Berger H M, Scott P H, Kenward C, Scott P, Wharton B A
Arch Dis Child. 1978 Dec;53(12):926-30. doi: 10.1136/adc.53.12.926.
Metabolic acidosis is common in babies fed cows' milk-based formulae. Therefore the effects of adding alkaline salts (sodium and potassium citrate) to a demineralised whey formula were studied in vitro and in 26 low birthweight babies fed on the formula or formula plus citrate. The alkali altered the pH and titratable acidity to a value nearer human milk but it increased the buffering capacity to a value further away. This may effect the bacterial flora of the intestine. The babies fed on formula plus citrate did not make greater gains in weight, length, head circumference, skinfold thickness, or midarm muscle circumference, although they had a greater blood base excess. Some of these babies developed a mild metabolic alkalosis and 3 had hyponatraemia despite their increased sodium intakes. These babies also had lower levels of plasma transferrin but showed no differences in urea, albumin, cholesterol, and calcium levels. No baby fed on the demineralised whey formula without added citrate had a base deficit exceeding 5 mmol/l; late metabolic acidosis is less common in babies fed on this formula and the routine addition of alkali can have untoward metabolic effects.
代谢性酸中毒在以牛奶为基础配方奶喂养的婴儿中很常见。因此，在体外以及对26名以该配方奶或该配方奶加柠檬酸盐喂养的低体重儿进行了研究，观察向脱矿质乳清配方奶中添加碱性盐（柠檬酸钠和柠檬酸钾）的效果。这种碱将pH值和可滴定酸度改变至更接近人乳的值，但却将缓冲能力提高到了更远的值。这可能会影响肠道菌群。以添加柠檬酸盐的配方奶喂养的婴儿在体重、身长、头围、皮褶厚度或上臂肌肉周长方面并没有更大的增长，尽管他们的血液碱剩余更高。这些婴儿中有一些出现了轻度代谢性碱中毒，3名婴儿尽管钠摄入量增加但仍出现了低钠血症。这些婴儿的血浆转铁蛋白水平也较低，但在尿素、白蛋白、胆固醇和钙水平方面没有差异。未添加柠檬酸盐的脱矿质乳清配方奶喂养的婴儿中，没有一个碱缺乏超过5 mmol/l；以这种配方奶喂养的婴儿中晚期代谢性酸中毒较少见，常规添加碱可能会产生不良代谢影响。
