Xanthan- and Rice Cereal-Based Thickeners in Infants: A Multidisciplinary Single-Center Experience

Area of Science:

• Pediatrics
• Gastroenterology
• Nutrition

Background:

• Infants aspirating thin liquids require thickened liquids for lung protection.
• The safety of commonly used thickeners, including xanthan-based and rice cereal-based, requires further investigation.
• Xanthan-based thickeners have been linked to necrotizing enterocolitis, while rice cereal-based thickeners are associated with constipation and excessive weight gain.

Purpose of the Study:

• To compare the rates of adverse events between xanthan-based and rice cereal-based milk thickeners in infants.
• To evaluate the safety profiles of different infant milk thickeners.

Main Methods:

• A retrospective chart review was conducted at a tertiary pediatric care center.
• Infants fed xanthan- or rice cereal-based milk thickeners were included (n=53).
• Adverse events including diarrhea, constipation, overweight, and obesity were assessed at 3-6 and 6-12 months post-initiation.

Main Results:

• No significant differences in rates of diarrhea, constipation, overweight, or obesity were observed between xanthan-based and rice cereal-based thickener groups.
• Eight Canadian pediatric hospitals reported significant variability in thickening practices.

Conclusions:

• Xanthan-based and rice cereal-based milk thickeners appear to have similar safety profiles in infants.
• Larger studies are warranted to confirm these safety findings and inform clinical practice regarding infant feeding strategies.