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Randomized comparison of a nutrient-dense formula with an energy-supplemented formula for infants with faltering growth

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Abstract Introduction 

The practice of supplementing standard infant formula with energy for infants with faltering growth has been widespread. This increases energy density but disturbs the protein : energy ratio, and increases risks of microbial contamination and errors in feed preparation. This study aimed to compare the effectiveness of a nutrient-dense formula (NDF) with an energy-supplemented formula (ESF) in infants with faltering growth. Methods 

In an open, parallel, randomized study, 49 infants with faltering growth were randomized to receive a NDF (4.2 kJ mL−1) or an ESF (4.2 kJ mL−1), for 6 weeks. Anthropometry, biochemistry, feed intake, stool and vomit frequency were collected. Results 

No significant differences in tolerance, feed volumes or energy intakes were recorded but the NDF group received 42% more protein and 15–40% more vitamins and minerals. Blood urea concentration in the ESF group fell by 50% over the trial period, suggesting a suboptimal protein : energy ratio in the ESF feed. The NDF group retained a normal mean blood urea concentration, a higher urinary potassium concentration and did not have the significant fall in length z-score seen in the ESF group. Conclusion 

Increasing the energy content of normal infant formula without also increasing protein and micronutrients should not be practiced in infants with faltering growth.
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Keywords: energy supplements; faltering growth; infant; infant formula; protein : energy ratio

Document Type: Research Article

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

Publication date: 2007-08-01

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