Abstract

Introduction: Data on GE are lacking for various types of infant formulas. The aims of this double blind randomized study were to assess GE in infants fed an intact protein, a partially hydrolysed & an extensively hydrolysed formula (Nan1, Nan HA1 & Experimental Formula, Nestlé) and to compare GE data with reference values for breast milk (1). Methods: Twenty healthy newborns (6 boys) were investigated, after parental consent. The infants had a mean gestational age of 37 wks (28–40 wks) and a birth weight of 2698g (720–3690g). At enrollment, mean age was 4 wks 3 d (range 6 d-13 wks) and mean weight was 3466g (2100–5700g). The 13C-octanoic acid (OA) breath test was used to assess GE of the 3 formulas fed in random order at 2-d intervals. A symptom diary was kept. Test meals were given after a fasting period of at least 3 hrs. After 2 basal breath samples, one of the 13C OA labeled infant formulas was administered and breath samples collected every 15 min over the next 4 hrs. Analysis of breath samples for 13C-enrichment was performed using isotope-ratio mass spectrometry and the GE curve and half emptying time (t1/2) was determined. Results: The extensively hydrolysed formula (t1/2 mean±SD: 45±16 min) emptied significantly faster than both the intact (75±58 min; p=.002) and partially hydrolysed (58±21 min; p=.032) formulas. There was no significant difference between GE of the partially hydrolysed and intact formula (p=0.31). In comparison to GE of breast milk (mean t1/2±SD: 47±18 min) in a different study group (1), the extensively hydrolysed formula emptied faster (14%), the partially hydrolysed and intact protein formula slower (11% & 22%)(not significant). In these healthy infants, no differences in stool patterns, cramping and vomiting were recorded after receiving the various formulas (p=0.48–0.84). Conclusion: In healthy infants, GE of an extensively hydrolysed formula is significantly faster than that of a partial hydrolysate, an intact protein formula and even breast milk. The potential therapeutic applications of this important feature remain to be studied in infants with feeding intolerance.

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