Incidence of gastroesophageal reflux with whey- and casein-based formulas in infants and in children with severe neurological impairment.
Ten exclusively gastrostomy-fed, neurologically impaired children (4.5-14.5 years old) with gastroesophageal reflux were randomly assigned to receive feedings with either a casein- or a whey-based formula for 48 h each and then crossed over to the other formula. One 24-h pH probe study each was performed while being fed casein- and whey-based formula, respectively. There was a significant reduction in episodes and duration of gastroesophageal reflux while consuming the whey-based formula (p < 0.05). Whey-based feedings should be considered an additional tool in conjunction with other antireflux measures to treat gastroesophageal reflux more effectively in children with severe neurological impairment. A similar study was also conducted involving 14 infants (3-12 months old) with documented gastroesophageal reflux using 24-h pH probe monitoring while consuming a casein-based formula. The formula was changed to a whey-based formula and the pH probe study repeated within 3-5 days. Four infants showed improvement and the rest showed either deterioration (1/14) or comparable results (9/14). The reduction in the mean number of episodes or duration of gastroesophageal reflux with the whey-formula was not significantly different from that with the casein-based formula (p > 0.05). Based on these findings, generalized recommendations for the use of whey-based formula in infants with gastroesophageal reflux cannot be made.
Khoshoo
V
V
Children's Hospital, New Orleans, Louisiana 70118, USA.
Zembo
M
M
King
A
A
Dhar
M
M
Reifen
R
R
Pencharz
P
P
D000293:Adolescent; D002364:Caseins; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D005260:Female; D005526:Food, Formulated; D005764:Gastroesophageal Reflux / Q000150:complications / Q000178:diet therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008894:Milk Proteins; D000067816:Whey Proteins
D002364:Caseins; D008894:Milk Proteins; D000067816:Whey Proteins