Martínez-Vázquez Jorge, Martínez-Vargas Ernesto, Mora-Jiménez Jeaustin, Arguedas-Chacón Sebastián, García-Montero Jonathan, Chaves-Romero Noelia, Murillo-Cubero Josué, Zavaleta-Monestel Esteban
Pediatrics, Hospital Clínica Bíblica, San José, CRI.
Department of Research, Hospital Clínica Bíblica, San José, CRI.
Cureus. 2025 Apr 21;17(4):e82692. doi: 10.7759/cureus.82692. eCollection 2025 Apr.
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.
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。
