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Should high-energy infant formula be given at full strength from its first day of usage?

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Abstract 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.

Keywords: faltering growth; glucose polymer; high-calorie infant formula; osmolality; tolerance

Document Type: Research Article


Affiliations: 1: Dietetic Department, Birmingham Children's Hospital, Birmingham, UK 2: Institute of Child Health, Birmingham University, Birmingham, UK

Publication date: June 1, 2006


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