Guidelines for Formula Selection
Selection of an optimal infant, pediatric or adult enteral formula
for use in a pediatric patient depends on both patient factors and
formula factors as follows:
Patient Factors 
Formula Factors 
Age
Diagnosis
Associated nutritional problems
Nutritional requirements
Gastrointestinal function 
Osmolality
Renal solute load
Caloric density and viscosity
Nutrient composition: type & amount of CHO, Fat and protein
Product availability and cost 
Infant, Pediatric and Adult Enteral Formulas  Refer
to:
Modifying Formula Caloric and Nutrient Density
Children who are critically or chronically ill may be unable to take
adequate formula volume to meet their nutritional needs. Infant and
pediatric formulas may be prepared differently to provide a greater
caloric or nutrient density by any one or a combination of the
following methods:
 Concentration  increasing the amount of formula
base or decreasing the amount of free water added when mixing the
formula.
 Supplementation  Adding a macronutrient module in
order to increase caloric density without increasing all other nutrient
sources. This may be accomplished through the addition of:
 Carbohydrate source: Polycose (Ross Laboratories), Moducal
(MeadJohnson)
 Fat source: Microlipid (MeadJohnson)
 Protein source: ProMod (Ross Laboratories)
 Addition of powdered formula (adds all macro and
micronutrients)
(The addition of 1 tsp of Polycose and 2 cc of Microlipid per 4 oz
of a formula base will increase the caloric density by 3
kcal/oz)
