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Alternative forms in which to administer RUTF

This question was posted the Management of wasting/acute malnutrition forum area and has 3 replies.

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Spencer Rivadeneira Danies


Normal user

13 Nov 2018, 18:47

Buenas tardes. Soy Spencer Rivadeneira, pediatra. En Colombia hace poco estamos utilizando los alimentos terapéuticos listos para consumir. La gran mayoría de niños muestra excelente aceptación, pero, un pequeño grupo lo rechaza, bien sea desde el inicio o poco después. Esto ha hecho que se exploren algunas alternativas que mejoren la aceptación, entre ellas está la administración en forma de malteada, licuada con agua. Hay alguna experiencia al respecto? qué tan alto es el riesgo de síndrome de reaimentación? qué otros riesgos enfrentamos?


Google translate:

Good afternoon. I'm Spencer Rivadeneira, pediatrician. In Colombia we have recently started using ready to use therapeutic foods. The great majority of children show excellent acceptance, but a small group rejects it, either from the beginning or shortly after. This has led to the exploration of some alternatives that improve acceptance, among which is administration in the form of shakes, liquefied with water. Is there any experience in this regard? How high is the risk of reactive syndrome? What other risks do we face?

Thank you.

Sameh Al-Awlaqi

Public Health and Nutrition Consultant

Normal user

14 Nov 2018, 12:03

Dear Spencer Rivadeneira Danies,

Which RUTF form are you using? If it is the peanut-based paste, there's another form called BP100, it takes a biscuit form and I found it useful for children who refused the peanut-based (e.g. PlumpyNut) when I was managing a nutrition project in Yemen. It can be mixed with water too. Please have a look on the below documents from UNICEF on BP100:

Hope that helps,



Suzanne Fuhrman

Project Manager, Micronutrient Forum

Normal user

14 Nov 2018, 16:10

Hi Spencer,

It is expected that some children with severe acute malnutrition will have poor appetite which will require inpatient care. Children that do not pass the appetite test using RUTF should be admitted to inpatient care. Inpatient care is needed until the appetite has returned. During inpatient care, 24 hour support is needed. Therapeutic milks should be given during inpatient care (F-75 and F-100 during the phases of treatment in inpatient care).

After the appetite has returned the child should then continue to receive outpatient care using RUTF until full recovery.

There are generic CMAM guidelines available here ( that discuss the appetite test and the steps required for inpatient care. Perhaps there is guidelines in country or a neighboring country?

Is there F75/F100 available in country?


Spencer Rivadeneira Danies


Normal user

15 Nov 2018, 02:56

Buenas noches. Estamos usando plumpy´nut, el cual, en algunos hospitales de La Guajira colombiana, se licúa en agua y se administra en forma de malteada, con mayor aceptación por parte de los niños. ¿es segura esta práctica? ¿hay evidencia científica que soporte esta forma de administración?

Good evening, We are using plumpy'nut, which, in some hospitals in La Guajira, Colombia, is being diluted with water and administered in the form of a shake/drink with greater acceptance by children. Is this a safe practice? Is there any scientific evidence to support this type of administration?

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