour (such as corn or rice flour)
- Vegetable oil
- Mineral-Vitamin Mix (CMV)
- Cooled, boiled water: to make 1,000 ml final volume
Preparation Steps
- Mixing the Paste: Combine the dried skimmed milk, sugar, cereal flour, and vegetable oil in a 1-litre measuring jug. Mix thoroughly to create a paste.
- Adding Water: Gradually add cooled, boiled water, stirring continuously until the 1,000 ml mark is reached.
- Cooking: Transfer the mixture to a cooking pot. Boil gently for approximately 4 minutes while stirring continuously to prevent lumps and ensure the flour is cooked.
- Re-measuring: After cooking, the volume may have reduced due to evaporation. Pour the mixture back into the measuring jug and add additional cooled, boiled water to reach the 1,000 ml mark again.
- Final Steps: Whisk well, allow to cool to feeding temperature, and add the Mineral-Vitamin mix as directed. Store according to guidelines.
How to Make F-75 without Cooking Facilities
When cooking is not possible, an alternative recipe is available. This version replaces the cereal flour with extra sugar to provide energy, which is a simpler process but carries a higher risk of hyperosmolarity if proportions are incorrect.
Ingredients for 1,000 ml of F-75 (No Cooking)
- Dried skimmed milk
- Sugar
- Vegetable oil
- Mineral-Vitamin Mix (CMV)
- Cooled, boiled water: to make 1,000 ml final volume
Preparation Steps
- Initial Mix: In a 1-litre measuring jug, combine the milk powder, sugar, and vegetable oil. Mix until a smooth paste is formed.
- Add Water and Mix: Slowly add the cooled, boiled water to the 1,000 ml mark, whisking vigorously to ensure a uniform mixture without lumps or oil separation.
- Incorporate Minerals: Stir in the Mineral-Vitamin mix as per instructions.
- Ready to Serve: Cool to feeding temperature before serving, or use immediately if already at the correct temperature.
Homemade F-75 vs. Commercial F-75: A Comparison
| Feature | Homemade F-75 | Commercial F-75 (Pre-packaged) |
|---|---|---|
| Convenience | Requires precise measurement and multiple steps. | Ready-to-use liquid or pre-measured powder for easy mixing. |
| Nutritional Precision | Relies on manual weighing and measuring, increasing risk of error. | Guaranteed, standardized nutritional profile and composition. |
| Shelf-Life | Highly perishable, must be used within a few hours of preparation or stored carefully under refrigeration. | Long shelf-life when unopened, offering reliable stock management. |
| Safety | High risk of contamination if hygiene protocols are not strictly followed. Potential for hyperosmolarity with no-cook recipe. | Produced in a sterile environment, minimizing contamination risks. |
| Cost | Potentially lower initial cost if bulk ingredients are available. | Typically a higher cost per unit, but includes convenience and safety assurance. |
The Critical Role of Therapeutic Milk in SAM Treatment
Understanding how to prepare F-75 is a key competency in the management of Severe Acute Malnutrition. It is a critical initial intervention that addresses the patient's immediate metabolic needs and life-threatening complications. Once the patient is stabilized and their appetite returns, a healthcare provider will transition them to the F-100 diet, which contains more protein, fat, and energy to support rapid weight gain and recovery. This staged approach, starting with the careful stabilization provided by F-75, is central to the effectiveness of WHO's inpatient SAM protocol.
Conclusion
Preparing F-75 requires precision, strict hygiene, and adherence to established medical protocols. Whether using homemade recipes with or without cooking facilities or relying on commercial preparations, the correct procedure is vital to ensure patient safety and effective treatment. Remember that F-75 is a specialized medical tool for the stabilization phase of Severe Acute Malnutrition and should only be used under the direction of qualified medical staff. The goal is to gently restore the body's delicate metabolic balance, paving the way for the next phase of nutritional rehabilitation. More detailed technical guidelines for the preparation of F-75 and F-100 can be found on authoritative websites, such as those provided by the UNICEF Supply Division, which offers product specifications and preparation instructions.
