Differences in Thickening Effects Between Hypoallergenic and Standard Infant Formulas Thickened with Infant Cereals
Background: Dysphagia, a condition characterized by sucking or swallowing deficits, is a condition that commonly plagues medically fragile infants. Thickening infant formula using infant cereals is a leading dysphagia treatment. However, research suggests that composition of hypoallergenic formulas may impair the ability of cereals to bind to the formula and achieve the desired thickening effects. This investigation examined the ability to thicken eight commonly used hypoallergenic formulas using Beechnut™ Rice and Oatmeal Cereals.
Methods: Graduated volumes (2, 3, 4, 5tsp/2oz formula) of Beechnut™ Rice and Oatmeal Cereals were mixed with room temperature standard (Similac Advance® and Enfamil Infant®) and hypoallergenic (Similac Alimentum®, Enfamil Nutramigen®, Elecare®, PurAmino™, Similac Pro-Total Comfort™, Neocate®, Enfamil NeuroPro™, and Enfamil Pregestimil®) infant formulas. International Dysphagia Diet Standardization Initiative (IDDSI) flow testing was completed every five minutes for thirty minutes to measure formula thickness across a typical feeding duration. Formulas were categorized into IDDSI thickness levels based on residual volume remaining after flow testing. Thickness levels of standard formulas were compared to those of hypoallergenic formulas at each thickening ratio. Results are reported as the difference in residual volume between standard and hypoallergenic formulas.
Results: Hypoallergenic formulas differed in thickness levels from standard formulas prepared with the same cereal to formula ratios. The nature of this difference was dependent on the formula, cereal type, and mixing ratio.
Conclusion: Hypoallergenic formulas display thickness disparities when mixed with Beechnut™ rice and oatmeal cereals. When compared to standard formulas, results among hypoallergenic formula brands vary.