guidelines for the integrated management of severe acute malnutrition

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ACF-In Guidelines for the integrated management of SAM Annexes 172 BP 100 MedicFood For 100 g BP100 MedicFood is a compressed food product for use in the rehabilitation phase (Phase 2) of severe malnourished children and adults. The nutritional specification is close to identical with the specification for the therapeutic milk F100. The major nutritional difference between BP100 and F100 is that BP100 contains iron (10mg per 100g). In the initial phase of the treatment of severe malnutrition (Phase1 and Transition) Who to give BP100: Children from 12 months old, adolescents and adults severely malnourished in the rehabilitation phase (Phase 2) of the treatment. BP100 should never be used for patients below 6 months old. How to use BP100: BP100 can be eaten as a biscuit directly from the pack together with sufficient drinking water (2,5 to 3 dl per bar), or crumbled into water and eaten as porridge. For children 12 to 24 months of age, BP100 should always be given as porridge due to their problems demanding water when thirsty. Storage of BP100: BP100 has a shelf life of 2 years in an unopened package. After breaking the alu-foil bag the product should be used within 1-2 weeks depending on the storage conditions. Porridge made of BP100 and water should be used within 3 hours. Packaging: BP100 is compressed into tablets of 28.4g. Each package of BP100 (510g net) contains 18 tablets packed into 9 bars in grease-proof paper (1 bar = 2 tablets = 300 Kcal). Local production of RUTF Per sachet of 92 g The required ingredients for RUTF are as follows: Four basic ingredients of RUTF: sugar; Dried Skim Milk; oil; and a vitamin and mineral supplement. In addition up to 25% of the weight of the product can come from vegetable sources such as oil-seeds, groundnuts or cereals such as oats. In addition to good nutritional quality (protein, energy and micronutrients), RUTF should have the following attributes: • taste and texture suitable for young children For 100 g Per sachet of 92 g Energy 545 kcal 500 kcal Vitamin A 910 mcg 840 mcg Proteins 13.6 g 12.5 g Vitamin D 16 mcg 15 mcg Lipids 35.7 g 32.86 g Vitamin E 20 mg 18.4 mg Calcium 300 mg 276 mg Vitamin C 53 mg 49 mg Phosphoru s 300 mg 276 mg Vitamin B1 0.6 mg 0.55 mg Potassium 1 111 mg 1 022 mg Vitamin B2 1.8 mg 1.66 mg Magnesium 92 mg 84.6 mg Vitamin B6 0.6 mg 0.55 mg Zinc 14 mg 12.9 mg Vitamin B12 1.8 mcg 1.7 mcg Copper 1.8 mg 1.6 mg Vitamin K 21 mcg 19.3 mcg Iron 11.5 mg 10.6 mg Biotin 65 mcg 60 mcg Iodine 100 mcg 92 mcg Folic acid 210 mcg 193 mcg Selenium 30 mcg 27.6 mcg Pantothenic acid 3.1 mg 2.85 mg Sodium < 290 mg < 267 mg Niacin 5.3 mg 4.88 mg
ACF-In Guidelines for the integrated management of SAM Annexes 173 • does not need additional processing such as cooking before consumption • resistant to contamination by micro-organisms and a long shelf life without sophisticated packaging • ingredients are low cost and readily available in developing countries Recently WHO/UNICEF/WFP/SCN have produced DRAFT specifications for RUTF. They are as follows: Ready to use therapeutic food High energy, fortified ready to eat food suitable for the treatment of severely malnourished children. This food should be soft or crushable, palatable and should be easy for young children to eat without any preparation. At least half of the proteins contained in the product should come from milk products. Nutritional composition: Moisture content Energy Proteins Lipids Sodium Potassium Calcium Phosphorus (excluding phytate) Magnesium Iron Zinc Copper Selenium Iodine Vitamin A Vitamin D Vitamin E Vitamin K Vitamin B1 Vitamin B2 Vitamin C Vitamin B6 Vitamin B12 Folic acid 2.5% maximum 520-550 Kcal/100g 10 to 12 % total energy 45 to 60 % total energy 290 mg/100g maximum 1100 to 1400 mg/100g 300 to 600 mg/100g 300 to 600 mg/100g 80 to 140 mg/100g 10 to 14 mg/100g 11 to 14 mg/100g 1.4 to 1.8 mg/100g 20 to 40 µg 70 to 140 µg/100g 0.8 to 1.1 mg/100g 15 to 20 µg/100g 20 mg/100g minimum 15 to 30 µg/100g 0.5 mg/100g minimum 1.6 mg/100g minimum 50 mg/100g minimum 0.6 mg/100g minimum 1.6 µg/100g minimum 200 µg/100g minimum
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ACF-In Guidelines for the integrate
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guidelines for the integrated management of severe acute malnutrition

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