Abstract
Frequently, infants with chronic diarrhea and failure to thrive require TPN to overcome the intestinal absorptive defect. Weaning from TPN without exacerbation of diarrhea is difficult. We have developed a formula which can be structured to challenge the intestine sequentially with the various nutrient modules and concentrations. The Core formula is composed of whole casein and minerals calculated to deliver adequate electrolytes when used in a concentration cf 3 gms % protein. To this protein Core, fats and sugars can be added as needed and tolerated by the patient. When weaning from TPN, modules are added in 1 gm % increments every 12 hrs. starting with protein, fat and then carbohydrate. When the composition equals 3 gm % Core mix, 3.5 gm % fat and 6 gm % carbohydrate and this is tolerated for 1 week, the patient is switched to a proprietary formula which most closely matches. If a concentration is reached that causes diarrhea, it is maintained or slightly reduced until intestinal tolerance developes. In the past three years, more than 75 patients have been weaned to oral feedings in this manner with no difficulty. Work supported by: Ross Laboratory, David Underwood Trust, USPH RR-00188, and AM-05721-01.
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Klish, W., Rodriguez, J., Potts, E. et al. MODULAR FORMULA FOR WEANING INFANTS FROM TOTAL PARENTERAL NUTRITION (TPN). Pediatr Res 8, 382 (1974). https://doi.org/10.1203/00006450-197404000-00254
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DOI: https://doi.org/10.1203/00006450-197404000-00254