milk available in four preparations to raise the caloric content of EBM by 4, 6, 8,
and 10 calories per ounce.
Similac PM 60/40, used in renal failure patients, has the same amount of
protein as term infant formula (whey:casein content of 60:40), the same mineral
content as human milk, and less Na, K, and Phosphate than term infant formulas.
Carbohydrate-free formulas are indicated in patients who have disorders
of carbohydrate absorptionsuch as disaccharidase deficiencies. Diet powder
3232A, which is free of monosaccharides and disaccharides, is a bovine milk
protein hydrolysate with medium chain triglyceride (MCT) oil and minimal
carbohydrate. RCF is a soy product with protein and fat but minimal carbohydrate
and is used in infants who require a ketogenic diet. Both formulas require the
addition of specific carbohydrates.
V. Parenteral Nutrition
Parenteral nutrition is a lifesaving modality in certain situations.[ 5 ]
Premature infants require slow progression of feeding to allow tolerance and
prevent necrotizing enterocolitis. Extra low birth weight infants can become
deficient in essential fatty acids in as little as 3 days. Older children and adults
may develop significant morbidity if starvation exceeds 5-7 days. This is
especially true for patients with head injuries or burns who may be
hypermetabolic. While it is reasonable to delay the initiation of parenteral