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RUTF - SAM treatment

This question was posted the Prevention and treatment of severe 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 ?

Paul

Technical expert

18 Jun 2019, 12:26

Hi Anonymous,

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

https://www.odi.org/sites/odi.org.uk/files/odi-assets/events-documents/4273.pdf

Of particular interest may be the SCN policy paper No 21

https://www.who.int/maternal_child_adolescent/documents/pdfs/fnb_v27n3_suppl.pdf?ua=1

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:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672709/pdf/mcn0011-0859.pdf

Other discussions on RUTF dosage can be found on ENN:

https://www.en-net.org/question/532.aspx

https://www.en-net.org/question/2387.aspx

https://www.en-net.org/question/3580.aspx

I hope this helps,

Paul

Osman Mohamed Haji

SWISSO-KALMO

Normal user

19 Jun 2019, 04:49

What about 500kcal per kg/day?

Paul

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.

Paul



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