3232 A Protein Hydrolysate Formula for Infants & Children

3232 A is a Protein Hydrolysate Formula developed for infants and children with disaccharidase deficiencies or other disorders of carbohydrate metabolism. This Protein Formula is to be used with added carbohydrate. Manufactured by Mead Johnson, 3232 A Protein Hydrolysate Formula is a powder formula that comes ready-to-mix. The contents of 3232A are in a handy 1 pound can. Containing tapioca starch, 3232 A Protein is a protein hydrolysate formula for dietary management of carbohydrate metabolism disorders.

Two investigator groups reported on the use of the product. Ten patients with intractable diarrhea who could not tolerate other available formulas received the product while hospitalized. Two of the 10 infants also used the product after discharge. The investigators reported that weight gain for the infants taking 3232 A with added carbohydrate was comparable to that of normal infants. They concluded that 3232 A was valuable in the dietary management of infants with intractable diarrhea. The second group reported on an infant with protracted diarrhea who could not tolerate glucose polymers. The investigators reported that the infant thrived on 3232 A plus glucose for several months following hospital discharge.

3232 A Protein Hydrolysate Formula Features & Benefits

• Allows adjustment of added carbohydrate according to patient's tolerance.
• Hypoallergenic, protein hydrolysate.
• 85% of the fat from medium-chain triglycerides (MCT) oil.
• Protein supplement for dietary management of carbohydrate metabolism disorders.

3232 A Protein Hydrolysate Formula Specifications

• 3232 A Protein Formula Product Number: 042521.
• Size: 1 Pound.
• Container: Can.
• Calories Per Serving: 100.
• Application: Medical Food for Carbohydrate Metabolism Disorders.
• Protein Hydrolysate.
• Hypoallergenic.
• Manufacturer: Mead Johnson.
• UNSPSC Code: 42231803.
• HCPCS Code: B4161.

3232 A Protein Supplement Ingredients

Modified tapioca starch (35%), medium-chain triglycerides (MCT) oil (28%), casein hydrolysate (from milk)¹ (27%), corn oil (5%) and less than 2%: vitamin A palmitate, vitamin D3, vitamin E acetate, vitamin K1, thiamin hydrochloride, riboflavin, vitamin B6 hydrochloride, vitamin B12, niacinamide, folic acid, calcium pantothenate, biotin, sodium ascorbate, choline chloride, inositol, calcium citrate, calcium hydroxide, calcium phosphate, magnesium oxide, ferrous sulfate, zinc sulfate, manganese sulfate, cupric sulfate, sodium chloride, sodium iodide, potassium citrate, potassium phosphate, soy lecithin, L-cystine, L-tyrosine, L-tryptophan, taurine, L-carnitine.

¹Modified to be better tolerated in milk-allergic babies.

3232 A Protein Supplement Nutrition

	Per 100 Calories(5 fl oz)	Per 100 grams Powder (500 Cal)
Protein, g	2.8	22
Fat, g	4.2	33
Linoleic acid, mg	340	2700
Carbohydrate, g	13.4	33
Water, g	127	3

	Per 100 Calories(5 fl oz)	Per 100 grams Powder (500 Cal)
Vitamins/Other Nutrients
Vitamin A, IU	380	3000
Vitamin D, IU	75	590
Vitamin E, IU	3.8	30
Vitamin K, mcg	18.8	148
Thiamin (Vitamin B1), mcg	78	610
Riboflavin (Vitamin B2), mcg	94	740
Vitamin B6, mcg	63	490
Vitamin B12, mcg	0.31	2.5
Niacin, mcg	1250	9800
Folic acid (Folacin), mcg	15.6	123
Pantothenic acid, mcg	470	3700
Biotin, mcg	7.8	61
Vitamin C (Ascorbic acid), mg	11.7	92
Choline, mg	13.3	105
Inositol, mg	4.7	37

	Per 100 Calories(5 fl oz)	Per 100 grams Powder (500 Cal)
Minerals
Calcium, mg	94	740
Phosphorus, mg	63	490
Magnesium, mg	10.9	86
Iron, mg	1.88	14.8
Zinc, mg	0.63	4.9
Manganese, mcg	31	250
Copper, mcg	94	740
Iodine, mcg	7	55
Selenium, mcg	NA	NA
Sodium, mg	43	340
Potassium, mg	109	860
Chloride, mg	86	680

• * Product nutrient values and ingredients are subject to change. Please see product label for current information.
• Using 81 grams of 3232 A and 59 grams of carbohydrate per quart of prepared product.
• Values do not include added carbohydrate.
• Care must be taken to provide essential fatty acids and sufficient carbohydrates.
• NA = None Added

Nutrient Density	Prepared with 59 grams added carbohydrate at 20 Calories/fl oz	Prepared with no carbohydrate at 12.7 Calories/fl oz
Protein (% Calories)	11	18
Fat (% Calories)	35	55
Carbohydrate (% Calories)	54	27
Potential Renal Solute Load (mOsm/100 Calories)1	25	40
Potential Renal Solute Load (mOsm/100 mL)1	16.9	16.9
Lactose-Free		| Yes | Yes
Ga lactose-Free		| Yes | Yes

|| Prepared product is lactose- and ga lactose-free as no lactose or ga lactose are added.

3232 A Protein Preparation

• The child's health depends on carefully following these instructions. Use only as directed by a medical professional. Improper hygiene, preparation, dilution, use or storage may result in severe harm. Powdered formulas are not sterile and should not be fed to premature infants or infants who might have immune problems unless directed and supervised by a doctor.

Discuss with parents whether they need to use cooled, boiled water for mixing and whether they need to boil clean utensils, bottles, and nipples in water before use.
Parents should consult their child's doctor for instructions for the correct amounts of water and powder. Pour desired amount of water into the bottle. Add powder, cap and shake vigorously.

Powder

• Wash hands thoroughly with soap and water before preparing formula.
• Add 81 g of powder (packed, level 1/2 cup) and 59 g of the desired carbohydrate to 4 fl oz (120 mL) of water in a clean bottle or container.
• Mix well with fork or mixer until a smooth paste is formed.
• Add additional water to make one quart. Initial feedings of 3232 A may need to contain less than the full 59 g of carbohydrate recommended or the formula may need to be diluted to 10 Calories/fl oz or less and gradually increased to 20 Calories/fl oz.
• If incremental addition of carbohydrate is desired, consult Table 1.

Table 1

Incremental Addition of Carbohydrate (CHO) to 3232 A
Added CHO per 100 mL#**	(g)	0	0.1	1.2	2.1	3.2	4.1	5.2	6.1	6.2
Total CHO per 100 mL#	(g)	2.8	3	4	5	6	7	8	9	9.1
CHO to add per Quart	(g)	0	1	11	20	30	39	49	58	59
Total CHO per Quart of Prepared Formula	(g)	27	28	38	47	57	66	76	85	86
Calories/fl oz of Prepared Formula		12.7	12.8	14	15.2	16.4	17.5	18.8	19.9	20

# g of CHO per 100 mL = approximate % (weight volume) CHO concentration.
** Values are for added CHO (does not include modified tapioca starch present in the diet powder).
Includes added CHO and modified tapioca starch (stabilizer) present in the diet powder.
Prepared formula includes 81 g diet powder, the added carbohydrate and water added to make one quart.

Failure to follow these instructions could result in severe harm. Once prepared, formula can spoil quickly. Either feed immediately or cover and store in refrigerator at 35-40 degreesF (2-4 degreesC) for no longer than 24 hours. Do not use prepared formula if it is unrefrigerated for more than a total of 2 hours. Do not freeze prepared formula. After feeding begins, use within 1 hour or discard.

Powder Storage (cans)

Store cans at room temperature. After opening can, keep tightly covered, store in dry area and use contents within 1 month. Do not freeze powder and avoid excessive heat. Use by date on bottom of can.

CAUTION: Nutritional powders are not sterile. 3232 A is nutritionally incomplete. Care must be taken to provide enough carbohydrate to support growth. Use other foods with 3232 A as required. If used long term, supplementation of essential fatty acids should be considered. To be used only under the supervision of a doctor.

WARNING: Do not use a microwave oven to warm formula. Serious burns may result. Not for parenteral (I.V.) use.

3232 A Protein Supplement Additional Information

• Fomon SJ, Ziegler EE. Renal solute load and potential renal solute load in infancy. J Pediatr. 1999;134:11-14.
• Fisher SE, Leone G, Kelly RH. Chronic protracted diarrhea: intolerance to dietary glucose polymers. Pediatrics. 1981;67:271-273.
• Bobo RC, Groothuis JR. 3232 A Formula for the management of intractable diarrhea of infancy (IDI). [abstract] Presented at the American College of Nutrition Annual Meeting. November 1, 1980.