Comparison of Two Special Infant Formulas Designed for the Treatment of Protracted Diarrhea

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 7; no. 1; pp. 76 - 83
• Main Authors: Galeano, Narmer F., Lepage, Guy, Leroy, Claudie, Belli, Dominique, Levy, Emile, Roy, Claude C.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott-Raven Publishers 01-01-1988; Lippincott
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Weight; Chronic Disease; Diarrhea, Infantile - diet therapy; Diarrhea, Infantile - metabolism; Diarrhea, Infantile - pathology; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Energy Intake; Energy Metabolism; Fat absorption; Feces - analysis; Humans; Infant; Infant Food; Infant Nutritional Physiological Phenomena; Intensive care medicine; Intractable diarrhea; Medical sciences; Nitrogen - pharmacokinetics; Nitrogen and energy balance; Protein hydrolysate formulas; Short bowel syndrome; Time Factors; Human; Diarrhea; Digestive diseases; Infant; Nutrient; Recurrent; Resuscitation; Enteral administration; Parenteral administration; Feeding
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1002/j.1536-4801.1988.tb09472.x

Summary
The nutritional management of intractable diarrhea and short bowel syndrome remains a challenging problem. The advantage of continuous nasogastric infusion is undisputed, but what to feed remains in question, and no studies, to these authors' knowledge, have yet compared two widely used specially designed protein hydrolysate formulas. A randomized crossover trial of two periods of 7 days was carried out with Alfare and Pregestimil administered by a constant infusion pump in six malnourished infants aged 1–13 months. Two had intractable diarrhea, and four the short bowel syndrome. Identical quantities of calories were administered during the two periods. There was good tolerance for both formulas and satisfactory weight gain. Despite compositional differences related to osmolality, the source of the hydrolysates and their profile, and the qualitative pattern of the carbohydrates, no difference was observed with regard to stool weight, Na+ and K+ losses, and the enteral absorption of fat, carbohydrate‐derived energy, and total energy. The percent absorption of nitrogen was somewhat higher (p < 0.01) with Pregestimil (83.8 ± 2.7) than with Alfare (77.3 ± 3.4), but nitrogen retention was unaffected. Energy absorption was the same on both formulas, but maldigested or malabsorbed carbohydrates accounted for 63% of total energy loss during Alfare feeding and 72% during the week of Pregestimil. These data call for studies with protein hydrolysate formulas reformulated with a lower concentration of carbohydrates and a higher one of fat.