The Core Purpose of Therapeutic Formulas
F75 and F100 are not standard infant formulas but are highly specialized medical foods designed for use in therapeutic feeding centers and hospitals, strictly under medical supervision. The names reflect their energy density per 100 milliliters of reconstituted formula: F-75 provides 75 kilocalories (kcal), and F-100 provides 100 kcal. Their development and use revolutionized the management of severe acute malnutrition (SAM), dramatically reducing mortality rates from as high as 70-80% to under 5% in many settings. The World Health Organization (WHO) has established a two-phase protocol for using these milks to ensure patient safety and promote optimal recovery.
The Stabilization Phase with F75
The initial phase of SAM treatment focuses on stabilizing the patient's condition, not promoting rapid weight gain. This is because severely malnourished children often have metabolic disturbances, fluid imbalances, and impaired organ function that cannot handle a sudden high intake of protein and energy. The F75 formula is specially formulated to address these fragile physiological needs safely. This phase typically lasts between 2 and 7 days, until the child is clinically stable and has regained their appetite. The goals include restoring metabolism with moderate energy and low protein intake to prevent refeeding syndrome, treating complications like hypoglycemia, and careful rehydration, often using ReSoMal.
The Rehabilitation Phase with F100
Once stable on F75 and with a returned appetite, the child transitions to F100 for the rehabilitation phase, aiming for rapid catch-up growth. F100 has a higher energy density (100 kcal/100ml) and increased protein (2.9g/100ml) compared to F75 (75 kcal and 0.9g/100ml), providing the necessary nutrients for tissue repair and growth. Micronutrient repletion is also a focus, sometimes with additional supplementation. F100 is often replaced by Ready-to-Use Therapeutic Foods (RUTFs) like Plumpy'Nut® in community settings, offering similar nutrients but being ready-to-eat and safer for home use.
F75 vs. F100: A Comparison
Here is a comparison highlighting the different roles of these therapeutic foods in treating severe acute malnutrition:
| Feature | F75 (Stabilization Phase) | F100 (Rehabilitation Phase) |
|---|---|---|
| Primary Goal | Patient stabilization and correcting metabolic disturbances | Rapid weight gain and catch-up growth |
| Energy (per 100ml) | 75 kcal | 100 kcal |
| Protein (per 100ml) | 0.9 g | 2.9 g |
| Electrolyte Balance | Low sodium, moderate potassium | Higher electrolyte content |
| Lactose Content | Lower (1.3g/100ml) | Higher (4.2g/100ml) |
| Risk of Refeeding Syndrome | Low risk | Higher risk |
| Patient Condition | Medically complicated, poor appetite | Medically stable, good appetite |
| Setting of Use | Inpatient care | Inpatient care, transitioning to outpatient with RUTF |
A Broader Look at Malnutrition Treatment
Effective SAM management extends beyond formulas, involving comprehensive approaches like Community-based Management of Acute Malnutrition (CMAM) programs that utilize RUTF for outpatient care. Early detection using tools like the Mid-Upper Arm Circumference (MUAC) tape is also vital. The overall goal is to treat malnutrition's immediate effects, prevent relapse, and ensure healthy development.
The Final Word
In conclusion, F75 and F100 are critical components of modern SAM treatment. They are used sequentially: F75 for stabilizing the child's fragile system and F100 (or RUTF) for subsequent rehabilitation and catch-up growth. This phased approach, supported by organizations like WHO, UNICEF, and MSF, has significantly improved outcomes for malnourished children.
To learn more about the broader strategy for managing acute malnutrition, the World Health Organization's ELENA page on transition feeding offers further authoritative guidance.
