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Whey‐ vs Casein‐Based Enteral Formula and Gastrointestinal Function in Children With Cerebral Palsy
Author(s) -
Savage Karina,
Kritas Stamatiki,
Schwarzer Andrea,
Davidson Geoffrey,
Omari Taher
Publication year - 2012
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607111428139
Subject(s) - reflux , medicine , cerebral palsy , enteral administration , casein , interquartile range , gastric emptying , gastroenterology , parenteral nutrition , whey protein , stomach , anesthesia , chemistry , food science , physical therapy , disease
Objectives : Children with severe cerebral palsy (CP) commonly have gastrointestinal (GI) dysfunction. Whey‐based enteral formulas have been postulated to reduce gastroesophageal reflux (GOR) and accelerate gastric emptying (GE). The authors investigated whether whey‐based (vs casein‐based) enteral formulas reduce GOR and accelerate GE in children who have severe CP with a gastrostomy and fundoplication. Methods : Thirteen children received a casein‐based formula for 1 week and either a 50% whey whole protein (50% WWP) or a 100% whey partially hydrolyzed protein (100% WPHP) formula for 1 week. Reflux episodes, gastric half‐emptying time (GE t 1/2 ), and reported pain and GI symptoms were measured. Results : Whey formulas emptied significantly faster than casein (median [interquartile range (IQR)] GE t 1/2 , 33.9 [25.3‐166.2] min vs 56.6 [46‐191] min; P = .033). Reflux parameters were unchanged. GI symptoms were lower in children who received 50% WWP (visual analog symptom score, median [IQR], 0 [0‐11.8]) vs 100% WPHP (13.0 [2.5‐24.8]) ( P = .035). Conclusion : This pilot study shows that in children who have severe CP with a gastrostomy and fundoplication, GE of the whey‐based enteral formula is significantly faster than casein. The acceleration in GE does not alter GOR frequency, and there appears to be no effect of whey vs casein in reducing acid, nonacid, and total reflux episodes. The results indicate that enteral formula selection may be particularly important for children with severe CP and delayed GE.