Evaluation of the using extensively hydrolyzed protein formula and amino acid based formula in children aged between one month and five years

Background and Aim: Medical nutrition therapy is used where standard diet can not meet nutritional needs or in the management of primary disease. Early and appropriate nutritional intervention is known to decrease mortality and morbidity in children with chronic/severe disease. In our study, the clinical features of children were treated with extensively hydrolyzed protein formula (EHF) and/or amino acid based (AAF) and the effects of this intervention on their nutritional status were analyzed. Materials and Methods: Infants and young children aged between 1 month and 5 years who had consumed EHF or AAF in our department were analyzed retrospectively about medical history, primary diseases, indications for formula initiation, dietary history, route of administration, gastrointestinal complaints during the formula use and nutritional anthropometric measurements. Results: Ninety children out of 137 who met the inclusion criteria were enrolled in the study. 50 of them were male (55.6%), the mean age was 9.9 ± 11.2 months (1-59 months). The indications of using EHF/AAF were food allergy in 23 (25.6%), malabsorption in 21 (23.3%), cystic fibrosis in 20 (22.2%), cholestasis in 20 (22.2%), short bowel syndrome in 6 (6.7%) patients. AAF was given to 36 (40%) of the subjects, and EHF was given to 54 (60%). Seventy-one patients (78.4%) were fed orally, 14 cases (15.6%) via nasogastric tube, 5 patients (5.6%) by percutaneous endoscopic gastrostomy. In 10% of the children, all nutritional needs were met with these formulas. The mean duration of EHF/AAF therapy was 18.4 ± 21 months (1 month-10 years). After the formula was initiated, body weight SDS increased at 1, 3, 6, 15, and 18 months of their follow-up (p<0.05), height SDS increased at 1, 3, 6 and 18 months of their follow-up (p<0.05), body mass index SDS increased at the 6th, 15th and 18th months of their follow-up (p<0.05). In the cases with malnutrition at the beginning, 43% of the treatment was treated in the 3rd month, 64% in the 6th month, 67% in the 15th month, and 80% in the 18th month. (p<0.05). We did not observe any significant gastrointestinal complaints with formula use. Conclusion: AAF and EHF were used as a part of medical nutritional therapy in children with food allergy, cystic fibrosis, cholestasis, malabsorption and short bowel syndrome in our center. This intervention provided increasing mean body weight, height, body mass index percentile and standard deviation score during 18-month follow-up period. 80% of patients with malnutrition have recovered. It has been observed that the most effective method of nutrition is the oral route, followed by the nasogastric route. There is no any significant complaints related to the formula use. Key words: Amino acid formula, extensively hydrolyzed formula, feeding route, food allergy, malnutrition, cystic fibrosis, short bowel syndrome, child, infant