Hypochloremic metabolic alkalosis from ingestion of a chloride-deficient infant formula

Outcome 9 and 10 years later

Michael Malloy, B. Graubard, H. Moss, M. McCarthy, S. Gwyn, P. Vietze, A. Willoughby, G. G. Rhoads, H. Berendes

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

In 1978 and 1979 two infant formulas, Neo-Mull-Soy and Cho-Free, were found to be deficient in chloride. The Centers for Disease Control received reports that hypochloremic metabolic alkalosis (HMA) had developed in 141 children as a result of exposure to these formulas. Thirty-five of these children were examined at 9 and 10 years of age and compared with a group of 32 children who were exposed to the chloride-deficient formulas but were not reported to experience HMA and a group of 61 children who received chloride-sufficient soy formulas in infancy. The control children were matched to the HMA children on sex, race, age, and maternal education. Growth characteristics, performance on the Wechsler Intelligence Scale for Children-Revised (WISC-R), the Boston Naming Test, the Rey-Osterrieth Test, the Clinical Evaluation of Language Fundamentals-Revised (CELF-R), and subtests from several other speech and language tests were compared across the groups. After adjustment for family income and the level of the father's education, significantly lower scores were observed in the HMA children on the WISC-R Arithmetic subtest (mean = 10.5) compared with the soy control children (mean = 12.0, P<.05) and on the WISC-R Coding subtest (mean= 9.0) compared with the soy control children (mean = 10.8, P<.01). All the WISC-R subtest scores were, however, within the normal range. Although no significant differences occurred on the CELF-between groups, the risk of an HMA child falling below the range expected for a standard population was increased on the CELF-R Composite Total, Receptive, and Expressive Language scores: risk ratios = 2.14, 2.14, and 3.03 respectively. Significant differences were observed between the children exposed, both HMA and non-HMA children, and the soy control children for behavioral problems as determined by the Achenbach Childhood Behavioral Checklist. It is concluded that as a group, children with documented HMA appear to have recovered from their growth failure and have normal cognitive development. They may, however, be at risk for deficits in language skills that require expressive language abilities.

Original languageEnglish (US)
Pages (from-to)811-822
Number of pages12
JournalPediatrics
Volume87
Issue number6
StatePublished - 1991
Externally publishedYes

Fingerprint

Alkalosis
Infant Formula
Chlorides
Eating
Wechsler Scales
Intelligence
Language
Accidental Falls
Language Tests
Education
Aptitude

Keywords

  • child development
  • chloride-deficient formulas
  • hypochloremic metabolic alkalosis
  • infant nutrition
  • language development
  • soy-based formulas

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Malloy, M., Graubard, B., Moss, H., McCarthy, M., Gwyn, S., Vietze, P., ... Berendes, H. (1991). Hypochloremic metabolic alkalosis from ingestion of a chloride-deficient infant formula: Outcome 9 and 10 years later. Pediatrics, 87(6), 811-822.

Hypochloremic metabolic alkalosis from ingestion of a chloride-deficient infant formula : Outcome 9 and 10 years later. / Malloy, Michael; Graubard, B.; Moss, H.; McCarthy, M.; Gwyn, S.; Vietze, P.; Willoughby, A.; Rhoads, G. G.; Berendes, H.

In: Pediatrics, Vol. 87, No. 6, 1991, p. 811-822.

Research output: Contribution to journalArticle

Malloy, M, Graubard, B, Moss, H, McCarthy, M, Gwyn, S, Vietze, P, Willoughby, A, Rhoads, GG & Berendes, H 1991, 'Hypochloremic metabolic alkalosis from ingestion of a chloride-deficient infant formula: Outcome 9 and 10 years later', Pediatrics, vol. 87, no. 6, pp. 811-822.
Malloy, Michael ; Graubard, B. ; Moss, H. ; McCarthy, M. ; Gwyn, S. ; Vietze, P. ; Willoughby, A. ; Rhoads, G. G. ; Berendes, H. / Hypochloremic metabolic alkalosis from ingestion of a chloride-deficient infant formula : Outcome 9 and 10 years later. In: Pediatrics. 1991 ; Vol. 87, No. 6. pp. 811-822.
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