When should I start F-75? Understanding the Critical Role of Therapeutic Diets in Severe Malnutrition

October 5, 2025 •

3 min read

Severe acute malnutrition affects an estimated 19 million children under 5 years old globally, necessitating specialized treatment. Knowing when should I start F-75 is a critical question for healthcare providers, as this therapeutic diet is the initial step for stabilizing medically complicated cases in a hospital setting, as per WHO guidelines.

Quick Summary

The F-75 therapeutic diet is for the initial stabilization of patients with severe acute malnutrition under medical care, addressing complications before moving to a rehabilitation phase.

Key Points

Start F-75 during the Stabilization Phase: The F-75 therapeutic diet is initiated during the first phase of inpatient treatment for severe acute malnutrition (SAM).
Initiation requires Medical Complications: It is used for critically ill patients with medical complications like infections, edema, or organ failure who cannot tolerate normal levels of nutrients.
F-75 is NOT for Weight Gain: The primary purpose is to stabilize metabolic function and treat life-threatening conditions, not to induce rapid weight gain.
Requires Medical Supervision: F-75 must only be administered by trained healthcare personnel in a clinical setting, like a hospital or therapeutic feeding center.
Transition when Stabilized: The patient transitions to higher-energy food (like F-100 or RUTF) only after their appetite returns, complications are resolved, and edema subsides.
Prevents Refeeding Syndrome: The low-protein, low-sodium composition is crucial for preventing dangerous complications, including refeeding syndrome, in fragile patients.
Not for Well-Nourished Individuals: The diet is explicitly not suitable for or intended for long-term feeding of well-nourished children or adults.

The F-75 therapeutic diet is a specialized milk-based formula designed for patients with Severe Acute Malnutrition (SAM). It is used during the initial stabilization phase of treatment, following World Health Organization (WHO) guidelines. The focus is on correcting metabolic imbalances and treating life-threatening complications rather than promoting rapid weight gain. F-75 is administered under medical supervision in a clinical setting.

When to Start F-75: The Stabilization Phase

Starting the F-75 diet is a medical decision. The principle is to begin cautious refeeding after addressing immediate issues like hypoglycemia or shock. F-75 is started during inpatient stabilization for SAM, especially with medical complications.

Key Indicators for Initiating F-75

Medical Complications: The patient has complications like infection or persistent diarrhea.
Poor Appetite: The patient fails the appetite test.
Edema: Bilateral pitting edema is present.
Critical Illness: The individual is weak or lethargic on admission.
Fragile Metabolism: The patient cannot tolerate standard formulas.

F-75 in the Multiphase Treatment Protocol

WHO guidelines outline a multi-phase SAM management process. F-75 is used in the initial stabilization phase (Phase 1). This phase typically lasts 1 to 7 days, focusing on treating medical issues and stabilizing the patient with small, frequent feeds of F-75 to avoid refeeding syndrome. The patient transitions over 2 to 3 days to a higher-energy diet (Transition Phase) once their appetite returns and complications are controlled. The Rehabilitation Phase (Phase 2) then uses F-100 or RUTF to promote weight gain.

Comparison: F-75 vs. F-100 Therapeutic Diets


Feature	F-75 Therapeutic Diet	F-100 Therapeutic Diet
Primary Goal	Stabilization of metabolic function	Nutritional rehabilitation and catch-up growth
Energy Density	~75 kcal/100 ml	~100 kcal/100 ml
Protein Content	Low	High
Fat Content	Moderate	Higher
Sodium Content	Low	Higher
Carbohydrate Content	High	Moderate
Usage Phase	Initial stabilization phase	Rehabilitation phase
Clinical Status	For critically ill patients with complications	For patients who are clinically stable and have a good appetite

Preparing F-75 Safely in a Clinical Setting

Proper preparation is essential to prevent infection. For powdered F-75, boiled water cooled to not below 70°C is used. Reconstituted formula must be used promptly.

From F-75 to the Next Step

Transitioning from F-75 depends on positive clinical markers:

Return of Appetite: The child eats enthusiastically.
Reduced Edema: Significant reduction or resolution of edema.
Tolerance: The patient tolerates F-75 well.
Weight Gain: Consistent weight gain is observed.

Once criteria are met, a gradual 2–3 day transition to F-100 or RUTF begins.

Crucial Importance of Medical Supervision

F-75 is a specialized medical product, not a general supplement. Its composition prevents refeeding syndrome. It must only be used under direct supervision of healthcare personnel in a hospital or therapeutic feeding center. For non-complicated SAM and the rehabilitation phase, RUTF is used.

Conclusion

Knowing "When should I start F-75?" is vital. It is exclusively for the initial, inpatient stabilization phase of severe acute malnutrition in cases with medical complications, poor appetite, and edema. The timing is determined by a healthcare provider assessing the patient's clinical condition. Following WHO protocol for F-75 and its transition is crucial for recovery. Seek immediate professional medical guidance for malnutrition. For more information on managing severe acute malnutrition, consult the WHO website.

Disclaimer: This information is for general knowledge and should not be taken as medical advice. Consult with a healthcare professional before starting any new supplement regimen.

Frequently Asked Questions

F-75 is a therapeutic milk-based diet used for the initial stabilization phase of treating severe acute malnutrition (SAM) in patients, typically children, who are critically ill or have medical complications.

No, F-75 is not for weight gain. It is specifically formulated to be low in protein, fat, and sodium to help stabilize a patient's compromised metabolism and treat medical complications, rather than promoting rapid weight increase.

F-75 should be given to patients with severe acute malnutrition who have complications like poor appetite, bilateral pitting edema, or infections and require inpatient care. It is typically for children over six months old.

After a patient is medically stable, their appetite returns, and edema is reduced, they are gradually transitioned from the F-75 diet to a higher-energy formula, such as F-100 or Ready-to-Use Therapeutic Food (RUTF), for the rehabilitation phase.

No, F-75 should never be given at home. It is a specialized medical product for hospital use under strict medical supervision due to the high risks associated with feeding severely malnourished individuals, such as refeeding syndrome.

The F-75 diet is primarily designed for children, and protocols for adults may differ. While it has been used in some adult therapeutic feeding centers, this is done under specific clinical protocols and medical supervision.

F-75 is a low-energy, low-protein diet for the initial stabilization phase. In contrast, F-100 is a higher-energy, higher-protein formula used during the rehabilitation phase to support rapid weight gain and catch-up growth.