Download Pediatric Enteral Formulas

Pediatric Enteral Formulas
The information below is intended to address the nutritional needs for children between one year of age (i.e. children greater
then twelve months old) to thirteen years of age.
Pediatric formulas are designed to meet the needs of children. There are several types of tube feed formulas
available to the pediatric enteral consumer. These pediatric formulas can be separated into eight groups.
These are groups are blenderized products, polymeric/standard products, calorically dense products,
elemental and semi-elemental products, specialized/disease specific products, modular/incomplete products
and metabolic/ neurological products. As with all medical decisions, we support reviewing the
appropriateness of using these formulas with your health care team. Below is a description of each group;
Blenderized Products
Blenderized formulas were developed for children with an intolerance to semi-synthetic formulas. These
formulas are made from liquefying actual foods such as chicken, peas, carrots, tomatoes and cranberry juice.
Similar formulas can been made in the home but “homemade” formulations carry a risk of bacterial
contamination.
Example: Compleat Pediatric
Polymeric / Standard Products
Polymeric or Standard formulas are nutritionally complete. They are made with intact protein,
carbohydrates, long chain triglycerides, vitamins and minerals. They may include fiber.
Examples: Boost Kids Essentials, Nutren Junior, Nutren Junior with Fiber, Pediasure, Pediasure with
Fiber, Pediasure with Fiber and Prebio
Calorically Dense Products
Calorically dense formulas are nutritionally complete and provide more calories per serving than standard
enteral products. They may provide equal to or greater than 1.5 kcal/ml. They contain protein,
carbohydrates, long chain triglycerides, vitamins and minerals. These products may also include fiber.
Examples: Boost Kids Essential 1.5, Boost Kids Essential 1.5 with Fiber, Pediasure 1.5 Cal, Pediasure 1.5
Cal with Fiber
Elemental and Semi-Elemental Products
Elemental and semi-elemental enteral formulas are nutritionally complete but their building blocks are broken
down into smaller components. This modification may be beneficial in cases of malabsorption. Elemental
formulas contain individual amino acids, glucose polymers, and are low fat with only about 2% to 3% of
calories derived from long chain triglycerides (LCT). Medium chain triglycerides (MCT) are the predominant
fat source. MCT can be absorbed directly across the small intestinal mucosa into the portal vein. Semielemental formulas contain peptides of varying chain length, glucose polymers and fat, primarily as MCT.
Examples: Peptamen Junior, Peptamen Junior 1.5, Peptamen Junior with Fiber, Peptamen Junior with
Prebio, and Vivonex Pediatric, and Elecare
Hypoallergenic / Gastrointestinal Malabsorption Products
Hypoallergenic / gastrointestinal products are may benefit children with a cow milk allergy, multiple food
protein intolerances or allergy-induced disorders. The formulas contain free amino acids which may reduce
the possibility of an allergic reaction. They benefit individuals with protein maldigestion, malabsorption,
severe food allergies, short-bowel syndrome, and eosinophilic GI disorders.
Examples: Elecare and Neocate Jr.
Specialized / Disease Specific Products
Specialized / Disease Specific Products are nutritionally complete and are designed to meet the needs of
individuals with specific disease states such as renal dysfunction, respiratory dysfunction or glucose
intolerance. The clinical evidence supporting the use of specialized / disease-specific products continues to
be debated. As with all adult formulas being used the pediatric population, careful consideration of protein,
micronutrients and water must be monitored especially in those whose tube feeding is the sole source of
nutrition. We support reviewing the appropriateness of use these formulas with your health care team.
Examples: Nepro with Carb Steady, Novasource Renal, Pulmocare, and Nutren Pulmonary, Choice DM,
Diabetasource AC, Nutren Glytrol, Glucerna, ** Resource Just for Kids with Fiber, **Nutren Junior with Fiber
**Note: Fiber slows the rate of intestinal transit and glucose absorption which may possibly improve blood
sugar control.
Modular/ Incomplete Products
Modular/ Incomplete products are used to deliver an additional source of a specific nutrient. They are not
designed to meet 100% of estimated nutritional needs, but can provide additional calories, protein or fat.
They may be taken alone or in combination with other products under the guidance of your medical team.
Examples: Duocal, Polycose, Benecalorie, Promod, Beneprotein, and MCT oil
Metabolic / Neurology Products
Metabolic products are used to in the dietary management of intractable epilepsy or inborn errors metabolism
such as phenylketonuria, maple syrup urine disease and tyrosinemia. This class of products should only be
used under strict medical guidance.
Examples: MSUD Maxamaid (toddler/young children), MSUD Maximum (older children), Periflex Junior
(toddlers), Periflex Advance (older children), Ketonex 1 (toddlers), Ketonex 2 (children) and KetoCal
For more information or if you do not see your formula here,
please email [email protected] or call 1(888) 684-7483
References;
Malone A. Enteral Formula Selection: A Review of Selected Product Categories. Practical Gastroenterology.
June 2005; 44-74.
Abbot Nutrition product information available at: http://abbottnutrition.com/Products/Nutritional-Products.aspx
Nestle Nutrition product information available at: http://www.nestle-nutrition.com/Products/Default.aspx
Nutricia product information available at: http://www.nutricia-na.com/pages/products.htm
Revised 9/2010 Jill Taliaferro RD, LDN CNSC
Our goal is to provide cost-effective care, positive clinical outcomes,
and improve quality of life for the home nutrition support patient.
FOR MORE INFORMATION, CONTACT US AT:
1-888-6-THRIVE (888-684-7483) or [email protected]
www.thriverx.net