Can the amino acid-based formula be the rescue therapy for resistant feeding intolerance in preterm infants?

Abstract

Feeding intolerance is a digestive disorder that occurs especially in preterm infants with gastric residual, abdominal distension and/or vomiting, often causes changes in the diet plan. In aminoacid-based formula (AAF), the protein is broken down to aminoacids, its allergenicity is very low and it is easily absorbed. In this case series, five cases with AAF a were evaluated in Eskişehir University Faculty of Medicine Neonatal Care Unit between 2018-2019. The temporary use of AAF through gradual increase of nutrition in preterm infants with very low birth weight, who could not tolerate even minimal enteral nutrition, led to the transition to full enteral nutrition. After the use of AAF, we experienced shorter parenteral feeding time, increased daily weight gain rate, decreased number of sepsis attacks. The tolerance of enteral nutrition in preterm infants depends on the degree of maturation (motility, enzymatic digestion, hormonal response, bacterial colonization, local immunity) of the gastrointestinal system. Since it can continue to be fed again with breast milk after the transition to full enteral nutrition, it was thought that, different from the protein allergy, it is enzymatic immaturity in the pathophysiology of this transient condition.