title: Effect of Time and Temperature on Thickened Infant Formula.
abstract: BACKGROUND
  Unlike adult populations, who primarily depend on liquids for hydration alone, infants rely on liquids to provide them with hydration and nutrition. Speech-language pathologists working within pediatric medical settings often identify dysphagia in patients and subsequently recommend thickened liquids to reduce aspiration risk. Caregivers frequently report difficulty attempting to prepare infant formula to the prescribed thickness.
  
  
  METHODS
  This study was designed to determine (1) the relationship between consistencies in modified barium swallow studies and thickened infant formulas and (2) the effects of time and temperature on the resulting thickness of infant formula. Prepackaged barium consistencies and 1 standard infant formula that was thickened with rice cereal and with 2 commercially available thickening agents were studied. Thickness was determined via a line spread test after various time and temperature conditions were met.
  
  
  RESULTS
  There were significant differences between the thickened formula and barium test consistencies. Formula thickened with rice cereal separated over time into thin liquid and solid residue. Formula thickened with a starch-based thickening agent was thicker than the desired consistency immediately after mixing, and it continued to thicken over time. The data from this project suggest that nectar-thick and honey-thick infant formulas undergo significant changes in flow rates within 30 minutes of preparation or if refrigerated and then reheated after 3 hours.
  
  
  CONCLUSIONS
  Additional empirical evidence is warranted to determine the most reliable methods and safest products for thickening infant formula when necessary for effective dysphagia management.
authors: 1 The University of Alabama, Tuscaloosa, Alabama, USA.|2 LeBonheur Children's Hospital, Memphis, Tennessee, USA.
authors: Memorie M
authors: MM
authors: Gosa
authors: 3 Brigham & Women's Hospital, Boston, Massachusetts, USA.
authors: Pamela
authors: P
authors: Dodrill
mesh_terms: D003680:Deglutition Disorders / Q000628:therapy; D002523:Edible Grain; D005511:Food Handling; D041943:Infant Formula / Q000737:chemistry*; D013213:Starch; D013696:Temperature; D013997:Time Factors; D014783:Viscosity
chemical_list: D013213:Starch
keywords: deglutition disorders; dysphagia; infant; infant formula; pediatrics; thickened liquids