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    William J. Klish, M.D., is Professor of Pediatrics, Head of Pediatric Gastroenterology at Baylor College of Medicine and Chief of the Nutrition and Gastroenterology Department at Texas Children's Hospital in Houston. Dr. Klish has served as chair of the Committee on Nutrition of the American Academy of Pediatrics.

    Q: I use formula, ready to feed. When I take it from the refrigerator, is it necessary to warm it up? My baby seems to prefer it cold, but will this cause any problems?

    A: The temperature of a formula should have no effect on its nutritional value. The tradition of warming formula probably developed to make infant formula more similar to breast milk, which of course is served warm. However it is not unusual for babies to adapt to a formula served cold. However, cold formula might not be tolerated in babies with reflux. The stomach tends to hold ingested material until it is approximately body temperature before releasing it into the intestine. This slower release of formula could possibly make reflux or spitting worse in babies that already have this problem.

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