Positioning and answers to major criticism on RUTF

This paper aims to answer and rebuff criticism on the use of ready-to-use therapeutic food to treat severe acute malnutrition.

Published: 2014

Objectives of this document:

– Equip ACF staff with answers to major criticism on RUTF based on the latest research and recommendations of the international nutrition and health community

– Assist missions with their advocacy efforts in countries where RUTF use is being questioned

Major criticism on RUTF

A number of criticisms on RUTF have been raised in different countries, including that:

– Using RUTF creates dependency on a product
– Efforts should be diverted from treatment to prevention
– RUTF undermines breastfeeding

Answers on major criticism

Action Against Hunger is highlighting the importance of treating the life threatening condition of uncomplicated severe acute malnutrition in children with a ready to use therapeutic food (RUTF) in light of the general lack of evidence of the efficacy of other proposed home-based methods today.

RUTF has never been promoted by Action Against Hunger for any other use than the nutritional recovery, at home, of uncomplicated cases of severe acute malnutrition. Action Against Hunger doesn’t support RUTF as a stand-alone solution. Solving the issue of undernutrition is a much wider goal, which would in fact require a number of curative strategies while developing an ambitious multisectorial preventive strategy tackling the underlying causes of undernutrition.

Like any medicine required to treat a medical condition, RUTF is only needed until the child is cured from severe acute malnutrition. Locally produced RUTF that meets WHO specifications already exist in different countries indicating the opportunity for local production to also be undertaken in other countries.

As a treatment for severe acute malnutrition, Action Against Hunger does not consider that the use of RUTF undermines breastfeeding. No RUTF should be given to infants below 6 months. For children aged 6-24 months, breastfeeding is actively encouraged before the child is offered RUTF. Action Against Hunger fully supports and agrees that exclusive breastfeeding for infants less than 6 months of age is essential for optimum child health. Action Against Hunger actively promotes this best practice, as well as advocating for sustained breastfeeding for children aged 6-24 months and beyond.