Feed thickener for infants up to six months of age with gastro-oesophageal reflux

Kwok, T'ng Chang; Ojha, Shalini; Dorling, Jon

doi:10.1002/14651858.cd003211.pub2

Cited by 30 publications

(50 citation statements)

References 74 publications

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“…A Cochrane meta‐analysis concluded that the observed reduction of two episodes of regurgitation per day is likely to be of clinical significance to caregivers . Moreover, cornstarch‐thickened formula showed a significant reduction in regurgitation frequency with −1.98 [−2.35; −1.61] episodes per day, which is less than the results of the present study. For locust bean gum, the decrease of −1.47 [−3.13; 0.19] regurgitation episodes per day is also lower than the present results but with a high heterogeneity between the studies .…”

Section: Discussioncontrasting

confidence: 89%

“…A review concluded that thickened formulae reduce the frequency and severity of regurgitations and are indicated in formula‐fed infants with persisting symptoms despite reassurance and appropriate feeding volume intake . A Cochrane meta‐analysis concluded that the observed reduction of two episodes of regurgitation per day is likely to be of clinical significance to caregivers . Moreover, cornstarch‐thickened formula showed a significant reduction in regurgitation frequency with −1.98 [−2.35; −1.61] episodes per day, which is less than the results of the present study.…”

Section: Discussioncontrasting

confidence: 78%

“…11 A Cochrane meta-analysis concluded that the observed reduction of two episodes of regurgitation per day is likely to be of clinical significance to caregivers. 9 Moreover, cornstarch-thickened formula showed a regurgitation episodes per day is also lower than the present results but with a high heterogeneity between the studies. 9 A partial hydrolysate thickened with locust bean gum and a specific starch reduced regurgitation statistically significantly more than a formula with intact protein thickened with locust bean gum.…”

Section: Discussioncontrasting

confidence: 69%

“…8 Other commonly used thickening agents include soy fibre and sodium carboxymethylcellulose. 9,10 A review concluded that no thickening agent is likely to be more effective than another, although evidence from comparative trials is very limited. 11 In a pilot study, the effect of an infant formula containing pectin, tapioca starch and locust bean gum was assessed based on regurgitation and stool patterns in children < 5 months old.…”

Section: Introductionmentioning

confidence: 99%

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Different thickening complexes with pectin in infant anti‐regurgitation formula

Dupont

Vandenplas

2019

Acta Paediatrica

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Aim To summarise the results from four clinical trials assessing the efficacy and safety of a thickening complex in the management of regurgitation in infants. Methods Infants (n = 392) younger than 5 months presenting with at least five regurgitations per day were recruited in four open‐label, interventional, single‐group, multi‐centric clinical trials sharing an identical design. The efficacy of four different formulae thickened with different thickening complexes of pectin, starch and locust bean gum, was evaluated on regurgitation at days 3, 14 and 90, and stools and growth at days 14 and 90. Results The daily number of regurgitation episodes was significantly reduced at days 3 and 14 vs baseline in all studies (P < .001), with the largest decrease with the formula having the highest pectin content (study 1; P < .001). In all studies, growth was within normal range. A trend towards stool normalisation for consistency was observed in three studies at day 90 vs baseline and was significant in study 1 (P < .001). Stool frequency was unchanged by the interventions. Conclusion The four tested thickened formulae reduced regurgitation and were proven to be safe. The formula with the largest amount of pectin and lowest starch content showed the best efficacy.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussioncontrasting

confidence: 78%

Section: Discussioncontrasting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Different thickening complexes with pectin in infant anti‐regurgitation formula

Dupont

Vandenplas

2019

Acta Paediatrica

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“…Our recent Cochrane review 4 identified eight randomised clinical trials analysing the impact of feed thickener in 637 healthy term formula feeding infants up to 6 months of age with symptoms of GOR or abnormal oesophageal pH probe measurement. The trials compared feed thickened with various thickeners including carob bean gum, rice cereal, corn starch or alginate, with unthickened feed, over a 1–8 weeks period.…”

Section: Evidencementioning

confidence: 99%

Feed thickeners in gastro-oesophageal reflux in infants

Kwok

Ojha

Dorling

2018

bmjpo

Self Cite

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The viscosity‐enhancing effect of carob bean gum and sodium carboxymethylcellulose when added to infant formula

Baert,

Ombecq,

Van Winckel

et al. 2024

Food Science & Nutrition

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Despite limited supporting evidence, the practice of thickening breast milk or infant formula with commercially available thickening agents is prevalent. This study explored the viscosity‐enhancing impact of carob bean gum (CBG) and sodium carboxymethylcellulose (NaCMC) when added to infant formula at various concentrations and for different thickening durations. The findings indicate that thickening leads to an exponential increase in milk viscosity, from 25% of the recommended dosage onward. This suggests that minor adjustments in dosage can significantly impact formula thickness, underscoring the importance of accurately dosing and preparing infant milk. The considerable variability in viscosity also emphasizes the need for thoughtful selection of teat size, considering the energy expenditure of the sucking infant. When using 50% of the recommended CBG dose or 25% of NaCMC, the resulting viscosity matches that of a commercially available casein‐based formula containing CBG for anti‐regurgitation. In the case of CBG, a viscosity plateau is only reached after 30 min. Therefore, educating parents on the correct handling and preparation steps for CBG‐thickened infant milk is crucial, including a 30‐min waiting period to achieve the intended thickening effect.

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Feed thickener for infants up to six months of age with gastro-oesophageal reflux

Abstract: Feed thickener for infants up to six months of age with gastro-oesophageal reflux.

Cited by 30 publications

References 74 publications

Different thickening complexes with pectin in infant anti‐regurgitation formula

Different thickening complexes with pectin in infant anti‐regurgitation formula

Feed thickeners in gastro-oesophageal reflux in infants

The viscosity‐enhancing effect of carob bean gum and sodium carboxymethylcellulose when added to infant formula

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