Ready-to-use therapeutic food (RUTF) is given during out-patient management of a severely malnourished child. The most commonly known brands of RUTF are Plumpy'nut® and BP-100® (see Figure 10.1). RUTF is ready to use, as its name indicates. That means it does not need cooking, or any other process before feeding the child. It is high energy food contained in a concentrated form, enriched with minerals and vitamins to replenish a severely malnourished child. Table 10.4 below shows you how much RUTF should be given to a child according to their weight in kg.

Plumpy'nut® and BP-100®

Figure 10.1 Plumpy'nut® and BP-100®. (Photo: UNICEF Ethiopia / Dr Tewoldeberhan Daniel)

Table 10.4 Amount of RUTF to be given to each child based on their weight.

Class of weight (kg)	Plumpy'nut®		BP-100®
	sachet per day	sachet per week	bars per day	bars per week
3.0-3.4	1¼	9	2	14
3.5-4.9	1½	11	2½	18
5.0-6.9	2	14	4	28
7.0-9.9	3	21	5	35
10.0-14.9	4	28	7	49
15.0-19.9	5	35	9	63

You should explain to the caregiver the following key messages about RUTF so they are able to help with the treatment.

RUTF is a food and medicine for malnourished children only. It should not be shared
For breastfed children, always give breastmilk before the RUTF and breastfeed on demand
RUTF should be given before other foods. Give small regular meals of RUTF and encourage the child to eat often, every three to four hours
Always offer plenty the child plenty of clean water to drink while eating RUTF
The caregiver should use soap and water to wash their hands before feeding the child
Keep food clean and covered
Sick children get cold quickly, so it is important to keep the child covered and warm at all times.