{rfName}
In

License and Use

Icono OpenAccess

Altmetrics

Analysis of institutional authors

Luque, VeronicaAuthor

Share

June 2, 2024
Publications
>
Article

Infant formulas for the treatment of functional gastrointestinal disorders: A position paper of the ESPGHAN Nutrition Committee

Publicated to: Journal Of Pediatric Gastroenterology And Nutrition. 79 (1): 168-180 - 2024-07-01 79(1), DOI: 10.1002/jpn3.12240

Authors:

Haiden, N; Savino, F; Hill, S; Kivelae, L; De Koning, B; Köglmeier, J; Luque, V; Moltu, SJ; Norsa, L; De Pipaon, MS; Verduci, E; Bronsky, J
[+]

Affiliations

ASST Papa Giovanni XXIII, Pediat Hepatol Gastroenterol & Transplantat Unit, Bergamo, Italy - Author
Azienda Osped Univ Citta Salute & Sci Torino, Regina Margher Regina Margher Children Hosp, Dept Patol & cura bambino, Turin, Italy - Author
Erasmus MC Sophia Childrens Hosp, Dept Pediat Gastroenterol, Rotterdam, Netherlands - Author
Great Ormond St Hosp Children NHS Fdn Trust, Dept Paediat Gastroenterol, Unit Nutr & Intestinal Failure Rehabil, London, England - Author
Great Ormond St Hosp Children NHS Fdn Trust, Gastroenterol Dept, Nutr & Intestinal Failure Div, London, England - Author
Helsinki Univ Hosp, Childrens Hosp, Helsinki, Finland - Author
Kepler Univ Hosp, Dept Neonatol, Krankenhausstr 26-30, A-4020 Linz, Austria - Author
Oslo Univ Hosp, Dept Neonatal Intens Care, Norway Pediat, Oslo, Norway - Author
Tampere Univ Hosp, Dept Pediat, Tampere, Finland - Author
Tampere Univ, Celiac Dis Res Ctr, Tampere, Finland - Author
Univ Autonoma Madrid, Neonatol Hosp La Paz Inst Hlth Res IdiPAZ, Madrid, Spain - Author
Univ Hosp Motol, Dept Paediat, Prague, Czech Republic - Author
Univ Milan, Vittore Buzzi Hosp, Dept Pediat, Metab Dis Unit, Milan, Italy - Author
Univ Oslo, Res Inst, Oslo, Norway - Author
Univ Rovira & Virgili IISPV, Paediat Nutr & Dev Res Unit, Tarragona, Spain - Author
See more

Abstract

Functional gastrointestinal disorders (FGID), such as infant regurgitation, infant colic, and functional constipation, are common and typically physiological phenomena during the early months of an infant's life and account for frequent consultations with pediatricians. Various infant formulas are marketed for their management and are frequently given by parents to infants before a medical consultation. However, the evidence supporting their effectiveness is limited and some have altered nutritional compositions when compared to standard formulas. Thus, these products should only be used under medical supervision and upon medical advice. Marketing and over-the-counter sales do not ensure proper medical guidance and supervision. The aim of this position paper is to review the current evidence regarding the safety and efficacy of formulas specifically formulated for addressing regurgitation, colic, and constipation, recognized as FGID. The objective is to provide guidance for clinical management based on the highest quality of available evidence. A wide search using Pubmed, MEDLINE, EMBASE and Cochrane Database of Systematic Reviews was performed including the MESH terms infant formula, colic, constipation, regurgitation, reflux, palmitate, lactase, lactose, magnesium, hydrolyzed protein, prebiotics or probiotics. 752 papers were identified and screened. Finally, 72 papers were included in the paper. In the absence of evidence, recommendations reflect the authors' combined expert opinion. Final consensus was obtained by multiple e-mail exchange and meetings of the Nutrition Committee. (1) For breastfed infants experiencing FGID such as regurgitation, colic, or constipation, transitioning from breastfeeding to commercial formulas is not recommended. (2) In general, whether an infant is breastfed or formula-fed, it's crucial to reassure parents that FGIDs are normal and typically do not necessitate treatment or change to a special formula. (3) Thickened formulas, often termed anti-reflux formulas, may be considered in specific cases of regurgitation. (4) The usage of specialized formulas for infants with colic is not advised due to a lack of clinical evidence. (5) In the case of constipation in infants, the use of formulas enriched with high beta-palmitate and increased magnesium content may be considered to soften the stool. Generally, there is limited evidence supporting the use of specialized formulas for FGID. Breastfeeding should never be discontinued in favor of formula feeding. What is Known Functional gastrointestinal disorders, such as infant regurgitation, infant colic, and functional constipation, are common and typically physiological phenomena during the early months of an infant's life. The infant food industry provides a wide range of formulas designed for managing these mild functional gastrointestinal disorders. Despite the widespread use of these formulas, their effectiveness in treating mild functional gastrointestinal disorders remains uncertain.What is New Weaning from breastfeeding is not advised for infants experiencing any or several functional gastrointestinal disorders. In majority of formula-fed infants, no specific formulas are indicated. In breastfed infants with regurgitation, breast milk can be expressed and supplemented with thickening agents and in formula fed infants, industrially thickened infant formulas often referred to as "anti-reflux formulas," or formulas with appropriately added thickeners can be considered in special cases under medical guidance. Special anti-colic formulas do not usually benefit infants with colic. In cases of infant constipation, considering formulas with high beta-palmitate and an elevated magnesium content may be an option to soften stool consistency. It is generally not recommended to use formulas for combined functional gastrointestinal disorders.
[+]

Keywords

ConstipationDouble-blindEuropean-societyFgidGastroesophageal-refluxHydrolyzed formulaInfant colicLactoseMilNecrotizing enterocolitisPediatric gastroenterologyRegurgitatioRegurgitationReuteri dsm 17938Thickened formula

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2024 there are still no calculated indicators, but in 2023, it was in position 33/191, thus managing to position itself as a Q1 (Primer Cuartil), in the category Pediatrics.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-05:

  • WoS: 6
  • Scopus: 12
[+]

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-05:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 48.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 48 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 20.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 30 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
[+]

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Austria; Czech Republic; Finland; Italy; Netherlands; Norway; United Kingdom.

[+]

Awards linked to the item

No funding was obtained for this study.
[+]