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PubMed2002

[Concentrations of calcium, magnesium, sodium and potassium in human milk and infant formulas].

Concentrations of calcium, magnesium, sodium and potassium were determined in 55 samples of mature human milk from Canary women and 5 samples of powdered infant formula. According to the literature our data fell within the normal intervals described for each kind of milk. The mean concentration of Ca, Mg, Na y K of powdered infant formula was higher than those concentrations found in the human milks. Significant differences among the concentrations of Ca, Mg and Na for the milks of the considered mothers were observed. Only the Ca intakes for infants fed with human milk were lower than those requirements recommended by the Food and Nutrition Board (1989). However, the infants fed with powdered infant formula had an adequate intake of all the studied metals. A progressive decrease of the Na, K and Ca concentrations with the lactation stage was observed. Maternal age, parity and sex of the newborns did not affect the metal concentrations significantly.

Adult↗

PubMed1981

Availability of zinc: loading tests with human milk, cow's milk, and infant formulas.

Uptake of zinc with human milk, cow's milk, and four infant formulas investigated using a standard zinc loading test. Female subjects consumed 25 mg of zinc with the milk or formula, the amount of which was calculated to provide 5 gm of protein, after an eight-hour fast. Blood samples were taken prior to (base line) and at 30-minute intervals for three hours after consumption of zinc. Plasma zinc response was calculated as the area under the curve change in plasma zinc from the base line value, plotted against time over three hours. The plasma response with human milk was significantly greater (P less than .005) than with cow's milk and all the formulas. The response with cow's milk and a cow's milk-based formula was one third that with human milk; responses with a soy-based and two casein hydrolysate-based formulas were lower. These results are compatible with the concept, strongly suggested by indirect evidence, that the bioavailability of zinc with human milk is better than with cow's milk or infant formulas.

Animals↗

PubMed1982

The content of phylloquinone (vitamin K1) in human milk, cows' milk and infant formula foods determined by high-performance liquid chromatography.

Phylloquinone (2-methyl-3-phytyl-1,4-naphthoquinone) in human and cows' milk and in infant formula foods has been assayed by a method based on high-performance liquid chromatography (HPLC). The method has three chromatographic steps consisting of a preliminary purification of lipid extracts by conventional liquid chromatography, a further fractionation by semipreparative HPLC and a final analytical step by reversed-phase HPLC in which phylloquinone was resolved from the remaining contaminants and quantified by reference to an internal standard (phylloquinone 2,3-epoxide). The identity of the chromatographic peak ascribed to phylloquinone (vitamin K1) was established by mass spectrometry. Mature human milk from 20 lactating mothers gave a mean concentration of phylloquinone of 2.1 micrograms/liter, and colostrum from 9 mothers gave a mean value of 2.3 micrograms/liter. These levels in human milk were significantly lower than those found in either Friesian (holstein) cows' milk (mean 4.9 micrograms/liter) or unsupplemented infant formula foods containing only cows' milk fat (mean 4.2 micrograms/liter). The mean phylloquinone content of two unsupplemented infant formula foods containing only vegetable oils was 11.5 micrograms/liter. After an oral dose of 20 mg phylloquinone, the concentration of K1 in the breast milk of one mother rose to 140 micrograms/liter after 12 hours and at 48 hours was still about twice the average endogenous level of human milk.

Adult↗

PubMed1994

Zinc supplementation of infant formula.

The effect of zinc supplementation of infant formula on zinc nutrition and growth of healthy infants was studied longitudinally from birth to age 12 mo. The zinc-supplemented group (n = 16) received the same formula as the unsupplemented group (n = 16) except for the addition of 61 mumol (4 mg) Zn/L as sulfate. After age 2 mo in the breast-fed and unsupplemented groups the mean serum zinc concentration remained stable at approximately 9.9 mumol/L. The zinc supplement increased the mean serum zinc concentration to 13.0 mumol/L by age 6 mo. With increasing intake of solid foods, the concentration fell by age 9 mo to the same concentration as in the other groups. The supplement did not increase the velocity of weight or length growth. In their growth the unsupplemented infants were not inferior to the breast-fed or zinc-supplemented infants.

Female↗

PubMed1989

Upper limit of vitamin E in infant formulas.

Reports of toxicity to enterally administered vitamin E are rare in infants. However, increased risks of sepsis and necrotizing enterocolitis have been reported after both enteral and parenteral vitamin E, primarily when plasma (or serum) vitamin E levels exceed 3.5 mg/dl. Levels this high are seldom seen with enteral vitamin E when intake is 25 mg d-alpha-tocopherol equivalent/(kg.d) or less. Intakes below this threshold will be provided by infant formulas with vitamin E to energy ratios of up to 20 mg/100 kcal (30 IU/100 kcal) so long as energy intake does not exceed 125 kcal/(kg.d). To allow a margin of safety, it would be reasonable to limit the amount of vitamin E added to the formula during its manufacture to half this amount, or 10 mg/100 kcal (15 IU/100 kcal). This level coincides with the highest levels of vitamin E found in human colostrum and is 20 times the recommended lower limit for vitamin E in infant formula of 0.5 mg/100 kcal.

Adult↗

PubMed2005

Global standard for the composition of infant formula: recommendations of an ESPGHAN coordinated international expert group.

The Codex Alimentarius Commission of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) develops food standards, guidelines and related texts for protecting consumer health and ensuring fair trade practices globally. The major part of the world's population lives in more than 160 countries that are members of the Codex Alimentarius. The Codex Standard on Infant Formula was adopted in 1981 based on scientific knowledge available in the 1970s and is currently being revised. As part of this process, the Codex Committee on Nutrition and Foods for Special Dietary Uses asked the ESPGHAN Committee on Nutrition to initiate a consultation process with the international scientific community to provide a proposal on nutrient levels in infant formulae, based on scientific analysis and taking into account existing scientific reports on the subject. ESPGHAN accepted the request and, in collaboration with its sister societies in the Federation of International Societies on Pediatric Gastroenterology, Hepatology and Nutrition, invited highly qualified experts in the area of infant nutrition to form an International Expert Group (IEG) to review the issues raised. The group arrived at recommendations on the compositional requirements for a global infant formula standard which are reported here.

Evidence-Based Medicine↗

PubMed2001

Importance of insulin content in infant diet: suggestion for a new infant formula.

Oral insulin promotes intestinal maturation and may prevent diabetes in animal models. The aim of this study was to evaluate the concentration of insulin in human milk and in different infant formulas. Our results show that the concentration of insulin in human milk is significantly higher (60.23 +/- 41.05 microU/ml mean +/- SD) compared with cow's milk (16.32 +/- 5.98 microU/ml mean +/- SD) and that insulin is hardly detectable in infant formulas. We propose the addition of human insulin to infant formula to match its composition more closely to human milk.

Dietary Supplements↗

PubMedDate not supplied

Liquid chromatographic determination of vitamin K1 in infant formulas and milk.

Vitamin K1 in infant formulas and milk products is determined by reversed-phase liquid chromatography (LC) with UV detection. The sample is hydrolyzed enzymatically, and the vitamin is extracted with hexane. Fractionation by normal-phase semi-preparative LC is followed by analytical LC, with quantitation by the internal standard technique. Recovery of the analyte was 97.4 +/- 2.8%. Linearity was established between 0.05 and 4.0 micrograms/mL. The limit of quantitation is 0.5 microgram/100 g for milk powder, which allows the method to quantitate endogenous levels of vitamin K1.

Animals↗

PubMed1982

Analytical methods used by industry for lead in infant formula.

The lead content of liquid infant products has been a prime focus of regulatory, industrial, and private analysts for some time. The principal source of Pb in these products is the solder used in 3-piece can manufacture. Voluntary surveys by the Infant Formula Council member companies from 1978 to present show that even low 1978 levels have been significantly reduced. Two procedures, anodic stripping voltammetry and electrothermal atomization (graphite furnace and carbon rod) atomic absorption spectrophotometry, are currently used by industry analysts. The results of 2 comparison studies provide a means of estimating the reliability of the procedures. Results of thousands of trace Pb determinations have demonstrated that steps to ensure the validity of results must be integrated into the entire analytical scheme. Quality control practices are described. Control of the laboratory environment is essential for ultimate sensitivity, and the design and performance of a trace metals analysis facility are discussed.

Electrochemistry↗

PubMed1982

Microbiological quality of dry-milk mixes and milk substitute infant formulas.

The microbiological quality of dry-milk mixes and milk substitute infant formulas at the retail level was determined by a national survey of 1,574 analytical units. The geometric mean values for aerobic plate counts of milk-containing and milk substitute infant formulas were 25 and 52/g, respectively. The mean value for Staphylococcus aureus and for coliform organisms was less than 3/g. Each unit had an Escherichia coli most-probable-number value of less than 3/g.

Animals↗

PubMedDate not supplied

Enzymatic determination of free carnitine in milk and infant formulas.

A simple spectrophotometric assay for free carnitine in milk and supplemented infant formulas has been developed. After acid extraction, carnitine is measured enzymatically through its reaction with carnitine acetyltransferase coupled with acetyl coenzyme A and dithiobenzoate (DTNB). The manually performed method is rapid, accurate, and convenient for routine quality-control analysis of infant formulas. The chemistry is also suitable for automation, for greatly enhanced throughput.

Acetyl Coenzyme A↗

PubMed1996

Arachidonate and docosahexaenoate added to infant formula influence fatty acid composition and subsequent eicosanoid production in neonatal pigs.

As natural components of human milk, arachdonic and docosahexaenoic acids play important roles in neonatal development; thus, addition of these fatty acids to infant formula has been suggested. This study examined the effects of supplementation of infant formula with microbial sources of either arachidonate or docosahexaenoate or both on accretion of these fatty acids in phospholipids and subsequent modulation of eicosanoid production in neonatal pig lung. One-day-old piglets received for 25 d one of four diets (n = 5): 1) standard diet containing a fat blend similar to that of conventional infant formula, 2) diet containing 0.9 g/100 g of total fatty acids as arachidonate, 3) diet containing 0.7 g/100 g as docosahexaenoate, or 4) a diet containing both 1.0 g/100 g as arachidonate and 0.8 g/100 g as docosahexaenoate. Arachidonate supplementation resulted in 30-60% significantly greater arachidonate in lung phosphatidylethanolamine and phosphatidylcholine. In phosphatidylinositol, however, arachidonate was resistant to dietary manipulation. Accretion of docosahexaenoate in all three phospholipid classes was 2.6- to 4.7-fold greater in docosahexaenoate-supplemented groups than in the standard group. Inclusion of arachidonate in the diet augmented both prostacyclin and thromboxane production by 25 to 35%. Docosahexaenoate supplementation resulted in the least eicosanoid production among the treatments, and significant suppression was observed for thromboxane when supplementation with both fatty acids was compared with supplementation with arachidonate alone. Thus, dietary arachidonic acid and docosahexaenoic acid at concentrations only slightly greater than those found in human milk tended to exercise opposing effects on lung eicosanoid production.

Animals↗

PubMed2005

The efficacy of fluorocarbon, surfactant, and their combination for improving acute lung injury induced by intratracheal acidified infant formula.

We conducted the current study to compare the efficacy of partial liquid ventilation (PLV), pulmonary surfactant (PSF), and their combination in ameliorating the acidified infant-formula-induced acute lung injury (ALI). In the Part I study, 42 rabbits receiving volume-controlled ventilation with positive end-expiratory pressure 10 cm H(2)O were randomly divided into 6 groups (groups noninjuryI, gas ventilation [GVi], PLVi, PSFi, PLVi-->PSFi, and PSFi-->PLVi). ALI was induced by intratracheal acidified infant formula (2 mL/kg, pH 1.8). Group GVi received neither PLV nor PSF therapy. Groups PLV and PSF received intratracheal fluorocarbon 15 mL/kg or surfactant 100 mg/kg, respectively, 30 min after acidified infant formula. Groups PLVi-->PSFi and PSFi-->PLVi received both treatments at 30-min intervals. In Part II, 42 rabbits (in 6 groups) undergoing pressure-controlled ventilation received the same drug therapies as in Part I. The lungs were excised to assess biochemical and histological damage 150 min after induction of ALI. In Parts I and II, PSF, fluorocarbon, and their combination attenuated lung leukosequestration and edema and superoxide production of neutrophils, consequently improving oxygenation, lung mechanics, and pathological changes. Independent of ventilation mode, PSF followed by fluorocarbon provided the most beneficial effects and fluorocarbon followed by PSF produced the least efficacy.

Acids↗

PubMedDate not supplied

Extension of AOAC official method 999.14 (choline in infant formula and milk) to the determination of choline in dietary supplements.

AOAC Official Method 999.14 is applicable for the determination of choline in milk and infant formulas. To date, its use has not been extended beyond these matrixes. We modified Official Method 999.14 and applied it to the determination of choline in a range of choline-containing dietary supplements. Dietary supplement tablets, capsules, wafers, softgels, liquid products, and drink powders were included. We found that the standard curve could be extended to cover a wider range of choline concentrations and defined a procedure for the use of Norit for samples in which the vitamin C content was high enough to interfere with the analysis. Recoveries of choline added to infant formula powders and to representative dietary supplement tablets, capsules, powdered drink mix, and wafer products were 85-114%. The use of Norit during the procedure did not affect the recovery of choline added to infant formula powders or to dietary supplements. An alkaline digestion was included for use with a product containing lecithin as the sole source of choline. Ten of 11 dietary supplement products analyzed by the modified method contained amounts of choline at or above declarations found on the product labels. The remaining product contained about 40% of the label-declared amount of choline.

Animals↗

PubMed1983

Growth and biochemical response of preterm infants fed human milk or modified infant formula.

My colleagues and I compared the biochemical status and rates of growth of three groups of preterm infants: one group was fed milk obtained early from mothers of preterm infants; one group received milk produced during the mature stage of lactation by mothers of term infants; and one group received a whey-based infant formula. Sixty healthy preterm infants with birth weights of 1600 g or less were randomly assigned to one of the three feedings groups. The 20 infants in each group were followed until they reached a weight of 1800 g. The mean (+/- S.E.M.) number of days required to regain birth weight was similar for infants receiving the formula (10.3 +/- 0.8) and those receiving milk from mothers of preterm infants (11.4 +/- 0.8); both were significantly less than the number (18.8 +/- 1.7) for infants receiving milk from mothers of term infants (P less than 0.001). Subsequent rates of weight gain were greater for the groups receiving formula (27.0 +/- 0.8 g per day) and milk from mothers of preterm infants (23.7 +/- 1.1) than for the group receiving milk from mothers of term infants (15.8 +/- 0.8) (P less than 0.001). Similarly, the average increments in crown-to-heel length and in the head circumference were significantly greater for the groups given formula and milk from mothers of preterm infants (P less than 0.005 and P less than 0.001, respectively). These data indicate that feeding with either milk from mothers of preterm infants or a whey-based infant formula results in more appropriate growth in preterm infants than feeding with milk from mothers of term infants.

Acid-Base Equilibrium↗

PubMed2006

Enterobacteriaceae in dehydrated powdered infant formula manufactured in Indonesia and Malaysia.

To determine the occurrence of Salmonella and Shigella in infant formula from Southeast Asia, 74 packages of dehydrated powdered infant follow-on formula (recommended age, > 4 months) from five different manufacturers, four from Indonesia and one from Malaysia, were analyzed. None of the 25-g test portions yielded Salmonella or Shigella. However, further identification of colonies growing on selective media used for Salmonella and Shigella detection revealed the frequent occurrence of several other Enterobacteriaceae species. A total of 35 samples (47%) were positive for Enterobacteriaceae. Ten samples (13.5%) from two Indonesian manufacturers yielded Enterobacter sakazakii. Other Enterobacteriaceae isolated included Pantoea spp. (n = 12), Escherichia hermanii (n = 10), Enterobacter cloacae (n = 8), Klebsiella pneumoniae subsp. pneumoniae (n = 3), Citrobacter spp. (n = 2), Serratia spp. (n = 2), and Escherichia coli (n = 2). To our knowledge, this is the first report to describe the contamination of dehydrated powdered infant formula from Indonesia with E. sakazakii and several other Enterobacteriaceae that could be opportunistic pathogens. Improper preparation and conservation of these products could result in a health risk for infants in Indonesia.

Colony Count, Microbial↗

PubMed2003

Infant formulas with increased concentrations of alpha-lactalbumin.

Human and bovine milk differ substantially in the ratio of whey to casein protein (approximately 60:40 in human milk and approximately 20:80 in bovine milk) and in the proportions of specific proteins. Although current infant formulas closely mimic the ratio of total whey to casein inhuman milk, the concentration of a-lactalbumin (the dominant protein in human milk) is relatively low in formula, whereas beta-lactoglobulin, a protein not found in human milk, is the most dominant whey protein in formula. Because of the differences in the protein profiles of human milk and infant formula, amino acid profiles also differ. To meet all essential amino acid requirements of infants, formula concentrations of protein must be higher than those in human milk. Recently, whey sources with elevated concentrations of alpha-lactalbumin have become available, which permitted the development of formulas with increased concentrations of this protein and decreased concentrations of beta-lactoglobulin. alpha-Lactalbumin is rich in tryptophan, which is typically the limiting amino acid in formula, and as a result, formulas have been developed with lower protein but higher tryptophan concentrations. This type of formula may offer a number of advantages to the neonate, which include producing plasma tryptophan concentrations equal to those found in breastfed infants and obviating the need for the body to dispose of excess nitrogen loads.

Dose-Response Relationship, Drug↗

PubMed1987

Interaction of the infant formula industry with the academic community.

The infant formula industry and the academic community have developed and maintained significant educational and research interactions over the past four decades. A third partner in the enterprise is government. These cooperative efforts have led to the development of quality formula products to meet the needs of healthy infants and the special needs of infants with various medical disorders.

Education, Medical, Continuing↗