Thickening Infant Formula: The Reliability of Commercial Thickener Provided Recipes
Partners with Isabel Visuri
Background: A growing number of infants are suffering from swallowing deficits (dysphagia). These deficits are a source of pulmonary morbidity if left untreated. Provision of thickened liquids through the addition of commercial thickener to infant formula is recommended to mitigate these deficits. While there are a variety of commercial thickeners available, little is known regarding their ability to reach desired thickness levels. This investigation evaluated the validity of two manufacturer-provided thickeners and their associated recipes.
Methods: Similac AdvanceⓇ powder formula was thickened with PurathickTM and GelmixⓇ according to manufacturer instructions. Manufacturers of both thickeners provided a range in fluid ounces for each thickness level. For this investigation, the lower end was tested. Formula thickness was evaluated using International Dysphagia Diet Standardization Initiative (IDDSI) gravity flow testing. Each condition underwent testing every 5 minutes for 35 minutes following thickening to simulate a typical bottle-feed.
Results: PurathickTM recipes met corresponding IDDSI thickness level criteria for both slightly and moderately thick, within the suggested 5 minute wait time. Mildly thick reached its desired thickness level after 10 minutes following mixing. The only GelmixⓇ recipe to meet IDDSI criteria was mildly thick, which met the criteria after 25 minutes. Slightly thick remained thin throughout the 35 minutes.
Conclusions: The validity of commercial thickeners and their associated manufacturer-provided recipes is variable across brands. Recipes provided by PurathickTM and GelmixⓇ were not valid according to IDDSI classification criteria. Future investigations examining the source for these discrepancies are warranted to enable the provision of effective dysphagia interventions.