For feeding a pancreatic insufficient CF infant, which option is NOT indicated unless another medical reason exists?

• A. Protein hydrolysate formula with MCT
• B. Human milk
• C. Standard formula with enzymes
• D. Free amino acid formula with MCT

Answer: (A)

In pancreatic insufficiency, the focus is on ensuring adequate fat digestion with pancreatic enzyme replacement and using feeds that don’t add unnecessary complications. Human milk is preferred when possible, and a standard formula with enzymes is a common, appropriate choice to meet energy and nutrient needs. The use of formulas that pre-digest protein—whether protein hydrolysate or free amino acid-based—is reserved for specific, non-pancreatic conditions such as protein allergy or intolerance, or other metabolic issues. Therefore, a protein hydrolysate formula with MCT is not indicated for a pancreatic insufficient CF infant unless there’s another medical reason (like cow’s milk protein allergy) to justify it. The other options are more routinely considered in CF infants with pancreatic insufficiency, with enzymes added as needed.