Gosa Memorie M, Dodrill Pamela
1 The University of Alabama, Tuscaloosa, Alabama, USA.
2 LeBonheur Children's Hospital, Memphis, Tennessee, USA.
Nutr Clin Pract. 2017 Apr;32(2):238-244. doi: 10.1177/0884533616662991. Epub 2016 Sep 25.
Unlike adult populations, who primarily depend on liquids for hydration alone, infants rely on liquids to provide them with hydration and nutrition. Speech-language pathologists working within pediatric medical settings often identify dysphagia in patients and subsequently recommend thickened liquids to reduce aspiration risk. Caregivers frequently report difficulty attempting to prepare infant formula to the prescribed thickness.
This study was designed to determine (1) the relationship between consistencies in modified barium swallow studies and thickened infant formulas and (2) the effects of time and temperature on the resulting thickness of infant formula. Prepackaged barium consistencies and 1 standard infant formula that was thickened with rice cereal and with 2 commercially available thickening agents were studied. Thickness was determined via a line spread test after various time and temperature conditions were met.
There were significant differences between the thickened formula and barium test consistencies. Formula thickened with rice cereal separated over time into thin liquid and solid residue. Formula thickened with a starch-based thickening agent was thicker than the desired consistency immediately after mixing, and it continued to thicken over time. The data from this project suggest that nectar-thick and honey-thick infant formulas undergo significant changes in flow rates within 30 minutes of preparation or if refrigerated and then reheated after 3 hours.
Additional empirical evidence is warranted to determine the most reliable methods and safest products for thickening infant formula when necessary for effective dysphagia management.
与主要仅依靠液体来补充水分的成人不同,婴儿依靠液体来补充水分和营养。在儿科医疗环境中工作的言语病理学家经常会识别出患者的吞咽困难,随后会建议使用增稠液体以降低误吸风险。护理人员经常报告说,按照规定的浓度准备婴儿配方奶粉很困难。
本研究旨在确定(1)改良钡餐吞咽研究中的浓度与增稠婴儿配方奶粉之间的关系,以及(2)时间和温度对婴儿配方奶粉最终浓度的影响。研究了预包装钡剂的浓度以及1种用米粉和2种市售增稠剂增稠的标准婴儿配方奶粉。在满足各种时间和温度条件后,通过线扩散试验确定浓度。
增稠配方奶粉与钡剂测试浓度之间存在显著差异。用米粉增稠的配方奶粉会随着时间的推移分离成稀液体和固体残渣。用淀粉基增稠剂增稠的配方奶粉在混合后立即比所需浓度更稠,并且会随着时间的推移继续变稠。该项目的数据表明,在制备后30分钟内或冷藏3小时后再加热,花蜜状稠度和蜂蜜状稠度的婴儿配方奶粉的流速会发生显著变化。
有必要提供更多的实证证据,以确定在必要时为有效管理吞咽困难而增稠婴儿配方奶粉的最可靠方法和最安全产品。