Assessment of Growth of Infants Fed an Amino Acid-Based Formula

Corkins, Mark R.; Czerkies, Laura; Storm, Heidi; Sun, Shumei S.; Saavedra, José M.

doi:10.4137/cmped.s33071

Cited by 11 publications

(29 citation statements)

References 15 publications

(18 reference statements)

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“…Based on the criteria outlined in Section 2.2.1 , the literature was reviewed to identify studies that reported the growth of healthy term infants exclusively fed either an EHF or AAF during early infancy. Seven controlled, randomized, prospective growth trials of healthy term infants fed EHFs or AAFs at similar time points during the first four months of life have been reported and are presented in Table 3 [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. All of these studies, except for one [ 20 ], reported data that could be compared at least for some variable to that reported in the other studies.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported data for EHFs [ 14 , 15 , 16 , 17 , 18 ]; four studies reported data for AAFs [ 14 , 18 , 19 , 20 ] and the formulas are detailed in Table 1 . The protein in EHFs is extensively hydrolyzed, thus, a sizeable percent of the protein is in the form of FAAs, perhaps as high as 50% or more, with the remainder largely in the form of very short peptides.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas

2018

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The aim of this narrative review was to assess published growth data for healthy, term, infants consuming extensively hydrolyzed protein-based (EHF), or amino acid-based formulas (AAF). These data may be of use to clinicians managing infants with medical conditions consuming these products. A search was conducted using key terms: amino acid-based, hydrolysate, hydrolyzed, hydrolysed, infant formula, infant formulae or formulas, baby formula, or formulae or formulas, infant, infants, infantile, and growth. Seven controlled, randomized, prospective growth trials of healthy term infants fed EHFs or AAFs at similar time points during the first four months of age met these and other criteria, including that the trial was published in a peer-reviewed journal, subjects were enrolled by ≤14 days of age and were exclusively formula-fed at entry and throughout the duration of the trial, and infants were assessed at regular intervals with weight measures available ideally at 14 days, one, two, three, and four months of age. Results suggested that healthy infants receiving commonly available EHFs and AAFs do not appear to experience accelerated growth as reported for infants fed many standard formulas. Differences in growth patterns were observed with some formulas supporting normative growth patterns during the first four months but others appearing to support markedly lower growth patterns. These observations should be confirmed in well-designed prospective randomized trials. Until that time, it is recommended that EHFs and AAFs be chosen carefully with individual patient needs considered.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas

2018

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“…An eHF should be considered as the first choice in all cases of CMPA, except the most severe ones, since it is cheaper than AAF and more effective at inducing tolerance. Several studies have demonstrated that hydrolyzed formulas support the normal growth of healthy term infants, also in the first months of life . The risk of having less than the recommended daily intake of calcium and vitamin D in children with CMPA has been shown to be lower if children consume a cow's milk–free infant formula …”

Section: Specialized Infant Formulasmentioning

confidence: 99%

“…Several studies have demonstrated that hydrolyzed formulas support the normal growth of healthy term infants, also in the first months of life. [54][55][56][57][58][59][60] The risk of having less than the recommended daily intake of calcium and vitamin D in children with CMPA has been shown to be lower if children consume a cow's milk-free infant formula. 61 Infant milk formulas from non-bovine animals (goat, ewe, mare, donkey, or camel) have been widely marketed as substitutes for cow's milk, but they are not nutritionally appropriate for infants' needs 50 and could cause harm, since they carry a high risk (up to 80%) of cross-reactivity.…”

Section: Extensively Hydrolyzed Cow's Milk Protein Formulas and Aminomentioning

confidence: 99%

Standard and Specialized Infant Formulas in Europe: Making, Marketing, and Health Outcomes

et al. 2019

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Infant formulas are the only suitable substitute for human milk. The most common infant formulas are standard formulas based on cow's milk. In addition, there are formulas for infants showing signs and symptoms of intolerance and for clinical conditions such as allergy, prematurity, and gastrointestinal diseases. A comprehensive review of the literature was made to review the composition of standard and specialized infant formulas and analyze indications for use, real or presumed nutrition differences and properties, and impact on infant growth. A brief consideration on costs is outlined for each formula. Over the past few years, industrial production and advertising of infant formulas have increased. Human milk still remains the most complete source of nutrition for infants and should be continued according to the current recommendations. Few differences exist between infant formulas, both for the nutrition action and the macronutrient/micronutrient composition. Specialized infant formulas have limited indications for use and high costs. The role of the pediatrician is crucial in the management of infant nutrition, promotion of breastfeeding, and prescribing of specialized formulas only in specific clinical conditions.

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“…Short-term tolerance to amino acid-based formulas has been established [10, 11]. Multiple trials of elemental formula that lasted from 12 to 15 weeks have shown normalized weight gain and growth parameters in infants with cow milk protein intolerance [12, 13]. A prospective, 16-week trial of 82 infants (age 0–8 months) showed adequate mineral status after consuming an amino acid-based formula (Neocate [NC]; Nutricia North America); the patients had milk protein intolerance but were otherwise healthy [14].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Metabolic Bone Disease in Tube-Fed Children Receiving Elemental Formula

et al. 2018

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Background: Previous studies suggest normal mineral status in children receiving elemental formula. However, a recent multicenter survey described 51 children who developed hypophosphatemia and bone disease while receiving elemental formula. Our aim is to determine the prevalence of metabolic bone disease in children receiving extensively hydrolyzed or amino acid-based formula. Methods: We established a retrospective cohort using an institutional database of tube-fed children. We defined a “confirmed case” as a child with biochemical and radiographic evidence of bone disease (rickets and/or low-trauma fractures). We defined a “suspected case” as a child who had biochemical evidence and/or radiographic evidence of bone disease but with incomplete data during the review period. Results: A total of 102 tube-fed children receiving elemental or semi-elemental formula were identified. The four elemental and semi-elemental formulas evaluated were Neocate®, EleCare®, Pregestimil®, and Alimentum®. Not all children had complete monitoring data performed during the review period. Of the children receiving Neocate who had monitoring data (46%), 23% developed hypophosphatemia and radiographic abnormalities (fractures or rickets), which resolved with phosphorus supplementation and/or change in the formula brand. Conclusions: We estimate that at least 11% and up to 23% of all tube-fed children receiving Neocate develop metabolic bone disease. Based upon the estimated prevalence, we recommend cautious use of this formula with monitoring for evolving bone disease in this population.

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Assessment of Growth of Infants Fed an Amino Acid-Based Formula

Cited by 11 publications

References 15 publications

Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas

Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas

Standard and Specialized Infant Formulas in Europe: Making, Marketing, and Health Outcomes

Prevalence of Metabolic Bone Disease in Tube-Fed Children Receiving Elemental Formula

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