The nutrient composition of most infant formulas simulates maternal milk:
protein 8-12%; carbohydrates 41-43%; fat 41-49%. Docosahexaenoic acid
(DHA) and arachidonic acid (ARA) are added for brain and retinal development.
Iron is added to infant formulas to meet the 2-4 mg/kg/day requirements. Enfamil,
Similac, and Good Start are made from bovine milk. Isomil and Prosobee, based
on soy protein and corn syrup, can be used in infants with lactose or milk protein
intolerance. Pregestimil and Alimentum are bovine milk based with hydrolyzed
protein and are thought to benefit patients with suboptimal digestion and
absorption such as short bowel syndrome, malabsorption, cystic fibrosis, and
biliary atresia. Pregestimil and Portagen are formulas with the highest
percentage of medium chain triglycerides and are used in children with lymph
leak and some fatty acid disorders. Neocate and Elecare are elemental and are
used in patients with severe milk protein allergies and those with other digestive
problems whose nutrition has failed on Pregestimil and Alimentum.
Premature infant formulas are indicated for preterm infants with birth
weights <1800 grams to account for their immature digestive tract. Similac
Special Care and Enfamil Premature are only available in premixed 20, 24, and
30 kcal/ounce formulations. Preemies typically are fed with 22 kcal/oz formula.
Human Milk Fortifier (HMF) is a bovine milk based powder that can be
added to EBM to increase caloric density. One packet adds 2 kcal/oz when
added to 50 ml of EBM. Prolacta is a fortifier concentrated from donor human