{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:43:15Z","timestamp":1766518995688,"version":"3.48.0"},"reference-count":17,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Inadequate caloric intake is a common cause of faltered growth in infants. When investigating an infant with faltered growth, it is important to ensure recommended feeding volumes. Both overdiluted and underdiluted milk formula are common when mixing milk formula. In recent years, automated formula dispensers have been available to facilitate the preparation of milk formula. Our case illustrates a preterm infant who presented with faltered growth in combination with brief apnoea and hypothermia. After clinical examination, investigation and history taking, it was concluded that the faltered growth was a result of underdiluted milk formula produced by an automated formula dispenser. Our case report aims to raise awareness regarding the potential risk of faltered growth when using an automated milk formula dispenser. Hence, encouraging healthcare professionals to improve the history taking when investigating an infant with faltered growth, as well as informing caregivers that using a milk formula dispenser is not infallible.<\/jats:p>","DOI":"10.1136\/bcr-2025-268301","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:40:29Z","timestamp":1766518829000},"page":"e268301","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Growth faltering in a preterm infant associated with inaccurate formula preparation by an automated formula dispenser"],"prefix":"10.1136","volume":"18","author":[{"given":"Lisa","family":"Nobel","sequence":"first","affiliation":[{"name":"Sachs' Children and Youth Hospital, S\u00f6dersjukhuset, Region Stockholm, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8832-6918","authenticated-orcid":false,"given":"Stefan","family":"Johansson","sequence":"additional","affiliation":[{"name":"Sachs' Children and Youth Hospital, S\u00f6dersjukhuset, Region Stockholm, Stockholm, Sweden"},{"name":"Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"Lundberg","sequence":"additional","affiliation":[{"name":"Sachs' Children and Youth Hospital, S\u00f6dersjukhuset, Region Stockholm, Stockholm, Sweden"},{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"2025122311401969000_18.12.e268301.1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12468"},{"key":"2025122311401969000_18.12.e268301.2","first-page":"597","article-title":"Growth Faltering and Failure to Thrive in Children","volume":"107","author":"Goodwin","year":"2023","journal-title":"Am Fam Physician"},{"key":"2025122311401969000_18.12.e268301.3","unstructured":"World Health Organization . Global nutrition targets 2025: breastfeeding policy brief. Geneva: WHO; 2014. Available: https:\/\/www.who.int\/publications\/i\/item\/WHO-NMH-NHD-14.7"},{"key":"2025122311401969000_18.12.e268301.4","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003642"},{"key":"2025122311401969000_18.12.e268301.5","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/MPG.0000000000002234","article-title":"Breastfeeding Rates and Programs in Europe: A Survey of 11 National Breastfeeding Committees and Representatives","volume":"68","author":"Theurich","year":"2019","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2025122311401969000_18.12.e268301.6","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2018-2525","article-title":"Mixed Message on Formula Mixing","volume":"143","author":"Wilkinson","year":"2019","journal-title":"Pediatrics"},{"key":"2025122311401969000_18.12.e268301.7","doi-asserted-by":"publisher","DOI":"10.1136\/adc.88.10.855"},{"key":"2025122311401969000_18.12.e268301.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1996.tb14164.x"},{"key":"2025122311401969000_18.12.e268301.9","doi-asserted-by":"crossref","first-page":"42","DOI":"10.3390\/ijns6020042","article-title":"Expanded Screening of One Million Swedish Babies with R4S and CLIR for Post-Analytical Evaluation of Data","volume":"6","author":"S\u00f6rensen","year":"2020","journal-title":"Int J Neonatal Screen"},{"key":"2025122311401969000_18.12.e268301.10","unstructured":"National Guideline Alliance (UK) . Faltering growth \u2013 recognition and management. London National Institute for Health and Care Excellence (NICE); 2017."},{"key":"2025122311401969000_18.12.e268301.11","doi-asserted-by":"crossref","DOI":"10.3389\/fnut.2024.1385496","article-title":"Variability and error in measurement of infant formula powder and water: an experimental study","volume":"11","author":"Rosenkranz","year":"2024","journal-title":"Front Nutr"},{"key":"2025122311401969000_18.12.e268301.12","article-title":"Salt Poisoning Due to Inadequate Infant Formula Preparation: A Rare Cause of Hypernatremia and Massive Cerebral Hemorrhage in a Newborn","volume":"14","author":"Kakoo Brioso","year":"2022","journal-title":"Cureus"},{"key":"2025122311401969000_18.12.e268301.13","doi-asserted-by":"crossref","DOI":"10.1111\/mcn.13567","article-title":"The safety of at home powdered infant formula preparation: A community science project","volume":"20","author":"Grant","year":"2024","journal-title":"Matern Child Nutr"},{"key":"2025122311401969000_18.12.e268301.14","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.3390\/nu12041150","article-title":"Modifications to Infant Formula Instructions Improve the Accuracy of Formula Dispensing","volume":"12","author":"Gilmore","year":"2020","journal-title":"Nutrients"},{"key":"2025122311401969000_18.12.e268301.15","first-page":"D8220","article-title":"Automatic formula dispensers, relief or risk?","volume":"169","author":"Bel","year":"2025","journal-title":"Ned Tijdschr Geneeskd"},{"key":"2025122311401969000_18.12.e268301.16","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1177\/00099228221139539","article-title":"Failure to Thrive: A Modern Recipe for Success","volume":"62","author":"Lucas","year":"2023","journal-title":"Clin Pediatr (Phila)"},{"key":"2025122311401969000_18.12.e268301.17","unstructured":"N S. Baby Brezza, a $200 formula maker, may pose health risks to infants. The New York Times; 2020."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T19:40:31Z","timestamp":1766518831000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":17,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,23]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-268301"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268301","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}