Enteral feeding (formulas)

Formulated for pediatric patients ≥1 year old

• Has been shown to be safe in case studies as a fortifier for expressed breastmilk (EBM)

  • Can be alternative for Similac 60/40 or used for patients who have significant hyperkalemia issues despite decanting

Powder (unflavored), standard mixing 30 kcals/oz

• Can be concentrated up to 2 kcals/mL (60 kcals/oz)

• Usually dosed based on grams or scoops

Suitable for oral and tube feeding use

• Unflavored: does not taste great but can be mixed in with other food products (e.g., used in baking)

Not suitable as a sole-source of nutrition

• Used for supplemental feeds, added to food products, or as an additional ingredient in part of a feeding recipe with a more nutritionally complete formula with greater micronutrient content

Lower in protein, calcium, chloride, potassium, phosphorus and vitamin A compared to standard pediatric formulas

Made by Abbott

The only renal-specific infant formula

Suitable for birth-12 months or older if patient would benefit from additional catch-up growth

• Infant formula has higher percentage of fat to more closely match breastmilk

Powder (unflavored), standard mixing 20 kcals/oz

• Can be used as a fortifier for EBM

Suitable for oral and tube feeding use

Suitable as sole-source of nutrition

Lower in calcium, phosphorus, iron, sodium and potassium compared to standard pediatric formulas

• Infants often still need decanting for potassium but often require phosphorus supplementation and iron supplementation

Intact, whey-based protein powder

Suitable for oral and tube feeding use

Not suitable as a sole-source of nutrition

Used for a child who needs additional protein and does not have milk protein allergy

Made by Nutricia

AA-based protein powder

• Safe for patients with cow's milk allergy or multiple food allergies

Suitable for oral and tube feeding

Not suitable as a sole-source of nutrition

High calorie powder

• Only contains CHO and fat

• Safe for patients with cow's milk

• Trace amounts of micronutrients but rarely causes issues unless given in excessive amounts

Suitable for oral and tube feeding use

Not suitable as a sole-source of nutrition

Unflavored (~7.7 kcals/mL)

For patients who are unable to digest or absorb conventional fats

• MCTs are more readily hydrolyzed and absorbed than long chain fats

• MCTs are absorbed directly into the portal circulation and do not require the bile salts for emulsification

  • Helpful for patients with fat malabsorption who struggle with other modulators like duocal

Suitable for oral and tube feeding use

Not suitable as sole source of nutrition

Administered alone, not mixed with formula

• Hydrophobic, does not interact well with water

Emulsified for easier mixing

• 50% MCT/50% water

• Can be mixed with formula or provided alone

• May not be the best choice for someone who is very fluid restricted

Unflavored ~4.5 kcals/mL

For patients who are unable to digest or absorb conventional fats

• MCTs are more readily hydrolyzed and absorbed than long chain fats

• MCTs are absorbed directly into the portal circulation and do not require bile salts for emulsification

Suitable for oral and tube feeding use

Not suitable as a sole source of nutrition

Emulsified for easier mixing

• 50% MCT/50% water

• Can be mixed with formula or provided alone

Microlipid has long chains

• Avoided in chylothorax but either is a fine choice for the kidney population

For patients who are unable to digest or absorb conventional fats

• MCTs are more readily hydrolyzed and absorbed than long chain fats

• MCTs are absorbed directly into the portal circulation and do not require bile salts for emulsification

Suitable for oral and tube feeding use

Not suitable as a sole source of nutrition