The Leeds Teaching Hospitals NHS Trust, Leeds, UK.
J Hum Nutr Diet. 2013 Feb;26(1):32-7. doi: 10.1111/j.1365-277X.2012.01286.x. Epub 2012 Dec 4.
Hyperosmolar infant feeds can cause osmotic diarrhoea and may be a risk factor for necrotising enterocolitis; the osmolality of infant formula is therefore usually <400 mOsm kg(-1) . However, in fluid-restricted infants and those needing nutritional support, formulas may be over-concentrated or supplemented. The present study aimed to determine the effect of these practices on osmolality.
A clinical laboratory osmometer was used to measure the osmolality of infant formulas. The effect of over-concentration and supplementation on osmolality was then determined using three and seven different infant formulas, respectively. Osmolalities were measured in triplicate.
The effect of over-concentration was shown to be linear using Pepti Junior (Cow & Gate, Trowbridge, UK) at concentrations of 12.8% (standard), 17% and 19%. This linear relationship was also demonstrated with Enfamil A.R. (Mead Johnson Nutritionals, Uxbridge, UK) (15%) and Neocate (SHS International Ltd, Liverpool, UK) (21%). The effect of individual additives on osmolality was found to be similar for the seven infant formulas. All preparations of SMA High Energy (SMA Nutrition, Maidenhead, UK) and five of the 12 preparations of Nutriprem 1 (Cow & Gate) exceeded an osmolality of 400 mOsm kg(-1) .
The effect of over-concentrating infant formulas was shown to be linear, meaning that the osmolality at different concentrations can be predicted accurately. The over-concentrated infant formulas that were measured in the present study did not exceed 400 mOsm kg(-1) , with the exception of 21% Neocate, which would not be used in practice. When supplemented, some infant formulas exceeded an osmolality of 400 mOsm kg(-1) ; this may be relevant in cases of feed intolerance or in those at risk of necrotising enterocolitis.
高渗婴儿配方奶可导致渗透性腹泻，可能是坏死性小肠结肠炎的一个危险因素；因此，婴儿配方奶的渗透压通常<400 mOsm kg(-1)。然而，在液体限制的婴儿和需要营养支持的婴儿中，配方奶可能会过度浓缩或补充。本研究旨在确定这些做法对渗透压的影响。
使用临床实验室渗透压计测量婴儿配方奶的渗透压。然后，分别使用三种和七种不同的婴儿配方奶来确定过度浓缩和补充对渗透压的影响。渗透压测量重复三次。
使用 Pepti Junior（Cow & Gate，Trowbridge，英国）在 12.8%（标准）、17%和 19%的浓度下，显示出过度浓缩的效果呈线性。这种线性关系也在 Enfamil A.R.（Mead Johnson Nutritionals，Uxbridge，英国）（15%）和 Neocate（SHS International Ltd，Liverpool，英国）（21%）中得到证明。对于七种婴儿配方奶，发现单个添加剂对渗透压的影响相似。SMA High Energy（SMA Nutrition，Maidenhead，英国）的所有制剂和 Nutriprem 1（Cow & Gate）的 12 种制剂中的 5 种制剂的渗透压均超过 400 mOsm kg(-1)。
表明过度浓缩婴儿配方奶的效果呈线性，这意味着在不同浓度下的渗透压可以准确预测。在本研究中测量的过度浓缩婴儿配方奶没有超过 400 mOsm kg(-1)，除了 21%的 Neocate，它不会在实践中使用。当补充时，一些婴儿配方奶的渗透压超过 400 mOsm kg(-1)；在喂养不耐受或有坏死性小肠结肠炎风险的情况下，这可能是相关的。
