Diététique basée sur les preuves : que retenir pour la prescription d'une préparation pour nourrissons et d'une préparation de suite en 2007 ?

Abstract

All infant and follow-on formulae available on the market are of high quality. Nevertheless, they are not identical. Several formulae recently launched are characterized by innovations that may have interesting functional effects in some infants. The rising number of formulae and the uncertainty on the validity of the claims presented to justify these innovations make more and more difficult the prescription of a formula that has to be individually tailored for each child. A rational prescription should only be approached on the principle of evidence-based dietetics. Infant formulae satisfy by themselves the nutritional needs of infants up to 6 months of age whereas follow-on formulae should only be used after 6 months when complementary feeding has been introduced into the diet. None of these formulae can claim any nutritional superiority, in particular over breast feeding, which is the reference mode of feeding during the first 6 months of life. The nature of the protein source is the main criteria for choosing an infant formula. In the absence of breast feeding, cow's milk protein infant and follow-on formulae represent the first choice, with the exception of infants at risk for allergy, who should be exclusively fed a hypoallergenic formula during the first 6 months of life. The main interest of soy protein infant and follow-on formulae is feeding infants in vegan families. A functional benefit has only been shown for anti regurgitation formulae as well as for formulae that have the potential to soften stools. Except for the prevention of allergic disease in at-risk families with the use of hypoallergenic infant (and not follow-on) formulae, there is no convincing evidence supporting the prescription of specific formulae in a preventive approach.