Incidence of gastroesophageal reflux with whey- and casein-based formulas in infants and in children with severe neurological impairment

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 22; no. 1; pp. 48 - 55
• Main Authors: Khoshoo, V. (Children's Hospital, New Orleans, LA.), Zembo, M, King, A, Dhar, M, Reifen, R, Pencharz, P
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott-Raven Publishers 01.01.1996; Lippincott
• Subjects: Adolescent; ALIMENT POUR NOURRISSON; ALIMENTOS PARA NINOS; BEBES; Biological and medical sciences; CASEINA; CASEINE; Caseins; Cerebral Palsy - complications; Child; Child, Preschool; Cross-Over Studies; DIETA; ENFANT EN BAS AGE; Female; Food, Formulated; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - diet therapy; Humans; Hydrogen-Ion Concentration; LACTOSERUM; Male; Medical sciences; Milk Proteins; Other diseases. Semiology; REGIME ALIMENTAIRE; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; SUERO DE LA LECHE; TRASTORNOS DEL SISTEMA NERVIOSO; TRASTORNOS DIGESTIVOS; TROUBLE DIGESTIF; TROUBLE DU SYSTEME NERVEUX; Whey Proteins; Human; Enrichment; Gastroesophageal reflux; Nervous system diseases; Esophageal disease; Whey; Incidence; Result; Humanized milk; Casein; Digestive diseases; Severity score; Biological effect; Neurological disorder; Child
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/00005176-199601000-00008

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