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婴儿肠内配方奶粉:历史沿革、营养成分及儿科临床应用的叙述性综述

Enteral Infant Formulas: A Narrative Review of Historical Evolution, Nutritional Composition, and Clinical Use in Pediatrics.

作者信息

Martínez-Vázquez Jorge, Martínez-Vargas Ernesto, Mora-Jiménez Jeaustin, Arguedas-Chacón Sebastián, García-Montero Jonathan, Chaves-Romero Noelia, Murillo-Cubero Josué, Zavaleta-Monestel Esteban

机构信息

Pediatrics, Hospital Clínica Bíblica, San José, CRI.

Department of Research, Hospital Clínica Bíblica, San José, CRI.

出版信息

Cureus. 2025 Apr 21;17(4):e82692. doi: 10.7759/cureus.82692. eCollection 2025 Apr.


DOI:10.7759/cureus.82692
PMID:40400894
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12094131/
Abstract

This narrative review aims to describe the evolution, classification, nutritional composition, and clinical applications of enteral infant formulas, with an emphasis on pediatric patients who are unable to be breastfed or follow conventional feeding methods. The primary objective is to analyze the different types of formulas available - polymeric, hydrolyzed, elemental, and blenderized - and their indications based on clinical scenarios and specific patient needs. The methodology used was a non-systematic narrative review. Relevant scientific literature was selected through a targeted search of databases such as PubMed, Scopus, ScienceDirect, and Google Scholar, including publications from the last 20 years in both English and Spanish. Key search terms included "enteral nutrition," "infant formula," "nutritional therapy," and "pediatric enteral feeding." The article traces the historical development of infant nutrition, from breastfeeding and wet nursing to modern enteral formulas. It explains the macronutrient composition of each formula type, their preparation methods, palatability, osmolality, and caloric density. Clinical considerations and recommended formulas for specific diseases - such as obesity, cow's milk allergy, Crohn's disease, eosinophilic esophagitis, necrotizing enterocolitis, short bowel syndrome, and cystic fibrosis - are discussed in detail. Additionally, the review outlines the regulatory context in the United States and Europe, noting that these products are classified as medical foods and not pharmaceuticals, and are thus subject to distinct safety, composition, and labeling requirements. The review concludes that although breastfeeding remains the gold standard in infant nutrition, enteral formulas are indispensable in many clinical situations. Future research is expected to focus on the development of more targeted, functional, and personalized formulas to address the needs of vulnerable pediatric populations.

摘要

本叙述性综述旨在描述肠内婴儿配方奶粉的演变、分类、营养成分和临床应用,重点关注无法进行母乳喂养或遵循传统喂养方法的儿科患者。主要目的是分析现有的不同类型配方奶粉——整蛋白型、水解型、氨基酸型和自制型——以及它们基于临床情况和特定患者需求的适用情况。所采用的方法是一项非系统性的叙述性综述。通过有针对性地检索PubMed、Scopus、ScienceDirect和谷歌学术等数据库选择相关科学文献,包括过去20年以英文和西班牙文发表的文献。关键检索词包括“肠内营养”“婴儿配方奶粉”“营养治疗”和“儿科肠内喂养”。本文追溯了婴儿营养的历史发展,从母乳喂养和代哺到现代肠内配方奶粉。它解释了每种配方奶粉类型的宏量营养素组成、制备方法、适口性、渗透压和热量密度。详细讨论了针对特定疾病——如肥胖症、牛奶蛋白过敏、克罗恩病、嗜酸性食管炎、坏死性小肠结肠炎、短肠综合征和囊性纤维化——的临床考虑因素和推荐配方奶粉。此外,该综述概述了美国和欧洲的监管背景,指出这些产品被归类为医疗食品而非药品,因此受到不同的安全、成分和标签要求的约束。该综述得出结论,尽管母乳喂养仍然是婴儿营养的金标准,但肠内配方奶粉在许多临床情况下是不可或缺的。未来的研究预计将集中在开发更具针对性、功能性和个性化的配方奶粉,以满足脆弱儿科人群的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/cb530a704ac1/cureus-0017-00000082692-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/b827084e4151/cureus-0017-00000082692-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/f054812ccf11/cureus-0017-00000082692-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/76a2a9dd7b0f/cureus-0017-00000082692-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/cb530a704ac1/cureus-0017-00000082692-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/b827084e4151/cureus-0017-00000082692-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/f054812ccf11/cureus-0017-00000082692-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/76a2a9dd7b0f/cureus-0017-00000082692-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cc/12094131/cb530a704ac1/cureus-0017-00000082692-i04.jpg

相似文献

[1]
Enteral Infant Formulas: A Narrative Review of Historical Evolution, Nutritional Composition, and Clinical Use in Pediatrics.

Cureus. 2025-4-21

[2]
Semi-Elemental and Elemental Formulas for Enteral Nutrition in Infants and Children with Medical Complexity-Thinking about Cow's Milk Allergy and Beyond.

Nutrients. 2021-11-25

[3]
Elemental Formulas: Indications of Use in Pediatric Clinical Practice.

Nutrients. 2025-3-12

[4]
Enteral nutritional therapy for induction of remission in Crohn's disease.

Cochrane Database Syst Rev. 2007-1-24

[5]
Standard and Specialized Infant Formulas in Europe: Making, Marketing, and Health Outcomes.

Nutr Clin Pract. 2019-2-11

[6]
Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.

Cochrane Database Syst Rev. 2022-2-1

[7]
Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants.

Cochrane Database Syst Rev. 2006-10-18

[8]
Enteral nutritional therapy for inducing remission of Crohn's disease.

Cochrane Database Syst Rev. 2001

[9]
Pediatric Formulas: An Update.

Pediatr Rev. 2024-7-1

[10]
Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants.

Cochrane Database Syst Rev. 2003

本文引用的文献

[1]
Infant feeding practices in three Latin American countries in three decades: what demographic, health, and economic factors are relevant?

Front Nutr. 2023-10-4

[2]
Homemade blenderized tube feeding improves gut microbiome communities in children with enteral nutrition.

Front Microbiol. 2023-8-23

[3]
Food or medicine? A European regulatory perspective on nutritional therapy products to treat inborn errors of metabolism.

J Inherit Metab Dis. 2023-11

[4]
A comprehensive review on infant formula: nutritional and functional constituents, recent trends in processing and its impact on infants' gut microbiota.

Front Nutr. 2023-6-21

[5]
Comparison of Home-Blenderized Formula and Commercial Enteral Formulas for Gastrostomy Tube-Fed Children: A Retrospective, Prospective Cohort Study.

Cureus. 2023-4-21

[6]
Pediatric formulas: Categories, composition, and considerations.

Nutr Clin Pract. 2023-4

[7]
Nutritional Care in Children with Cystic Fibrosis.

Nutrients. 2023-1-17

[8]
Nutritional Management of Intestinal Failure due to Short Bowel Syndrome in Children.

Nutrients. 2022-12-23

[9]
The Role of Infant Formulas in the Primary Prevention of Allergies in Non-Breastfed Infants at Risk of Developing Allergies-Recommendations from a Multidisciplinary Group of Experts.

Nutrients. 2022-9-27

[10]
Outcomes of Blenderized Gastrostomy Feeding in Children at Rouen University Hospital.

Pediatric Health Med Ther. 2022-8-10

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