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Should high‐energy infant formula be given at full strength from its first day of usage?
Author(s) -
Evans S.,
Twaissi H.,
Daly A.,
Davies P.,
MacDonald A.
Publication year - 2006
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/j.1365-277x.2006.00689.x
Subject(s) - medicine , head circumference , pediatrics , vomiting , infant formula , zoology , gestational age , pregnancy , genetics , biology
Objective To evaluate the feeding tolerance of a high‐energy (1 kcal mL −1 ) infant formula (HEIF) for infants with faltering growth, weighing 2.5–8 kg, when administered at full strength from day 1 compared with stepwise introduction. Methods Thirty infants (aged 2–43 weeks) from a supraregional children's hospital requiring a high‐energy formula for faltering growth were randomly allocated to receive either a 1 kcal mL −1 ready to feed infant formula at full strength from day 1 or the same formula in diluted form, graded to full strength over 3 days. Bowel actions, vomits and volume of feed taken were recorded daily for 2 weeks. Weight, length, head circumference and mid‐upper arm circumference were recorded at recruitment and after 2 weeks. Results The number of bowel actions in the first 2 days was significantly higher for the full strength group than for the stepwise group ( P = 0.02); younger infants (<12 weeks) had more bowel actions over the first 2 days on the HEIF at full strength (Spearman's correlation = −0.5; P = 0.04); and infants with a total higher energy intake (kJ kg −1 ) had more frequent bowel actions over the first 4 days (Spearman's correlation = 0.48; P = 0.01). There was no significant difference between groups for growth or vomiting. Conclusions High‐energy infant formula was generally well tolerated in infants under the age of 12 months with faltering growth when administered at full strength from day 1. However, younger infants (<12 weeks of age) may benefit from a graded introduction in order to avoid increased bowel frequency.