Methods of increasing caloric density of infant formula

For concentrated formula (40 kcal/oz)*
Approximate caloric density of final product (kcal/oz)	Volume concentrate (oz)	Volume water (oz)
20	13	13
22	13	10.5
24	13	8.5
27^¶	13	6
30^¶	13	4.5
For powdered formula (40 kcal/scoop): Consult the manufacturer's website or contact the manufacturer directly^Δ
Agents that can be added to infant formula
Agent	Kcal/unit	Comments
Carbohydrate
Maltodextrin (glucose polymer)	7.7 kcal per teaspoon 7.7 kcal per 2 g	Increases osmolality
Corn syrup	3.8 kcal/mL	Increases osmolality
Fat
Medium chain triglyceride oil (MCT oil)	7.7 kcal/mL	Nonemulsified
Corn oil	8.4 kcal/mL	Nonemulsified
Safflower oil	8.4 kcal/mL	Nonemulsified

kcal: kilocalorie; oz: ounce.
* Based on the calculation: ((a × b)/c) – a = y.

a = volume of concentrated formula to be diluted (ie, 13 oz), b = caloric density of concentrated formula (40 kcal/oz), c = desired caloric density of final product (kcal/oz), and y = amount of water needed.

¶ Formulas usually are not concentrated beyond 24 kcal/oz unless fluid restriction is necessary (eg, for infants with congenital heart disease). Increases in the caloric density beyond 24 kcal/oz should be made gradually (eg, in increments of 3 kcal/oz) with modular supplements (glucose polymers, medium chain triglycerides) to a maximum of 30 kcal/oz.
Δ Variability in scoop sizes and household measures precludes provision of a general recipe.

Data from:

American Academy of Pediatrics Committee on Nutrition. Appendix C. Increasing the caloric density of infant formula. In: Pediatric Nutrition, 8^th ed, Kleinman RE, Greer FR (Eds), American Academy of Pediatrics, Itasca, IL 2019. p.1519.
Singla S, Olsson JM. Enteral nutrition. In: Pediatric Hospital Medicine. Textbook of inpatient Management, Perkin RM, Swift JD, Newton DA (Eds), Lippincott Williams & Wilkins, Philadelphia 2003. p.812.

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Methods of increasing caloric density of infant formula