SEARCH · PubMed Health

Results for “Infant Formula”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,063 records · Page 59Linked to original sources

PubMed1991

Impact of dietary cereal on nutrient absorption and fecal nitrogen loss in formula-fed infants.

STUDY OBJECTIVE: To determine the capacity of infants to digest and absorb rice cereal and to determine the effect of cereal feeding on total energy and nitrogen absorption. SETTING: Subject's residences and the Texas Children's Hospital Clinical Research Center, Houston. PATIENTS: Eight healthy 1-month-old bottle-fed infants. INTERVENTIONS: Infants were fed their usual formula for 3 days. For the subsequent 6 days, they received 4 gm of rice cereal, labeled with carbon 13, per 30 ml of the formula. MEASUREMENTS AND MAIN RESULTS: Fecal balance studies were performed for a 72-hour period while the infants received only formula and again during the last 3 days of cereal feeding. Breath samples for hydrogen measurement were collected before and after the cereal feeding. Nutrient intake was measured and stools were analyzed for 13C abundance, energy, nitrogen, fiber content, and bacterial mass. Cereal absorption was 88 +/- 9% (mean +/- SD). Despite a significant increase in energy and nitrogen intake from cereal feeding, the coefficient of absorption fell (energy: 97% to 90%, p = 0.048; nitrogen: 94% to 74%, p = 0.009). Fecal dry weight increased after the cereal feeding (p = 0.004), primarily as a result of a sevenfold increase in fecal bacterial mass (p = 0.002). Fecal nitrogen increased primarily because of incorporation of nitrogen into bacteria. No differences were detected in breath hydrogen as a consequence of formula feeding versus formula-cereal feeding. CONCLUSIONS: Although cereal was relatively well-absorbed in this group of infants and increased their intakes of energy and nitrogen, it did not increase the coefficients of energy and nitrogen absorption. Cereal feeding increased fecal bacterial mass and bacterial nitrogen.

Bacteria↗

PubMed2003

Human milk substitutes. An American perspective.

Formula is a substitute for the preferred nutritional fluid for infants, human milk. Considering that human milk is uniquely suited for human infants, formula feeds have done remarkably well in promoting growth and development of bottle-fed and partially breast-fed infants. Early in the last century, the horrendously high infant mortality rate spurred the development of infant formula. A clean source of milk was thought to be necessary to overcome the mainly diarrheal deaths due to unhygienic conditions. Initially, the success of a formula was measured merely by the survival of the infant. As formulas more closely mimicked the performance of human milk, feedings were compared by the ability to support growth. Now, the additions and alterations to formulas have become more sophisticated and the outcome measures may be protection from infections, visual acuity and mental development. Studies to test these outcomes are difficult and often long term. Additionally, mere growth is recognized as an insufficient measure, rather quality of growth needs to be considered. Formula, like no other food, is potentially the sole source of an individual's nutrition for 4 to 6 months of life. In recognition of its importance, formula is the only food that is regulated by its own law in the United States, the Infant Formula Act of 1986. For the future, breast feeding will remain preferable for almost all infants and breastfeeding should be encouraged. Formulas will continue to be used and will continue to be needed. Improving and assuring the adequacy and safety of infant formulas is an increasingly difficult challenge.

Dietary Carbohydrates↗

PubMed2000

Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods.

BACKGROUND: An obvious difference between breast-fed and formula-fed newborn infants is the development of the intestinal flora, considered to be of importance for protection against harmful micro-organisms and for the maturation of the intestinal immune system. In this study, novel molecular identification methods were used to verify the data obtained by traditional culture methods and to validate the culture independent fluorescent in situ hybridization (FISH) technique. METHODS: From each of six breast-fed and six formula-fed newborn infants, six fecal samples were obtained during the first 20 days of life. The microbial compositions of the samples were analyzed by culturing on specific media and by FISH, by using specific 16S rRNA-targeted oligonucleotide probes. The colonies growing on the media were identified by random amplified polymorphic DNA pattern analysis and by polymerase chain reaction amplification and subsequent analysis of the 16S rRNA gene. RESULTS: Molecular identification of the colonies showed that the selective media are insufficiently selective and unsuitable for quantitative analyses. Qualitative information from the culturing results combined with the data obtained by the FISH technique revealed initial colonization in all infants of a complex (adult-like) flora. After this initial colonization, a selection of bacterial strains began in all infants, in which Bifidobacterium strains played an important role. In all breast-fed infants, bifidobacteria become dominant, whereas in most formula-fed infants similar amounts of Bacteroides and bifidobacteria (approximately 40%) were found. The minor components of the fecal samples from breast-fed infants were mainly lactobacilli and streptococci; samples from formula-fed infants often contained staphylococci, Escherichia coli, and clostridia. CONCLUSIONS: This study confirms the differences in development of intestinal flora between breast-fed and formula-fed infants. The results obtained from the FISH technique were consistent. Although the repertoire of probes for this study was not yet complete, the FISH technique will probably become the method of reference for future studies designed to develop breast-fed-like intestinal flora in formula-fed infants.

Bacteroides↗

PubMed1982

The microbial ecology of the large bowel of breast-fed and formula-fed infants during the first year of life.

The succession of bacterial populations in the large bowel of seven breast-fed and seven formula-fed infants was examined during the first year of life. The composition of the intestinal microflora varied according to the infant's diet. During the first week of life breast-fed and formula-fed infants were colonised by enterobacteria and enterococci followed by bifidobacteria, Bacteroides spp., clostridia and anaerobic streptococci. From week 4 until solid foods were given, breast-fed babies had a simple flora consisting of bifidobacteria and relatively few enterobacteria and enterococci. Formula-fed babies during the corresponding period were more often colonised by other anaerobes in addition to bifidobacteria and had higher counts of facultatively anaerobic bacteria. The introduction of solid food to the breast-fed infants caused a major disturbance in the microbial ecology of the large bowel as counts of enterobacteria and enterococci rose sharply and colonisation by Bacteroides spp., clostridia and anaerobic streptococci occurred. This was not observed when formula-fed infants began to take solids; instead, counts of facultative anaerobes remained high while colonisation by anaerobes other than bifidobacteria continued. At 12 months, the anaerobic bacterial populations of the large bowel of breast-fed and formula-fed infants were beginning to resemble those of adults in number and composition and there was a corresponding decrease in the number of facultative anaerobes. These changes are discussed in relation to changes in susceptibility to gastro-intestinal infection.

Actinomycetaceae↗

PubMed1997

Erythrocyte incorporation of iron is similar in infants fed formulas fortified with 12 mg/L or 8 mg/L of iron.

Although feeding of formulas with iron concentration of 215 mumol/L (12 mg/L) is a reliable means of preventing iron deficiency, high intakes of iron may adversely affect absorption of copper and zinc. Because data are not available to establish whether fortification at a lower level would result in equivalent iron absorption, we tested the hypothesis that iron absorption is greater by infants fed formulas with an iron concentration of 215 mumol/L (12 mg/L) than by those fed formulas with an iron concentration of 143 mumol/L (8 mg/L). Fifty-two normal infants entered the study at 112 +/- 4 d of age, and 46 of these were successfully studied until 196 d of age. Using the stable isotope 58Fe, we determined erythrocyte incorporation of iron by infants fed Formula 8 [iron approximately 143 mumol/L (8 mg/L)] and by infants fed Similac with Iron [iron approximately 215 mumol/L (12 mg/L)]. On each of three test days beginning at 154 d of age, a major portion of the formula was labeled with 58Fe. Geometric mean erythrocyte incorporation of iron adjusted for plasma ferritin concentration at 168 d of age was 4.82 mumol/d (0.269 mg/d) by infants fed Formula 8 and 5.21 mumol/d (0.291 mg/d) by infants fed Similac with Iron. Corresponding values at 196 d of age were 5.12 and 5.41 mumol/d (0.286 and 0.302 mg/d). The differences in quantity of iron incorporated into erythrocytes by infants fed Formula 8 and Similac with Iron were not statistically significant (P = 0.66 at 168 d of age, P = 0.75 at 196 d of age) and were judged to be nutritionally trivial. Because we were unable to provide support for our hypothesis that iron absorption is greater by infants fed formulas providing 215 mumol (12 mg) of iron per liter than by those fed formulas providing 143 mumol (8 mg) of iron per liter, we conclude that, pending the results of further studies, It is reasonable to decrease the iron concentration of iron-fortified infant formulas.

Body Weight↗

PubMed1984

[Free amino acids of various lacteal formulas used in Spain].

A comparative study has been made upon free amino-acids in human milk, cow's milk and some infant formulas commercialized in Spain. The contents of free amino-acids in human milk is significantly increased when compared to those of raw of UHT sterilized cow's milk and to those of infant formulas. The concentrations of alanine are significantly lower in cow's milk and in infant formulas compared to human milk. The same occurs with branched chain amino-acids, glutamic acid, serine, threonine and taurine. On the contrary, the levels of free cysteine are significantly higher in cow's milk and in infant formulas. The concentrations of free amino-acids determined in different infant formulas on sale in Spain are rather similar between each others, being the cuantitative pattern very different from that determined in human milk.

Amino Acids↗

PubMedDate not supplied

Different degree of antibody response to hepatitis B virus vaccine in breast- and formula-fed infants born to HBsAg-positive mothers.

Antibody response to hepatitis B virus vaccine was compared in 47 breast- and 112 formula-fed infants born to hepatitis B surface antigen-(HBsAg-) positive mothers. No difference was observed as to the percentage of infants who seroconverted. However, formula-fed infants developed transient but significantly higher anti-HBs antibody levels as compared to breast-fed infants. Suppressive factors in human milk or orally induced tolerance may explain this finding. The latter hypothesis may be supported by the presence of HBsAg in more than half of the milk samples we studied.

Antibodies, Viral↗

PubMed1991

pH-adjusted formula and gastroesophageal reflux.

To facilitate the detection of postcibal gastroesophageal reflux (GER), we have constructed an infant formula from modular carbohydrate, fat, and protein components with a pH of 4 and a nutrient composition identical to standard infant formula. In comparison to standard infant formula and sugar solutions, this pH-adjusted formula demonstrates a significantly greater amount of gastroesophageal reflex during the first postcibal hour. We speculate that the greater caloric density and slower gastric emptying of regular infant formula promotes greater gastroesophageal reflux than is observed with regular dextrose feedings. This effect is obscured unless the pH of the formula is adjusted. Use of this weakly acid formula in conjunction with postcibal esophageal pH probe recording facilitates the detection and, during simultaneous apnea monitoring, potential association of symptoms with postcibal gastroesophageal reflux.

Gastroesophageal Reflux↗

PubMed1989

Cow's milk whey protein elicits symptoms of infantile colic in colicky formula-fed infants: a double-blind crossover study.

There are several causes of infantile colic. The aim of this study was to evaluate, under controlled conditions, whether bovine whey proteins can elicit symptoms of infantile colic in colicky formula-fed infants. The mean age for entering the study was 6.4 weeks and the mean age for colic debut was 3.7 weeks. In 24 of 27 infants with severe colic, the symptoms disappeared when they were given a cow's milk-free diet (Nutramigen). These 24 infants were entered into a double-blind crossover study. The infants (receiving cow's milk-free diet) were given the contents of identical capsules with each meal during day 6. The same procedure was repeated on day 10. The capsules contained either whey protein powder (with Nutramigen added) or human albumin powder (with Nutramigen added). Eighteen infants receiving the whey protein-containing capsules reacted with colic, two infants receiving placebo reacted with colic (P less than .001), and four infants did not react at all. Crying hours per day for the 24 infants were 5.6 hours for formula-fed infants and 0.7 hour for cow's milk-free diet-fed infants (P less than .001). Crying hours per day were 3.2 hours for the infants receiving whey protein capsules and 1.0 hour for those receiving placebo (P less than .001). In conclusion, bovine whey protein can elicit symptoms of infantile colic in colicky formula-fed infants.

Animals↗

PubMed1977

Iron absorption from infant milk formula and the optimal level of iron supplementation.

Thirty healthy infants, aged 11-13 months, were studied with regard to the iron absorption from proprietary milk formula. The infants were divided into three groups (I-III) depending on the concentration of iron in the formula: 0.8 (I), 6.8 (II), and 12.8 (III) mg/l, respectively. The calculated amount of iron absorbed per test dose of 50 ml of milk averaged 5 microgram (I), 32 microgram (II), and 43 microgram (III). Group I differed significantly from groups II and III. No correlation was found between iron absorption and hemoglobin, MCV, serum transferrin saturation or serum ferritin within the range of normal values. Our findings suggest that at least 7 mg of iron as ferrous sulphate per litre of formula is required to prevent iron deficiency.

Animals↗

PubMed2000

Breast-fed and formula-fed infants do not differ in immunocompetent cell cytokine production despite differences in cell membrane fatty acid composition.

BACKGROUND: Breast-fed and formula-fed infants differ in the amount and type of polyunsaturated fatty acids consumed. The fatty acid composition of cell membranes is related to dietary fatty acids and, in adults, changes in membrane fatty acid composition are accompanied by changes in monocyte cytokine production and hence a modification of the immunologic response. OBJECTIVE: Our objective was to determine whether production by immunocompetent cells of the proinflammatory cytokines interleukin 1 (IL-1) and tumor necrosis factor (TNF) differs between breast-fed and formula-fed infants. DESIGN: Twenty-six healthy infants (13 breast-fed and 13 fed modified cow-milk formula) aged 2-4 mo were studied. The fatty acid composition of red blood cell (RBC) membrane phospholipids was measured by gas-liquid chromatography and IL-1 and TNF release were measured in whole blood culture in bacterial-endotoxin-stimulated and unstimulated cells. RESULTS: The infants' ages, weights, hemoglobin concentrations, and white blood cell counts did not differ significantly between groups. The percentage of n-3 fatty acids of total RBC phospholipid fatty acids was significantly higher in breast-fed than in formula-fed infants (6.31 +/- 2.5% compared with 2.98 +/- 0.97%); docosahexaenoic acid (22:6n-3) concentrations were also markedly higher in breast-fed infants (5.1 +/- 1.2% compared with 2.2 +/- 0.9%, P: < 0.001), but eicosapentaenoic acid (20:5n-3) and docosapentaenoic acid (22:5n-3) concentrations did not differ significantly between groups. The percentage of n-6 fatty acids was not significantly different between groups. The percentage of oleic acid (18:1) was higher in formula-fed than in breast-fed infants (16.2 +/- 0.7% compared with 20.6 +/- 1.1%; P: < 0.001). IL-1 and TNF release in whole blood culture did not differ significantly between groups. CONCLUSION: The release of proinflammatory cytokines by immunocompetent cells does not differ significantly in breast-fed and formula-fed infants despite differences in cell membrane fatty acid composition.

Breast Feeding↗

PubMed2001

Feeding infant piglets formula with long-chain polyunsaturated fatty acids as triacylglycerols or phospholipids influences the distribution of these fatty acids in plasma lipoprotein fractions.

Several sources of long-chain polyunsaturated fatty acids (LCP) are currently available for infant formula supplementation. These oils differ in their fatty acid composition, the chemical form of the fatty acid esters [triacylglycerols (TG) or phospholipids (PL)] and presence of other lipid components. These differences may affect LCP absorption, distribution and metabolic fate after ingestion. The purpose of the present study was to evaluate the influence of different chemical forms of dietary LCP on the composition of plasma, plasma lipoproteins, liver and jejunum in infant piglets. Thirty pigs (5 d old) were bottle-fed different diets for 4 wk: a control diet (C), a diet containing LCP as TG from tuna and fungal oils (TF-TG) or a diet containing LCP as PL from egg yolk (E-PL). We measured lipid and fatty acid composition of plasma and lipoproteins, as well as lipid composition of liver and intestinal mucosa. The arachidonic and docosahexaenoic acids in HDL-PL were significantly higher in piglets fed the E-PL diet than in those fed the TF-TG diet. Opposite results were found in the LDL-PL diet. No significant differences were found between groups in TG or cholesterol concentrations of plasma or lipoproteins. Arachidonic acid in plasma PL and cholesteryl esters was significantly higher in the E-PL group than in the TF-TG group. The chemical form in which LCP esters are present in different dietary sources influences their distribution in plasma lipoproteins. This may be important for infant nutrition and suggests that not all LCP sources may be biologically equivalent.

Animal Feed↗

PubMed2007

Clinical evaluation of a new starter formula for infants containing live Bifidobacterium longum BL999 and prebiotics.

OBJECTIVES: The larger number of bifidobacteria in the intestine of breast-fed infants has been associated with their better health compared with formula-fed infants. We assessed the safety and tolerability of an experimental formula containing 2 x 10(7) colony-forming units of Bifidobacterium longum BL999 and 4 g/L of a prebiotic mixture containing 90% galacto-oligosaccharides and 10% fructo-oligosaccharides. METHODS: A 7-mo prospective, randomized, reference-controlled, double-blinded trial was performed in infants who were not breast fed after the 14th day of birth. One hundred thirty-eight infants were enrolled and assigned to receive the control or experimental formula until they were 112 d old. Mean weight gain (primary outcome) and recumbent length, head circumference, tolerability (gastrointestinal symptoms), and overall morbidity (secondary outcomes) were measured at 14, 28, 56, 84, and 112 d of age. RESULTS: Equivalence in mean weight gain between the two groups was shown. The treatment difference in the intention-to-treat and per-protocol populations were within the predefined equivalence boundaries of +/-3.9 g/d. No statistically significant difference in recumbent length, head circumference, or incidence of adverse events was found between the two groups. Infants in the experimental group had fewer incidences of constipation and had stool characteristics that suggest that the experimental formula was tolerated well. Furthermore, these infants showed a trend toward fewer respiratory tract infections. CONCLUSIONS: The starter formula containing BL999 and galacto-oligosaccharides/fructo-oligosaccharides is safe and well-tolerated.

Bifidobacterium↗

PubMed1977

Differences in subcutaneous fat in breast- and formula-fed infants.

During the first 6 weeks of life, 87 breast-fed infants had a significantly greater increase in skinfold thickness than 173 infants fed only with artificial milk formulae. The two groups were similar in respect of racial origin, gestational age, birthweight, and weight gain in the first 6 weeks of life. These findings show that formula-fed infants have a different distribution of body fat from breast-fed infants.

Adipose Tissue↗

PubMed2004

Growth and feeding practices of Vietnamese infants in Australia.

OBJECTIVE: To investigate the growth and feeding practices in first-generation Vietnamese infants living in Australia. DESIGN: Cohort study. SETTING: The study was conducted between 1999 and 2002 in Sydney. SUBJECTS: A total of 239 Vietnamese women were recruited randomly from antenatal clinics, and of these 210 were initially seen. During the first year, 20 cases (9.5%) were lost to follow-up. Data were collected at 0.5, 2, 4, 6, 9 and 12 months. RESULTS: Vietnamese infants were significantly longer and heavier than reference data (both P<0.0001). The Vietnamese infants had a significant decline in weight growth with age compared with reference data (P<0.001). The Vietnamese infants had marginally higher s.d. score for ideal weight for length than reference data (P=0.044). There was a significant decline in ideal weight for length with age compared with reference data (P=0.0065). Both parents were significantly shorter (mean s.d. height scores: -1.5+/-0.8 (mother) and -1.8+/-0.8 (father)) than reference data (P<0.001). The incidence of breast feeding was 79%, but half of the breast feeding women had stopped breast feeding by 3 months. A total of 162 (79.8%) infants were given infant formula within the first week, of whom 131 (80.1%) were fed infant formula within the first 24 h after birth. CONCLUSIONS: Vietnamese infants in this study had growth comparable with reference data despite their parents being shorter than reference data. Breast feeding duration was short with infant formula being introduced early.

Anthropometry↗

PubMed1995

Polyamine profiles in human milk, infant artificial formulas, and semi-elemental diets.

Using a sensitive high-performance liquid chromatography method, we quantified the concentration of polyamines (putrescine, spermidine, and spermine) in human milk as well as in a representative group of commonly used artificial infant formulas. Variations in polyamine levels were also analyzed in human milk during the immediate postnatal period. During the first week postpartum, putrescine levels in human milk remained very low and varied little, while spermidine and spermine concentrations rose markedly during the first 3 days, reaching plateau levels that were 12 and eight times higher, respectively, than the values measured on day 0. The mean total polyamine concentration was 557 +/- 18 nmol/dl with the following profile: spermine, 313 +/- 16; spermidine, 220 +/- 20; and putrescine, 24 +/- 3.5. In artificial powdered formulas, the polyamine concentration was approximately 10 times lower than in human milk, with no difference in putrescine and spermine contents between first-age and second-age formulas. By contrast, semi-elemental diets prepared by hydrolytic procedures using crude extracts of pancreatic enzymes were shown to be major sources of polyamines with a profile similar to that of human milk. Compared with first-age formulas, mean concentrations in spermine and spermidine were 39 and six times higher, respectively, in these semi-elemental diets, whereas putrescine levels remained almost equivalent in all types of milk tested. These data indicate that human milk and some semi-elemental diets provide substantial amounts of spermine and spermidine to neonates and infants that could potentially modulate intestinal maturation.

Chromatography, High Pressure Liquid↗

PubMed1992

Randomised trial of a ready-to-feed compared with powdered formula.

Forty three infants were assigned randomly to a ready-to-feed infant formula or a standard formula that required reconstitution from powder. Despite similar nutrient composition of the two formulas those fed the powdered formula had significantly increased body weight and skinfold thickness gains, and became significantly heavier than a further group of 20 breast fed infants by 3 and 6 months. Of those fed the powdered formula 6/19 had become overweight (above the 90th or 97th centile) by 6 months, whereas 1/19 fed the ready-to-feed product was overweight at this age. While differences in fat absorption might have been contributory, our data suggest that errors in reconstitution of formula from powder might be the main cause for the growth differences observed. If it is appropriate to take the breast fed infant as a model, infants fed ready-to-feed formula in this study showed a more physiological pattern of growth than those fed a standard formula reconstituted from powder. These results require replication using other formulas as the findings have potentially important implications for infant feeding.

Body Weight↗

PubMed2003

Visual, cognitive, and language assessments at 39 months: a follow-up study of children fed formulas containing long-chain polyunsaturated fatty acids to 1 year of age.

OBJECTIVE: Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are long-chain polyunsaturated fatty acids found in breast milk and recently added to infant formulas. Their importance in infant nutrition was recognized by the rapid accretion of these fatty acids in the brain during the first postnatal year, reports of enhanced intellectual development in breastfed children, and recognition of the physiologic importance of DHA in visual and neural systems from studies in animal models. These considerations led to clinical trials to evaluate whether infant formulas that are supplemented with DHA or both DHA and ARA would enhance visual and cognitive development or whether conversion of linoleic acid and alpha-linolenic acid, the essential fatty acid precursors of ARA and DHA, respectively, at the levels found in infant formulas is sufficient to support adequately visual and cognitive development. Visual and cognitive development were not different with supplementation in some studies, whereas other studies reported benefits of adding DHA or both DHA and ARA to formula. One of the first trials with term infants that were fed formula supplemented with DHA or both DHA and ARA evaluated growth, visual acuity (Visual Evoked Potential; Acuity Card Procedure), mental and motor development (Bayley Scales of Infant Development), and early language development (MacArthur Communicative Developmental Inventories). Growth, visual acuity, and mental and motor development were not different among the 3 formula groups or between the breastfed and formula-fed infants in the first year of life. At 14 months of age, infants who were fed the formula with DHA but no ARA had lower vocabulary production and comprehension scores than infants who were fed the unsupplemented control formula or who were breastfed, respectively. The present follow-up study evaluated IQ, receptive and expressive vocabulary, visual-motor function, and visual acuity of children from the original trial when they reached 39 months of age. METHODS: Infants were randomized within 1 week after birth and fed a control formula (n = 65), one containing DHA (n = 65), or one containing both ARA and DHA (n = 66) to 1 year of age. A comparison group (n = 80) was exclusively breastfed for at least 3 months after which the infants continued to be exclusively breastfed or were supplemented with and/or weaned to infant formula. At 39 months, standard tests of IQ (Stanford Binet IQ), receptive vocabulary (Peabody Picture Vocabulary Test-Revised), expressive vocabulary (mean length of utterance), visual-motor function (Beery Visual-Motor Index), and visual acuity (Acuity Card Procedure) were administered. Growth, red blood cell fatty acid levels, and morbidity also were evaluated. RESULTS: Results were analyzed using analysis of variance or linear regression models. The regression model for IQ, receptive and expressive language, and the visual-motor index controlled for site, birth weight, sex, maternal education, maternal age, and the child's age at testing. The regression model for visual acuity controlled for site only. A variable selection model also identified which of 22 potentially prognostic variables among different categories (feeding groups, the child and family demographics, indicators of illness since birth, and environment) were most influential for IQ and expressive vocabulary. A total of 157 (80%) of the 197 infants studied at 12 months participated in this follow-up study. Characteristics of the families were representative of US families with children up to 5 years of age, and there were no differences in the demographic or family characteristics among the randomized formula groups. As expected, the formula and breastfed groups differed in ethnicity, marital status, parental education, and the prevalence of smoking. Sex, ethnicity, gestational age at birth, and birth weight for those who participated at 39 months did not differ from those who did not. The 12-month Bayley mental and motor scores and 14-month vocabulary scores of the children who participated also were were not different from those who did not. At 39 months, IQ, receptive and expressive language, visual-motor function, and visual acuity were not different among the 3 randomized formula groups or between the breastfed and formula groups. The adjusted means for the control, ARA+DHA, DHA, and breastfed groups were as follows: IQ scores, 104, 101, 100, 106; Peabody Picture Vocabulary Test, 99.2, 97.2, 95.1, 97.4; mean length of utterance, 3.64, 3.75, 3.93, 4.08; the visual-motor index, 2.26, 2.24, 2.05, 2.40; and visual acuity (cycles/degree), 30.4, 27.9, 27.5, 28.6, respectively. IQ was positively associated with female sex and maternal education and negatively associated with the number of siblings and exposure to cigarette smoking in utero and/or postnatally. Expressive language also was positively associated with maternal education and negatively associated with the average hours in child care per week and hospitalizations since birth but only when the breastfed group was included in the analysis. The associations between maternal education and child IQ scores are consistent with previous reports as are the associations between prenatal exposure to cigarette smoke and IQ and early language development. Approximately one third of the variance for IQ was explained by sex, maternal education, the number of siblings, and exposure to cigarette smoke. Growth achievement, red blood cell fatty acid levels, and morbidity did not differ among groups. CONCLUSIONS: We reported previously that infants who were fed an unsupplemented formula or one with DHA or with both DHA and ARA through 12 months or were breastfed showed no differences in mental and motor development, but those who were fed DHA without ARA had lower vocabulary scores on a standardized, parent-report instrument at 14 months of age when compared with infants who were fed the unsupplemented formula or who were breastfed. When the infants were reassessed at 39 months using age-appropriate tests of receptive and expressive language as well as IQ, visual-motor function and visual acuity, no differences among the formula groups or between the formula and breastfed groups were found. The 14-month observation thus may have been a transient effect of DHA (without ARA) supplementation on early vocabulary development or may have occurred by chance. The absence of differences in growth achievement adds to the evidence that DHA with or without ARA supports normal growth in full-term infants. In conclusion, adding both DHA and ARA when supplementing infant formulas with long-chain polyunsaturated fatty acids supports visual and cognitive development through 39 months.

Arachidonic Acid↗