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Type: Journal article
Title: Whey- vs casein-based enteral formula and gastrointestinal function in children with cerebral palsy
Author: Savage, K.
Kritas, S.
Schwarzer, A.
Davidson, G.
Omari, T.
Citation: Journal of Parenteral and Enteral Nutrition, 2012; 2012(1 SUPPL.):118S-123S
Publisher: Amer Soc Parenteral & Enteral Nutrition
Issue Date: 2012
ISSN: 0148-6071
Statement of
Karina Savage, Stamatiki Kritas, Andrea Schwarzer, Geoffrey Davidson, and Taher Omari
Abstract: 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 t1/2), and reported pain and GI symptoms were measured. Results: Whey formulas emptied significantly faster than casein (median [interquartile range (IQR)] GE t1/2, 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.
Keywords: pediatrics; life cycle; enteral formulas; enteral nutrition; gastroenterology; proteins
Rights: © 2012 American Society for Parenteral and Enteral Nutrition
RMID: 0020122027
DOI: 10.1177/0148607111428139
Appears in Collections:Paediatrics publications

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