The viscosity-enhancing effect of carob bean gum and sodium carboxymethylcellulose when added to infant formula

Food Sci Nutr. 2024 Jan 11;12(4):2661-2670. doi: 10.1002/fsn3.3947. eCollection 2024 Apr.

Abstract

Despite limited supporting evidence, the practice of thickening breast milk or infant formula with commercially available thickening agents is prevalent. This study explored the viscosity-enhancing impact of carob bean gum (CBG) and sodium carboxymethylcellulose (NaCMC) when added to infant formula at various concentrations and for different thickening durations. The findings indicate that thickening leads to an exponential increase in milk viscosity, from 25% of the recommended dosage onward. This suggests that minor adjustments in dosage can significantly impact formula thickness, underscoring the importance of accurately dosing and preparing infant milk. The considerable variability in viscosity also emphasizes the need for thoughtful selection of teat size, considering the energy expenditure of the sucking infant. When using 50% of the recommended CBG dose or 25% of NaCMC, the resulting viscosity matches that of a commercially available casein-based formula containing CBG for anti-regurgitation. In the case of CBG, a viscosity plateau is only reached after 30 min. Therefore, educating parents on the correct handling and preparation steps for CBG-thickened infant milk is crucial, including a 30-min waiting period to achieve the intended thickening effect.

Keywords: gastro‐esophageal reflux; gastro‐esophageal reflux disease; infant formula; pediatrics; thickening agents; viscosity.