[Literature library] High sn-2 palmitate infant formula and gastrointestinal (GI) tolerance


This observational study highlights the remarkable improvement in stool characteristics and gastrointestinal (GI) tolerance of healthy-term infants with a high sn-2 palmitate infant formula.

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Study Design

  • Multicenter, open-label, observational study of healthy-term infants aged between 2 and 12 weeks in the Kingdom of Saudi Arabia (KSA) and the United Arab Emirates (UAE)


  • Healthy-term infants (n = 227) prescribed a high sn-2 palmitate infant formula and received at least 2 feedings per day for the past 2 weeks prior to the study

Study Duration and Key Measurements

  • From baseline to 12 weeks after enrollment  
  • Clinic visits were conducted at enrollment, weeks 4 and 12
  • Parents were trained to fill the Amsterdam stool form scale and a diary


Stool characteristics (baseline versus week 12),

  • The median number of stools per day reduced from 4 to 3 (p = 0.015)
  • The percentage of hard stool decreased from 17.4% to 0.4% (p < 0.001)
  • Infants tended to have a higher stool amount at the end
    • At baseline, 56.5% of the infants had a stool amount of 25-50% of the diaper, while 16.3% had a stool amount of 25% of the diaper
    • At week 12, 61.2% of the infants had a stool amount of 25-50% of the diaper, while 33.7% had a stool amount greater than 50% of the diaper
  • Percentages of pale yellow, green, and black stools declined (p < 0.001)

GI symptoms (baseline versus week 12),

  • Incidence of colic and abdominal distension declined from 21.4% and 39.9% to 2.9% and 9.4% respectively (p < 0.05)
  • Improved regurgitation score
    • The percentage of infants without regurgitation changed from 54.7% at baseline to 83.7% at week 12 (p < 0.05)

Growth parameter (baseline versus week 12),

  • Weight, hip/waist ratio and head circumference increased significantly


  • Well tolerated with a low rate of adverse effects

Acceptability of parents and pediatricians,

  • Most parents and pediatricians rated good-to-excellent tolerability


  • Infant formula with a high sn-2 palmitate content may help with GI tolerance and stool characteristics in formula-fed infants
  • It is tolerable and safe for non-breastfed healthy infants

Link to the full article:


Possner M et al. Acceptability of “high sn-2” infant formula in non-breast fed healthy term infants regarding gastrointestinal tolerability by both parents and pediatrician: an open-label pilot study in the Gulf Cooperation Council (GCC) countries. Pediatric Reports. 2021; 13(4):639-649.

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