A lactose-free, medium-chain triglyceride (MCT)-casein formula (Lactose-Free Portagen) was used with success gen) the management of four children with kwashiorkor and three infants with persistent hypoalbuminemia, two of whom had associated infections. A second formula (Pregestimil), based on a casein hydrolysate and MCTs, with dextrose as the major carbohydrate, was used successfully in five infants with severe marasmus, one with kwashiorkor, and five with marasmus, severe diarrhea, and infection. The absence of lactose was of definite benefit, as was probably the MCT content. It is probable that the dextrose was of benefit to some of the sickest infants but this was not proved in these studies.
Graham GG, Baertl JM, Cordano A, Morales E. Lactose-Free, Medium-Chain Triglyceride Formulas in Severe Malnutrition. Am J Dis Child. 1973;126(3):330-335. doi:10.1001/archpedi.1973.02110190292008