Implications of changing the amount of thickener in thickened infant formula for infants with dysphagia

When a dysphagic infant is prescribed thickened infant formula (TIF) as a treatment method, some clinicians determine their own addition rates of thickener to meet the specific needs of the infant rather than relying on the directions on the tin. In this study the rheological behaviour of a TIF at different addition levels of thickener was measured to determine whether there was a difference in full rheological response and in viscosity. In addition, the time taken for the TIF to reach a near-stable viscosity was also measured. One hundred grams of Karicare® infant formula was made up according to the manufacturer’s instructions and Karicare® feed thickener was added at levels of 2, 3, 4, 5, and 6 g, respectively. A strain-controlled rheometer (ARES) with Couette geometry was used to rheologically characterise the TIF at the different levels of thickener addition. There was a significant difference in viscosity between the low levels and the higher levels of addition thickener (p < 0.05). Also, the low levels of thickener addition showed Newtonian-like behaviour, whereas the higher levels of addition were shear-thinning. The time taken for the thickener to reach a near-stable viscosity was found to be 10 min. Guidelines for thickened infant formula need to take into account the different levels of thickener addition rates.