Whey- vs Casein-Based Enteral Formula and Gastrointestinal Function in Children With Cerebral Palsy
| Autor: | Andrea Schwarzer, Geoffrey P. Davidson, Stamatiki Kritas, Taher Omari, Karina Savage |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Fundoplication Medicine (miscellaneous) Pilot Projects Gastroenterology Enteral administration Enteral Nutrition Double-Blind Method Interquartile range Casein Internal medicine medicine Humans Child Gastrostomy Cross-Over Studies Nutrition and Dietetics Gastric emptying business.industry Cerebral Palsy digestive oral and skin physiology Reflux Caseins Milk Proteins Surgery Whey Proteins Parenteral nutrition Gastric Emptying Child Preschool Gastroesophageal Reflux Female Gastrointestinal function business |
| Zdroj: | Journal of Parenteral and Enteral Nutrition. 36:118S-123S |
| ISSN: | 1941-2444 0148-6071 |
| Popis: | Objectives Children with severe cerebral palsy (CP) commonly have gastrointestinal (GI) dysfunction. Whey-based enteral formulas have been postulated to reduce gastroesophageal reflux (GOR) and accelerate gastric emptying (GE). The authors investigated whether whey-based (vs casein-based) enteral formulas reduce GOR and accelerate GE in children who have severe CP with a gastrostomy and fundoplication. Methods Thirteen children received a casein-based formula for 1 week and either a 50% whey whole protein (50% WWP) or a 100% whey partially hydrolyzed protein (100% WPHP) formula for 1 week. Reflux episodes, gastric half-emptying time (GE t(1/2)), and reported pain and GI symptoms were measured. Results Whey formulas emptied significantly faster than casein (median [interquartile range (IQR)] GE t(1/2), 33.9 [25.3-166.2] min vs 56.6 [46-191] min; P = .033). Reflux parameters were unchanged. GI symptoms were lower in children who received 50% WWP (visual analog symptom score, median [IQR], 0 [0-11.8]) vs 100% WPHP (13.0 [2.5-24.8]) (P = .035). Conclusion This pilot study shows that in children who have severe CP with a gastrostomy and fundoplication, GE of the whey-based enteral formula is significantly faster than casein. The acceleration in GE does not alter GOR frequency, and there appears to be no effect of whey vs casein in reducing acid, nonacid, and total reflux episodes. The results indicate that enteral formula selection may be particularly important for children with severe CP and delayed GE. |
| Databáze: | OpenAIRE |
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