Dietary management of malnourished children with a new enteral feeding

Balance (nitrogen, fat, carbohydrate) and growth studies were carried out in nine children (6 to 26 months old) recovering from protein-energy malnutrition (PEM) using a concentrated (1 kcal/mL) formula designed specifically for 1- to 6-year-olds. The formula provided 12% of energy as protein (18% whey, 82% casein), 44% of energy as carbohydrate (69% corn syrup solids, 31% sucrose), and 44% of energy as fat (50% high-oleic safflower oil, 30% soy oil, 20% medium-chain triglycerides). Means +/- standard deviations of apparent nitrogen retention and absorption were 90 +/- 3% and 39 +/- 13%, respectively. Mean fecal fat excretion was 1.3 +/- 1.0 g/day. Length-age increased 3.0 +/- 0.8 months and weight-age increased 8.3 +/- 3.8 months during the 2.4 +/- 0.3 months of the study. (Length-age and weight-age were defined as the age (in months) to which the child's length or weight corresponded at the 50th percentile of the National Center for Health Statistics reference data). Thirteen additional 40- to 30-month-old children with kwashiorkor were fed the formula for 8 to 35 days as part of the initial management of PEM. The result was prompt weight gain and increases in serum proteins. Its formulation and the findings of our study indicate that this new formula offers a notable advantage over products designed for infants or adults in the enteral alimentation of young children.