This is totally overwhelming to stop and look at the response for the need of formula for the children in Pleven! Thank you to each and everyone of you who is donating formula, taking over formula, and getting the word out about this effort of so many. I have received quite a few emails and comments with questions regarding the nutrition we are sending over. Some things I could answer but other things needed some expert answers. With that I was able to contact a wonderful doctor who has expertise in the area of nutrition for children. She answered some of the questions I forwarded on to her so I could share it with those of you. She also said to please feel free to repost her response wherever you need to
first of all, i think i'd not call it high calorie, it's not any higher in calories than any other formula unless you mix it to make it so. the doctor can prescribe the very best calorie per milliliter ratio for each child, and these powdered formulas can be perfectly adapted for each child's needs.
Children with long term, severe malnutirion are often unable to efficiently digest and metabolize many foods. When a child comes to the US and is treated for profound malnutrition, they are usually fed IV for quite a while at the beginning, with oral or tube feedings starting very slowly. Unfortunately, that is a luxury these children don't have. The next best thing is carefully monitored feeding with very specialized formulas. Formulas such as Vivonex Pediatric, Elecare and Neocate are called "elemental diets" because each ingredient, the proteins, fats and carbohydrates, are broken down into the smallest, simplest possible elements. They are also manufactured under the strictest controls, just like medicines, so every gram has the absolutely accurate amount of each component.
The malnourished child's body has to do NO WORK to digest these formulas. 100 % of the ingredients can be absorbed and used for metabolism, healing and growth. Because the doctors know exactly how much of the formula is going to be able to be used by the sick child (100 %) it is possible to very precisely prescribe the exact amount needed each day, or even each hour.
Refeeding hypophosphatemia is a truly frightening syndrome that can happen to anyone who has malnutrition and then is given calories. Obviously, these children are at higher risk than, for example, you or I would be after a crash diet or being sick for a while. Therefore, it is essential that when they begin to be fed, that they are fed carefully and with the utmost precision.
These highly specialized metabolic, elemental formulas are perfect for this situation. They are not recommended by the World Health Organization for treatment of starvation because they are amaingly expensive, and in countries with many starving children, they can't be found at any price. But they are the very best enteral (meaning "using the gastrointestinal system") feeding option for children who are very fragile.
Another question I'm often asked is this: Do these children need to stay on these special formulas once they're home? Probably not. Once they are stable, safe, and growing, the very most healthy option is eating real food. Sad to say,a certain percentage of these children may never be able to eat enough regular food to be healthy and grow. They may end up needing to be tube fed long term. Children who have an underlying enzyme deficiency or are missing a large portion of their intestines may require a lifetime of these elemental formulas. But most children who continue to need formula can, and should, eventually be on a formula that's as close as possible to real food. Each child's doctor will make that decision as the child heals and grows.
If you have any other questions that you would like answered please send them to me via email at email@example.com and I will do my best to get you answers.