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Tytuł pozycji:

The Effect of Additives for Reflux or Dysphagia Management on Osmolality in Ready-to-Feed Preterm Formula: Practice Implications.

Tytuł :
The Effect of Additives for Reflux or Dysphagia Management on Osmolality in Ready-to-Feed Preterm Formula: Practice Implications.
Autorzy :
Levy DS; Speech and Language Pathology, Health and Communication Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Osborn E; Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Hasenstab KA; Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Nawaz S; Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Jadcherla SR; Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.; Divisions of Neonatology, Pediatric Gastroenterology, and Nutrition, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
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Źródło :
JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2019 Feb; Vol. 43 (2), pp. 290-297. Date of Electronic Publication: 2018 Jul 10.
Typ publikacji :
Journal Article; Research Support, N.I.H., Extramural
Język :
English
Imprint Name(s) :
Publication: 2018- : [Hoboken, NJ] : Wiley
Original Publication: Thorofare, N. J., Slack.
MeSH Terms :
Dietary Supplements*
Food Additives*
Food, Formulated*
Deglutition Disorders/*therapy
Gastroesophageal Reflux/*therapy
Infant Formula/*chemistry
Humans ; Osmolar Concentration
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Grant Information :
P01 DK068051 United States DK NIDDK NIH HHS; R25 HD086885 United States HD NICHD NIH HHS
Contributed Indexing :
Keywords: infant feeding*; osmolality*; preterm formula*; supplements*; thickening*
Substance Nomenclature :
0 (Food Additives)
Entry Date(s) :
Date Created: 20180712 Date Completed: 20200819 Latest Revision: 20200819
Update Code :
20210914
PubMed Central ID :
PMC6328349
DOI :
10.1002/jpen.1418
PMID :
29992586
Czasopismo naukowe
Background: A common osmolality threshold for feedings is to stay <450 mOsm/kg for normal infants. Preterm formulas are frequently modified to improve growth, modify nutrition, and manage gastroesophageal reflux (GER) or dysphagia. Relationships between osmolality and additives to ready-to-feed preterm formulas are unclear. Our aims were to evaluate and compare the effects of caloric density, thickening agent recipes, and supplements to ready-to-feed preterm formula on osmolality.
Methods: A freezing point osmometer was used to measure the osmolality of 47 preterm infant formula combinations with varying caloric densities (ready-to-feed 22 and 30 cal/oz), thickening agents (rice vs oatmeal cereal), thickener amounts (0.0, 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 tsp/oz), and combinations of supplements (saline, iron, vitamin D, or multivitamin). Ten samples per combination were tested using a 10-μL pipette. Comparisons were made using analysis of variance and t-tests for group and pair-wise comparisons, respectively.
Results: A total of 470 osmolality samples were analyzed: (1) raters had high agreement (r = 0.98; P < .001); (2) for every 0.5 tsp/oz of thickener, the osmolality increases by 30 mOsm/kg (P < .001); (3) osmolality was higher with the oatmeal (vs rice) thickening agent (P < .001); and (4) vitamin and electrolyte supplement combinations increase osmolality.
Conclusions: Alteration of ready-to-feed preterm formulas may significantly increase osmolality and have unintended consequences. Caution and monitoring should be exercised with modifying ready-to-feed preterm formulas for regurgitation, rumination, GER, dysphagia, feeding intolerance, or emesis. This study supports the concept of achieving volume tolerance before further manipulation of additives.
(© 2018 American Society for Parenteral and Enteral Nutrition.)

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