Cornstarch thickened formula reduces oesophageal acid exposure time in infants

Xinias, Ioannis; Mouane, Nezha; Luyer, B. Le; Spiroglou, Kleomenis; Demertzidou, Vasiliki; Hauser, Bruno; Vandenplas, Yvan

doi:10.1016/j.dld.2004.07.015

Cited by 44 publications

(29 citation statements)

References 18 publications

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“…19 However, a recent multicentre trial found a caseindominant formula thickened with a specifically treated cornstarch to reduce esophageal acid exposure, and to reduce clinical symptoms. 20 Our data confirm a reduction in the frequency of regurgitation and vomiting with the same formula (Novalac AR). Moreover, 25% strengthening of the formula, a traditional approach in Taiwan, did not seem to decrease regurgitation.…”

Section: Discussionsupporting

confidence: 81%

“…previously reported that milk thickened with carob bean gum decreased the number of acid reflux episodes, but the total duration of acid exposure remained unchanged, presumably because of slower clearance of the thickened acid refluxate from the esophagus 19 . However, a recent multicentre trial found a casein‐dominant formula thickened with a specifically treated cornstarch to reduce esophageal acid exposure, and to reduce clinical symptoms 20 . Our data confirm a reduction in the frequency of regurgitation and vomiting with the same formula (Novalac AR).…”

Section: Discussionmentioning

confidence: 99%

“…A benefit of thickened formula in infants who spit up frequently is that as a consequence of the decreased regurgitation the losses of nutrients decrease, which can be advantageous for infants who fail to thrive in this situation. [18][19][20] Studies of various thickening agents, including guar gum, carob bean gum, and soybean polysaccharides, indicate the potential for: decreased intestinal absorption of carbohydrates, fats, calcium, iron, zinc, and copper; alterations in metabolic utilization of dietary substrates; and alterations of mucosal and endocrine responses. 24 However, no conclusive information is available on the potential effects of thickening agents on the bioavailability of dietary nutrients and growth in infants.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the effect of a cornstarch thickened formula and strengthened regular formula on regurgitation, gastric emptying and weight gain in infantile regurgitation

Chao

Vandenplas

2007

Diseases of the Esophagus

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The purpose of this study was to evaluate the efficacy of a specially selected cornstarch-supplemented formula on clinical symptoms, gastric emptying and weight gain in infants with regurgitation. We performed a prospective randomised trial evaluating the therapeutic efficacy of two different formula feedings (cornstarch-thickened formula, group A; 25% strengthened formula, group B) in 81 young infants with regurgitation/vomiting > or = 3 times/day. A Tc-99 m milk scintigraphy was performed at inclusion and after 2 months to quantify gastric emptying time; all studied infants underwent a 2-month period of clinical follow-up evaluating regurgitation and body weight gain. At inclusion, group A and B had a similar age and weight. After the 2-month period of intervention, regurgitation and vomiting had both greater decrease (both P < 0.001 at 1 and 2 months) in group A (from a score of 4.19 +/- 1.71 to 0.93 +/- 0.42) than in group B (from a score of 4.15 +/- 1.68 to 2.89 +/- 1.16). Non-regurgitation symptoms (irritability, cough, choking, night-waking) decreased (P = 0.045 at 1 month and 0.017 at 2 months) in group A (from a score of 18 at baseline to 3 after 8 weeks) as compared to group B (from a score of 18 at baseline to 11 after 8 weeks). Weight increased more in group A (29.1 +/- 3.9 g/day over 8 weeks) versus group B (23.6 +/- 3.5 g/day over 8 weeks) (P < 0.01 at 1 and 2 months) Gastric emptying improved significantly in group A as compared with group B (all P < 0.001 for T1/2, and residual volume at 60 and 90 min). Ingested feeding volume was significantly larger in the group receiving cornstarch-thickened formula, both at 4 weeks (109.4 +/- 24.5 vs. 98.5 +/- 23.6 mL/meal) (P: 0.042) and at 8 weeks (137.6 +/- 27.9 vs. 115.7 +/- 26.5 mL/meal) (P < 0.001). Cornstarch-thickened formula feeding decreases the frequency of regurgitation/vomiting, provides better body weight gain and has an accelerated gastric emptying in comparison to a 25% strengthened regular formula in infants with regurgitation.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of the effect of a cornstarch thickened formula and strengthened regular formula on regurgitation, gastric emptying and weight gain in infantile regurgitation

Chao

Vandenplas

2007

Diseases of the Esophagus

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“…Dietary management by feeding thickened formula is a part of a stepwise approach to treating for gastroesophageal reflux (GER) in infants 1–3 . Thickening of the formula is achieved by addition of rice cereal, rice starch or cornstarch in the USA, 4–8 while carob flour or locust bean gum (LBG) is used commonly in Europe 2,9 . These thickened formulas are effective in decreasing recurrent regurgitation episodes 2–9 …”

mentioning

confidence: 99%

Effect of formula thickened with locust bean gum on gastric emptying in infants

Miyazawa

Tomomasa

Kaneko

et al. 2006

J Paediatrics Child Health

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“…Despite a significant decrease of symptoms as regurgitations and vomiting and an increase in daily weight gain, thickening agents were ineffective in reducing acid GOR indexes [36]. An improvement of acid GOR features in infants fed a corn starch thickened formula has been reported in only one trial [37]. As for nonacid GOR, a remarkable reduction of reflux episodes, mean oesophageal reflux height, and frequency of regurgitation was observed by Wenzl et al in association with the use of a galactomannan-thickened formula [38].…”

Section: Feed Thickeningmentioning

confidence: 99%

Nonpharmacological Management of Gastroesophageal Reflux in Preterm Infants

Corvaglia

Martini

Aceti

et al. 2013

BioMed Research International

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Gastroesophageal reflux (GOR) is very common among preterm infants, due to several physiological mechanisms. Although GOR should not be usually considered a pathological condition, its therapeutic management still represents a controversial issue among neonatologists; pharmacological overtreatment, often unuseful and potentially harmful, is increasingly widespread. Hence, a stepwise approach, firstly promoting conservative strategies such as body positioning, milk thickening, or changes of feeding modalities, should be considered the most advisable choice in preterm infants with GOR. This review focuses on the conservative management of GOR in the preterm population, aiming to provide a complete overview, based on currently available evidence, on potential benefits and adverse effects of nonpharmacological measures. Nonpharmacological management of GOR might represent a useful tool for neonatologists to reduce the use of antireflux medications, which should be limited to selected cases of symptomatic babies.

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Cornstarch thickened formula reduces oesophageal acid exposure time in infants

Cited by 44 publications

References 18 publications

Comparison of the effect of a cornstarch thickened formula and strengthened regular formula on regurgitation, gastric emptying and weight gain in infantile regurgitation

Comparison of the effect of a cornstarch thickened formula and strengthened regular formula on regurgitation, gastric emptying and weight gain in infantile regurgitation

Effect of formula thickened with locust bean gum on gastric emptying in infants

Nonpharmacological Management of Gastroesophageal Reflux in Preterm Infants

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