Feed modification for increased energy and protein density as nutrition therapy in critically ill children: A protocol for a scoping review

Jacinta Winderlich, Bridget Little, Alice Anderson, Felix Oberender, Andrew A. Udy, Emma J. Ridley

Research output: Contribution to journalArticleOtherpeer-review


Background and aims: Meeting the nutritional requirements of critically ill infants and young children with breastmilk or formula alone is often challenging due to disease-related increased requirements and fluid restriction. ‘Feed modification’ is a nutrition therapy strategy to increase energy and protein density, and includes fortification of expressed breast milk, preparation of standard powdered formula at an increased concentration and utilisation of concentrated ready-to-feed liquid formulas. However, despite anecdotal evidence suggesting frequent and varied use internationally, the evidence for feed modification is unclear and has not been reviewed systematically. This article describes the methods for a scoping review to collate the key definitions, concepts, methods and evidence for use of modified feeds for increased energy and protein density as nutrition therapy in critically ill children. Methods: A scoping review will be completed, including searches of MEDLINE, Embase, Emcare and CINAHL databases. Grey literature will be searched using ProQuest, Web of Science, Trove Australian theses, WorldCat Dissertations and Theses, EThOS, Dart European and conference collections via Ovid. Study selection and data charting will be undertaken by two reviewers. Results of this review will be presented in a tabular format and include frequency counts. Literature related to use of feed modification for increased energy and protein density in children up to the age of 5 years from the year 2010 to present and in English language only will be included. This review will be the first of its kind and of interest to all areas of paediatrics utilising feed modification for increased energy and protein density.

Original languageEnglish
Pages (from-to)13-19
Number of pages7
JournalClinical Nutrition Open Science
Publication statusPublished - Dec 2022


  • Dietary energy
  • Fortification
  • Modified feed
  • Nutrition
  • Pediatric critical care
  • Scoping review

Cite this