Children with medical complexities, such as multi-system disorders and/or neurological impairments, often experience feeding difficulties and need enteral nutrition. They frequently have impaired motility and digestive–absorbing functions related to their underlying condition. If a cow’s milk allergy (CMA) occurs as a comorbidity, it is often misdiagnosed, due to the symptoms’ overlap. Many of the commercialized mixtures intended for enteral nutrition are composed of partially hydrolyzed cow’s milk proteins, which are not suitable for the treatment of CMA; thus, the exclusion of a concomitant CMA is mandatory in these patients for obtaining symptoms relief. In this review, we focus on the use of elemental and semi-elemental formulas in children with neurological diseases and in preterm infants as clinical “models” of medical complexity. In children with neurodisabilities, when gastrointestinal symptoms persist despite the use of specific enteral formula, or in cases of respiratory and/or dermatological symptoms, CMA should always be considered. If diagnosis is confirmed, only an extensively hydrolyzed or amino-acid based formula, or, as an alternative, extensively hydrolyzed nutritionally adequate formulas derived from rice or soy, should be used. Currently, enteral formulas tailored to the specific needs of preterm infants and children with neurological impairment presenting concomitant CMA have not been marketed yet. For the proper monitoring of the health status of patients with medical complexity, multidisciplinary evaluation and involvement of the nutritional team should be promoted.

Semi-elemental and elemental formulas for enteral nutrition in infants and children with medical complexity—thinking about cow’s milk allergy and beyond / E. Verduci, S. Salvatore, I. Bresesti, E. Di Profio, E. Pendezza, A. Bosetti, M. Agosti, G.V. Zuccotti, E. D'auria. - In: NUTRIENTS. - ISSN 2072-6643. - 13:12(2021 Nov 25), pp. 4230.1-4230.14. [10.3390/nu13124230]

Semi-elemental and elemental formulas for enteral nutrition in infants and children with medical complexity—thinking about cow’s milk allergy and beyond

E. Verduci
Primo
;
I. Bresesti;E. Di Profio;E. Pendezza;G.V. Zuccotti
Penultimo
;
2021-11-25

Abstract

Children with medical complexities, such as multi-system disorders and/or neurological impairments, often experience feeding difficulties and need enteral nutrition. They frequently have impaired motility and digestive–absorbing functions related to their underlying condition. If a cow’s milk allergy (CMA) occurs as a comorbidity, it is often misdiagnosed, due to the symptoms’ overlap. Many of the commercialized mixtures intended for enteral nutrition are composed of partially hydrolyzed cow’s milk proteins, which are not suitable for the treatment of CMA; thus, the exclusion of a concomitant CMA is mandatory in these patients for obtaining symptoms relief. In this review, we focus on the use of elemental and semi-elemental formulas in children with neurological diseases and in preterm infants as clinical “models” of medical complexity. In children with neurodisabilities, when gastrointestinal symptoms persist despite the use of specific enteral formula, or in cases of respiratory and/or dermatological symptoms, CMA should always be considered. If diagnosis is confirmed, only an extensively hydrolyzed or amino-acid based formula, or, as an alternative, extensively hydrolyzed nutritionally adequate formulas derived from rice or soy, should be used. Currently, enteral formulas tailored to the specific needs of preterm infants and children with neurological impairment presenting concomitant CMA have not been marketed yet. For the proper monitoring of the health status of patients with medical complexity, multidisciplinary evaluation and involvement of the nutritional team should be promoted.
children with medical complexity; cow’s milk allergy; enteral nutrition; hydrolyzed formula; neurological children; preterm infants; animals; child; child, preschool; diagnostic errors; enteral nutrition; female; humans; infant; infant formula; infant, newborn; infant, premature; male; milk hypersensitivity; multiple chronic conditions; nervous system diseases; protein hydrolysates
Settore MED/49 - Scienze Tecniche Dietetiche Applicate
Settore MED/38 - Pediatria Generale e Specialistica
Article (author)
File in questo prodotto:
File Dimensione Formato  
nutrients-13-04230.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 616.53 kB
Formato Adobe PDF
616.53 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/898422
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact