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Two different low birth weight formulae compared
S A Spencer1, S McKenna, J Stammers
1North Staffordshire Maternity Hospital, Harpfields, Stoke-on-Trent, UK.
Insights
Two preterm infant formulas, Prematil and Osterprem, were compared for low birth weight infants. Osterprem, with higher fat content, led to increased energy intake but similar weight gain and poorer fat absorption compared to Prematil.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Infant Formula Composition
Background:
- Preterm infants require specialized nutrition for optimal growth and development.
- Commercially available infant formulas vary in composition, potentially impacting tolerance and nutrient absorption.
- Understanding the effects of different formula compositions is crucial for clinical practice.
Purpose of the Study:
- To compare the clinical performance of two low birth weight formulas: Prematil and Osterprem.
- To evaluate the impact of compositional differences, specifically fat content and medium-chain triglycerides (MCTs), on preterm infants.
- To assess tolerance, stool characteristics, fat balance, and weight gain in response to the two formulas.
Main Methods:
- A randomized controlled study involving preterm infants with birth weights under 1500 g.
- Infants were assigned to receive either Prematil or Osterprem formula.
- Data collection included clinical evaluation, energy intake, weight gain, stool frequency and consistency, and a three-day fat balance study.
Main Results:
- Osterprem, containing 40% more fat and no MCTs, resulted in significantly higher mean energy intake (3442 kJ/kg/week) versus Prematil (3127 kJ/kg/week).
- Despite higher energy intake, mean weight gain was not significantly different between the groups (123 g/kg/week for Osterprem vs. 112 g/kg/week for Prematil).
- Osterprem was associated with increased stool frequency (20.5 stools/week vs. 14.5 stools/week), firmer stools, higher fat output (2.3 g/kg/day vs. 0.9 g/kg/day), and lower fat absorption (71.6% vs. 83.5%).
Conclusions:
- Both Prematil and Osterprem are well-tolerated in preterm infants.
- The higher fat content in Osterprem, lacking MCTs, leads to reduced fat absorption and altered stool characteristics, without improving weight gain compared to Prematil.
- Fat absorption is inversely related to the chain length of unsaturated fatty acids, a factor influenced by formula composition.
Abstract:
The performance of two different, commercially available, low birth weight formulae feeds was compared in preterm infants. The aim of the study was to determine the effect of compositional differences on tolerance, stool frequency and consistency, fat balance and weight gain. Inborn infants with birth weight less than 1500 g were randomised at birth to receive Prematil or Osterprem. Thirty infants received more than 900 ml/kg per week of designated formula alone during a total of 70 weeks of study. Three day fat balance was performed on 23 infants. Osterprem contains 40% more fat than Prematil. The composition of this fat is different in that Osterprem contains no medium chain triglycerides (MCT) compared to 30% in Prematil. Clinical evaluation demonstrated that Osterprem is associated with a significantly higher mean energy intake compared to Prematil (3442 and 3127 kJ/kg per week) but mean weight gain is not significantly different (123 and 112 g/kg per week). Mean stool frequency is higher on Osterprem (20.5 and 14.5 stool/week) and the consistency of stools firmer. This is attributable to a higher mean fat output (2.3 and 0.9 g/kg per day) secondary to the higher fat content of the feed and lower mean absorption (71.6 and 83.5%). Both feeds are well tolerated. The study also confirms that absorption of unsaturated fatty acids is inversely proportional to chain length.