Donna, a nurse in my NICU, recently mentioned to me that she often hears from parents after their baby's NICU stay that the pediatricians they see do not seem to know very much about infant formulas. This issue arises when the formerly preterm infants of these parents have feeding or gastrointestinal problems such as reflux, colic, possible allergies, constipation, diarrhea, gas, or growth problems, and they seek help from their infants' pediatricians.

Apparently Donna, and the parents she talks to, are right about this. Two researchers from The Children's Hospital at Monmouth Medical Center in New Jersey assessed the familiarity of pediatricians with commercially available formulas.1 Using a survey, they asked pediatricians to indicate their familiarity with widely available and specialized formula with regard to protein and carbohydrate sources, energy content, hypoallergenicity, and indication for infant colic. The respondents answered an average of 46% of the questions correctly. Pediatricians who participated in the study were very familiar with 27% of the formulas and unfamiliar with 35%.

The study authors concluded that pediatricians have a poor understanding of the content and appropriate use of neonatal and infant formulas.1 This information has implications for discharge planning of preterm infants. Nurses should provide parents with resource material about infant formulas rather than assuming that they will receive guidance from their pediatricians. Magazines and Web sites for parents of preterm infants are other good sources of information about formulas and feeding problems.

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