Additional increases
in the caloric density of formulae should be made
gradually (e.g. in increments of 3 kcal/30 ml) with
modular supplements (glucose polymers, medium
chain triglycerides) to a maximum of 100 kcal/
100 ml. In this setting, the prescriber should be
certain that individual nutrients are not provided in
excessive amounts. The addition of carbohydrate or
fat to infant formulae alters the nutrient ratio of the
formula by providing no protein calories [37, 38].
Care should be taken to avoid providing more than
60 percent of energy from fat, which may induce
ketosis.