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RUTF - SAM treatment

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

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Anonymous 24408

Normal user

15 May 2019, 19:13

Standard acute malnutrition treatment protocols base RUTF dosage (no. of 92g sachets) for SAM treatment on weight of the child.
What evidence is this dosage based on, particularly for the 3-5 year old age group ?


Technical expert

18 Jun 2019, 12:26

Hi Anonymous,

Below is a link to a number of references that consider the use of RUTF.

Of particular interest may be the SCN policy paper No 21

Among those, the paper of Ann Ashworth particularly considers dosing of RUTF. 

A guiding principle resulting from the consultation was that:

"When RUTF is given to children with severe malnutrition, 150 to 220 kcal/kg/day should be provided."

Of interest may also be the paper on the use of 'low-dose RUTF' for continued recovery once the child is no longer classified as SAM:

Other discussions on RUTF dosage can be found on ENN:

I hope this helps,


Osman Mohamed Haji


Normal user

19 Jun 2019, 04:49

What about 500kcal per kg/day?


Technical expert

19 Jun 2019, 11:54

Hi Osman,

500 kcal / kg / day is too much for any age group. Did you mean 500 Kcal / day (i.e. 1 packet)? This is the amount of RUSF typically given for MAM cases.


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