Infant Standard Nutritional Formulas

What are Infant Standard Nutritional Formulas

Standard infant formulas are enteral formulas that are nutritionally complete and designed for infants during the first year of life.

They are intended to provide total nutrition during the first 6 months of life to term infants who are not breast-feeding or as a supplement to human breast milk. After 6 months of age, infant formula will continue to provide a significant portion of the infant’s nutritional requirements as the infant transitions to a diet of solid foods.

Standard infant formulas may also be used as tube feedings in infants unable to feed via the oral route.

Standard infant formulas usually contain cow’s milk protein; however, soy-based standard infant formulas are available for infants unable to tolerate cow’s milk protein-based formula.

Soy-based formulas have no nutritional advantage over cow’s milk protein-based formulas and are only recommended for the following clinical conditions: galactosemia, hereditary lactase deficiency, and in situations in which a vegetarian diet is preferred. Data do not support the routine use of soy-based formulas for other conditions such as colic or fussiness, cow’s milk protein-induced enteropathy or enterocolitis, or prevention of atopic disease.

Standard infant cow’s milk-based formulas contain unaltered protein molecules (intact protein), carbohydrates, and fats and are best for infants that can digest and absorb nutrients without difficulty.

Standard infant cow’s milk-based formulas contain more protein (through a combination of whey and casein) at 1.4—1.7 g/dL compared with human milk at 0.9 g/dL.

In an attempt to simulate human milk, which has a higher whey-to-casein ratio (60:40 in mature milk) than cow’s milk (18:82), many standard infant cow’s milk-based formulas are whey-predominant.

When mixed to standard concentration, these formulas usually contain approximately 19—20 kcal/oz. Standard infant formulas also contain iron to prevent iron-deficiency anemia.

Iron-fortified formulas contain between 10—12 mg/L of iron (1.5—1.8 mg/100 calories). Low-iron formulas are no longer available, as there is no convincing contraindication to iron-supplemented formulas. In a statement by the American Academy of Pediatrics (AAP), the use of low-iron formulas during infancy poses an unacceptable risk for iron deficiency, and there is no role for them in the feeding of healthy term infants.

Standard infant formulas are available in a variety of formulations; however, the different product formulations are very similar in nutrient composition.

Follow-up formulas, both cow’s milk-based and soy-based, are also available for infants and young children 9—24 months.

The main difference between follow-up formulas and infant formulas is the calcium and phosphorus content, which is approximately 190—300% higher in follow-up formulas. Other nutrients that differ may include iron (11—33% more in follow-up formulas), vitamins E and C, and protein.

The standard caloric concentration of follow-up formulas is 19—20 kcal/oz.

Indications

• complete nutrition
• nutritional supplementation

Monitoring Parameters

• serum electrolytes
• weight

Contraindications

• breast-feeding
• cardiac disease
• dehydration
• electrolyte imbalance
• galactosemia
• hypothyroidism
• immunosuppression
• intravenous administration
• malnutrition
• milk protein hypersensitivity
• phenylketonuria
• pregnancy
• premature neonates
• refeeding syndrome
• renal impairment
• severe combined immunodeficiency (SCID)
• soya lecithin hypersensitivity

Interactions

No information is available regarding drug interactions associated with Infant Standard Nutritional Formulas