For children facing both a lack of access to nutritional food and safe drinking water, it can feel like the odds are against them.
Lack of access to nutritional food leads to undernutrition which can manifest itself through wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age). With a greater need for nutrients and more vulnerable to the harms of nutritional deficiencies, young children (as well as women who are pregnant or breastfeeding) are most at risk for undernutrition. Globally, over 60 million children are wasted and 144 million are stunted. Undernutrition is linked to 45% of deaths among children under five years of age. Severe acute malnutrition, which is defined as severe wasting, bilateral oedema, or very low mid-upper arm circumference (MUAC), affects approximately 19 million children under five years of age worldwide and kills 400,000 children every year.
Around the world, 2.2 billion people - which includes children - do not have access to safe drinking water. Unclean water can harbor waterborne diseases (like diarrhea, cholera, dysentery, typhoid, and polio) which is one of the leading causes of death among children under five years of age. In addition, unsafe water can lead to or make malnutrition worse, no matter how much a child eats.
Therefore, access to both adequate, nutritional food and clean drinking water is necessary to ensure the health of our world’s children - one without the other is insufficient.
When it comes to malnutrition, and most critically, severe acute malnutrition, strides have been made in providing a treatment that helps children get back on track. According to the WHO, children suffering from severe acute malnutrition can be treated with a couple of different specially-formulated therapeutic foods. These foods include the following:
F-75: a low-protein, milk-based product mixed with water and used to stabilize patients who require inpatient treatment due to complicated severe acute malnutrition
F-100: a milk-based product with a higher protein and energy content mixed with water and used in the rehabilitation phase (after stabilization) for inpatient treatment
Ready-To-Use Therapeutic Foods (RUTFs): high-energy, non-water-based foods similar to F-100 that are used for treatment of uncomplicated severe acute malnutrition in the outpatient setting
RUTFs have lowered the risks of infection and allowed for easier treatment of uncomplicated severe acute malnutrition. Unlike F-75 and F-100, RUTFs are not water-based which means bacteria are less likely to grow in them and they can be used in areas without refrigeration and easy access to safe water sources (like homes and villages). However, while RUTFs lower the risk of contracting waterborne diseases by eliminating water as an ingredient, water is still a necessity for survival. Children using RUTF still need to be given safe drinking water. Furthermore, depending on the severity of malnutrition and age, many infants and young children may be unable to eat solid foods like RUTFs, relying instead on therapeutic foods that require that water be mixed in. In places where clean drinking water is scarce, contaminated water used for hydration or to mix into therapeutic foods will introduce diseases and make malnutrition worse.
Maternova is distributing an innovative and cost-effective set of pediatric therapeutic milk solutions addressing this two-pronged issue. Built to include two pouches - one with F-75 or F-100 powdered milk and one with clean, sterile water - the pediatric milk solutions provide both clean, purified water for hydration and therapeutic food to address severe acute malnutrition. In addition, the powder and water are mixed within the packaging itself by breaking a separating membrane between the pouches. In other words, the mixing process does not require any other tools or products, eliminating the introduction of pathogens.
Made primarily to address malnutrition among infants and young children in disaster areas where healthcare infrastructure has been destroyed and breastmilk and clean water are inaccessible, the F-75/100 pediatric milk solutions fill a gap in the nutritional solutions market left empty by larger companies. While breastfeeding is unequivocally the gold standard and optimal for infants, when it is not possible we must have an alternative solution available.
The powdered milk used in the F-75/100 pediatric milk solutions is based off of the WHO formulation guidelines for both the F-75 and F-100 solutions. In addition, the powder is the only one of its kind that is both whey-dominant and lactose-free. In areas where lactose-intolerance is high, a lactose-free nutritional solution reduces the risk of gastrointestinal issues that can perpetuate malabsorption and malnutrition. Additionally, unlike other powders that are casein-dominant - a protein that is hard to digest - a whey-dominant powder is more digestible and more closely resembles the composition of natural breastmilk. These solutions make it easier to digest and absorb needed nutrients and are therefore nutritionally superior to other nutritional solutions. With a nine-month shelf life, the F-75/100 pediatric milk solutions are long-lasting and can be bought in bulk and stored until needed.
Solutions like F-75/100 pediatric milk that address multiple issues are critical in disaster settings where multiple factors interact to make it challenging to protect the health of people, especially infants and young children.
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.
The Pumani bubbleCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubbleCPAP which we posed to Jocelyn Brown, inventor of the Pumani bubbleCPAP, and Molly McCabe, Director of Product Management.