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Methods of increasing caloric density of infant formula

Methods of increasing caloric density of infant formula
Recipe using liquid concentrate infant formula (40 kcal/oz [1.35 kcal/mL])*
Approximate caloric density of final product Volume concentrate Volume water
20 kcal/oz (0.68 kcal/mL) 13 oz (385 mL) 13 oz (385 mL)
22 kcal/oz (0.74 kcal/mL) 13 oz (385 mL) 10.5 oz (310 mL)
24 kcal/oz (0.81 kcal/mL) 13 oz (385 mL) 8.5 oz (250 mL)
27 kcal/oz (0.91 kcal/mL) 13 oz (385 mL) 6.25 oz (185 mL)
30 kcal/oz (1.0 kcal/mL) 13 oz (385 mL) 4.5 5 oz (133 mL)
For powdered formula (40 kcal/scoop): Consult the manufacturer's website, or contact the manufacturer directlyΔ
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 (MCT) oil 7.7 kcal/mL Nonemulsified
Corn oil 8 kcal/mL Nonemulsified
Safflower oil 8 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)
  • 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.

◊ The addition of carbohydrate or fat to standard infant formulas alters the nutrient ratio of the formula by providing nonprotein calories. Consultation with a dietitian may be warranted to ensure an appropriate balance of macronutrients.

Data from:
  1. American Academy of Pediatrics Committee on Nutrition. Appendix C. Increasing the caloric density of infant formula. In: Pediatric Nutrition, 8th ed, Kleinman RE, Greer FR (Eds), American Academy of Pediatrics, Itasca, IL 2019. p.1519.
  2. 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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