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[A new cow's milk formula to Complementary Feeding National Program: nitrogen and caloric balance].

Nitrogen, fat and energy retention were measured in 10 male infants (mean age = 6.8 mo) recovering from marasmic malnutrition while they were fed with either cow's milk based formula (LP) or a modified cow's milk formula (LPM). Their mean weight for age ratio was 72% and their weight for length ratio was 95% (NCHS standards). They went through two consecutive balance periods of 6 days each (3 d. for adaptation and 3 d. for urine and feces collection) beginning with either formula randomly. Both formulas had 85 kcal/dl with 11% protein calories in LPM and 13% in LP. Energy intake, absorption and relative retention were slightly greater with LPM than LP. Fat intake was greater under LPM than LP (5.4 vs. 4.5 g-kg-d, p < 0.025), which resulted in significant differences in fat absorption (LPM 4.3 vs. LP 3 g-kg-d, p < 0.025). Nitrogen intake was significantly lower under LPM than LP (487 vs. 571 mg-kg-d, p < 0.025) with lower urinary nitrogen excretion for LPM than for LP (304 vs. 417 mg-kg-d, p < 0.001). Apparent nitrogen retention averaged 115 mg-kg-d for LPM and only 69 mg-kg-d for LP (NS). A significant correlation was observed between nitrogen intake and nitrogen retention: r = 0.70 (y = 0.57x -167; p < 0.05) with LPM, and r = 0.77 (y = 0.63x -291, p < 0.01) with LP. A correlation was also found between energy intake and weight gain: r = 0.55 (NS) with LPM, and r = 0.88 (y = 0.26x -26; p < 0.001) with LP.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Enteral feeding in children].

Enteral nutrition in children is indicated in and outside gastrointestinal (GI) diseases. When administered as a continuous flow, it makes it possible to obtain stationary motor, secretory and hormonal functions of the digestive tract and to increase its capacity for digestion and absorption. The introduction of semi-elemental diets has made it easier to perform and has enhanced its effectiveness; the preparation of nutritional mixtures requires a structure that is capable of ensuring accuracy and sterility. In some circumstances the conventional nasogastric tube can be replaced by percutaneous gastrostomy. Both monitoring and variations in intakes must take into account the child's nutritional and digestive status in terms of tolerability and efficacy. Enteral nutrition is indicated in such GI diseases as prolonged severe diarrhoea, extensive intestinal resections and inflammatory diseases. Outside GI pathologies it can be used in neonatology, metabolic diseases and intensive care. Enteral nutrition at home enables the nutritional support to be pursued in an optimal psychoaffective environment, and it must be envisaged as soon as medical condition permits.

Child↗

Tube feeding in the real world: formulas, equipment, finances, and feeding problems.

When selecting enteral feedings for infants and children on continuous peritoneal dialysis care should be taken to meet individual needs to provide for nutritional adequacy and normal growth rates. This requires a combination of complete feedings plus modules. The feedings should be evaluated frequently to adjust for growth and changes in renal function or treatment.

Child↗

Efficacy and safety of a soy-protein-formula for feeding babies with atopic dermatitis and cow's milk hypersensitivity.

In this paper we report 21 infants with atopic dermatitis (AD) due to cow's milk (CM) hypersensitivity in 20/21 of whom a CM-free diet using as a CM-substitute a soy-protein formula improved the skin lesions, in addition to insuring a regular growth in all infants. Only one infant failed to complete the trial due to an absolute refusal of the soy protein formula. A possible secondary sensitization to soy was found in one infant, in whom dietary therapy alone was not effective. We conclude that soy-protein formulas represent an effective CM-substitute when CM must be eliminated from the diet of an infant with AD.

Dermatitis, Atopic↗

Formula feeding in the first year of life.

Over 60% of all infants in the United States are completely formula-fed by 2 months of age. A nursing diagnosis framework can aid nurses in supporting and guiding parents who formula-feed their infants.

Education, Nursing, Continuing↗

[Preparation and chemical and nutritional evaluation of an infant food based on sweet lupine, wheat and milk].

This paper deals with the development of a food for infants and young children based upon a mixture of 27.5% wheat flour, 20% sweet lupin flour and 20% powdered milk (GL) (18% fat content) with added vitamins and minerals. The blend of wheat and lupin flour was processed in an extrusion-cooker (Wenger X 25) before mixing with the other ingredients. The proximate chemical analysis performed on the wheat-lupin-milk blend (LTL) showed 18.7% protein and 12.5% fat with a calculated caloric value of 427 kcal/100 g. Amino acid analysis indicated a deficiency of methionine + cystine and of threonine in the blend. Nevertheless, studies with rats on the biological quality of the protein, such us protein efficiency ratio and apparent digestibility, revealed that this blend was as good as the reference diet (powdered egg). It is therefore felt that the LTL blend may be a useful substitute in food programs directed to infants and school children.

Amino Acids↗

[Chylous ascites in infants].

In a one month-old boy apparently idiopathic chylous ascites recovered with enteral feedings of an elementary diet excluding long-chain triglycerides. The authors emphasize the usual idiopathic character of chylous ascites in very young infants; the little interest of invasive investigations at such an age when data suggesting etiology are lacking; the interest of a trial of a non-invasive medical treatment, such as the one reported.

Chylous Ascites↗

Rationale and guidelines for parenteral and enteral transition feeding of the 3- to 30-kg child.

To provide optimal nutrition support for the pediatric patient in transition from parenteral to enteral support, the clinician must select an appropriate formula, design a feeding regimen, and taper the parenteral support accordingly. Formula selection is based on the child's age, any overriding disease entity, and the caloric density, osmolarity, carbohydrate and fat source, protein content, and nutrient complexity of the formula. The feeding regimen is designed to allow for adaptive increases in digestive enzymes and digestive surface area within the gut. Small advances in volume are made first; increases in concentration of the formula follow. A systematic, six-step method for the progression of enteric support and the tapering of parenteral support provides the clinician with guidelines for managing this interval.

Body Weight↗

[Use of chickpea (Cicer arietinum L.) in non-dairy formulas. II. Nitrogen balance in children with lactose intolerance, fed with a formula based on chickpea and a commercial soybean product].

The nutritive value of chick-pea and soy infant formulas was evaluated. Nitrogen balance was performed in 17 malnourished babies, seven of which were fed with the chick-pea formula, and 10 with the soy commercial formula (Sobee). The percentage of absorption, retention and biological value of the chick-pea formula were 72.4, 26.4 and 35.1, respectively and 69.6, 24.3 and 34.0 in the same order, with the soy formula. Since the nutritional quality of the chick-pea was not different to the commercial soy formula and the diarrhea was better controlled by the former, this formula could be recommended in the treatment of lactating babies with lactose intolerance.

Blood Proteins↗

[Neonatal hyperbilirubinemia of inadequately breast-fed infants and the effect of formula supplementation].

One hundred and fifty full-term breast-fed infants were analysed for their oral intake in the first 6 days. Fifty infants with less than 330 ml/kg/6 days breast feeding were defined as inadequately breast-fed infants. Twenty inadequately breast-fed infants without formula supplementation had significantly lower total fluid intake, lower total calorie intake, more body weight loss and significantly higher rates of hyperbilirubinemia and requirement of phototherapy when compared with the control group of 100 infants with more than 330 ml/kg/6 days breast feeding. On the other hand, 30 inadequately breast-fed infants with formula supplementation had significantly higher total fluid intake, higher total calorie intake, lower body weight loss and requirement of phototherapy than those without formula supplementation. From these data, we suggest that (1) Inadequate feeding may be a factor responsible for the higher prevalence of early neonatal jaundice in breast-fed infants reported in the literature. (2) Lower fluid intake, lower calorie intake and greater body weight loss may be associated with the higher incidence of hyperbilirubinemia and requirement of phototherapy. (3) Formula supplementation may be helpful in decreasing the risk of hyperbilirubinemia in inadequately breast-fed infants.

Breast Feeding↗

Specialized formulas and feedings for infants with malabsorption or formula intolerance.

The composition of specialized formulas for infants who experience malabsorption or formula intolerance is described in detail. The limited studies of efficacy, as well as a rationale for selecting an appropriate formula for infants with malabsorption or formula intolerance, are discussed. Infants with symptoms of diarrhea or emesis may have intolerance to milk lactose or milk protein. Soy formulas contain no lactose or cow's milk and should be the first choice of an alternative feeding because of cost and convenience. Some infants may be intolerant of soy as well as cow's milk protein. They benefit from formula containing neither cow's milk nor soy protein or from a specially processed milk-based formula containing hydrolyzed casein. A carbohydrate-free formula to which the desired type of carbohydrate is added may be helpful in the diagnosis and treatment of disaccharidase deficiencies and monosaccharide intolerances. Infants with extensive intestinal resections or intractable diarrhea may require specialized infant formulas with qualitative/quantitative modifications of fat, carbohydrate, and protein. Formulas with medium-chain triglycerides may be useful for infants with steatorrhea. "Preterm" formulas or milk from the infant's mother are preferred for preterm infants, since such feedings promote improved fat and carbohydrate absorption and better meet the infant's nutrient requirements.

Animals↗

Increased excretion of histidyl-L-proline diketopiperazine by infants receiving Pregestimil and Nutramigen formulas.

Histidyl-L-proline diketopiperazine is excreted in increased amounts by infants receiving Nutramigen or Pregestimil. When these formulas are discontinued, its excretion becomes undetectable. The compound was isolated from Nutramigen and Pregestimil, as well as from the urine of the infants receiving these formulas, and was identified by comparison with authentic histidyl-L-proline diketopiperazine standard in various chromatographic and electrophoretic systems. A neuropeptide widely distributed in the brain and gut and having a variety of biological functions, histidyl-L-proline diketopiperazine may have as-yet-undetermined effects on infants who are receiving these formulas.

Electrophoresis↗

Dietary management of intestinal lymphangiectasia complicated by short gut syndrome.

The dietary management of a child with intestinal lymphangiectasia complicated by short gut syndrome following surgery at the age of 3 weeks is described. Diets containing amino acids and peptides were not tolerated due to high osmolality. Satisfactory nutrition was achieved by using a feed with low osmolality and containing whole whey protein, maltodextrin, medium-chain triglycerides (MCT) and a small amount of long-chain triglycerides (LCT) to supply essential fatty acids (RD231).

Female↗