Methods for preparation of infant powdered formulas (by using scoops and by weighing milk formula powders before adding water) were evaluated at two hospital formula kitchens. The sample covered a total of 105 bottles, randomly selected in a period of 100 days, which were compared with reference standards developed at our laboratory. The study of the prepared bottles, through direct osmometry, showed a clear bias towards overdilution of the formulas, in relation to what is prescribed, particularly when the preparation is made by scoops. The observed variability was independent of the personnel in charge of the preparation.These findings confirm the inadequacy of methods for the preparation of powder-based formulas point out another cause for inadequate growth in LBW infants, given the low energy and protein density of formulas as administered to infants at hospitals.
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