Medium-chain triglyceride（MCT） remains a key component of supplementation in cholestasis. The limited data point to improved growth in cholestatic infants fed with a ratio of MCT/ long-chain triglyceride (LCT) supplementation of 30% to 70% (MCT/LCT mix). It is important to highlight that MCTs are less efficient fuel sources, as MCTs contain fewer kilocalories per gram than LCTs (8.3 kcal/g MCT vs 9 kcal/g LCT), increase total energy expenditure, and are not a source of essential fatty acids. For this reason, a diet of exclusive MCT lipids (>80%, or lower in severe cholestasis) increases the risk of Essential Fatty Acid Deficiency and may contribute to suboptimal weight gain. Supplementation of the diet with MCT may be offered in the form of both MCT supplementation and MCT-containing formulas. it should be noted that while the practice of enriching the diet with MCT oils in the clinical setting is commonplace, a trial comparing MCT to LCT supplementation has never been performed in pediatric cholestasis. A total of 300 infants with Congenital Biliary Atresia after Kasai Portoenterostomy will be enrolled ( randomly divided 150 in the experimental group and 150 in the control group). To evaluate the efficacy, safety, and tolerance of MCT supplementation with breast milk and formula compared with high MCT formula.
This study is a prospective, single-center, randomized controlled, parallel, and open clinical study.