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PubMed2003

Advances in nutritional modifications of infant formulas.

Modifications to infant formulas are continually being made as the components of human milk are characterized and as the nutrient needs of diverse groups of infants are identified. Formulas with long-chain polyunsaturated fatty acids added in amounts similar to those in human milk have recently become available in the United States; infants fed these formulas or human milk have higher tissue concentrations of long-chain polyunsaturated fatty acids and reportedly have better visual acuity than do infants fed nonsupplemented formulas. Selenium, an important antioxidant, is present in higher concentrations in human milk than in non-fortified cow milk-based formula, and the selenium intakes of infants fed nonfortified formulas are reported to be at or below recommended levels. Blood selenium concentrations and plasma glutathione peroxidase activity are higher in infants fed selenium-supplemented formulas or human milk than in infants fed non-fortified formulas. Nucleotides and their related products play key roles in many biological processes. Although nucleotides can be synthesized endogenously, they are considered "conditionally essential." Nucleotide concentrations in human milk are higher than in unsupplemented cow milk-based formulas, and studies in animals and human infants suggest that dietary nucleotides play a role in the development of the gastrointestinal and immune systems. Formulas for preterm infants after hospital discharge are designed to meet the needs of a population in whom growth failure is common. Several studies have shown that preterm infants fed nutrient-enriched formulas after hospital discharge have higher rates of catch-up growth than do infants fed standard term-infant formulas.

Fatty Acids, Unsaturated↗
PubMed1987

Retinal degeneration in 3-month-old rhesus monkey infants fed a taurine-free human infant formula.

Rhesus monkey infants were raised from birth on a taurine-free soy protein-based human infant formula or on the same formula supplemented with taurine. The monkeys were killed 3 months after birth and the retinas examined by light and electron microscopy. All of the monkeys raised on formula alone showed degenerative ultrastructural changes in photoreceptor outer segments that ranged from swelling and disorientation to fragmentation and disorganization. Cones were more severely affected than rods, and changes were most pronounced in the foveal region. Changes were also noted in the fine structure of the retinal pigment epithelium. These changes were prevented in all but one monkey fed the same formula supplemented with taurine. These results provide further support for the addition of taurine to commercial human infant formulas.

Animals↗
PubMed1997

A critical analysis of total sialic acid and sialoglycoconjugate contents of bovine milk-based infant formulas.

BACKGROUND: Several infant formulas were bovine milk-based products. Mature bovine milk has a very low sialoglycoconjugate content compared with human milk from the first phases of lactation. METHODS: The present study was undertaken to determine total sialic acid and oligosaccharide, glycoprotein, and ganglioside sialic acid contents of bovine milk-based formulas. RESULTS: Starter formulas, designed for the first days/weeks after birth, have very similar sialic acid contents (233-266 mg/L fresh milk). We found more oligosaccharide-bound sialic acids (167-174 mg/L fresh milk) than those bound to proteins (53-84 mg/L fresh milk) in these formulas. The ganglioside sialic acid contents of starter formulas (952-1135 micrograms/L fresh milk) vary slightly from formula to formula. However, all the above-mentioned contents are lower than in human colostrum or transitional milk. CONCLUSIONS: Infants fed starter formulas have total sialic acid and oligosaccharide, glycoprotein, and ganglioside sialic acid intakes of 36, 28, 50, and 20%, respectively, of those fed human colostrum or transitional milk. By contrast, follow-on formulas, used from 4 to 5 months of age, provide total sialic acid and oligosaccharide, glycoprotein, and ganglioside sialic acid contents similar to those furnished by mature human milk. Since the reference standard for optimal nutrition in the early months of infancy is human milk, a supplementation with sialic acid-containing glycoconjugates of infant formulas recommended for the first days after delivery could be advisable when breast-feeding is not possible.

Animals↗
PubMed1997

Intolerance to protein hydrolysate infant formulas: an underrecognized cause of gastrointestinal symptoms in infants.

The purpose of this study was to determine the effectiveness of an amino acid-based infant formula in infants with continued symptoms suggestive of formula protein intolerance while they were receiving casein hydrolysate formula (CHF). Twenty-eight infants, 22 to 173 days of age, were enrolled; each had received CHF for an average of 40 days (10 to 173 days) and continued to have bloody stools, vomiting, diarrhea, irritability, or failure to gain weight, or a combination of these symptoms. Sigmoidoscopy with rectal biopsy was performed in all infants. The infants then received an amino acid-based infant formula, Neocate, for 2 weeks. After 2 weeks of treatment, 25 of the infants demonstrated resolution of their symptoms and underwent challenge with CHF. Of the 25 who were challenged, eight tolerated the CHF and the remainder had recurrence of their symptoms. The histologic features in these infants varied from eosinophilic infiltration to normal. We conclude that not all infants with apparent formula protein-induced colitis respond to CHF and that these infants may have resolution of their symptoms when fed an amino acid-based infant formula.

Dietary Proteins↗
PubMed1995

Zinc and manganese bioavailability from human milk and infant formula used for very low birthweight infants, evaluated in a rat pup model.

The bioavailability of zinc and manganese from diets used for very low birthweight infants was investigated in a rat pup model using radioisotopes. The effect of protein source and content and of pasteurization was evaluated, and two different approaches for evaluation of zinc and manganese bioavailability from the studied human milk and infant formula for very low birthweight infants was high. Liver uptake of 65Zn from labeled premature infant diets in sucklings rat pups was 26-29%, and absorption calculated as the difference between administered dose and nonabsorbed activity 6 h after oral intubation was 93-95%. Retention of manganese calculated as the sum of 54Mn retained by organs and carcass was 85-95% from human milk and premature infant formula, and absorption calculated from nonabsorbed activity was 83-88% after 6 h. Fortification of early human milk significantly increased the bioavailability of zinc. No effect of pasteurization of human milk was found on zinc or manganese bioavailability. Liver zinc uptake was found to be a more sensitive parameter than absorption for evaluation of diets with a high zinc bioavailability. Measurement of retained activity of manganese in carcass and organs was judged to be the preferred parameter for evaluation of diets with high manganese availability.

Absorption↗
PubMed1996

Isocratic high-performance liquid chromatographic determination of tryptophan in infant formulas.

The application to infant formulas of a method for tryptophan determination by isocratic HPLC with UV detection at 254 nm, after derivatization with phenyl isothiocyanate, was studied. Protein was hydrolysed by barium hydroxide at 120 degrees C for 8 h, followed by derivatization with phenyl isothiocyanate, HPLC and UV detection at 254 nm. The optimum chromatographic conditions (pH, ionic strength of elution solvent and eluent ratio) were established. The analytical parameters (linearity, precision, accuracy of derivatization and limits of detection and quantification) were determined. The values obtained demonstrated that the method is useful for determining the tryptophan content of infant formulas. The tryptophan contents in six different types of infant formulas were 0.535-0.848 g per 100 g of protein.

Acetates↗
PubMed2004

Risk of hypervitaminosis D from prolonged feeding of high vitamin D premature infant formula.

BACKGROUND: Most premature infant formulas marketed in Japan have high vitamin D content. Potential for vitamin D intoxication was assessed in premature infants with prolonged feeding of such a premature formula vitamin D content, 2700 IU/L. METHODS: Serum vitamin D, calcium and phosphorus, and urinary calcium, were measured in 12 very premature infants fed premature infant formula, regular formula (vitamin D content; 460 IU/L), and/or mother's milk. RESULTS: Concentrations of 25(OH)D in sera associated with sole feeding of premature infant formula (n = 40) were significantly higher than sera corresponding to regular formula or breast milk (n = 25; 175 versus 115 nmol/L, P <0.0001). No sample showed a serum 25(OH)D concentration below 25 nmol/L. Of 65 samples, 49 (75.4%) showed 25(OH)D concentrations exceeding 100 nmol/L, but serum calcium and phosphorus concentrations were normal. Unexpectedly, urinary calcium correlated negatively with serum 25(OH)D. CONCLUSION: In prolonged feeding of premature infant formula with high vitamin D, it was concluded that it could cause a high blood concentration of vitamin D in premature infants, and also that in these infants urine calcium is not a reliable indicator of excessive vitamin D intake.

Calcium↗
PubMed1997

The lead concentration of reconstituted infant formula.

OBJECTIVE: To characterize practices of infant formula reconstitution and to measure the lead concentration of the home-prepared reconstituted infant formula. METHODS: Convenience sample of metropolitan Boston infants less than 9 months of age who were being evaluated in an urban pediatric emergency department and had home-prepared reconstituted infant formula available. A questionnaire was administered to gather demographic information and details of formula preparation. A 30-90 mL sample of home-prepared reconstituted infant formula was collected in an acid-washed, distilled water-rinsed glass tube, then analyzed for lead by atomic absorption spectrophotometry (precision +/- 2 micrograms/L or 2 ppb). RESULTS: Forty infants were evaluated. Mean (SD) chronological age was 112 +/- 78 d. Reported daily reconstituted infant formula daily volume was 870 +/- 300 mL. Two of the 40 samples (5% [95% CI: 2.0, 18.2%]) had lead concentrations above 15 micrograms/L, the current action level for safe water according to the Environmental Protection Agency. The two samples with lead concentrations of 17 and 70 micrograms/L were prepared using cold tap water (water run for 5 and 30 sec, respectively) drawn from the plumbing of houses greater than 20 years old. CONCLUSION: These data suggest that the use of infant formulas which require reconstitution may present inadvertent lead hazards to young infants. Pediatricians should provide education about these potentially hazardous practices to parents who use these formulas.

Female↗
PubMed2001

Does processing of a powder or in-bottle-sterilized liquid infant formula affect calcium bioavailability?

Processing of infant formulas can induce Maillard reaction or lactose isomerization, among other changes. These reactions were evaluated with furosine and lactulose, respectively. Protein alteration was assessed with sodium dodecylsulfate-polyacrylamide gel electrophoresis. Repercussions on calcium bioavailability in powder and in-bottle-sterilized liquid infant formulas were studied. Lactulose, advanced Maillard-reaction products, and denatured proteins were higher in liquid infant formula. After in vitro digestion, soluble non-dialyzed calcium was significantly higher in liquid than in powder infant formula, but there were no differences in dialyzed insoluble calcium. Two-week-old rat pups drank the powder or liquid infant formula for 7 d. Food intake and final body weight were significantly lower in those fed liquid formula. Accordingly, the intake, apparent absorption, and retention of calcium were measured; the percentages of retention versus absorption and retention versus intake were significantly lower, although calcium digestibility (percentage of absorption versus intake) was higher. These results show that, although calcium in the sterilized infant formula was available in vitro and was absorbed more efficiently in vivo, it was poorly used by suckling rats. The low acceptability of this formula and the interaction of calcium with lactulose and advanced but absorbable Maillard-reaction products might explain the results. Thus, for calcium bioavailability, we recommend the powder instead of the conventional sterilized infant formula.

Animals↗
PubMed2003

Glycomacropeptide and alpha-lactalbumin supplementation of infant formula affects growth and nutritional status in infant rhesus monkeys.

BACKGROUND: Advances in dairy technology make it possible to enrich infant formula with specific bovine milk components that may enhance nutrient status. Glycomacropeptide, a carbohydrate-rich casein peptide, may increase absorption of calcium, iron, or zinc. alpha-Lactalbumin, a major breast-milk protein, may contribute to a balanced amino acid pattern and increase calcium and zinc absorption. OBJECTIVE: We determined the effects of glycomacropeptide- and alpha-lactalbumin-supplemented infant formula on growth; trace mineral status; iron, zinc, and calcium absorption; and plasma amino acid, blood urea nitrogen, and plasma insulin concentrations. DESIGN: Infant rhesus monkeys (n = 5 infants per group) were breastfed or fed control or alpha-lactalbumin- or glycomacropeptide-supplemented formula from birth to 4 mo of age. Hematologic measures and growth were assessed monthly. Mineral absorption was measured with radioisotopes and whole body counting. RESULTS: Infants fed glycomacropeptide had higher food intake than did other formula-fed infants. Infants fed glycomacropeptide or control formula had higher hematocrit values than did infants that were breastfed or fed alpha-lactalbumin. Infants fed glycomacropeptide or control formula had higher plasma zinc and zinc absorption than did breastfed infants. Where differences were observed, breastfed infants and infants fed alpha-lactalbumin had similar plasma essential amino acid and insulin profiles, which were different from those of infants fed glycomacropeptide or control formula. CONCLUSIONS: Glycomacropeptide- or alpha-lactalbumin-supplemented formula has no adverse effects on nutritional status in infant monkeys. Glycomacropeptide supplementation increases zinc absorption, which may permit the reduction of formula zinc concentrations, and alpha-lactalbumin supplementation promotes a plasma amino acid pattern similar to that of breastfed infant monkeys.

Amino Acids↗
PubMed2005

Lead levels in retail samples of Spanish infant formulae and their contribution to dietary intake of infants.

Lead concentrations in 82 different types of infant formulae (cow's milk and soy based) marked in Spain were analysed by acid-microwave decomposition and anodic stripping voltammetry. Dietary lead intake from infant formula and tap water used for powder formula reconstitution were estimated in comparison with the provisional tolerable weekly intake (PTWI). Additionally, the influence of physical state (powder and ready-to-use formulae), the type of container used and the impact of the industrial process from different manufacturers on lead levels were evaluated. According to the results, lead exposure from drinking water was negligible with respect to formulae investigated; where soya formulae contributed the highest intake (58-73% PTWI), non-adapted starter and specialized formulae gave an moderate intake (31-42 and 26-37% PTWI, respectively), and, finally, pre-term, adapted starter and follow-up formulae provided the lowest lead intake (22-25, 22-26 and 16-22% PTWI, respectively). Based on the current state of knowledge about lead toxicity, manufacturers are called to make an additional effort in order to keep a maximum lead level at 20 microg l-1 for all infant formulae, although it is recommendable that these formulations supply the upper limit (5 microg l-1) of 'normal' human milk.

Animals↗
PubMed1984

Infant formula promotion and infant-feeding practices, Bicol region, Philippines.

A 1978 household survey and a 1981 survey of stores and health facilities document the availability of breast milk substitutes, promotion of infant food and formula through the medical sector, and the effects of such promotion on the infant-feeding practices of mothers in the Bicol region of the Philippines. Breast milk substitutes were universally available in the region. Infant food and formula companies were active in the modern medical sector with promotional efforts that included distributing free formula samples, providing pamphlets and posters, and organizing professional meetings. Industry activities had mixed effects on health professionals' knowledge of breast-feeding and attitudes towards the practice. Activities of multinationals tended not to affect mothers' breast-feeding behavior directly but increased the probability of their introducing breast milk substitutes within the first six months, and thus in practicing a program of mixed feeding.

Adolescent↗
PubMed1995

Determination of iodine concentration in human milk, cows' milk and infant formula and estimation of daily iodine intake of infants.

A simple and sensitive kinetic-catalytic method was used for the determination of iodine concentration in human milk, cows' milk and infant formula. The method, based on the catalytic effect of iodine on the redox reaction between CeIV and AsIII, was first described by Sandell and Kolthoff. The calibration curve was constructed by plotting absorbance of CeIV after a known time versus iodine concentration. The precision, accuracy and recovery of the method was determined. After the application of the method to milk and infant formula samples, the daily iodine intake of infants on their first or second day after delivery was estimated at 20.0 +/- 11.9 micrograms d-1 and 13.0 +/- 3.3 micrograms d-1 from human milk and infant formula, respectively.

Animals↗
PubMed1998

High absorption of fortification iron from current infant formulas.

BACKGROUND: Estimations of iron absorption from infant formulas are based on 20-year-old data. Data about iron bioavailability from currently used infant formulas are scarce, considering that during the last decades, formulas have had modifications that could affect iron absorption. METHODS: Bioavailability of isotopically labeled iron (55Fe and 59Fe) from several infant formulas administered to contraceptive-using women between the ages of 30 to 50 years was measured. Six infant formulas and one follow-on formula were compared with a powdered, whole cow's milk, and the results were normalized to an absorption of 40% from a reference dose of iron. RESULTS: Iron bioavailability from the infant formulas was consistently higher (19%), contrasting with the low value (4%) of the unmodified cow's milk (p < 0.0001). Iron absorption of the follow-on formula was intermediate (13%). Formulas with 8 mg/l iron and one with 7 mg/l supply approximately 1 mg of absorbed iron, assuming a consumption of 750 ml/day of formula. This amount covers the iron needs of most infants during their period of greatest vulnerability. Formulas containing 12 mg/l iron would allow the absorption of approximately twice the infant iron requirements. CONCLUSIONS: Current infant formulas have a high iron bioavailability, which is an appealing argument for lowering the level of iron fortification in these products.

Absorption↗
PubMed2006

Chromium content in different kinds of Spanish infant formulae and estimation of dietary intake by infants fed on reconstituted powder formulae.

Chromium is well documented as an essential element for humans. Trivalent chromium, the main chemical form found in foods, is essential for maintaining normal glucose metabolism. Owing to analytical difficulties, several literature reports of chromium content of foods, especially for the lower levels, show large variability and should be interpreted with caution. Zeeman background correction, transversely heated graphite furnace atomic absorption spectrometry was used to determine the chromium content of 104 different infant formulae (cow's milk and soy protein based) marketed in Spain following an acid-digestion sample preparation procedure in a closed, pressurized and microwave digestion unit. The mean and range of chromium values, regarding types and main protein-based infant formulae are presented. Additionally, the influence of the type of container used, the impact of industrial process from different manufacturers and the physical state (powder and liquid formulae) on chromium levels is also discussed. In general, the infant formulae contain a higher chromium concentration than that found in human milk (reference range: 0.20-8.18 microg l-1), particularly in the case of hypoallergenic (18.16 +/- 7.89 microg l-1), lactose-free (11.37 +/- 3.07 microg l-1), pre-term (11.48 +/- 3.15 microg l-1) and soya (10.43 +/- 4.05 microg l-1) formulae. The maximum theoretical estimated intake of infants fed on the studied formulae was lower than the upper limit safety for trivalent chromium of 1 mg kg-1 (14 microg kg-1 b.w. day-1) recommended by the experts of Council for Responsible Nutrition (Hathcock 2004; available at: http://crnusa.org/safety.html), amounting to about 10, 15-18 and 26% of the standard (adapted and follow-up) and toddler, soya, lactose-free and pre-term, and hypoallergenic formulae, respectively. Therefore, manufacturers are called upon to make continued efforts to routinely monitor chromium levels, particularly for specialised and pre-term formulae, and at the same time, might consider the inclusion of labelling the levels of chromium at least in these complex formulations.

Animals↗
PubMed2003

Aluminium content of Spanish infant formula.

Levels of aluminium in 82 different infant formulae from nine different manufacturers in Spain were determined by acid-microwave digestion and graphite furnace atomic absorption spectrophotometry. The influence of aluminium content in tap water in reconstituted powder formulae was examined and an estimate was made of the theoretical toxic aluminium intake in comparison with the provisional tolerable weekly intake (PTWI). Possible interactions between aluminium and certain essential trace elements added to infant formulations have been studied according to the type or main protein-based infant formula. In general, the infant formulae contained a higher aluminium content than that found in human milk, especially in the case of soya, preterm or hydrolysed casein-based formulae. Standard formulae gave lower aluminium intakes amounting to about 4% PTWI. Specialized and preterm formulae resulted in a moderate intake (11-12 and 8-10% PTWI, respectively) and soya formulae contributed the highest intake (15% PTWI). Aluminium exposure from drinking water used for powder formula reconstitution was not considered a potential risk. In accordance with the present state of knowledge about aluminium toxicity, it seems prudent to call for continued efforts to standardize routine quality control and reduce aluminium levels in infant formula as well as to keep the aluminium concentration under 300 microg l(-1) for all infant formulae, most specifically those formulae for premature and low birth neonates.

Aluminum↗