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PubMed1987

A comparison of the antigenicity of soya-bean-based infant formulas.

1. The antigenicity of four soya-bean-based infant formulas (Prosobee powder, Prosobee liquid concentrate (Mead Johnson, Uxbridge, Middx), Wysoy (Wyeth, Maidenhead, Berks) and Formula S (Cow and Gate, Trowbridge, Wilts] was measured by enzyme-linked immunosorbent assays (ELISAs) specific for glycinin and beta-conglycinin. Results were compared with in vivo assessments of antigenicity using guinea-pigs, rabbits and calves. 2. The levels of antigenic glycinin and beta-conglycinin in Wysoy and Formula S were below the limits of detection of the ELISA. Both these proteins were detected in Prosobee powder and Prosobee liquid concentrate with the highest levels, especially for glycinin, being present in Prosobee powder. 3. Wysoy was sufficiently antigenic to evoke a soya-bean-specific serum antibody response in rabbits injected with this formula emulsified in complete Freunds adjuvant. A significantly greater response was obtained when rabbits were similarly injected with Prosobee powder. 4. The formulas varied in their ability to sensitize guinea-pigs for both anaphylaxis and antibody production when given orally, although the differences were not statistically significant. Prosobee powder appeared to be the most antigenic and Formula S the least, with Prosobee liquid concentrate and Wysoy being intermediate. 5. Similar variations in antigenicity were observed when Prosobee powder, Wysoy and Formula S were fed to soya-bean-sensitive calves. These formulas were all capable of provoking intestinal disturbances (seen as increased ileal flow-rate, decreased small intestinal transit time and decreased nitrogen absorption) but the most severe reactions were seen when Prosobee powder was fed and the least with Formula S. 6. Thus the four soya-bean-based infant formulas showed considerable differences in antigenicity. In vivo studies using guinea-pigs, rabbits and calves were in good agreement and broadly correlated with the immunochemical assessment of antigenicity. However, the in vitro and in vivo results did not correspond exactly and levels of glycinin and beta-conglycinin below the limit of detection by ELISA could evoke an immune response in the different animal species. We believe that these variations in antigenicity of different commercial products prepared from isolated soya-bean protein may be important when interpreting the results from studies of the development of allergy in infants given soya-bean-based formulas.

Anaphylaxis↗

PubMed1980

Food and Drug Administration--infant formulas; interim guidelines for nutrient composition; notice to manufacturers, packers, and distributors. Notice.

The Food and Drug Administration (FDA) is announcing in this notice a statement of policy concerning interim guidelines for the nutrient composition and nutrient levels in infant formulas. The recommendations on standards for nutrient levels in infant formulas made by the Committee on Nutrition of the American Academy of Pediatrics in 1976 should be followed by infant formula manufacturers as interim guidelines until revision in the existing infant formula nutrient composition regulation (21 CFR 105,65) is completed.

Food Labeling↗

PubMed2005

A case of infant botulism with a possible link to infant formula milk powder: evidence for the presence of more than one strain of Clostridium botulinum in clinical specimens and food.

Infant botulism was confirmed in a 5-month-old female by both isolation of Clostridium botulinum type B and by detection of type B botulinum neurotoxin in rectal washout and faeces. DNA fingerprinting of nine isolates from faeces yielded two different amplified-fragment length polymorphism (AFLP) patterns. C. botulinum was isolated from two of 14 food and drink items from the patient's home: C. botulinum type A was recovered from an opened container of dried rice pudding and C. botulinum type B from opened infant formula milk powder. Ten C. botulinum type B isolates from the opened infant formula yielded four AFLP patterns, two of which were indistinguishable from the clinical isolates. Fifteen unopened foods were tested and C. botulinum type B of a unique AFLP pattern was recovered from one unopened infant formula of the same batch as the opened container. It is suggested that multiple C. botulinum were present in both food and the intestine during infant botulism.

Botulinum Toxins↗

PubMed1996

alpha-Lactalbumin-enriched low-protein infant formulas: a comparison to breast milk feeding.

Tryptophan (TRP) is the limiting amino acid in low-protein infant formulas. This is mainly due to lower alpha-lactalbumin (alpha LA) content in cow's milk whey as compared with human milk protein. To study the effect of alpha LA-enrichment on the TRP supply, cross-over studies were carried out in 20 healthy infants up to 3 months of age. In this study, two protein-reduced (1.3%) infant formulas (moderate TRP content of 1.88% and higher TRP content of 2.10%) were alternately fed over a 2 week period in two groups of infants. Serum TRP levels of the formula-fed infants with the higher TRP content did not differ significantly from an exclusively breastfed control group of 11 infants (10.5 +/- 4.8 versus 10.9 +/- 4.7 mg l-1, p = 0.841), whereas levels of the formula-fed infants with the moderate TRP content were significantly lower (7.4 +/- 3.9, p = 0.038). The supplementation of alpha LA resulting in a higher TRP supply to low-protein diets is a further step towards the production of infant formulas more closely adapted to human breast milk.

Amino Acids↗

PubMed2005

Free amino acids in full-term and pre-term human milk and infant formula.

OBJECTIVE: Although the nutritional value of human milk has been thoroughly studied, few reports describing its free amino acid (FAA) content have been published. Although infant formulas are designed to approximate the nutrient composition of human milk, the content and concentration of free amino acids are unknown. We compared the FAA concentrations of milk from mothers of preterm and full-term infants with those in several infant formulas. METHOD: Human milk was obtained during three different stages of lactation (colostral, transitional and mature milk). Sixty-seven samples were collected from 44 healthy mothers of term infants and 23 mothers of premature infants 29 to 36 weeks gestation (mean 33 weeks). Two brands of powdered term formula (TF-A and TF-B) and two brands designed for preterm infants (PTF-A and PTF-B )were also studied. Ion exchange chromatography was used for free amino acid analysis. RESULTS: The mean concentration of total FAA in human milk was significantly higher than any of the infant formulas (8139 micromol/L for pre-term human milk; 3462 micromol/L for full term human milk; TF-A, 720 micromol/L; TF-B, 697 micromol/L; PTF-A, 820 micromol/L; PTF-B, 789 micromol/L) (P <0.01). FAA concentration in term and premature human colostral milk was significantly higher than in human transitional and mature milks (P <0.01). In comparing individual FAAs, there were significant differences in concentrations between term human milk and preterm milk except for phosphoethanolamine, hydroxyproline, asparagine, and alpha-amino-eta-butyric acid. There were significant differences in all FAA concentrations between all human milks and infant formulas (P <0.05), but no significant differences were found among the study formulas. CONCLUSION: The concentration of FAA is high in human colostral milk and decreases through the transitional and mature milk stages. FAA is higher in all human milks than in infant formulas.

Amino Acids↗

PubMed2006

Palm olein in the fat blend of infant formulas: effect on the intestinal absorption of calcium and fat, and bone mineralization.

OBJECTIVE: To evaluate the published clinical data on the physiologic effects of using palm oil and its low melting fraction, palm olein (PO) as a dominant lipid source in the fat blend in infant formulas. DESIGN: A systematic search of Medline and the Cochrane Database of Systematic Reviews was performed to retrieve studies comparing infants who received infant formulas containing PO with those who received infant formulas without PO or which contained synthetic triacylglyceride as a source of palmitic acid. Outcomes of interest include intestinal fractional absorption of fat, palmitic acid and calcium; and bone mass. The effect size for each dependent variable in each published study was obtained by standardizing based on the difference in means between non-PO and PO group with respect to the standard deviation of the PO group. Trend analysis of the outcome of interest was performed when 3 or more between group comparisons were available. The comparison of effect size across different studies was based on all available data and includes results that showed no significant difference between infants fed PO or non-PO study formulas in the outcomes of interest. RESULTS: Nine publications were identified with non-PO and PO comparison groups. The gestational ages of infants in the published studies were between 28 to 42 weeks and postnatal ages were birth to 192 days at study onset. Within each published study, there was some variability in the effect size between non-PO and PO groups. The standardized results were consistently significantly (p < 0.05) positive in favor of the feeding with non-PO formulas with respect to increased intestinal fractional absorption of fat, palmitic acid and calcium. The latter two variables were significantly different by at least 0.6 SD. Bone mass measured as total body bone mineral content was significantly higher in the non-PO group by at least 0.3 SD. CONCLUSION: The use of PO in infant formulas to match the human milk content of palmitic acid has unintended physiological consequences including diminished intestinal absorption of fat, palmitic acid and calcium and lower bone mass. The avoidance of PO or its substitution with synthetic triacylglyceride in infant formulas can prevent this detrimental effect.

Calcification, Physiologic↗

PubMed2005

A systematic review of the role of hydrolyzed infant formulas in allergy prevention.

OBJECTIVE: To critically examine the published literature to determine whether feeding hydrolyzed infant formulas from birth has a role in allergy prevention. DATA SOURCES: We identified data through a MEDLINE search using allergy prevention and infant formulas as indexing terms. The search was restricted to 1985 through the present, English-language articles, and human subjects. STUDY SELECTION: Criteria for inclusion in the review were prospective controlled trials published in peer-reviewed journals. DATA EXTRACTION: Symptoms of allergy were defined and observed by health care providers (physicians and nurses). DATA SYNTHESIS: Nine published trials evaluated the use of extensively hydrolyzed formulas, 12 evaluated the use of partially hydrolyzed formulas in high-risk infants, and 1 evaluated the use of partially hydrolyzed formulas in an unselected infant population. The reports compared hydrolyzed formulas with breastfeeding, cow's milk formulas, soy formulas, and combinations thereof. The cohort of studies consistently showed reductions in the cumulative incidence of atopic disease from 12 to 60 months of age among high-risk infants fed extensively hydrolyzed casein formulas or partially hydrolyzed whey formulas vs cow's milk formulas. No studies showed an increase in allergy risk with any hydrolyzed formulas. CONCLUSIONS: Extensively hydrolyzed casein formulas and partially hydrolyzed whey formulas are appropriate alternatives to breast milk for allergy prevention in infants at risk. Because atopic disease in children cannot be predicted, the use of these formulas in the general population should be considered, and one must weigh cost, compliance, and long-term benefits.

Child, Preschool↗

PubMed1982

The Infant Formula Act of 1980.

The Infant Formula Act of 1980 is one of the most specific and detailed acts ever passed by Congress. It establishes minimum nutrient requirements, defines adulteration, provides for establishing nutrient and quality control procedures, prescribes recall procedures, and specifies inspection requirements.

Humans↗

PubMed2006

Should high-energy infant formula be given at full strength from its first day of usage?

OBJECTIVE: To evaluate the feeding tolerance of a high-energy (1 kcal mL(-1)) infant formula (HEIF) for infants with faltering growth, weighing 2.5-8 kg, when administered at full strength from day 1 compared with stepwise introduction. METHODS: Thirty infants (aged 2-43 weeks) from a supraregional children's hospital requiring a high-energy formula for faltering growth were randomly allocated to receive either a 1 kcal mL(-1) ready to feed infant formula at full strength from day 1 or the same formula in diluted form, graded to full strength over 3 days. Bowel actions, vomits and volume of feed taken were recorded daily for 2 weeks. Weight, length, head circumference and mid-upper arm circumference were recorded at recruitment and after 2 weeks. RESULTS: The number of bowel actions in the first 2 days was significantly higher for the full strength group than for the stepwise group (P = 0.02); younger infants (<12 weeks) had more bowel actions over the first 2 days on the HEIF at full strength (Spearman's correlation = -0.5; P = 0.04); and infants with a total higher energy intake (kJ kg(-1)) had more frequent bowel actions over the first 4 days (Spearman's correlation = 0.48; P = 0.01). There was no significant difference between groups for growth or vomiting. CONCLUSIONS: High-energy infant formula was generally well tolerated in infants under the age of 12 months with faltering growth when administered at full strength from day 1. However, younger infants (<12 weeks of age) may benefit from a graded introduction in order to avoid increased bowel frequency.

Double-Blind Method↗

PubMed2003

Efficacy of an infant formula containing anti-Escherichia coli colostral antibodies from hyperimmunized cows in preventing diarrhea in infants and children: a field trial.

OBJECTIVE: To examine the efficacy of using oral bovine hyperimmune immunoglobulin concentrate with high-titer antibodies against Escherichia coli in preventing diarrhea caused by enteropathogenic E. coli. DESIGN AND SETTING: This was a randomized, double-blind, controlled field trial conducted at the Al-Sheikh Omer Maternal and Child Health Center in Baghdad, Iraq from May to September 1998. PARTICIPANTS: One hundred and twenty-five infants who satisfied the study criteria were included. One hundred and seven infants had adequate outcome data for the assessment of efficacy. INTERVENTION: Infants were randomly assigned to receive either immunoglobulin concentrate-supplemented infant formula or non-supplemented control formula for 7 days. Groups were matched for physical characteristics at enrollment in the study. Another group, which was breastfed, was included to allow the collection of diarrhea morbidity data. Anthropometrics and diarrheal morbidity data were collected by weekly monitoring during the 6-month follow-up period. RESULTS: The infants receiving supplemented formula had a lower incidence of diarrhea than the infants receiving control formula (P <0.05). Episodes of diarrhea were shorter in infants receiving supplemented formula (P <0.01). Moreover, infants receiving supplemented formula gained significantly more weight than control infants after 8 months of follow-up. The preparation was safe and well tolerated. CONCLUSION: The results indicate that the reduction in morbidity associated with formula supplementation is of sufficient magnitude to be of public health significance. The use of these preparations provides an effective method for the prevention of diarrheal diseases.

Adult↗

PubMed1984

Research and development of infant formulae with reduced allergenic properties.

Infant formulae based on hydrolyzed proteins or elemental diets offer the best treatment of cow's milk allergy whenever exclusive breast-feeding is not possible. In situations with a family history of atopy, formulae using other protein sources such as soya or chicken meat can also be a good preventive measure. The food industry needs reliable research methods for the evaluation of every new option before considering clinical trials. Allergenicity of cow's milk proteins was evaluated by the induction of mouse monoclonal reagins and also by oral administration of milk preparations to mice and guinea pigs. Animals initially raised on commercial diets containing about 1% milk whey could not be sensitized. Maintenance of a milk-free diet from pregnancy until weaning, and feeding milk in a liquid form led to an optimal sensitization of the guinea pigs. These animals suffered systemic anaphylaxis and their sera sensitized skin in virgin hosts. Under optimal conditions, while giving liquid preparations to drink, a considerable proliferation of the milk flora occurred. As no mucosal alterations could be detected, primary gut damage due to infection was probably not the triggering factor for oral sensitization. Bacterial products (e.g., endotoxins, enterotoxins) could stimulate the gut response towards milk proteins, either due to an adjuvant effect or to increased mucosal permeability. Microbial contamination of milk is practically unavoidable and it can generally induce biologic activity, e.g., fresh milk regularly gives a positive limulus test for endotoxin by the time it is consumed or processed. Reduction of bacterial contaminants by milk protective factors might help to prevent oral sensitization.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2004

Manganese content of soy or rice beverages is high in comparison to infant formulas.

OBJECTIVE: Well-meaning but inadequately informed parents may perceive plant-based beverages such as soy beverages (SB) or rice beverages (RB) as an alternative to infant formula. Manganese (Mn) is an essential mineral nutrient found at high levels in plants such as soy and rice. Excessive Mn exposure increases the risk of adverse neurological effects. METHODS: We analysed, by atomic absorption spectrometry, the Mn content of 36 SB, 5 RB, 6 evaporated milks (EM), 14 soy-based infant formulas (SF) and 16 milk-based infant formulas (MF), obtained from commercial outlets in Ottawa, Canada. RESULTS: SB had the highest levels of Mn (16.5 +/- 8.6 micro g/g dry wt, mean +/- s.d.), followed by RB (9.9 +/- 1.7 micro g/g dry wt). Mn levels of individual SB/RB ranged from 2 to 17 times the mean Mn content of SF (2.4 +/- 0.7 micro g/g dry wt) and 7 to 56 times that of MF (0.70 +/- 0.35 micro g/g dry wt). EM contained very little Mn (0.02 +/- 0.03 micro g/g dry wt). Calculated mean Mn intakes from SB/RB by infants up to 6 months of age, assuming complete substitution of these products (0.78 L/day), approached the Tolerable Upper Intake Level (UL) for 1-3 year olds (no UL for Mn is available for infants under 1 year of age). Expressed as micro g Mn/100 kcal, SB/RB exceeded the range derived from ULs and typical energy intakes of 1-3 year olds. CONCLUSIONS: SB/RB should not be fed to infants because they are nutritionally inadequate and contain Mn at levels which may present an increased risk of adverse neurological effects if used as a sole source of nutrition.

Beverages↗

PubMed1997

Thermal resistance of Enterobacter sakazakii in reconstituted dried-infant formula.

Enterobacter sakazakii, designated a unique species in 1980, has been implicated in a rare but severe form of neonatal meningitis, with dried-infant formula being implicated as the mode of transmission. The high mortality rate (40-80%) and the lack of information about this organism led to a study of the heat resistance of Ent. sakazakii in reconstituted dried-infant formula. Ten Canadian Ent. sakazakii strains (5 clinical and 5 food isolates) were used to determine the heat resistance of this organism at 52, 54, 56, 58 and 60 degrees C in reconstituted dried-infant formula. D-values of 54.8, 23.7, 10.3, 4.2 and 2.5 min were obtained for each temperature, respectively. The overall calculated z-value was 5.82 degrees C. In a comparison of the D-values of several members of the Enterobacteriaceae in dairy products, Ent. sakazakii appeared to be one of the most thermotolerant organisms. The importance of process control during manufacture and the use of aseptic procedures during the preparation, use and storage of dried-infant formula is discussed.

Animals↗

PubMed1996

Is docosahexaenoic acid necessary in infant formula? Evaluation of high linolenate diets in the neonatal rat.

Neural accretion of docosahexaenoic acid (DHA) is thought to play an important role in the neural development of human infants. The lack of DHA in infant formulas contributes to the lowered neural accretion of DHA observed in formula-fed infants relative to those breast-fed. We hypothesized that lowering the dietary linoleic acid (LA) to alpha-linolenic acid (LNA) ratio may lead to increases in the level of DHA in the developing brain and retina. Lowering the LA to LNA ratio from 10:1 to 1:1 and to 1:12 in the artificially reared (AR) neonatal rat pup resulted in a significant increase in the percentage of brain DHA between AR dietary groups. The brain level of DHA in the AR group fed a 1:12 ratio was similar to that of a dam-reared reference group. However, levels of DHA in the retina of all AR groups were significantly lower than that of the (chow fed) dam-reared group. It appears that LNA may serve as an adequate substrate for the accretion of DHA in the brain, but not the retina of the developing rat. In both the brain and the retina, levels of arachidonic acid in the AR pups fed the 1:1 ratio were similar to that of the dam-reared group. However, levels in the 1:12 group were significantly reduced. The addition of long chain n-3 polyunsaturates such as DHA to infant formula may therefore be necessary for adequate neural DHA accretion and optimal neural development.

Animal Feed↗

PubMed2004

New supplements to infant formulas.

Foods, which, in addition to their nutritional attributes, contain also elements that are considered to be health-promoting, have been termed "functional foods". In this regard, human milk has gained recognition as being the ultimate functional food for infants - by its biological compatibility, nutritional value and the undisputed added value of its health promoting qualities. Intensive research activity has recently evolved in a quest to identify and define the components of human milk that might confer disease-preventing and health-enhancing properties and to determine the instances and clinical conditions in which these factors become particularly important. The outcome of such research would also provide a rationale for advocating the supplementation of commercial infant formulas with such substances. In effect, the body of data accumulated from scientific and clinical studies on nucleotides, probiotics, prebiotics and long-chain polyunsaturated fatty acids in human milk and as additives to infant formula, has become regarded as convincing enough by the infant formula industry so as to launch into the market formulas supplemented with one or more of these factors - in an effort to emulate human milk and its beneficial effects. The following review is intended for the reader to obtain a general idea of the new supplements that have been introduced to infant formulas. We summarize the pertinent experimental and clinical observations concerning each of the supplements, pointing out their potential specific benefits, their possible disadvantages and the issues that still remain unresolved.

Dietary Supplements↗

PubMed2006

Effects of bovine alpha-lactalbumin and casein glycomacropeptide-enriched infant formulae on faecal microbiota in healthy term infants.

OBJECTIVE: Certain milk factors may promote the growth of a host-friendly gastrointestinal microbiota, for example, one that is predominated by bifidobacteria, a perceived health-promoting genus. This may explain why breast-fed infants experience fewer intestinal infections than their formula-fed counterparts who are believed to have a more diverse microbiota, which is similar to that of adults. The effects of formulas supplemented with 2 such ingredients from bovine milk, alpha-lactalbumin (alpha-lac) and casein glycomacropeptide (GMP), on gut flora were investigated in this study. PATIENTS AND METHODS: Six-week-old (4-8 wk), healthy term infants were randomised to a standard infant formula or 1 of 2 test formulae enriched in alpha-lac with higher or lower GMP until 6 months. Faecal bacteriology was determined by the culture-independent procedure fluorescence in situ hybridisation. RESULTS: There was a large fluctuation of bacterial counts within groups with no statistically significant differences between groups. Although all groups showed a predominance of bifidobacteria, breast-fed infants had a small temporary increase in counts. Other bacterial levels varied in formula-fed groups, which overall showed an adult-like faecal microflora. CONCLUSIONS: It can be speculated that a prebiotic effect for alpha-lac and GMP is achieved only with low starting populations of beneficial microbiota (eg, infants not initially breast-fed.

Animals↗

PubMed1985

Tocopherols and tocotrienols in Finnish foods: human milk and infant formulas.

Individual tocopherols and tocotrienols in human milk, mother's milk substitutes and other infant formulas have been determined by an HPLC method. 107 human milk samples (23 colostral, 22 transitional and 62 mature) obtained from six healthy mothers throughout the lactation were found to contain all the tocopherols, although delta-tocopherol occurred only in traces. A high content of alpha-tocopherol was found in colostrum (average 1.90 +/- 1.62 (SD) mg/100 g), as compared with transitional (0.65 +/- 0.22 mg/100 g) and mature milk (0.47 +/- 0.16 mg/100 g). The content of beta-tocopherol averaged 0.05 +/- 0.03, 0.02 +/- 0.01 and 0.02 +/- 0.01 and gamma-tocopherol 0.11 +/- 0.09, 0.07 +/- 0.04 and 0.07 +/- 0.04 mg/100 g in colostral, transitional and mature milk respectively. The alpha-tocopherol equivalents thus were 1.93, 0.66 and 0.49 mg/100 g; their ratios to the contents of polyunsaturated fatty acids meet the nutritional need of the newborn and young infant: 5.7, 2.1 and 1.4 mg/g in colostral, transitional and mature milk. Mother's milk substitutes and gruel and porridge powders are enriched with tocopherol acetate to vitamin E levels similar to or higher than those in human milk: substitutes contained on average 1.4 mg alpha-tocopherol equivalents/100 g and reconstituted powders 1.1 mg/100 g. The ratio of vitamin E to polyunsaturated fatty acids of these infant formulas was higher than the recommended value of 0.6 mg/g. The average values for alpha-tocopherol equivalents in fruit-berry and meat-vegetable infant formulas were 0.46 and 0.38 mg/100 g.

Colostrum↗

PubMed1978

Selenium content of human milk, cow's mild and cow's milk infant formulas.

The selenium content of human milk, cow's milk and cow's milk infant formula were estimated by instrumental neutron activation analysis. The highest values were found in 3 samples of human colostrum (524--865 x 10(-9) g/g dry weight). There was a significant decrease with increasing time post partum. Mature human milk exhibited a selenium content of 230 +/- 79 x 10(-9) g/g dry weight. The selenium content of 45 samples of cow's milk from the north-western area of Germany was 200 +/- 39 x 10(-9) g/g dry weight. While there was no significant difference between the values of mature human milk and of cow's milk, cow's milk infant formula exhibited significantly (P less than 0.01) lower values than human milk. The average selenium content of 107 samples of 10 different commercially available fluid and powdered cow's milk infant formulas (range: 18--171 x 10(-9) g/g dry weight) amounted to about only one third of that in mature human milk.

Animals↗