IDDSI flow characteristics of paediatric formulas prepared with a maltodextrin/carob gum thickener in Türkiye

Objective: This study evaluated IDDSI syringe-flow behaviour of paediatric formulas in Türkiye under laboratory conditions when prepared with a maltodextrin/carob‑gum thickener commonly used locally and is marketed for reflux. Findings concern IDDSI flow under laboratory conditions and do not constitute clinical recommendations. Methods: Fifteen commercial paediatric formulas (5 powdered, 10 liquid) were prepared with the thickener at 1.7 g/100 mL using a 7-minute rest protocol. The IDDSI syringe flow test (10 mL, 10 s) was performed at 0, 7, 15, 30, and 45 minutes. Two independent researchers assessed flow; inter-rater reliability was evaluated. Preparation water was 37–38 °C; testing occurred under standard room conditions; samples were covered between timepoints. Linear regression examined potential associations between thickening success, formula type, and macronutrient content. Results: At baseline, all formulas were classified as IDDSI Level 0. After 45 minutes, 8 of the 15 formulas (53%) reached IDDSI Level 1 or higher. A higher percentage of liquid formulas (60%) thickened successfully compared to powdered formulas (40%), although this difference was not statistically significant. The thickness level increased significantly over time (p < 0.001), but the regression model revealed no significant associations between thickening success and formula type or macronutrient composition (p > 0.05). Conclusion: Under these standardised laboratory conditions, fewer than half of tested formulas reached IDDSI Level 1 with this maltodextrin/carob-gum thickener. Outcomes varied by product and were not predictable from nutritional content or formula type. Product-specific testing is warranted, and clinical studies are required before informing practice.