Peptamen Junior Definition Indications PEPTAMEN JUNIOR is a

Peptamen Junior: Definition , Indications PEPTAMEN JUNIOR® is a nutritionally complete peptide based formula specifically designed to deliver nutritional benefits to fragile and difficult to feed paediatric patients aged 1 -10 year old. MALDIGESTION/ MALABSORPTION Hypoalbuminemia, Cystic fibrosis, Intractable diarrhea, Malabsorption related to cancer treatment (Radiation Enteritis), HIV/AIDS Short bowel syndrome, Crohn's disease, Ulcerative Colitis, Pancreatitis, radiation enteritis, Transpalent patients. DELAYED GASTRIC EMPTYING / GASTROESOPHAGEAL REFLUX (GER) Feeding disorders ( Cerebral Palsy, . . ) Volum/fluid restrictions FEEDING INTOLERANCE GROWTH FAILURE CRITICAL ILLNESS (TRAUMA, BURNS, SEPSIS. . ) PICU EARLY ENTERAL FEEDING AND TRANSITION FROM TPN TO EN 1

Key Features of Product Formulation ENERGY MICRONUTRIENTS • Isocaloric, with 1. 0 kcal/ml at standard reconstitution, can be diluted up to 2 kcal/ml • 1000 -2000 ml meets the nutritional needs of most children (age 1 -10 years old). • Energy distribution tailored to the needs of children. PROTEIN • 12% of energy as protein. ( 100% Hydrolyzed Whey Protein) • A moderate level that meets the protein needs of a wide range of paediatric patients without overloading the kidneys. FAT • 33% kcal as lipid, with 60% MCT and 40% LCT • Designed to optimize tolerance in malabsorption, while meeting essential fatty acid needs for growth. • MCT contributes to the low osmolality of Peptamen Junior • n-6: n-3 = 7. 6: 1 CARBOHYDRATE • 55% kcal as carbohydrates as maltodextrin, potato starch and sucrose for ease of absorption • Clinically lactose free , Gluten Free • Low osmolatity due to the moderate chain length of. • Maltodextrin, promoting gastrointestinal tolerance. 2

Key Features of Product Formulation MICRONUTRIENTS AND FLAVOR Meet or exceeded the micronutrients ( Vitamin, Mineral, & trace element) for most children (100% US DRI) in: • 1000 kcal (ages 1 -3 y), • 1500 kcal (age 4 -8 y) • 2000 kcal for up to 10 y. • PEPTAMEN JUNIOR has a light vanilla flavor that is pleasing for oral consumption. • Easy to mix, allowing reconstitution at various caloric to mix densities without a blender to reduce the risk of contamination and provide a flexible nutritional support. contamination provide a flexible nutritional support • Low Osmolarity for excellent tolerance. It is powdered and appropriate for both oral and tub feeding 3

® Support Growth and the Entire GI System PEPTAMEN JUNIOR Gut Integrity • • • Balanced peptide profile Normal Nutrient Absorption Barrier between pathogens (bacteria, viruses) and antigens Stomach: Tolerance 100% WHEY-BASED TO FACILITATE GASTRIC EMPTYING OSMOLALITY: DESIGNED FOR TOLERANCE Gut: Absorption WHEY PEPTIDE-BASED TO ENHANCE PROTEIN ABSORPTION High quality protein Supports nitrogen retention 60 % OF MCT PROVIDES READILY AVAILABLE FUEL SOURCE MODERATE AMOUNT OF CHO 4

Key Nutritional Considerations Facilitate Gastric Emptying Decrease in gastric emptying time and episodes of regurgitation in children with spastic quadriplegia fed a whey-based diet Effects of Whey-Based Formulas on Gastric Emptying Time • 9 Children with spastic quadriplegic Cerebral Palsy and reflux • Given equal volumes of a caseinpredominant or 100% whey protein formula ü Significantly lower residual volumes on whey-based diet M Fried, V Khoshoo, et al. ; Journal of Pediatrics 1992; 16: 499 -504 5

Key Nutritional Considerations Well Tolerated in High Risk Patients Whey-Based Formulas Improve Tube Feeding Tolerance in Pediatric Burn Patients. Factors Affecting Nutritional Support Whey-Based Formula Casein-Based Formula Days to achieve goal feeding rate 8. 3 ± 5. 2 15. 4 ± 12 Incidence of diarrhea (≤ 3 loose stools/day) 0. 67 ± 1. 2 (p = 0. 03) 2. 6 ± 2. 6 56% 88% Percent of patients requiring formula hold for high gastric residuals TOLERANCE CONSIDERATIONS: • 50% LESS TIME TO REACH FEEDING GOAL WITH WHEY VS CASEIN • 75% LESS INCIDENCE OF DIARRHEA WITH WHEY VS CASEIN • 32% LESS EVENT OF GASTRIC RESIDUALS WITH WHEY VS CASEIN M Dylewski; Presented at the 5 th Annual Clinical Nutrition Week, February 2006 6

Resource Junior: Definition , Indications Resource JUNIOR® is a nutritionally complete polymerice formula specifically designed for the dietary management of undernourished children or those at risk of malnutrition aged 1 -10 year old. • • Failing to thrive Malnurished Suffering chronic illness Requiring short or long term tube feeding Increased Energy requierments Insufficient dietary intake Can be used as oral supplementation or as tube feeding, appropriate for both short and long term feeding. US DRI (2002) for healthy children Resource Junior CHO 45 -65% TEI 52% TEI Protein 5 -30% TEI 12% TEI Fat 25 -40% TEI 36 % TEI 7

Key Features of Product Formulation Growth Immune Protection Tolerance Failure to thrive Infection, diarrhoea Reflux, vomiting, diarrhoea • Energy • Protein • Lipids, including DHA • CHO • Micronutrient • Prebiotics • Probiotics • Whey protein improves antioxidant function through cysteine (rate limiting factor needed for glutathione production), thereby protecting against oxidative stress • Protein • CHO • Lipids (MCT) 8

MICRONUTRIENTS Key Features of Product Formulation ENERGY • • • 1 (1. 02) kcal/ml at standard reconstitution Powder form flexible caloric density. Can be concentrated up to 1. 5 kcal/ml Balanced energy distribution from CHO, Protein and Fat PROTEIN • 12% of energy as protein. • A moderate level that meets the protein needs of a wide range of paediatric patients without overloading the kidneys. • 50 % Whey and 50 % Casien ( High Quality Protein ) • Gluten Free FAT • 36% kcal as lipid, with 18. 5 % MCT and 5 % of Totall Energy as ESSENTISAL FATTY ACIDS • Designed to optimize tolerance while maintaining sufficient LCT to bring adequet levels of essential fatty acid needs for growth. • Added Fish oil with DHA 43 mg/l ; EPA 13 mg/l • n-6: n-3 Ratio= 5: 1 CHARBOHYDRATE • 52% kcal as carbohydrates as maltodextrin, Corn Syrup and sucrose for ease of absorption • Clinically lactose free • Moderate chain length of Maltodextrine as source of easily absorbed CHO helps to contribute to alow osmolarity. 9

Key Features of Product Formulation MICRONUTRIENTS AND FLAVOUR q contains all the necessary vitamins, nutrients and minerals to maintain growth and development according to the European FSMP regulation and US DRI recommendations. q Contains Total 30 Vitamins and Minerals q Soule Source of nutrition , Meets 24 out of 28 micronutrients for children in: • 1000 kcal (ages 1 -3 y), • 1500 kcal (age 4 -8 y) • 2000 kcal for up to 10 y. q Great tasting vanilla flavour -PRE- AND PROBIOTICS q Prebio 1 Plus= 50% Prebio 1 (70% FOS & 30% inulin) & 50% acacia gum The combination of these fibers in Resource® Junior provides a range of short (FOS), medium (inulin), and long chain (AG) prebiotic fibers and help to maintain balance of gut microbiota q 2 probiotic strains in equal proportions for complementary benefits: 50% Lactobacillus paracasei NCC 2461 (known as ST 11) 50% Bifidobacterium longum NCC 3001 (known as BB 536) At quantities that are sufficient and clinically proven to colonize the GI tract and exert functional benefits 10

Well tolerated: lactose free, gluten free, low osmolality Vanilla flavor with great taste for children Nutritionally complete. Good source of energy to increase energy intake & promote growth 50% whey for improved antioxidant status: GSH production Complete Vitamins and minerals to correct micronutrient deficiencies Essential fatty acids for development of nervous system and eyesight, with added DHA Contains high quality protein (whey and casein) to promote growth and muscle strength Well tolerated even in case of aspiration or vomiting due to whey protein Blend of pre- and probiotics (synbiotics) for improved gut health and immunity 18. 5% MCT provides quick source of energy 11

UNIT Indication ENERGY PRO Per 100 g Resource Junior undernourished , malnutrition 1 -10 Years Kcal Flexible Calori 1 -1. 5 Kcal/ml Kcal 455 KJ 1900 g 13. 1 (12 EN%) Intact 50% Casien 50% Whey g 60. 8 (52 EN%) Maltodextrine, corn syrup and sucrose. Prebio 1(Inulin+FOS) and acacia gum 63. 1 (55 EN%) Maltodextrin, corn syrup and sucrose. g g g 21. 3 ≤ 0. 4 17. 3(36 EN%) MCT Oil=18. 5 % High oleic sunflower oil, Rapeseed oil, sunflower oil, soy lecithin, 14. 2 ≤ 0. 4 16. 5(33 EN%) MCT Oil=60 % High oleic sunflower oil, Rapeseed oil, sunflower oil, soy lecithin, g g 4. 2 9. 8 8. 9 2. 6 2. 4 2. 2 0 CHO SUGARS LACTOSE Fat SATURATED MONOUNSATURATED POLYUNSATURATED FIBER, DIETERY Oligosacharidesg DHA Probiotic PER 100 g Peptamen Junior GI Compromised , Malabsorbtion, Mulnutrition 1 -10 Years Felexible Callori 1 -2 Kcal/ml 453 1894 12. 9 (12 EN %) peptide Based elemental 100% Whey g g g mg 1. 1 17. 8 Bifidobacterium longum Lactobacilus paracasei 0 0 0 12