When Are Therapeutic Feeds Required?
Formula 75 (F-75) and Formula 100 (F-100) are therapeutic formula feeds or extracts used in preparing therapeutic milk for infants or children suffering from malnutrition.
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F-75: It is the ‘starter’ type of formula-based milk used initially in managing malnutrition in infants soon after birth, this is usually continued for up to two to seven days until the child is moderately stabilized.
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F-100: This type is the most widely used therapeutic milk according to both United Nations Development Programme (UNDP) and World Health Organization (WHO) specifications.
The F75 type should only be used within the first few days of nutritional recuperation for the infant. F-75 and F-100 are classic examples of therapeutic formula milk now used by the United Nations International Children's Emergency Fund (UNICEF), Action Against Hunger, Médecins Sans Frontières (MSF), Concern Worldwide, Valid International, and among other organizations that use them on a broader scale to counteract severe malnutrition among vulnerable populations
However, these brands, F-75 and F-100 use only in therapeutic feeding programs, should ideally be restricted solely to the treatment of malnutrition or malnourished children. They should not be misused in otherwise healthy infants in a hospital or clinical setting. Their use and dosage must also be monitored by registered healthcare providers and pediatricians in that setting. Nutritionists also do not recommend therapeutic milk that may be unsuitable for long-term feeding, especially in well-nourished children who receive the necessary and essential nutrients from their mother's milk and dietary sources.
What Is the Rationale Behind Its Use?
Severely malnourished children or infants do not have the potential to tolerate even normal amounts of protein, sodium, or higher amounts of fat. In fact, the infant mortality rate is high according to case records that show a possibility of infant death when provided with excessive protein or sodium intake. Newborn children also require glucose as an essential requirement, so they must be given a diet that is fundamentally low in protein and sodium and higher in carbohydrates. F-75 therapeutic powder is designed specifically for mixing with milk to meet the child's needs without overwhelming the body's systems, especially in the initial stages of treatment for child malnutrition. The use of F-75 can not only prevent malnutrition-related deaths but can also be eventually substituted with F-100, which provides adequate nutritional content, approximately 75 kilocalorie and 0.9 gram protein per 100 milliliters, in order to rebuild wasted tissues in the infant.
As soon as the child is stabilized, the pediatrician or healthcare provider who has given F-75 will suggest the intake of F-100, which is used as a 'catch-up' formula. F-100 contains even more calories and enough protein to meet the infant's needs at this stage, with nearly 100 kilocalorie energy and approximately 2.9 gram protein per 100 milliliters being deemed most suitable. F-100 recipes also have the added advantage of not requiring any cooking (as they do not contain cereal flour). F-100 contains essential minerals such as potassium and magnesium that help rectify electrolyte imbalances in the child. Most mineral mixes are included in both F-75 and F-100 to correct electrolyte irregularities. The mineral mix is ideally prepared in the hospital pharmacy, but commercial products such as Combined Mineral Vitamin Mix (CMV) are also available, which are crucial in combination with therapeutic milk to provide the child with necessary minerals.
Vitamins are also essential ingredients that may improve therapeutic efficacy in milk and can be added to the feed. Usually, most children are given multivitamin drops soon after birth. These preparations typically do not contain iron because formula feeds do not include iron. Similarly, multivitamin preparations for infants should also exclude iron.
How Are Therapeutic Feeds Prepared in Clinical Settings?
F75 and F100 are also commercially available in prepackaged form and already contain all the required essential nutrients. In a hospital setting, these milks are prepared by adding one large packet of prepackaged F75 or F100 to approximately 2 liters of water, depending on the number of children being treated. If fewer children are being treated, smaller volumes can be used. The F-100 bag usually contains the appropriate quantity of dry extract that needs to be diluted in 2 liters of boiled water, resulting in nearly 2.4 liters of high-energy milk.
What Is the Impact of Therapeutic Feeds on Public Welfare and Research?
In 1994, Action Against Hunger (ACF) pioneered the use of F-100 milk formula in the treatment of children with severe and acute malnutrition symptoms. In 1997, French medical researchers through the company Nutriset succeeded in designing and supplying a nutrient-dense therapeutic formula for the treatment of severe acute malnutrition, which gained further popularity in the market. For the last two decades, this formula has been successfully used in therapeutic feeding centers to help hospitalized children overcome their nutrition-based deficiencies and systemic health issues.
The Scientific Committee of Action Against Hunger’s, which pioneered the F-100 therapeutic milk formula, widely recommends it, and most major humanitarian aid organizations use it to treat children suffering from acute malnutrition. The positive impact of these therapeutic milks on societal welfare is evident as they have successfully reduced the global mortality rate caused by malnourishment in children (especially those severely malnourished). Research also shows that the mortality rate for children under the age of five has been reduced from 25 percent to five percent after the introduction of therapeutic milks for commercial hospital use.
Conclusion:
Thus, Formula 75 and Formula 100 are specially designed therapeutic milk products used to treat infants suffering from moderate to severe malnutrition. These therapeutic formula products must, therefore, be used in re-nutrition centers and pediatric settings only under medical supervision.
