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PubMed1999

Iron fortification of infant formulas. American Academy of Pediatrics. Committee on Nutrition.

Despite the American Academy of Pediatrics' (AAP) strong endorsement for breastfeeding, most infants in the United States are fed some infant formula by the time they are 2 months old. The AAP Committee on Nutrition has strongly advocated iron fortification of infant formulas since 1969 as a way of reducing the prevalence of iron-deficiency anemia and its attendant sequelae during the first year.1 The 1976 statement titled "Iron Supplementation for Infants" delineated the rationale for iron supplementation, proposed daily dosages of iron, and summarized potential sources of iron in the infant diet.2 In 1989, the AAP Committee on Nutrition published a statement that addressed the issue of iron-fortified infant formulas3 and concluded that there was no convincing contraindication to iron-supplemented formulas and that continued use of "low-iron" formulas posed an unacceptable risk for iron deficiency during infancy. The current statement represents a scientific update and synthesis of the 1976 and 1989 statements with recommendations about the use of iron-fortified and low-iron formulas in term infants.

Anemia, Iron-Deficiency↗

PubMedDate not supplied

Gas chromatographic analysis of infant formulas for total fatty acids, including trans fatty acids.

Twelve powdered and 13 liquid infant formulas were analyzed by using an extension of AOAC Official Method 996.01 for fat analysis in cereal products. Samples were hydrolyzed with 8 N HCl and extracted with ethyl and petroleum ethers. Fatty acid methyl esters were prepared by refluxing the mixed ether extracts with methanolic sodium hydroxide in the presence of 14% boron trifluoride in methanol. The extracts were analyzed by gas chromatography. In powdered formulas, saturated fatty acid (SFA) content (mean +/- SD; n = 12) was 41.05 +/- 3.94%, monounsaturated fatty acid (MUFA) content was 36.97 +/- 3.38%, polyunsaturated fatty acid (PUFA) content was 20.07 +/- 3.08%, and total trans fatty acid content was 1.30 +/- 1.27%. In liquid formulas, SFA content (mean +/- SD; n = 13) was 42.29 +/- 2.98%, MUFA content was 36.05 +/- 2.47%, PUFA content was 20.65 +/- 2.40%, and total trans fatty acid content was 0.88 +/- 0.54%. Total fat content in powdered formulas ranged from 4.4 to 5.5 g/100 kcal and linoleic acid content ranged from 868 to 1166 mg/100 kcal. In liquid formulas, total fat content ranged from 4.1 to 5.1 g/100 kcal and linoleic acid content ranged from 820 to 1100 mg/100 kcal. There were no significant differences between powdered and liquid infant formulas in concentrations of total fat, SFA, MUFA, PUFA, or trans fatty acids.

Algorithms↗

PubMed2003

Comparison of mass spectrometry-based electronic nose and solid phase microextraction gas chromatography-mass spectrometry technique to assess infant formula oxidation.

Two headspace techniques based on mass spectrometry detection (MS), electronic nose, and solid phase microextraction coupled to gas chromatography-mass spectrometry (SPME-GC/MS) were evaluated for their ability to differentiate various infant formula powders based on changes of their volatiles upon storage. The electronic nose gave unresolved MS fingerprints of the samples gas phases that were further submitted to principal component analysis (PCA). Such direct MS recording combined to multivariate treatment enabled a rapid differentiation of the infant formulas over a 4 week storage test. Although MS-based electronic nose advantages are its easy-to-use aspect and its meaningful data interpretation obtained with a high throughput (100 samples per 24 h), its greatest disadvantage is that the present compounds could not be identified and quantified. For these reasons, a SPME-GC/MS measurement was also investigated. This technique allowed the identification of saturated aldehydes as the main volatiles present in the headspace of infant milk powders. An isotope dilution assay was further developed to quantitate hexanal as a potential indicator of infant milk powder oxidation. Thus, hexanal content was found to vary from roughly 500 and 3500 microg/kg for relatively non-oxidized and oxidized infant formulas, respectively.

Food Analysis↗

PubMed2004

Efficacy of partial liquid ventilation in improving acute lung injury induced by intratracheal acidified infant formula: determination of optimal dose and positive end-expiratory pressure level.

OBJECTIVES: Partial liquid ventilation with fluorocarbon was successfully used for acute lung injury induced by oleic acid or lung lavage. Positive end-expiratory pressure (PEEP) during partial liquid ventilation enhances the efficacy of fluorocarbon. The aim of the current study was to assess whether partial liquid ventilation can repair lung damage induced by intratracheal acidified infant formula and to determine the optimal fluorocarbon dose and PEEP level. DESIGN: Prospective, randomized animal study. SETTING: University research laboratory. SETTING AND SUBJECTS: Seventy-six male anesthetized rabbits. INTERVENTIONS: For study 1, acute lung injury was induced by intratracheal acidified infant formula in four groups. Next, three groups received 10, 15, or 20 mL/kg fluorocarbon, and the fourth group was conventionally gas ventilated. For study 2, acute lung injury was induced in five groups. One group was gas ventilated at a PEEP of 5 cm H2O, whereas the other four groups received fluorocarbon (15 mL/kg) and were assigned to one of four PEEP levels (5, 7.5, 10, or 12.5 cm H2O). The lungs were ventilated with 100% oxygen for 4 hrs after acute lung injury. MEASUREMENTS AND MAIN RESULTS: In study 1, fluorocarbon at doses of 15 and 20 mL/kg attenuated lung leukosequestration and edema and superoxide production of neutrophils, resulting in similar improvements in oxygenation, lung mechanics, and pathologic changes. The highest fluorocarbon dose caused mortality from pneumothorax. In study 2, the combination of PEEP with partial liquid ventilation improved gas exchange, lung compliance, pulmonary edema, and histologically observed damage. The beneficial effects of PEEP at 10 and 12.5 cm H2O were similar. Adverse side effects of 12.5 cm H2O PEEP included pneumothorax and hemodynamic instability. CONCLUSIONS: The combination of fluorocarbon and PEEP improved the physiologic, biochemical, and histologic lung injury induced by acidified infant formula. The beneficial effects of partial liquid ventilation are due, in part, to inhibition of pulmonary neutrophil accumulation and activation with fluorocarbon. The optimal fluorocarbon dose and PEEP level in our model were 15 mL/kg and 10 cm H2O, respectively.

Analysis of Variance↗

PubMed1984

Determinations of taurine in milk and infant formula diets.

Taurine was analyzed in 25 different formula diets for infants by using an automatic amino acid analyzer and a specific program of separation. Average values from 17 samples of cows' milk and 36 samples of human milk (mainly from the 3rd till 6th day) served as controls. The cows' milk samples were relatively low in taurine with values of 68 (30-123) mg/kg dry matter compared to the breast milk samples which exhibited an average value of 458 (163-1170) mg/kg dry matter. The 24 analyzed milk-based formulae for infant nutrition contained only 38 (24-55) mg taurine/kg dry matter. One milk-free formula was free also of taurine. The seven samples of highly whey-protein increased formulae had significantly higher levels of taurine than the preparations based on the original ratio of whey protein to casein in cows' milk.

Animals↗

PubMed2005

Real time PCR using TaqMan and SYBR Green for detection of Enterobacter sakazakii in infant formula.

Enterobacter sakazakii is an emerging pathogen that causes meningitis, bacteremia, sepsis, and necrotizing enterocolitis in neonates and children. Powdered milk-based infant formulas have been associated with the E. sakazakii-related outbreaks in premature or other immunocompromised infants. In this study, we developed two real time PCR assays using TaqMan and SYBR Green to identify the pathogen after selective enrichment in mLST and BHI. The accuracy of two detections was tested by 35 strains of E. sakazakii and 88 non-E. sakazakii bacterial strains. The results showed that all of these E. sakazakii strains were positive reaction to the detections and all of the non-E. sakazakii strains were negative. The newly developed assays enable us to detect 1.1 CFU/100 g infant formula. And both of the assays can be accomplished within 2 business days. Compared to the traditional detection, the real time PCR procedures are quicker and simpler. In this study, we also developed a new method to design the primers, which can support multiple real time PCR with one pair of primers in SYBR Green detection. The detection methods are more sensitive and effective based on Two-Tm-Value of PCR.

Animals↗

PubMed1997

Influence of partial replacement of butter fat with peanut oil (in infant formula) on erythrocyte fatty acids in infants.

Erythrocyte fatty acid composition was studied in infants fed with three different formulae: formula I containing 20% butter fat; formula II containing 10% butter fat and 10% peanut oil; and formula III containing 10% butter fat and 5% peanut oil with a fat content itself reduced to 15%. The linoleic acid levels were 2.5, 18 and 13% in formula I-III, respectively. Analysis of fatty acids at the time of birth, and 3 and 6 months thereafter, indicated that linoleic acid levels could be improved by supplementation with peanut oil. Arachidonic acid levels (20:4, n-6) did not show a proportional relationship with respect to linoleic acid intake. The other ratio such as triene/tetraene, oleic/linoleic, linoleic/arachidonic and arachidonic/linoleic were all within the normal range, indicating normal desaturase and elongase activity. Thus, our present study suggests that peanut oils could be used for enhancing the linoleic acid levels in infants.

Arachis↗

PubMedDate not supplied

Zero control reference materials for infant formula methods development.

A zero control reference material (ZRM) for milk and soy-based infant formula was manufactured and characterized. The ZRM was free of retinyl palmitate and all-rac-alpha-tocopheryl acetate. The composition was similar to commercially available infant formula. The ZRM provides a valuable tool to ascertain method performance.

Animals↗

PubMed1983

Do infant formula samples shorten the duration of breast-feeding?

To determine whether advertising by infant formula companies shortens the duration of breast-feeding, we randomly assigned 448 breast-feeding new mothers to either receive or not receive a formula sample packet upon discharge from a maternity ward. These mother, unaware of the study, were then telephoned 3 months post partum by a research assistant blind to the randomisation status. "Sample" mothers were less likely to still be breast-feeding at 1 month (78% vs 84%, p = 0.07) and more likely to have introduced solid foods by 2 months (18% vs 10%, p = 0.01). These trends became more significant in three vulnerable subgroups: less educated mothers, primiparas, and mothers who had been ill post partum. Our results suggest that infant formula samples may shorten the duration of breast-feeding and hasten the age at which solids are introduced.

Breast Feeding↗

PubMed1999

Plasma lipoprotein fatty acids are altered by the positional distribution of fatty acids in infant formula triacylglycerols and human milk.

BACKGROUND: Triacylglycerol digestion involves hydrolysis of fatty acids esterified at the glycerol 1,3 positions by gastric and pancreatic lipase to produce 2-monoacylglycerols and unesterified fatty acids, which are then absorbed, reesterified to triacylglycerol, and secreted in chylomicrons. Palmitic acid (16:0) is predominantly esterified to the 2 position of human milk triacylglycerol but to the 1,3 positions in the oils used in infant formulas. OBJECTIVE: We aimed to determine whether the position of 16:0 in human milk and infant formula triacylglycerol influences the position of fatty acids in postprandial plasma chylomicron triacylglycerol. DESIGN: Full-term infants were fed formula with 25-27% 16:0 with either 39% of the 16:0(synthesized triacylglycerol) or 6% of the 16:0 (standard formula) esterified at the triacylglycerol 2 position, or were breast-fed (23% 16:0, 81% at the triacylglycerol 2 position) from birth to 120 d of age. Chylomicron fatty acids and plasma lipids were assessed at 30 and 120 d of age. RESULTS: Infants fed the synthesized triacylglycerol formula, standard formula, or breast milk had 15.8%,8.3%, and 28.0% 16:0 in the chylomicron triacylglycerol 2 position (P < 0.05). These results suggest that >/=50% of the dietary triacylglycerol 2-position 16:0 is conserved through digestion, absorption, and chylomicron triacylglycerol synthesis in breast-fed and formula-fed infants. Infants fed the synthesized triacylglycerol formula had significantly lower HDL-cholesterol and apolipoprotein A-I and higher apolipoprotein B concentrations than infants fed the standard formula. CONCLUSION: Dietary triacylglycerol fatty acid distribution may alter lipoprotein metabolism in young infants.

Cholesterol Esters↗

PubMed1997

Essential fatty acids and their trans geometrical isomers in powdered and liquid infant formulas sold in Canada.

BACKGROUND: Animal and human studies have suggested that trans fatty acids might alter some physiological functions and adversely affect the growth and essential fatty acid balance of infants. In this context it is important to know the fatty acid composition, including the levels of trans isomers of oleic, linoleic and alpha-linolenic acids in infant formulas. METHODS: Ten liquid and fourteen powdered formulas for term infants were purchased from retail stores in Canada. The fatty acid composition of each formula was determined by capillary gas-liquid chromatography. RESULTS: All the formulas met the minimum content of 500 mg of linoleic acid/100 kcal formula (equivalent to 4.5% of energy) specified under current Canadian regulations. The formulas all met the minimum energy levels of 3% as linoleic acid and 0.7% as alpha-linolenic acid recommended recently by an ad hoc committee of Health Canada. However, in nine formulas, the proportion of linoleic acid was more than 20% of total fatty acids, and consequently, in five of them, the ratio of linoleic acid to alpha-linolenic acid exceeded the maximum ratio of 16:1 recommended by the ad hoc committee. Trans fatty acids were present in all the samples, and generally the liquid formulas displayed a higher total trans content (mean 1.9%, range 0.9-3.1%) than powdered formulas (mean 1.4%, range 0.6-2.5%). The amounts of trans isomers of linoleic and alpha-linolenic acids and the degree of isomerization of these fatty acids were also higher in liquid formulas than in powdered formulas. CONCLUSIONS: A few of the Canadian infant formulas would provide one-third of alpha-linolenic acid as trans geometric isomers.

Canada↗

PubMed1976

Thyroxine (by competitive protein binding analysis) in human and cow milk and in infant formulas.

In 45 mothers of full term infants the level of thyroxine (T4) in serum (45 samples) and unskimmed milk (92 samples) was estimated with the aid of competitive protein binding analysis. On the 3rd day after delivery the T4 level in serum was found to be 11.1 +/- 0.4 mug/100 ml, while that in milk was 1.3 +/- 0.3 mug/100 ml. During following days of lactation the T4 concentration in sera decreased. In contrast, however, a gradual increase of the T4 content in milk was observed. The serum and milk levels equalized during the third week post partum (7.3 +/- 1.3 and 7.6 +/- 1.4 mu6/100 ml, respectively). After the 25th day the T4 level in milk was found to be higher than in sera from the same women (paired test: P less than 0.005). Values of 12.9 +/- 1.3 in milk and 8.1 +/- 0.7 mug/100 ml in sera were found in the second month of lactation. A negative correlation between serum and milk T4 level was found during the early lactation (3-20 days), while after 20th day this correlation was positive. Very low and almost undetectable levels of T4 were found in cow's milk and infant formulas derived from it.

Animals↗

PubMed1992

Evaluation of the allergenicity of infant formulas in a guinea pig model.

In the present study we evaluated the allergenicity of infant formulas using a guinea pig model. Seven groups of ten guinea pigs each maintained on a diet free of cow milk received either water or pasteurized cow milk (PCM) or a conventional cow milk infant formula (CMF) or whey hydrolysate formula (WHF) to drink. On day 37 all the animals were challenged by intravenous injection with 0.5 mL of supernatant of either PCM or WHF. The reactions to the challenge were expressed as none, mild, severe nonfatal, and fatal. A score ranging from 0 to 3 was assigned to each animal and considered in the statistical analysis; P values are expressed as comparisons to the negative water-fed control group. Animals fed WHF and challenged with WHF (group 1), showed 10% fatal reactions and 50% severe but not fatal reactions (P less than .05). When challenged with PCM (group 2), 40% showed a mild reaction. Cow milk formula-fed animals showed 10% fatal reactions and 70% severe reactions when challenged with WHF (group 3). The same challenge caused 40% severe reactions in animals fed PCM (group 4) (P greater than .05). Animals fed and challenged with PCM (group 5) showed 100% fatal reaction (P less than .01). Animals fed water showed no reaction when challenged with either WHF (group 6) or PCM (group 7). The results suggest that WHF has less anaphylactic sensitizing power than PCM and CMF.

Allergens↗

PubMed1992

Modulation of infant formula fat profile alters the low-density lipoprotein/high-density lipoprotein ratio and plasma fatty acid distribution relative to those with breast-feeding.

The effect of breast-feeding was compared with that of two fat-modified milk formulas in 45 infants (15 per group) studied by assessing body weight gain for 4 months and plasma lipids, lipoprotein profiles, fatty acid profiles of plasma and red blood cells, and plasma tocopherol status 3 months after birth. A saturated fat formula with coconut oil/soybean oil (COCO/SOY) had a fatty acid content and polyunsaturated/saturated ratio (P/S, 0.55) comparable with that of human milk fat (P/S, 0.39) and had the same fat energy content (50% kcal). The second formula, with corn oil/soybean oil (CORN/SOY), was highly unsaturated (P/S, 4.6), with only 35% kcal from fat. Energy intake and body weight gain were similar for all groups. Plasma total cholesterol, triglyceride, and phospholipid levels were significantly lower (greater than 20% on average) in infants fed the CORN/SOY formula than in infants fed either the COCO/SOY formula or human milk. Infants fed the CORN/SOY formula also had lower (25% to 35%) plasma low-density lipoprotein cholesterol and apolipoprotein B levels and low-density lipoprotein/high-density lipoprotein and apolipoprotein B/apolipoprotein A-I ratios. Plasma, red blood cell, and cholesteryl ester fatty acids from infants fed COCO/SOY contained less 18:1 and more 18:2; cholesterol esters in plasma from breast-fed infants had the highest 20:4n-6 levels. Plasma tocopherol levels were higher in infants consuming formulas. The presence of cholesterol in human milk appeared to expand the low-density lipoprotein pool and exert an "unfavorable" increase in the low-density lipoprotein/high-density lipoprotein ratio. Thus modulation of infant lipoproteins by changing dietary fat and cholesterol is feasible and in keeping with the known response in adults.

Apolipoproteins↗

PubMedDate not supplied

Evaluation of infant formula protein quality: comparison of in vitro with in vivo methods.

Two-week protein efficiency ratio (2-wk PER), net protein ratio (NPR), calculated-protein efficiency ratio (C-PER), and discriminant computed-protein efficiency ratio (DC-PER) of milk- and soy-based infant formulas were compared to a 4-week protein efficiency ratio (PER). Expressed relative to ANRC casein, 2-week PER and NPR correlated significantly (P less than 0.01, r = 0.90) with PER. Although C-PER and DC-PER also correlated significantly (P less than 0.01) with PER, r = 0.71 and r = 0.87, respectively, these in vitro methods did not distinguish differences in protein quality among soy-based infant formulas. C-PER and DC-PER, as currently designed, are not applicable to the measurement of protein quality for all types of infant formulas.

Amino Acids↗

PubMed1992

Determination of the optimal ratio of linoleic acid to alpha-linolenic acid in infant formulas.

The fatty acid composition of erythrocyte total lipids taken from a group of term infants 10 weeks after being fed a commercial infant formula with a high ratio of linoleic acid (18:2n-6) (LA) to alpha-linolenic acid (18:3n-3) (ALA) (19:1; LA, 14%; ALA, 0.7%; group A, n = 10) was compared with the fatty acid composition of erythrocytes from infants fed formulas that contained LA/ALA ratios reduced by either increasing ALA (4:1; LA, 13%; ALA, 3.3%; group B, n = 11) or decreasing LA (3:1; LA, 3.5%; ALA, 1.1%; group C, n = 8). Results were compared with those in an age-controlled group (n = 9) of breast-fed infants. Decreasing the LA/ALA ratio increased n-3 C20 and C22 fatty acid incorporation (formula B = 8.98% +/- 0.65%; formula C = 9.30% +/- 0.95%) relative to formula A (5.97% +/- 0.76%; p less than 0.05). Although docosahexaenoic acid (22:6n-3) (DHA) incorporation was highest in infants fed formulas B and C (4.78% +/- 0.45% and 4.48% +/- 0.49%, respectively) relative to formula A (3.47% +/- 0.46%; p less than 0.05), it did not reach levels found in breast-fed infants (6.55% +/- 1.23%; p less than 0.05). In addition, levels of arachidonic acid (20:4n-6) (AA) were lower in all formula-fed groups (p less than 0.05) relative to those in breast-fed infants. Based on some equations, it is predicted that AA levels in tissues of infants fed lower LA/ALA ratios would be reduced even further. Because both AA and DHA are probably essential for normal neural development of the infant, formulas with LA/ALA ratios below 4:1 are likely to result in fatty acid profiles notably different from those of breast-fed infants.

Arachidonic Acid↗

PubMed2003

Dietary fibre and prebiotics in infant formulas.

Prebiotics have the potential to promote immediate and long-term effects on the health and well-being of infants. They have been added to infant formulas in Japan for 20 years and have only recently been used in Europe. The objective is to change the intestinal microflora in order to mimic the bacteriological effect and, thus, the functional effects of human milk. There is, however, a potential risk of long-term effects of the use of these infant formulas. The consequences of using prebiotics in infants, during the first months of life, on the composition and development of the intestinal microflora, and on the resulting bacterial-bacterial and bacterial-host interactions are not known. Attempts have been made to improve infant and follow-on formulas by prebiotic supplementation, but intervention studies are needed to evaluate their immediate and long-term beneficial effects and demonstrate the absence of harmful consequences from their use.

Dietary Fiber↗

PubMed1996

Urinary excretion of lactose and oligosaccharides in preterm infants fed human milk or infant formula.

At present, not much is known about the absorption and metabolism of human milk (HM) oligosaccharides in term and preterm infants. We investigated the renal excretion of lactose and complex oligosaccharides in preterm infants fed HM (n = 9, mean actual body weight 2290 g) or a cow's milk-based infant formula (n = 9, mean actual body weight 2470 g). We found that the renal excretion of lactose in HM-fed infants was slightly lower than in formula-fed infants (14.0 +/- 7.4 versus 20.4 +/- 8.7 mg kg-1 day-1, mean +/- SD). The excretion of neutral sugars deriving from oligosaccharides was similar in HM-fed and formula-fed infants (3.8 +/- 2.1 versus 2.9 +/- 0.9 mg kg-1 day-1); the difference between means was not statistically significant. The separation and characterization of oligosaccharides by high-pH anion exchange chromatography with pulsed amperometric detection (HPAE-PAD) and subsequent analysis by fast atom bombardment-mass spectrometry (FAB-MS) revealed a more complex pattern in HM-fed infants compared to the formula-fed group. Lactose-derived oligosaccharides characteristic for HM (e.g. lacto-N-tetraose, and lacto-N-fucopentaoses I and II) were excreted in HM-fed but not in formula-fed infants. These results indicate that nutrition has a significant impact on the oligosaccharide composition in urine of preterm infants.

Chromatography, High Pressure Liquid↗