• Enfamil® EnfaCare® 12.8 oz Powder
  • Enfamil® EnfaCare® 8oz RTU
  • Enfamil® EnfaCare® 2oz Nursette

Enfamil® EnfaCare®

Milk-based, 22 cal discharge formula for babies who were born prematurely or with low birth weight.

Available in Powder, 2 fl oz and 8 fl oz Ready to Use

Last Updated: Friday, January 5, 2018

  • Description/Indication
    • Enfamil EnfaCare is a milk-based, 22 Cal/fl oz, iron-fortified, post-discharge formula with enriched nutrition for infants who were born prematurely or with low birth weight*. Enfamil EnfaCare contains vitamin and mineral levels specially tailored for premature babies’ first year of life after discharge from the hospital. Enfamil EnfaCare is typically used during the first year of life for infants from approximately 1800 grams in weight.

      * Increased caloric density, protein, and some vitamins and minerals compared to standard term formula to help support weight and growth in babies born prematurely.

  • Product Features
      • Clinically proven to promote catch-up growth to help support developmental outcomes during the first year1,†:
        • 2.8 g protein/100 Calories, which is a higher protein level than Enfamil PREMIUM® Infant formula
        • 54% more calcium than Enfamil PREMIUM Infant formula
        • 53% more phosphorus than Enfamil PREMIUM Infant formula
        • 25% more vitamin D than Enfamil PREMIUM Infant formula
      • DHA to promote brain and eye development2-9:
        • DHA at the clinically proven amount of 0.32% of total fatty acids, the same amount as the worldwide breast milk average10,‡
      • 20% of the fat blend from medium-chain triglycerides (MCT) oil
      • 80:20 whey-to-casein ratio patterned after early breast milk11,§
      • Has choline to help support brain development
      • Kosher

      † When used in a program of Enfamil® formulas: Enfamil® Premature, Enfamil EnfaCare and Enfamil Infant. ‡ Average amount of DHA in worldwide breast milk is 0.32% ± 0.22% (mean ± standard deviation of total fatty acids) based on an analysis of 65 studies of 2,474 women10. § Based on whey:casein ratio 3-5 days after lactation begins.

  • Nutrients
    • Product nutrient values and ingredients are subject to change. Please see product label for current information.

      (Normal Dilution) Per 100 Calories (4.5 fl oz) Per 100 Calories (4.5 fl oz) Per 100 mL Per 100 mL Per 100 grams Powder (500 Cal)
      Powder Liquid Powder Liquid
      Protein, g 2.8 2.8 2.1 2.1 13.9
      Fat, g 5.3 5.3 3.9 3.9 26
      Linoleic acid, mg 860 860 640 640 4300
      Carbohydrate, g 10.4 10.4 7.7 7.7 52
      Water, g 119 120 88 89 2.5
      (Normal Dilution) Per 100 Calories (4.5 fl oz) Per 100 Calories (4.5 fl oz) Per 100 mL Per 100 mL Per 100 grams Powder (500 Cal)
      Vitamins/Other Nutrients Powder Liquid Powder Liquid
      Vitamin A, IU 450 450 330 330 2200
      Vitamin D, IU 75 75 56 56 370
      Vitamin E, IU 4 4 3 3 20
      Vitamin K, mcg 9 9 6.7 6.7 45
      Thiamin (Vitamin B1), mcg 180 180 133 133 890
      Riboflavin (Vitamin B2), mcg 200 200 148 148 990
      Vitamin B6, mcg 67 67 50 50 330
      Vitamin B12, mcg 0.3 0.3 0.22 0.22 1.49
      Niacin, mcg 1000 1000 740 740 5000
      Folic acid (Folacin), mcg 26 26 19.3 19.3 129
      Pantothenic acid, mcg 850 850 630 630 4200
      Biotin, mcg 6 6 4.4 4.4 30
      Vitamin C (Ascorbic acid), mg 16 16 11.9 11.9 79
      Choline, mg 24 24 17.8 17.8 119
      Inositol, mg 24 24 17.8 17.8 119
      (Normal Dilution) Per 100 Calories (4.5 fl oz) Per 100 Calories (4.5 fl oz) Per 100 mL Per 100 mL Per 100 grams Powder (500 Cal)
      Minerals Powder Liquid Powder Liquid
      Calcium, mg 120 120 89 89 600
      Phosphorus, mg 66 66 49 49 330
      Magnesium, mg 8 8 5.9 5.9 40
      Iron, mg 1.8 1.8 1.33 1.33 8.9
      Zinc, mg 1 1 0.74 0.74 5
      Manganese, mcg 15 15 11.1 11.1 74
      Copper, mcg 90 90 67 67 450
      Iodine, mcg 21 21 15.6 15.6 104
      Selenium, mcg 2.8 2.8 2.1 2.1 13.9
      Sodium, mg 37 37 27 27 184
      Potassium, mg 105 105 78 78 520
      Chloride, mg 78 78 58 58 390
  • Nutrient Facts
    • Nutrient Density 22 Calories/fl oz
      Protein (% Calories) 11
      Fat (% Calories) 47
      Carbohydrate (% Calories) 42
      Potential Renal Solute Load (mOsm/100 Calories)12 25
      Potential Renal Solute Load (mOsm/100 mL)12 18.4
      Nutrient Density 22 Calories/fl oz 22 Calories/fl oz
      Powder Liquid
      Osmolality (mOsm/kg water) 310 230
      Osmolarity (mOsm/L) 270 200
      Lactose-free No No
      Galactose-free No No
  • Product Forms
    • Enfamil EnfaCare is available in powder, ready-to-use liquid and Nursette® bottles.

      Item #: 001904
      Description: Enfamil EnfaCare Pwd
      Unit Size: 12.8 oz can
      Cal./Unit: 1800
      Prod. Yield / Unit (fl oz): 82
      Case: 6 cans per case
      Reimbursement Code: 00087-001944

    • Item #: 139001
      Description: Enfamil EnfaCare Nursette® 22 Cal RTU
      Unit Size: 2 fl oz bottle
      Cal./Unit: 44
      Prod. Yield / Unit (fl oz): 2
      Case: 48 bottles per case
      Reimbursement Code: 00087-139041

    • Item #: 149501
      Description: Enfamil EnfaCare RTU
      Unit Size: 8 fl oz bottle
      Cal./Unit: 176
      Prod. Yield / Unit (fl oz): 8
      Case: 24 bottles per case
      Reimbursement Code: 00087-510298

      HCPCS Code

  • Composition
    • Ingredients: Powder: Nonfat milk, whey protein concentrate, corn syrup solids, lactose, high oleic sunflower oil, soy oil, medium chain triglycerides (MCT oil), coconut oil and less than 2%: Mortierella alpina oil||, Crypthecodinium cohnii oil, calcium phosphate, calcium carbonate, ferrous sulfate, magnesium phosphate, zinc sulfate, potassium citrate, sodium chloride, cupric sulfate, manganese sulfate, sodium selenite, potassium iodide, soy lecithin, inositol, vitamin A palmitate, ascorbic acid, niacinamide, calcium pantothenate, thiamin hydrochloride, riboflavin, vitamin B6 hydrochloride, vitamin D3, folic acid, vitamin K1, biotin, vitamin B12, choline chloride, vitamin E acetate, nucleotides (cytidine 5’-monophosphate, adenosine 5’-monophosphate, disodium uridine 5’-monophosphate, disodium guanosine 5’-monophosphate), taurine, L-carnitine.

      Ingredients: Ready To Use (2 fl oz Nursette): Water, nonfat milk, maltodextrin, lactose, whey protein concentrate, high oleic sunflower oil, soy oil, medium chain triglycerides (MCT oil), coconut oil and less than 0.5%: Mortierella alpina oil||, Crypthecodinium cohnii oil, mono- and diglycerides, soy lecithin, calcium phosphate, calcium hydroxide, potassium citrate, calcium citrate, magnesium chloride, sodium chloride, potassium chloride, sodium citrate, ferrous sulfate, zinc sulfate, cupric sulfate, potassium iodide, manganese sulfate, sodium selenite, rice starch, ascorbic acid, sodium ascorbate, vitamin E acetate, niacinamide, calcium pantothenate, thiamin hydrochloride, vitamin A palmitate, riboflavin, vitamin B6 hydrochloride, folic acid, vitamin D3, vitamin K1, biotin, vitamin B12, choline chloride, inositol, nucleotides (cytidine 5’-monophosphate, disodium uridine 5’-monophosphate, adenosine 5’-monophosphate, disodium guanosine 5’-monophosphate), taurine, L-carnitine.

      Ingredients: Ready To Use (8 fl oz bottle): Water, nonfat milk, maltodextrin, lactose, whey protein concentrate, high oleic sunflower oil, soy oil, medium chain triglycerides (MCT oil), coconut oil and less than 0.5%: Mortierella alpina oil||, Crypthecodinium cohnii oil, mono- and diglycerides, soy lecithin, calcium phosphate, calcium hydroxide, potassium citrate, calcium citrate, magnesium chloride, sodium chloride, potassium chloride, sodium citrate, ferrous sulfate, zinc sulfate, cupric sulfate, potassium iodide, manganese sulfate, sodium selenite, rice starch, sodium ascorbate, ascorbic acid, vitamin E acetate, niacinamide, calcium pantothenate, thiamin hydrochloride, vitamin A palmitate, riboflavin, vitamin B6 hydrochloride, folic acid, vitamin D3, vitamin K1, biotin, vitamin B12, choline chloride, inositol, nucleotides (cytidine 5’-monophosphate, disodium uridine 5’-monophosphate, adenosine 5’-monophosphate, disodium guanosine 5’-monophosphate), taurine, L-carnitine.

      || A source of arachidonic acid (ARA). ¶ A source of docosahexaenoic acid (DHA).

  • Potential Allergens
    • Enfamil® EnfaCare® contains milk and soy.

  • Preparation of Feedings
    • The baby’s health depends on carefully following the instructions below. Use only as directed by a medical professional. Proper hygiene, preparation, dilution, use and storage are important when preparing infant formula. Powdered infant formulas are not sterile and should not be fed to premature infants or infants who might have immune problems unless directed and supervised by a doctor. Discuss with parents which formula is appropriate for the baby.

      Discuss with parents whether they need to use cooled, boiled water for mixing and whether they need to boil clean utensils, bottles and nipples in water before use.

      WARNING: Do not use a microwave oven to warm formula. Serious burns may result.

      Refer to the product label for the most accurate information.

      POWDER

      Failure to follow these instructions could result in severe harm. Once prepared, infant formula can spoil quickly. Either feed immediately or cover and store in refrigerator at 35–40°F (2–4°C) for no longer than 24 hours. Do not use prepared formula if it is unrefrigerated for more than a total of 2 hours. Do not freeze prepared formula. After feeding begins, use formula within 1 hour or discard.

      1. Wash hands thoroughly with soap and water before preparing formula.
      2. Pour desired amount of water into bottle. Add powder.
      3. Cap bottle and SHAKE WELL.

      Use the charts below for correct amounts of water and powder. Use scoop in tub or can to measure powder. Store DRY scoop in lid holder in tub or in can.

      Enfamil® EnfaCare®

      To Make Water Powder Weight
      2 fl oz bottle 2 fl oz 1 unpacked level scoop 9.8 g
      4 fl oz bottle 4 fl oz 2 unpacked level scoops 19.6 g
      8 fl oz bottle 8 fl oz 4 unpacked level scoops 39.2 g

      ¶ Each scoop adds about 0.2 fl oz to the amount of prepared formula.

      READY TO USE

      2 fl oz Nursette® Bottles

      1. Inspect each bottle for signs of damage.

      2. Wash hands thoroughly with soap and water before preparing bottle for feeding.

      3. SHAKE BOTTLE WELL and remove cap.

      4. Attach nipple unit (not included).

      WARNING: Do not use a microwave oven to warm formula. Serious burns may result.

      Failure to follow these instructions could result in severe harm. Opened bottles can spoil quickly. Either feed immediately or replace cap and store in refrigerator at 35–40°F (2–4°C) for no longer than 24 hours. Do not use opened bottle if it is unrefrigerated for more than a total of 2 hours. Do not freeze. After feeding begins, use formula within 1 hour or discard.

      8 fl oz Bottles

      1. Wash hands thoroughly with soap and water before preparing feeding bottles.

      2. SHAKE BOTTLE WELL, remove protective seal around cap, remove cap and foil seal.

      3. Pour into feeding bottle(s).

      WARNING: Do not use a microwave oven to warm formula. Serious burns may result.

      Failure to follow these instructions could result in severe harm. Opened bottles and prepared formula can spoil quickly. Either feed immediately or cover and store in refrigerator at 35–40°F (2–4°C) for no longer than 48 hours. Do not use opened bottle and/or prepared formula if they are unrefrigerated for more than a total of 2 hours. Do not freeze prepared formula. After feeding begins, use prepared formula within 1 hour or discard.

  • Product Characteristics
    • Calories

      Enfamil® EnfaCare® provides 22 Calories/fl oz, which is between the energy density of Enfamil® Premature formula (24 Calories/fl oz) and that of Enfamil® Infant (20 Calories/fl oz). This increased energy density allows infants with conditions such as prematurity or low birth weight to receive extra calories in a smaller volume than they would with term formulas.

      Fat

      Enfamil EnfaCare provides 47% of total calories from fat.

      Experts recommend that both preterm and term infants receive approximately 40%-55% of their total Calories from fat15-17. This is the usual amount provided by mature term human milk. Because growing preterm infants may continue to have difficulty digesting and absorbing long-chain fatty acids, medium-chain triglycerides (MCTs) are added to help ensure good fat absorption. Medium-chain triglycerides are more rapidly and completely hydrolyzed than long-chain triglycerides, and the resulting medium-chain fatty acids are effectively absorbed by individuals with fat malabsorption18. The fat blend in Enfamil EnfaCare consists of approximately:

      • 34% high oleic vegetable oil
      • 29% soy oil
      • 20% MCT oil
      • 14% c.5oconut oil
      • 2.5% single-cell oil blend rich in docosahexaenoic acid (DHA) and arachidonic acid (ARA)

      The essential fatty acids linoleic acid and alpha-linolenic acid provide 7.7% and 0.77% of the energy in the formula, respectively. The ratio of omega-6 to omega-3 fatty acids is 7.6:1.

      DHA and ARA

      Enfamil EnfaCare includes DHA and ARA, two nutrients also found in breast milk, that are important building blocks for a baby's brain and eyes2-9. Some studies also show that DHA and ARA may enhance growth of premature infants compared to the same formulas without DHA and ARA (now discontinued)1,19. The level of DHA in Enfamil EnfaCare is similar to that found in average worldwide breast milk20,** as well as similar to the levels specified by expert groups15,21-24.

      ** Average level of DHA and ARA in worldwide breast milk is 0.32% ± 0.22% and 0.47% ± 0.13% (mean ± standard deviation of total fatty acids) based on an analysis of 65 studies of 2,474 women20

      Enfamil EnfaCare DHA level within recommended levels

      Protein

      Protein provides 11% of total Calories in Enfamil EnfaCare, and is patterned after early human milk with 80% whey and 20% casein from whey protein concentrate and nonfat milk††. The level of protein is 2.8 g/100 Calories, which is lower than the level found in Enfamil Premature and higher than the level found in Enfamil Infant.

      †† Comparison to whey:casein ratio of typical early breast milk (3-5 days after lactation begins).

      Carbohydrate

      Carbohydrate provides 42% of total Calories in Enfamil EnfaCare and is a blend of 66% lactose and 34% corn syrup solids in the powder. The carbohydrate in the liquid is 60% maltodextrin and 40% lactose. The carbohydrate blend helps avoid overloading the infant's capacity to digest lactose.

      Vitamins and Minerals

      Enfamil EnfaCare meets U.S. Food and Drug Administration requirements for vitamins and minerals as mandated by the U.S. Infant Formula Act and the associated Code of Federal Regulations 21 C.F.R. part 10725.

      Calcium and Phosphorus

      Enfamil EnfaCare contains 120 mg calcium/100 Calories and 66 mg phosphorus/100 Calories, which are less than in Enfamil Premature but greater than in Enfamil Infant. The calcium:phosphorus ratio in Enfamil EnfaCare is about 1.82:1, similar to that of human milk26,27.

      Iron

      Enfamil EnfaCare provides 13.3 mg iron/L, the same level per 100 Calories found in Enfamil Premature with Iron and Enfamil Infant.

      Electrolytes—Sodium, Potassium, and Chloride

      The electrolyte levels in Enfamil EnfaCare are within the ranges specified by U.S. Food and Drug Administration regulations as mandated by the Infant Formula Act25. The sodium, potassium and chloride levels are 37 mg/100 Calories, 105 mg/100 Calories and 78 mg/100 Calories, respectively.

      Nucleotides

      The nucleotide levels in Enfamil EnfaCare are patterned after the average level of free nucleotides found in breast milk 
(28 mg/L)10-12. The level of free nucleotides in Enfamil EnfaCare is 31 mg/L.

  • Clinical Experience
    • A clinical study with Enfamil formulas with DHA and ARA‡‡, which included Enfamil EnfaCare, demonstrated that Enfamil formulas with DHA and ARA promote growth and are well tolerated and safe for infants with conditions such as prematurity or low birth weight. In addition, premature infants fed formulas with DHA and ARA had higher scores on a test of infant development than similar infants fed the same formulas without DHA and ARA (now discontinued)1,§§.

      ‡‡ Study used Enfamil Premature, Enfamil EnfaCare and Enfamil Infant. §§ Study was conducted before the reformulation of Enfamil Premature and Enfamil EnfaCare.

      Efficacy

      Infants in this study were also evaluated with the Bayley Scales of Infant Development II at 18 months corrected age (CA)1,‡‡. Infants who received formulas with DHA and ARA achieved higher scores on both the Mental Development Index (MDI) and Psychomotor Development Index (PDI) than infants who received the same formulas without DHA and ARA1,§§.

      • 5.5-point increase on MDI (p=0.056)
      • 7.8-point increase on PDI (p<0.05)

      Mean Scores on Bayley Scales of Infant Development II at 18 months CA1,|||

      Mean Scores on Bayley Scales of Infant Development II at 18 months CA

      ‡‡ Study used Enfamil Premature, Enfamil EnfaCare and Enfamil Infant. §§ Study was conducted before the reformulation of Enfamil Premature and Enfamil EnfaCare. |||| From a randomized, double-blind, multicenter trial involving 245 VLBW infants. Some infants in this study were fed formulas supplemented with DHA from a fish source, but data are not shown in the graph.

      Growth

      Premature infants who received Enfamil formulas with DHA and ARA (Enfamil Premature, Enfamil EnfaCare and Enfamil Infant) grew well. In a randomized, double-blind, prospective, multi-center trial, very low-birth-weight infants were assigned to one of 3 formula groups: formulas with no DHA and ARA; formulas with DHA from fish oil and ARA from single-cell oil; or formulas with DHA and ARA from single-cell oils. Each formula group included a premature formula (24 Calories/fl oz), a nutrient-enriched, discharge formula (22 Calories/fl oz) and a term formula (20 Calories/fl oz). The investigators involved in the study chose when each formula type (premature, discharge or term formula) was fed to the infants. Assigned DHA and ARA levels and sources were maintained in each type of formula. Formulas were the only source of diet until 4 months CA and were fed with beikost until 12 months CA. Between 12 months CA and 18 months CA, infants were fed diets determined by their parents. Term infants (n=105) who were to receive breast milk for 4 months served as a reference group. The study found that the group of infants that received premature, discharge and term formulas with DHA and ARA from single-cell oils had significantly greater achieved weight from 6 through 18 months CA when compared to infants who received formula without DHA and ARA. The weight of the infants in the group fed formula with single-cell DHA and ARA was comparable to that of full-term breastfed infants at 18 months CA. Infants in this group also had a significantly greater achieved length at 2, 9 and 12 months CA than infants who received the same formula without DHA and ARA (now discontinued)1,§§.

      §§ Study was conducted before the reformulation of Enfamil Premature and Enfamil EnfaCare.

      Growth of Premature Infants Fed Enfamil Infant Formulas1,§§

      Growth of Premature Infants Fed Enfamil Infant Formulas

      ** P<0.05 for breastfed full-term infants vs all preterm groups. †† No significant difference (P>0.05) for Enfamil Infant formulas with DHA and ARA vs breastfed, full-term infants, but P<0.05 for Control formulas without DHA and ARA vs breastfed, full-term infants. ‡‡ P<0.05 for Control formulas without DHA and ARA vs Enfamil Infant formulas with DHA and ARA.

      From a randomized, double-blind, multicenter trial involving 245 VLBW infants and 105 breastfed, full-term infants. Some infants in this study were fed formulas supplemented with DHA from a fish source, but data are not shown in the graph.

      §§ Study was conducted before the reformulation of Enfamil Premature and Enfamil EnfaCare.

      Safety and Tolerance

      In the study described above, formulas with DHA and ARA were well tolerated by premature infants. The addition of DHA and ARA to formulas had no effect on the incidence of adverse events1,§§. The sources of DHA and ARA in Enfamil EnfaCare are Generally Recognized as Safe (GRAS) for use in infant formula by the U.S. Food and Drug Administration28,29.

      §§ Study was conducted before the reformulation of Enfamil Premature and Enfamil EnfaCare.

  • References
    • 1. Clandinin MT, Van Aerde JE, Merkel KL, et al. Growth and development of preterm infants fed infant formulas containing docosahexaenoic acid and arachidonic acid. J Pediatr. 2005;146:461–468.

      2. Birch EE, Hoffman DR, Uauy R, et al. Visual acuity and the essentiality of docosahexaenoic acid and arachidonic acid in the diet of term infants. Pediatr Res. 1998;44:201–209.

      3. Birch EE, Garfield S, Hoffman DR, at al. A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants. Dev Med Child Neurol. 2000;42:174–181.

      4. Birch EE, Hoffman DR, Castañeda YS, et al. A randomized controlled trial of long-chain polyunsaturated fatty acid supplementation of formula in term infants after weaning at 6 wk of age. Am J Clin Nutr. 2002;75:570–580.

      5. Hoffman DR, Birch EE, Castañeda YS, et al. Visual function in breast-fed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months: a randomized clinical trial. J Pediatr. 2003;142(6):669–677.

      6. Hoffman DR, Birch EE, Castaneda YS, et al. Maturation of visual and mental function in 18-month-old infants receiving dietary long-chain polyunsaturated fatty acids [abstract]. FASEB J. 2003;17:A727–A728. Abstract 445.1.

      7. Hoffman DR, Birch EE, Birch DG, et al. Impact of early dietary intake and blood lipid composition of long-chain polyunsaturated fatty acids on later visual development. J Pediatr Gastroenterol Nutr. 2000;31:540-553.

      8. Birch EE, Castañeda YS, Wheaton DH, et al. Visual maturation of term infants fed long-chain polyunsaturated fatty acid-supplemented or control formula for 12 mo. Am J Clin Nutr. 2005;81:871-879.

      9. Morale SE, Hoffman DR, Castañeda YS, et al. Duration of long-chain polyunsaturated fatty acids availability in the diet and visual acuity. Early Hum Dev. 2005;81:197-203.

      10. Brenna JT, Varamini B, Jensen RG, et al. Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr. 2007;85:1457-1464.

      11. Kunz C, Lönnerdal B. Re-evaluation of the whey protein/casein ratio of human milk. Acta Paediatr. 1992;81:107-112.

      12. Fomon SJ, Ziegler EE. Renal solute load and potential renal solute in infancy. J Pediatr. 1999;134:11-14.

      13. Data on file, Mead Johnson Nutritionals, March 1998.

      14. Fomon SJ, Ziegler EE. Renal solute load and potential renal solute in infancy. J Pediatr. 1999;134:11-14.

      15. Klein CJ. Nutrient requirements for preterm infant formulas. J Nutr. 2002;132(suppl):1395S-1577S.

      16. Assessment of nutrient requirements for infant formulas. J Nutr. 1998;128:i-iv, 2059S-2293S.

      17. National Academy of Sciences. Dietary Refernce Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press; 2005.

      18. Bach AC, Babayan VK. Medium-chain triglycerides: an update. Am J Clin Nutr. 1982;36:950-962.19. Innis SM, Adamkin DH, Hall RT, et al. Docosahexaenoic acid and arachidonic acid enhance growth with no adverse effects in preterm infants fed formula. J Pediatr. 2002;140:547–554.

      19. Innis SM, Adamkin DH, Hall RT, et al. Docosahexaenoic acid and arachidonic acid enhance growth with no adverse effects in preterm infants fed formula. J Pediatr. 2002;140:547–554.

      20. Brenna JT, Varamini B, Jensen RG, et al. Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr. 2007;85:1457-1464.

      21. Koletzko B, Poindexter BB, Uauy R (eds). Nutritional Care of Preterm Infants: Scientific Basis and Practice Guidelines. World Rev Nutr Diet. Basel, Karger. 2014;110:1-314.

      22. Agostoni C, Buonocore G, Carnielli VP, et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50:85-91.22. The British Nutrition Foundation. Recommendations for intake of unsaturated fatty acids. In: Unsaturated Fatty Acids: Nutritional and physiological significance: The Report of the British Nutrition Foundation's Task Force. London: Chapman & Hall, 1992;152-163.

      23. Simopoulos AP, Leaf A, Salem N Jr. Workshop on the essentiality of and recommended dietary intakes for omega–6 and omega–3 fatty acids. J Am Coll Nutr. 1999;18:487-489.

      24. Koletzko B. et al. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations J. Perinat Med 2008;36:5-14

      25. Nutrient Requirements for Infant Formulas. Code of Federal Regulations 21, C.F.R. 107.100. April 1, 2006.

      26. Data on file, Mead Johnson Nutritionals, October 2005.

      27. Jensen RG, ed. Handbook of Milk Composition. San Diego, Calif: Academic Press;1995.

      28. U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition web site. Agency response letter GRAS Notice No. GRN 000041. available at: http://www.cfsan.fda.gov/~rdb/opa-g041.html. Accessed April 19, 2007.

      29. U.S. Food and Drug Administration Center for Food Safety and Applied Nutrition web site. Agency response letter GRAS Notice No. GRN 000080. available at: http://www.cfsan.fda.gov/~rdb/opa-g080.html. Accessed April 19, 2007.

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