F-75 therapeutic milk use in infants <6 months with severe malnutrition who cannot be exclusively breast-fed
For infants <6 months of age with severe wasting and/or nutritional oedema admitted for inpatient care who cannot be exclusively breast-fed, F-75 is recommended as part of a supplementary feed strategy within severe acute malnutrition inpatient management. [1]
If breastfeeding is not possible, F-75 may be used as the supplementary milk (including as a standalone supplementary feed when expressed breast milk is not possible). [1]
Feeding priorities when breastfeeding is not possible
Breastfeeding should be attempted where possible, with support provided to the mother or female caregiver to breastfeed. [1]
When breastfeeding is not possible, re-lactation should be encouraged. [1]
When re-lactation is not possible, wet nursing should be encouraged. [1]
A supplementary feed should be provided in addition to breastfeeding-related strategies. [1]
Indications for F-75 as a supplementary feed by clinical subtype
For infants with severe wasting but no oedema, expressed breast milk should be given where possible. [1]
When expressed breast milk is not possible in severe wasting without oedema, commercial (generic) infant formula or F-75 (or diluted F-100) may be given either alone or as the supplementary feed together with breast milk. [1]
For infants with oedema, commercial (generic) infant formula or F-75 should be given as a supplement to breast milk. [1]
Replacement feeding when there is no realistic prospect of breastfeeding
If there is no realistic prospect of being breastfed, appropriate and adequate replacement feeds should be provided, including commercial (generic) infant formula with support for safe preparation and use after transfer from inpatient care. [1]
Safety-related feeding clarification for therapeutic milk choice
Full-strength F-100 should not be given to clinically unstable infants and/or those with diarrhoea or dehydration and/or nutritional oedema, due to the renal solute load and risk of hypernatraemic dehydration. [1]
Recommendation strength
The inpatient feeding recommendations for infants <6 months of age with severe wasting and/or nutritional oedema are listed as a strong recommendation with very low certainty evidence. [1]