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PubMed2004

Ratio of maltose to maltulose and furosine as quality parameters for infant formula.

Nonenzymic browning reactions in commercial infant formulas were evaluated through their furosine content as well as the isomeric disaccharides formed during processing. Lactulose was observed only in samples containing appreciable amounts of lactose, whereas maltulose was present in all samples due to the isomerization of maltose. Because formation of maltulose depends on the initial amount of maltose present, the ratio maltose/maltulose was used for comparative purposes. The ratio maltose/maltulose varied within a wide range, 27-167; therefore, low values in maltose/maltulose ratio may indicate severe processing conditions during manufacture, whereas high values may indicate mild processing conditions. Variable amounts of furosine content in samples with similar maltose/maltulose ratios may be attributed to different conditions used during storage. Levels of furosine higher than those reported for milk powder were detected in most studied samples. Determination of both furosine and maltose/maltulose ratio would yield information retrospectively about the heat treatment applied during processing and the storage conditions of commercial infant formula.

Chromatography, Gas↗
PubMed2002

Fatty acid and sn-2 fatty acid composition in human milk from Granada (Spain) and in infant formulas.

OBJECTIVE: To investigate differences in fatty acid and sn-2 fatty acid composition in colostrum, transitional and mature human milk, and in term infant formulas. SETTING: Departament de Nutrició i Bromatologia, University of Barcelona, Spain and University Hospital of Granada, Spain. SUBJECTS: One-hundred and twenty mothers and 11 available types of infant formulas for term infants. DESIGN: We analysed the fatty acid composition of colostrum (n=40), transitional milk (n=40), mature milk (n=40) and 11 infant formulas. We also analysed the fatty acid composition at sn-2 position in colostrum (n=12), transitional milk (n=12), mature milk (n=12), and the 11 infant formulas. RESULTS: Human milk in Spain had low saturated fatty acids, high monounsaturated fatty acids and high linolenic acid. Infant formulas and mature human milk had similar fatty acid composition. In mature milk, palmitic acid was preferentially esterified at the sn-2 position (86.25%), and oleic and linoleic acids were predominantly esterified at the sn-1,3 positions (12.22 and 22.27%, respectively, in the sn-2 position). In infant formulas, palmitic acid was preferentially esterified at the sn-1,3 positions and oleic and linoleic acids had higher percentages at the sn-2 position than they do in human milk. CONCLUSION: Fatty acid composition of human milk in Spain seems to reflect the Mediterranean dietary habits of mothers. Infant formulas resemble the fatty acid profile of human milk, but the distribution of fatty acids at the sn-2 position is markedly different.

Colostrum↗
PubMed2000

Comparison of a partially hydrolyzed infant formula with two extensively hydrolyzed formulas for allergy prevention: a prospective, randomized study.

The aim of this study was to compare the allergy-preventive effect of a partially hydrolyzed formula with two extensively hydrolyzed formulas, in infants with a high risk for development of allergic disease. High-risk infants from four Danish centres were included in the period from June 1994 to July 1995. Five-hundred and ninety-five high-risk infants were identified. High-risk infants were defined as having biparental atopy, or a single atopic first-degree relative combined with cord blood immunoglobulin E (IgE)> or =0.3 kU/l. At birth all infants were randomized to one of three different blinded formulas. All mothers had unrestricted diets during pregnancy and lactation and were encouraged to breast-feed exclusively. If breast-feeding was insufficient, one of the three formulas, according to randomization, was given during the first 4 months. It was recommended not to introduce cow's milk, cow's milk products. and solid foods until the age of 4 months. After the age of 4 months a normal unrestricted diet and conventional cow's milk-based formula were given when needed. All infants were followed-up prospectively with interview and physical examination at the age of 6, 12, and 18 months, and if any possible atopic symptoms were reported. If food allergy was suspected, controlled elimination/challenge procedures were performed in a hospital setting. Of 550 infants included in the study, 514 were seen at all visits and 36 were excluded owing to noncompliance. Of 478 infants who completed the study, 232 were exclusively breast-fed, 79 received an extensively hydrolyzed casein formula (Nutramigen), 82 an extensively hydrolyzed whey formula (Profylac), and 85 a partially hydrolyzed whey formula (Nan HA), during the first 4 months of life. These four groups were identical in regard to atopic predisposition, cord blood IgE, birthplace, and gender. Exclusively breast-fed children were exposed less to tobacco smoke and pets at home and belonged to higher social classes, whereas the three formula groups were identical concerning environmental factors. The frequency of breast-feeding was high; only eight (2%) children were not breast-fed at all. The three formula groups were identical in regard to duration of breast-feeding and age at introduction of formula and solid foods. No significant differences were found in the three groups of infants receiving formula milk regarding the cumulative incidence of atopic dermatitis or respiratory symptoms. The cumulative incidence of parental-reported cow's milk allergy was significantly higher in children fed partially hydrolyzed formula (Nan HA) compared with extensively hydrolyzed formula (Nutramigen or Profylac) at 12 and 18 months (NanHA, 7.1%; Nutramigen, 2.5%; Profylac, 0%; p=0.033). The cumulative incidence of confirmed cow's milk allergy was 1.3% (three of 232) in exclusively breast-fed infants, 0.6% (one of 161) in infants fed extensively hydrolyzed formula (Nutramigen or Profylac), and 4.7%(four of 85) in infants fed partially hydrolyzed formula (Nan HA). Partially hydrolyzed formula was found to be less effective than extensively hydrolyzed formula in preventing cow's milk allergy, 0.6% vs. 4.7% (p=0.05), but because of the small number of cases the results should be interpreted with caution. Compared with other similar studies the frequency ofatopic symptoms was low, even though the dietetic intervention did not include either maternal diet during lactation or dietary restrictions to the children after the age of 4 months.

Breast Feeding↗
PubMed2006

WIC's promotion of infant formula in the United States.

BACKGROUND: The United States' Special Supplemental Nutrition Program for Women, Infants and Children (WIC) distributes about half the infant formula used in the United States at no cost to the families. This is a matter of concern because it is known that feeding with infant formula results in worse health outcomes for infants than breastfeeding. DISCUSSION: The evidence that is available indicates that the WIC program has the effect of promoting the use of infant formula, thus placing infants at higher risk. Moreover, the program violates the widely accepted principles that have been set out in the International Code of Marketing of Breast-milk Substitutes and in the human right to adequate food. SUMMARY: There is no good reason for an agency of government to distribute large quantities of free infant formula. It is recommended that the large-scale distribution of free infant formula by the WIC program should be phased out.

Journal Article↗
PubMed1983

Iron, zinc, copper, and manganese in infant formulas.

The concentrations of the trace elements iron, zinc, copper, and manganese were determined in 53 regular infant formulas and 41 special infant formulas used for clinical disorders. Several infant formulas had lower concentrations of trace elements than human milk. The ranges of concentrations found in the formulas were as follows: Iron, 0.0 to 57.5 mg/L; copper, 0.01 to 2.14 mg/L; zinc, 0.10 to 13.5 mg/L; and manganese, 0.0 to 7.8 mg/L. In addition to the wide variation in absolute amounts of the trace elements in the formulas, large variations in the ratios of trace elements were found. While the average ratios of zinc/copper, zinc/iron, and iron/manganese in human milk range from 3.3 to 10, 2.5 to 10, and 25 to 100, respectively, they ranged from 0.4 to 74, 0.02 to 40, and 0.04 to 425 in the formulas. These differences in the ratios may be important, as the ratio can affect the absorption of the individual elements. These findings indicate that more attention should be given to the trace element levels in infant formulas.

Copper↗
PubMed1981

Gastric emptying in infants fed human milk or infant formula.

Gastric emptying of meals of human milk or infant formula was studied in 17 healthy infants aged 4 weeks to 6 months using a marker dilution technique. In the 24 studies performed gastric emptying followed a biphasic pattern in 11 and a linear pattern in 12 studies. The average gastric half-emptying time for meals of human milk was 48 min, and for meals of infant formula 78 min. After 1 hour an average of 29.5 ml of human milk and 22.7 ml of infant formula per 0.1 m2 of body surface area had emptied from the stomach.

Gastric Emptying↗
PubMed1998

Decreased citrate improves iron availability from infant formula: application of an in vitro digestion/Caco-2 cell culture model.

We have applied an in vitro digestion/Caco-2 cell culture model to the assessment of iron availability from human milk and a generic cow's milk-based infant formula. Experiments were designed to determine the availability of iron from human milk relative to infant formula and whether known promoters of iron absorption would increase Caco-2 cell iron uptake and availability from the infant formula. In addition, we sought to determine if decreasing the citrate concentration in the infant formula would increase the iron uptake. Although approximately twice as much iron was in solution from digests of the infant formula relative to that of human milk, smaller or equal amounts of iron were taken up from the infant formula relative to the human milk digest. These results are qualitatively similar to in vivo studies. Addition of known iron uptake promoters to infant formula did not enhance Caco-2 cell iron uptake from the infant formula digest, indicating that the iron in the infant formula existed predominantly in a tightly bound unavailable form(s). Enzymatic pretreatment of the infant formula with citrate lyase and oxalacetate decarboxylase decreased the citrate concentration by 67% and resulted in a 64% increase of iron in solution, which corresponded to a 46% increase in the cell iron uptake. Iron uptake from the "low citrate" formula plus cysteine was 102% greater relative to the nontreated formula. The results indicate that too much citrate can reduce iron uptake, particularly if it is present at concentrations greater than promoters such as ascorbic acid and cysteine.

Animals↗
PubMed2003

Selenium composition of cereal-containing infant formulas: assessment of dietary intake status.

The selenium (Se) content of 11 infant formulas had been determined using electrothermal and hydride generation atomic absorption spectrometry. The Se content ranged between 0.43 and 17.17 microg/100 g powder infant formulas with wide variations reaching 40.36-fold excess between the poorest RIRI-1 (0.43 microg/100 g) and Milupa-2 (17.2 microg/100 g powder). After reconstituting with water, the adequacies of the 11 studied infant formulas were evaluated with respect to Se supply. Based on the daily adequate intakes (AIs) of 15 and 20 microg Se for children 4-6 and 7-12 months old, respectively, four analyzed infant formulas were found to contain adequate Se content (>75% of the AIs), whereas the other seven formulas could satisfy 63% or less. In conclusion, the national regulation for the trace element (Se) contents in the infant formulas is highly warranted.

Eating↗
PubMed2006

Gamma radiation sensitivity of Enterobacter sakazakii in dehydrated powdered infant formula.

The observed Enterobacter sakazakii D10-values for tryptic soy broth and dehydrated powdered infant formula were 0.27 +/- 0.05 and 0.76 +/- 0.08 kGy, respectively. A decrease of approximately 3 log in the dehydrated powdered infant formula was obtained by irradiation with 3.0 kGy or rehydration with hot water at 80 degrees C. No recoverable bacteria were found in the powdered infant formula irradiated at 5.0 kGy and stored, either before or after rehydration. A radiation dose of up to 5.0 kGy had no marked effect on the sensory properties of the dehydrated powdered infant formula after rehydration and heating. Gamma radiation could potentially be used to inactivate E. sakazakii in dehydrated powdered infant formula; however, nutritional studies need to be conducted before the use of radiation can be recommended.

Colony Count, Microbial↗
PubMed1985

Lead content of water and of reconstituted infant formula in Vienna.

Daily lead intake from infant formula was estimated for young infants living in Vienna based on determinations of the lead concentration of drinking water and powdered formulas. The lead concentration in water was higher in houses built before 1945 (median 15.6 micrograms/l) than in houses built between 1945 and 1965 (median 4.4 micrograms/l) and in houses built after 1965 (median 2.8 micrograms/l). Boiling water for 1 min substantially reduced (p less than 0.0005) the lead concentration in water from all houses, apparently because of the coprecipitation of lead with boiler scale. The mean lead concentration in infant formula powder (n = 36) was 161.8 (SD 103.7) micrograms/kg. The lead concentration of an 'average' reconstituted infant formula, calculated using the mean lead concentration of boiled water (5.4 micrograms/l) and of formula powder, was 27.5 micrograms/l. This corresponded to 4.1 micrograms/100 kcal, which was substantially below the FDA maximum value of 16 micrograms/100 kcal. The lead concentration in the fat-free mass of a hypothetical young infant was estimated, assuming formula as the only source of lead and average values for caloric intake and retention of ingested lead. Between 0 and 4 months the estimated lead concentration in the fat-free mass declined from the concentration present at birth, indicating that the lead intake from formula is not likely to cause lead accumulation in the body during early infancy.

Austria↗
PubMed1990

Antiviral and antibacterial lipids in human milk and infant formula feeds.

Human milk and two infant formula feeds were tested for antiviral and antibacterial activity before being given to 21 low birthweight (LBW) infants; neither was present. When samples were aspirated from the stomachs of the infants within one to three hours of feeding, however, they reduced titres of enveloped virus and also killed both Staphylococcus epidermidis and Escherichia coli. The lipid fraction of the gastric aspirate from an infant who had been given human milk as well as those from four infants who had been given a conventional LBW infant formula feed, showed antiviral and antibacterial activities at least equal to the activities of the unfractionated aspirates. There was no consistent difference in antiviral or antibacterial activity of either the stomach aspirates or the lipid fractions of these aspirates between infants given human milk and those given formula feeds. The antiviral and antibacterial activities of the gastric aspirates seem to result from intragastric production of monoglycerides and fatty acids from the triglyceride content of the ingested feeds.

Antiviral Agents↗
PubMedDate not supplied

Extension of AOAC Official Method 996.01 to the analysis of Standard Reference Material (SRM) 1846 and infant formulas.

There is currently no official method for the analysis of fatty acids (including trans fatty acids) in infant formulas. AOAC Official Method 996.01 for Fat Analysis in Cereal Products was extended to the analysis of milk-based infant formula Standard Reference Material (SRM)1846 to determine its applicability for use with infant formulas. Following the analysis of SRM 1846, 2 infant formulas, one milk-based liquid and one soy-based powdered infant formula, were analyzed for total fatty acid composition. Fatty acid methyl esters were prepared and analyzed by gas chromatography. The results of the analysis of SRM 1846 show that the mean analyzed values were highly reproducible as indicated by low coefficients of variation (CV). The CVs were <5% for the major fatty acids. Mean analyzed values for individual fatty acids in SRM 1846 were within +/- 1 standard deviation of the certificate values. The analyzed value for total fat as triglycerides (26.27 +/- 0.25%) agreed well with the certificate value (27.1 +/- 0.59%). Analyses of infant formulas showed that the concentrations of linoleic acid and fat meet the requirements for such formulas.

Animals↗
PubMed2005

Effects of infant formula containing a mixture of galacto- and fructo-oligosaccharides or viable Bifidobacterium animalis on the intestinal microflora during the first 4 months of life.

Adding prebiotics or probiotics to infant formula to improve the intestinal flora of formula-fed infants is considered to be a major innovation. Several companies have brought relevant formulations onto the market. However, comparative data on the effects of pre- and probiotics on the intestinal microflora of infants are not available. The present study aimed to compare the effects of infant formula containing a mixture of galacto- and fructo-oligosaccharides or viable Bifidobacterium animalis on the composition and metabolic activity of the intestinal microflora. Before birth, infants were randomised and double blindly allocated to one of three formulas. The prebiotic (GOS/FOS) group (n 19) received regular infant formula supplemented with a mixture of galacto-oligosaccharides and fructo-oligosaccharides (6 g/l). The probiotic (Bb-12) group (n 19) received the same formula supplemented with 6.0x10(10) viable cells of B. animalis per litre. The standard group (n 19) received non-supplemented regular formula. A group of sixty-three breast-fed infants was included as a reference group. Faecal samples were taken at postnatal day 5 and 10, and week 4, 8, 12 and 16. Compared with the groups fed Bb-12 and standard formula, the GOS/FOS formula group showed higher faecal acetate ratio (69.7 % (sem 2.7), 69.9 % (sem 3.9) and 82.2 % (sem 5.3); P<0.05) and lactate concentration (11.3 (sem 7.9), 3.1 (sem 2.3) and 34.7 (sem 10.7) mmol/kg faeces) and lower pH (6.6 (sem 0.2), 7.1 (sem 0.2) and 5.6 (sem 0.2); P<0.05) at 16 weeks. Differences in percentage of bifidobacteria between the GOS/FOS (59.2 % (sem 7.7)), Bb-12 (52.7 % (sem 8.0)) and the standard (51.8 % (sem 6.4)) groups were not statistically significant at 16 weeks. Feeding infants GOS/FOS formula resulted in a similar effect on metabolic activity of the flora as in breast-fed infants. In the Bb-12 group, composition and metabolic activity of the flora were more similar to those of the standard group.

Bifidobacterium↗
PubMed2006

Effects of preculturing conditions on lag time and specific growth rate of Enterobacter sakazakii in reconstituted powdered infant formula.

Enterobacter sakazakii can be present, although in low levels, in dry powdered infant formulae, and it has been linked to cases of meningitis in neonates, especially those born prematurely. In order to prevent illness, product contamination at manufacture and during preparation, as well as growth after reconstitution, must be minimized by appropriate control measures. In this publication, several determinants of the growth of E. sakazakii in reconstituted infant formula are reported. The following key growth parameters were determined: lag time, specific growth rate, and maximum population density. Cells were harvested at different phases of growth and spiked into powdered infant formula. After reconstitution in sterile water, E. sakazakii was able to grow at temperatures between 8 and 47 degrees C. The estimated optimal growth temperature was 39.4 degrees C, whereas the optimal specific growth rate was 2.31 h(-1). The effect of temperature on the specific growth rate was described with two secondary growth models. The resulting minimum and maximum temperatures estimated with the secondary Rosso equation were 3.6 degrees C and 47.6 degrees C, respectively. The estimated lag time varied from 83.3 +/- 18.7 h at 10 degrees C to 1.73 +/- 0.43 h at 37 degrees C and could be described with the hyperbolic model and reciprocal square root relation. Cells harvested at different phases of growth did not exhibit significant differences in either specific growth rate or lag time. Strains did not have different lag times, and lag times were short given that the cells had spent several (3 to 10) days in dry powdered infant formula. The growth rates and lag times at various temperatures obtained in this study may help in calculations of the period for which reconstituted infant formula can be stored at a specific temperature without detrimental impact on health.

Animals↗
PubMedDate not supplied

Determination of choline in infant formula by ion chromatography.

Choline was determined in infant formula by ion chromatography with suppressed conductivity detection. Samples were digested with 1M hydrochloric acid, filtered, diluted, and injected into the chromatographic system. Choline and the alkali and alkaline earth metals were separated on a high-resolution cation-exchange column and detected by suppressed conductivity. The method was linear between 2 and 200 mg/L (r2 = 0.9999), the concentration range of the diluted samples. This method accurately determined choline in powdered, concentrated, and ready-to-feed infant formulas. Recoveries of choline spikes into powdered infant formula at approximately 1, 0.8, 0.5, and 0.2 times the labeled value ranged from 85 to 114%. This method had good agreement for 8 blind duplicates. The values determined for these samples, which were used in an AOAC collaborative study of an enzymatic method, were consistent with the values determined by the enzymatic method.

Alcohol Oxidoreductases↗
PubMed2006

Adequacy and safety of an infant formula with a protein/energy ratio of 1.8 g/100 kcal and enhanced protein efficiency for term infants during the first 4 months of life.

OBJECTIVE: Excess protein in infant formula may lead to renal overload and play a role in later obesity. The objective of this controlled, prospective, randomized, double-blind study was to assess the suitability and safety of a modified protein content infant formula and its noninferiority as compared to a conventional formula. PATIENTS AND METHODS: Healthy term infants age < 7 days were either breast-fed or randomized to be fed exclusively with a conventional casein-predominant formula (protein/energy ratio: 2.6 g/100 kcal) or the isocaloric whey-predominant study formula (protein/energy ratio: 1.8 g/100 kcal) for 120 days. Primary outcome was daily weight gain between D0 and D120 (noninferiority criterion: difference in daily weight gain < or = 4 g). Secondary outcomes were daily gain in weight, length, head circumference and body mass index at monthly intervals. Tolerance and safety were assessed at each visit. RESULTS: 162 infants were enrolled, 84% of the formula-fed infants and 36% of the breast-fed infants completing the study. Mean daily weight gain from D0 to D120 in the formula-fed groups differed by 0.38 g/day [95% CI: -2.59; 1.83] signifying the noninferiority of the study formula. Secondary outcomes did not differ between the 2 groups at any time and were comparable to outcomes in the breast-fed group. Tolerance was good and adverse events were not different between study groups. CONCLUSIONS: The whey-predominant study infant formula with a protein/energy ratio of 1.8 g/100 kcal and enhanced protein efficiency is safe and not inferior to a conventional formula in ensuring normal growth during the first four months of life.

Anthropometry↗
PubMed1993

[Sialic acid in breast milk and infant formula food].

OBJECTIVE: Sialic acid (N-acetylneuraminic acid, NANA) is an essential component of mucins, glycoproteins and gangliosides and therefore important for the function of cell membranes, membrane receptors and the normal development of the brain. The capacity of the metabolic pathway for the synthesis of sialic acid from glucose and other carbohydrate sources in preterm infants and term-born neonates is currently unknown. METHODS: In the present study the overall nutritional sialic acid supply of infants was analysed by means of HPLC-based determination of sialic acid concentrations in a total of 51 human milk samples obtained from nursing mothers at different stages of lactation. The data were compared with 3 commercial preterm infant formulas, 7 adapted infant formulas, 11 partially adapted infant formulas, 4 follow-up and 2 soy-based formulas. RESULTS: The sialic acid concentration in colostrum and transitory human milk was 1300 +/- 322 mg/l. After the 10th day of lactation the concentration dropped to 983 +/- 455 mg/l (p < 0.01). Preterm infant formulas contained 197 +/- 31, adapted formulas 190 +/- 31, partially adapted formulas 100 +/- 33, follow-up formulas 100 +/- 33 and soy-based formulas 34 +/- 9 mg sialic acid/l, respectively. CONCLUSIONS: Formula-fed infants obtain less than 20% of the amount of sialic acid supplied if breast-fed. A sufficient sialic acid supply may be essential in very-low-birth-weight infants and neonates at risk for the normal development of brain function.

Animals↗