Xinias I et al. (2005) Cornstarch thickened formula reduces oesophageal acid exposure time in infants. Dig Liver Dis 37: 23–27

The problem of infant regurgitation is sometimes addressed using thickened formula feed, although the efficacy of this approach has not been clearly demonstrated. Xinias et al. have recently published the results of their study of a cornstarch-thickened formula.

The multicenter study included 96 formula-fed infants with episodes of regurgitation and vomiting (more than five times daily) and abnormally low esophageal pH at baseline. The mean age of the infants was 93 days. The patients were randomized to 28 days' feeding using either a standard infant formula (n = 45) or a casein predominant formula thickened with a treated cornstarch (n = 51). Parents recorded symptoms of regurgitation throughout the study period.

At the end of the study, infants who had been fed on the cornstarch-thickened formula showed significant improvements compared to baseline in terms of reflux index (defined as a the percentage of the investigation time with an esophageal pH of <4.0) and the number and duration of reflux episodes. No such improvements were seen in the standard formula group.

The authors conclude that the cornstarch-thickened formula produced a significant decrease in esophageal acid exposure and so may be superior to other thickening agents, such as bean gum and rice starch. Furthermore, the results suggest that the thickened feed reduced both acid and nonacid reflux.