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Paediatric Nutrition

Paediatric Nutrition

Highlight of the month

Compleat Paediatric Webinar

Compleat Paediatric Webinar

Watch our webinar as Dr. Graeme O'Connor Ph.D., RD, MBDA reviews the clinical evidence on the impact of an enteral formula with food-derived ingredients in children.

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COMPLEAT® PAEDIATRIC - Nutritionally complete paediatric tube feed with a unique blend of whole foods

Purposefully designed with wholesome and familiar food ingredients to meet the nutritional needs of children requiring enteral nutrition.

COMPLEAT® PAEDIATRIC - Clinical Evidence Summary

Nutritionally complete paediatric tube feed with a unique blend of whole foods

COMPLEAT® PAEDIATRIC

Compleat® paediatric is a nutritionally complete 1.2kcal/ml standard enteral tube feed, containing food-derived ingredients (rehydrated chicken meat and vegetables, peach puree, orange juice from concentrate). Compleat® paediatric is a Food for Special Medical Purposes for use under medical supervision.

Nutritional Support in Children with Neurological Impairment

The Nutritional Support in Children with Neurological Impairment brochure is an ideal resource on how to support children with Cerebral Palsy in their nutritional management, taking a wholistic and multi-disciplinary approach. This resource is ideal for those in the field of Neurology, Gastroenterology, Physiotherapy, Nursing, Speech Therapy, Social Work, and Nutrition and Dietetics.

Calcium Calculator for Parents

This resource explains how the Calcium Calculator tool works and why it can be beneficial for parents of children with Cow’s Milk Allergy (CMA). The Calcium Calculator is an online tool containing a list of food that can be sources of calcium, and helps measure the calcium intake of a child with CMA.

Diagnosing Cow's Milk Protein Allergy

Diagnosing Cow's Milk Protein Allergy (CMPA) is a handy ready reckoner on the signs and symptoms of CMPA, CMPA Diagnostic Algorithm adapted from the ESPGHAN guidelines and the specialised formula options for the nutritional management of children with allergies.

Peptamen Junior Clinical Uses and Information

An online brochure that explores how whey peptide formulas may help to achieve better outcomes for patients who are unable to digest or absorb standard enteral formulas. This brochure has been developed specifically for Peptamen Junior which is a specialised enteral nutrition formula designed for children aged 1-10 years with gastrointestinal impairment.

Alfamino Case Study

A case study in which an infant who was irritable, experiencing poor weight gain and difficulty feeding at the breast and the bottle was diagnosed with non-Ige mediated cow's milk allergy and given ALFAMINO. This case study highlights the usage of ALFAMINO over the course of 6 months with relevant results. Ordering information for both ALFAMINO and  ALFAMINO JUNIOR is provided at the conclusion of the study.

Alfamino Junior Clinical Uses and Information

Information on the potential nutritional gaps in children aged 1-10 years with CMPA. This document also shows how these nutritional gaps can be met by highlighting the key nutritional benefits that  ALFAMINO JUNIOR offers to enable optimal growth in children aged 1+ years with multiple food allergies. 

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Videos

The Cow's Milk Related Symptom Score (CoMiSS®) Webinar

In this webinar, Professor Yvan Vandenplas will provide an in depth explanation of the CoMiSS® tool and its practical application for infants in the primary care setting to help increase awareness of the most common symptoms of CMA that can aid an earlier diagnosis.

The impacts of Human Milk Oligosaccharides in Infant Formula

Presented by Prof. Michael Gold and Dr. Ralf Heine, this webinar explores the clinical impact and microbiome effects in infants with cow’s milk protein allergy who consume formula containing two Human Milk Oligosaccharides.

Food Allergies in Infancy

In this webinar, Paediatric Immunologist and Allergist Dr Annaliesse Blincoe and Consultant Dietitian Anna Richards will take you through a case study of a paediatric patient’s journey through food allergy, focusing on cow’s milk protein allergy from a medical and dietetic perspective.

Understanding cow's milk protein allergy and specialised formulas Video

An online video  created by Nestle Health Science for parents explaining what cow's milk protein allergy  is and how this can be managed through the usage of specialised formulas. These specialised formulas such as ALFAMINO which was developed by Nestle Health Science is for use in infants with severe cow's milk protein allergy and multiple food protein allergy.

Nutrition support for children undergoing Bone Marrow Transplantation

In this webinar, Jodie Bartle, Paediatric Dietitian, Oncology/Immunology at The Royal Children's Hospital Melbourne, takes us through the findings of her clinical research and how she arrived at a Nutrition Feeding Algorithm for Children and Adolescents undergoing Haematopoietic Stem Cell Transplantation (HSCT), to assist clinicians to make objective and consistent enteral feeding decisions.

What do existing Food Allergy Prevention Studies tell us? What does the future hold?

This presentation discusses existing and new evidence supporting early and regular introduction of diverse food allergens at low doses. Of note, protein mixtures appear to show superior induction of an anti-allergenic state versus single foods, likely mediated by improvement in key biomarkers associated with sensitization.

How do Maternal Diet and Infant Complementary Feeding influence Food Allergy?

This presentation discusses the importance of diet diversity (including food allergen diversity) with early introduction of allergenic foods between 4 to 6 months of age as part of a complementary diet recommended by the majority of medical and scientific societies worldwide, including EAACI.

Early Interventions and Long Lasting Effect on Childhood Allergies: The GINI study 20y results

Presented at Pediatric Allergy & Asthma Meeting (PAAM) Digital 2021. This is 20-year follow-up data from the GINI study showing that early nutritional intervention with extensively hydrolyzed casein formula (eHF-C) or partially hydrolyzed whey formula (pHF-W) when compared to cow’s milk based formula exerts a preventive effect on both eczema and allergic airway manifestation that endures until adulthood.

Dietary Management of EoE: More Than Just Food Allergen Avoidance

This webinar discusses current evidence for the management of Eosinophilic esophagitis (EoE). In addition, it includes clinical presentation and prevalence, evidence-based dietary therapy and nutrition management of EoE. The role of elemental diets in the management of EoE, including practical guidance on how to initiate and support compliance is also discussed and the role of the microbiome in EoE and how it correlates with disease activity is also explored.

Structured Lipids Mode of Action Video

A short online video developed by Nestle Health Science  visually showing the benefits of structured lipids in the gut based around Alfamino.  The video highlights the O-P-O structure as well as how it may assist in increasing bone mineral content and strength, increase sleep duration, improving healthy gut bacteria and reduce crying.

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Article

CoMiSS®: an awareness tool to support the diagnosis of Cow’s Milk Protein Allergy

CoMiSS® is the Cow’s Milk-related Symptom Score. It is a simple, fast, easy to use, non-invasive tool which helps increase awareness of the most common symptoms seen in infants with CMPA, supporting earlier diagnosis. The CoMiSS® tool was first developed by international experts in 2015 to support healthcare professionals (HCPs) with the diagnosis of CMPA. Since 2015, 25 clinical studies have been conducted using the CoMiSS™ tool. It is intended to be used by healthcare professionals in conjunction with caregivers.

EXTENSIVE HA™: Specialised Nutrition for CMPA

EXTENSIVE HA™ is a specialised whey based, extensively hydrolysed infant formula (eHF), suitable for mild to moderate Cow’s Milk Protein Allergy (CMPA).

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External Link

Minor, G. et al. 2016. Formula Switch Leads to Enteral Feeding Tolerance Improvements in Children With Developmental Delays

Children with developmental delays are often dependent on enteral nutrition. This study evaluated the benefits of switching to a 100% whey, peptide-based formula from an intact protein based formula, which resulted in improved symptoms of feeding intolerance in the majority (92%) of developmentally delayed children eligible for the study.

Clinical Paper: Amino Acid-Based Formula Supplemented with Two Human Milk Oligosaccharides

An Australian based open-label, non-randomized, multicenter trial by Gold et al. 2022 uses an amino acid-based formula (AAF) supplemented with two human milk oligosaccharides (HMO) to demonstrate normal growth, good tolerance and significant microbiome shift in infants with a cow’s milk protein allergy (CMPA). 

Clinical Paper: Effects of Infant Formula with Human Milk Oligosaccharides on Growth and Morbidity

In a randomised multicenter trial by Puccio et al. 2017, it demonstrates that infant formula with 2'FL and LNnT is safe, well-tolerated, and supports age-appropriate growth. Secondary outcome findings show associations between consuming HMO-supplemented formula and lower parent-reported morbidity (particularly bronchitis) and medication use (antipyretics and antibiotics). 

Clinical Paper: Effects of an Extensively Hydrolyzed Formula Supplemented with Two Human Milk Oligosaccharides

In a randomised clinical trial by Vandenplas et al. 2022, using an extensively hydrolyzed formula (EHF) supplemented with two human milk oligosaccharides (HMO) in infants with cow’s milk protein allergy (CMPA), it demonstrated a reduction in frequency of upper respiratory tract infections and a lower incidence of ear infections at 12 months as well as supporting normal growth in infants with CMPA. 

Growth and tolerance seen with an Amino Acid Based Enteral Formula

Children with medical complexity switched to AA-MCT formula demonstrated growth. Formula was well tolerated, as shown by increased intake of formula, appropriate growth for age and BMI z-scores up to 1 year post-switch.

Evaluation of A Nutrition Feeding Algorithm for Children and Adolescents Undergoing Haematopoietic Stem Cell Transplantation (HSCT)

Nutrition support during the acute phase post allogeneic haematopoietic stem cell transplantation (HSCT) is required to optimise short- and long-term outcomes for children. An algorithm was developed and evaluated to assist clinicians to make objective and consistent enteral feeding decisions and has shown to help support better weight outcomes and reduced LOS in this patient cohort.

Ford K et al. 2022. Clinical Use of Peptide-Based Formula (Peptamen Junior®, Nestle) in the Paediatric Population

This retrospective observational audit describes the characteristics of the paediatric patients who have been prescribed a hydrolysed whey protein, medium chain triglycerides (MCT) based formula, Peptamen Junior® and the nutritional outcomes. This study demonstrates that semi elemental formula Peptamen Junior® appears to be well tolerated in paediatric patients with a variety of medical conditions that have complex pathologies and may have wider scope of use in a more diverse group of medical conditions than currently indicated.

Stool Saponified Fatty Acid, Behavior, Growth, and Stool Characteristics in Infants Fed a High-OPO Formula: A Randomized, Double-Blind Clinical Trial

This study demonstrates that the use of Sn-2 formula compared to standard infant formula may be associated with improved behaviors and stool characteristics in infants.

Possner, M.et al. Acceptability of High sn-2” Infant Formula in Non-Breast Fed Healthy Term Infants Regarding Gastrointestinal Tolerability by Both Parents and Pediatrician: An Open-Label Pilot Study in the Gulf Cooperation Council (GCC) Countries

This study looks at gastrointestinal tolerance, acceptability and safety of high sn-2 infant formulas among healthy term infants by measure of stool frequency and associated characteristics, and general gut symptoms.

Wu W et al. Neurodevelopmental Outcomes and Gut Bifidobacteria in Term Infants Fed an Infant Formula Containing High sn-2 Palmitate: A Cluster Randomized Clinical Trial

This study looks at the effect of increasing the amount of palmitic acid esterified in the sn-2 position in infant formula on neurodevelopment in healthy full-term infants and explores association of this effect with the altered gut Bifidobacteria.

Paediatric Nutrition in Practice eLearning Program

Paediatric Nutrition in Practice (PNP) eLearning Program aims to provide information to healthcare professionals who are looking for practical guidance on relevant issues surrounding the nutrition management of infants, children and adolescents. This eLearning Program has 12 modules that can be completed.

Polk, D.B. et al. 1992. Improved Growth and Disease Activity After Intermittent Administration of a Defined Formula Diet in Children With Crohn's Disease

This study was to determine the effect of an intermittent defined formula diet on growth and disease activity in children with Crohn’s disease and growth failure. The results indicate that an intermittent defined formula diet can improve growth failure and significantly decrease disease activity in children with Crohn's disease.

Romano, C. et al. 2018. ESPGHAN guidelines: Gastrointestinal and nutritional issues in children with neurological disability

Neurological disability is often associated with feeding and gastrointestinal disorders leading to malnutrition and growth failure. These clinical guidelines by ESPGHAN provide necessary nutritional and clinical guidance including assessment and monitoring of nutritional status, definition of nutritional requirements, diagnosis and treatment of gastro-oesophageal reflux disease, and indications for and modalities of nutritional support.

Ibrahim, H. et al. 2020. Peptide-based formula versus standard-based polymeric formula for critically ill children: is it superior for patients' tolerance?

This single blind case control study aim was to compare the effect of a peptide-based formula versus a standard polymeric formula on feeding tolerance parameters and other clinical outcomes among critically ill children. The study found that the peptide-based formula feeding was better tolerated than standard polymeric formula feeding in critically ill pediatric patients. However, the choice of patients receiving the peptide-based formula needs to be further evaluated.

Fried, M.D. et al. 1992. Decrease in gastric emptying time and episodes of regurgitation in children with spastic quadriplegia fed a whey-based formula

This study showed whey-based formulas reduce the number of episodes of vomiting by improving the rate of gastric emptying in patients 3 years or older with profound mental retardation, spastic quadriplegia, developmental delay, and scoliosis in comparison to patients that were fed casein-based formula.

Robbins, K. et al. 2014. Milk allergy is associated with decreased growth in US children

The objective of this study was to compare anthropomorphic measures and dietary intake of calcium, vitamin D, total calories, protein and fat between children with and without reported food allergy using The National Health and Nutrition Examination Survey (NHANES). This study which showed that mean weight, height, BMI & height-for-age percentile and calcium intake were significantly lower in children aged 2-17 years compared with those without CMPA.

Nutten, S. et al. 2020. Peptide size profile and residual immunogenic milk protein or peptide content in extensively hydrolyzed infant formulas

This study looked at the heterogeneity of extenstively hydrolysed formulas (eHFs) and compared the molecular weight profiles among eHF's from different manufacturers. The survey highlights the need for a more meaningful definition of EHF products. However, the clinical implications of it's findings are uncertain and further studies are required.

HMO Academy E Learning

HMO academy- Human Milk Oligosaccharides (HMOs)are an exciting and central area of research in infant nutrition. Scientific advances on HMOs are helping us know more about the role and importance of these essential components of Human milk. The HMO Academy has been created to share evidence-based information in interactive and user-friendly way from more than a decade of research on HMO.

Online Symposium - Nutritional Strategy to Prevent Food Allergy

An online symposium from Nestlé Health Science presented by Dr. Rosan Meyer, Prof. Kari Nadeau and Dr. Carina Venter that looks at the nutritional strategy to prevent food allergy. This webinar discusses the topics such as the introduction of solid foods, making sense of allergy prevent guidelines around the world and diversity of foods .

Litmanovitz, I. et al. 2014. Reduced crying in term infants fed high beta-palmitate formula: a double-blind randomized clinical trial

A double-blind randomised clinical trial in which he results indicated that consumption of a high beta-palmitate formula affects infant crying patterns during the first weeks of life, reducing crying duration and frequency, primarily during the afternoon and evening hours, thereby improving the wellbeing of formula fed infants and their parents.

Litmanovitz, I. et al. 2013. High Beta-palmitate formula and bone strength in term infants: a randomized, double-blind, controlled trial

In this randomised, double-blind controlled trial, it evaluated the impacts of infants consuming high beta-palmitate (Sn-2) formula on anthropometric measures and bone strength. After 12 weeks of consumption, changes in bone SOS (speed of sound) were comparable to those infants consuming breast milk and favourable compared to infants consuming low beta-palmitate (Sn-2) formula.

Kennedy, K. et al. 1999. Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization

A double-blind, randomised trial of a synthetic triacylglycerol in formula-fed term infants that demonstrated infants fed the higher sn-2 formula compared to a standard formula, measured bone mineral content, softer stools and lower stool fatty acid soaps, similar to that of breast-fed infants. The study noted that the greater bone mass measured could be important if it persisted beyond the trial period and would merit further investigation.

Béghin, L. et al. 2019. Growth, stool consistency and bone mineral content in healthy term infants fed sn-2-palmitate-enriched starter infant formula: A randomized, double-blind, multicentre clinical trial

This study demonstrated that infant formula enriched with sn-2 palmitate fed in infantcy is safe, improves stool consistency (from 2 weeks to 2 months) and increase bone mineral content (at 4 months).

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