Elemental Formulas: Indications of Use in Pediatric Clinical Practice

Background: Elemental or amino-acid-based formulas play a crucial role in pediatric nutrition, offering a therapeutic alternative when human milk is poorly tolerated or in specific disease states. Mostly used in various cases of allergy, maldigestion, or malnutrition, elemental formulas serve as a special therapeutic regimen in clinical practice to promote growth and development. Methods: This narrative review briefly surveys the literature of the past decade available on PubMed, Scopus, and Google Scholar, encompassing original research, review articles, and position papers. Results: The indications for using elemental formulas in pediatric clinical practice extend beyond cow's milk allergy to conditions such as eosinophilic esophagitis, intestinal failure, Crohn's disease, hepatic failure, chronic pancreatitis, and various neurological and other malnutrition-related disorders. Conclusions: Elemental formulas are associated with potential health benefits for pediatric patients in certain conditions, either as a first-line feeding option or under conditional use. Despite their drawbacks, they are regarded as a therapeutic tool with numerous indications, requiring careful implementation by a multidisciplinary team of healthcare experts. Future expert guidelines, including dosage, timing, and long-term effects of elemental diets, are needed for pediatric clinical practice.