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PubMed1993

Prevalence of bacterial respiratory pathogens in the nasopharynx in breast-fed versus formula-fed infants.

In several studies, breast-feeding has been associated with decreased frequency or duration of otitis media episodes. If a causal relationship exists, the mechanism of protection of breast-feeding has not been established. We hypothesized that infants who are breast-fed, compared with infants who are formula-fed, have a lower prevalence of nasopharyngeal colonization with the bacterial respiratory pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes) commonly isolated from the middle ear effusions of children with acute otitis media. In two private pediatric practices, we obtained specimens from the nasopharynx for culture from 211 infants at 1 month of age and from 173 of these infants at 2 months of age. A swab was left in place in the nasopharynx for 45 s and was then immediately transferred onto appropriate culture media. Exclusively breast-fed (n = 84) and exclusively formula-fed (n = 76) infants were similar regarding the number of persons in the household, the number of children in the household, the number of siblings in day care, and the proportion with a recent upper respiratory tract infection. The two groups did not differ significantly in the proportions found to have one or more respiratory pathogens at 1 month of age (10.7 versus 18.4%; P = 0.12) or 2 months of age (34.8 versus 35.1%; P = 0.57). We conclude that during the first 2 months after birth, the exclusive receipt of breast milk appears not to substantially influence the prevalence of nasopharyngeal colonization with common bacterial respiratory pathogens.

Age Factors↗

PubMed1992

[Sodium and potassium metabolism in infancy].

BACKGROUND: Recommendations for the concentration of most nutrients in infant formulas are based on their concentration in human milk. Industry succeeded in adapting sodium and potassium content in infant formulas to concentration found in human milk. Whether this adaptation affects on infants' mineral balances was studied in breast-fed and artificially-fed infants. METHODS: Sodium and potassium balances were performed in 16 term male infants from their 3rd until their 17th week of life. The balances were performed at home and comprised up to five periods in intervals of three to four weeks. Each balance period consisted of subsequent three 24 h collections of milk, stool and urine samples. Ten infants were breast-fed, six received an adapted infant formula supplemented with copper, zinc and iron. RESULTS: The breast-fed infants got a mean intake of 1 mmol Na/kg b w x day and a mean intake of 1.8 mmol K/kg b w x day. Man retention was 0.4 mmol Na and 0.7 mmol K/kg b w x day. The formula-fed infants received 1.9 mmol Na/kg b w x day and 2.1 mmol K/kg b w x day. Na- and K-retention in this group was 0.5 and 0.6 mmol/kg b w x day respectively. Although sodium intake in the formula-fed infants was nearly twice as much as in the breast-fed infants the difference in sodium retention was only small (0.4 vs 0.5 mmol/kg b w x day). The formula-fed infants got more potassium than the breast-fed infants, but potassium retention was the same in both groups. CONCLUSIONS: With the adapted infant formula of this study the artificially fed infant was as well supplied with sodium and potassium as the breast-fed infant. A further reduction of the sodium concentration seems not to be useful.

Animals↗

PubMed1993

Use of growth models to describe patterns of length, weight, and head circumference among breast-fed and formula-fed infants: the DARLING Study.

Nine mathematical models were applied to 24-month length, weight, and head circumference growth curves of 39 breast-fed and 31 formula-fed infants from the DARLING study. For both breast-fed and formula-fed infants, the Karlberg infancy-childhood-puberty (ICP) model best describes the relationship between recumbent length and age and the Jenss model best describes the relationship between head circumference and age. For formula-fed infants several models appropriately describe the relationship between weight and age, and we recommend the Jenss model. However, none of the models suitably describes the shape of the weight curve for breast-fed infants.

Analysis of Variance↗

PubMed2005

Prebiotic carbohydrates in human milk and formulas.

Human milk oligosaccharides play an important role, as prebiotic soluble fibres, in the postnatal development of the intestinal flora. Infant formulas are virtually free of prebiotic oligosaccharides. As a consequence, formula-fed infants develop an intestinal flora significantly different to the flora of breastfed infants. Due to the complexity of human milk oligosaccharides, it is necessary to use alternative sources of prebiotic ingredients as components of infant formulas. The present review summarizes the data of experimental research and clinical studies with a prebiotic mixture containing 90% short-chain galacto-oligosaccharides and 10% long-chain fructo-oligosacchrides are summarized. The data demonstrate that, with this prebiotic mixture, the growth of bifidobacteria and lactobacilli can be stimulated, the faecal pH can be decreased, and the presence of pathogens can be reduced to levels similar to those of breastfed infants. Thus, prebiotic oligosaccharides such as the studied mixture provide beneficial effects for formula-fed infants.

Breast Feeding↗

PubMed1991

Factors affecting insulin-like growth factor-I concentration in bovine milk.

To establish the naturally occurring range of insulin-like growth factor-I concentrations in bovine milk, samples from individual cows (n = 409) managed on five Missouri dairy herds were assayed. Parity, stage of lactation, and farm affected milk insulin-like growth factor-I concentration. Milk insulin-like growth factor-I concentration was higher in early lactation than mid and late lactation with concentrations in multiparous cows exceeding those in primiparous cows. Insulin-like growth factor-I concentration was negatively correlated to milk production the day of sample collection (r = -.15) and not correlated to predicted 305-d milk yields. Unprocessed bulk tank milk samples (n = 100) from a commercial processing plant had a mean concentration of insulin-like growth factor-I in milk of 4.32 ng/ml with a range of 1.27 to 8.10 ng/ml. This distribution was similar to the range detected in samples from individual cows, but values were lower than those reported for human milk. Concentration of insulin-like growth factor-I in milk was not altered by pasteurization (at 79 degrees C for 45 s). However, insulin-like growth factor-I was undetectable in milk heated to temperatures (121 degrees C for 5 min) required for infant formula preparation or in commercially available infant formula. These data indicated that insulin-like growth factor-I is a normal but quantitatively variable component of bovine milk that is not destroyed by pasteurization but is undetectable in infant formula. Concentration of insulin-like growth factor-I in bovine milk is lower than concentrations reported for human milk yet similar to those reported for human saliva.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1983

Double metabolic balances on low birthweight infants fed formulae of differing composition.

The comparative nutritional merits of two infant milk formulae, Ready-to-Feed Premium Babyfood (Cow and Gate Ltd.) and Prematalac (Cow and Gate Ltd.) were examined--Prematalac is modified in an attempt to meet the specific requirements of the low birthweight infant. Nine premature infants were enrolled for two metabolic balance periods in a cross-over experimental design. At the onset the infants were randomly allocated one of two milks. Various anthropometric data were collected at the start and end of each 4 day balance. All infants received more energy and protein per kg body weight per day on Prematalac compared with Premium. Incremental weight, though satisfactory for both milks over the balance periods, was greater when Prematalac was fed compared with Premium (mean and (range) 46 (25-93), 19 (9-44) g per day respectively). No differences were detected for gain in length between the two milks. Mean percent digestibility of energy intake was similar for both milks (92%). Infants retained more nitrogen when fed Prematalac compared with Premium (mean (+SD) 477 (59) and 299 (30) mg per kg per day respectively). Neither milk was considered ideal, and we conclude that standard formulae are unable to support the potential for gain in lean body tissue of the premature infant.

Anthropometry↗

PubMed1990

Energy expenditure and deposition of breast-fed and formula-fed infants during early infancy.

The energy intake, expenditure, and deposition of 40 breast-fed and formula-fed infants were investigated at 1 and 4 mo of age to explore possible differences in energy utilization between feeding groups. Energy intake was calculated from 5-d test-weighing records or pre- and postweighing of formula bottles, in combination with bomb calorimetry of the milks. Total daily energy expenditure (TDEE) was determined by the doubly labeled water method. Sleeping metabolic rate (SMR) and minimal observable energy expenditure were measured by indirect calorimetry. Activity was estimated as the difference between TDEE and SMR. Energy deposition was estimated from dietary intake and TDEE. Energy intakes were significantly higher for the formula-fed than breast-fed infants at 1 mo (118 +/- 17 versus 101 +/- 16 kcal/kg/d) and 4 mo (87 +/- 11 versus 72 +/- 9 kcal/kg/d) (p less than 0.001). TDEE averaged 67 +/- 8 and 64 +/- 7 kcal/kg/d at 1 mo and 73 +/- 9 and 64 +/- 8 kcal/kg/d at 4 mo for the formula-fed and breast-fed infants, respectively, and differed between feeding groups (p less than 0.04). SMR and minimal observable energy expenditure (kcal/min) were higher among the formula-fed infants at 1 and 4 mo (p less than 0.005). The energy available for activity and the thermic effect of feeding did not differ between feeding groups. Rates of weight gain (g/d) and energy deposition (kcal/kg/d) tended to be greater among the formula-fed infants at 1 and 4 mo (p less than 0.006).(ABSTRACT TRUNCATED AT 250 WORDS)

Basal Metabolism↗

PubMed1999

Dietary nucleotides: effects on the immune and gastrointestinal systems.

Nucleotides (NT) and their related metabolic products play key roles in many biological processes. NT can be synthesized endogenously and thus are not considered essential nutrients. Studies have demonstrated, however, that dietary NT can have beneficial effects; the term "conditionally essential" has been used to describe their role in human nutrition. These nutrients may become essential when the endogenous supply is insufficient for normal function, even though their absence from the diet does not lead to a classic clinical deficiency syndrome. Most dietary NT are rapidly metabolized and excreted. However, some are incorporated into tissues, particularly at younger ages and with fasting. Under conditions of limited NT intake, rapid growth or certain disease states, dietary NT may spare the cost of de novo NT synthesis and optimize the function of rapidly dividing tissues such as those of the gastrointestinal and immune systems. Animals fed NT-supplemented versus non-NT supplemented diets have enhanced gastrointestinal growth and maturation, and improved recovery following small and large bowel injury. Indices of humoral and cellular immunity are enhanced, and survival rates are higher following infection with pathogens. Infants receive NT in human milk, where they are present as nucleic acids, nucleosides, nucleotides and related metabolic products. The NT content of human milk is significantly higher than most cow's milk-based infant formulae. Dietary NT are reported to enhance the gastrointestinal and immune systems of formula-fed infants. Infants fed NT-supplemented versus non-supplemented formula have a lower incidence of diarrhea, higher antibody titers following Haemophilus influenzae type b vaccination and higher natural killer cell activity. These data suggest that human milk NT may contribute to the superior clinical performance of the breastfed infant.

Bottle Feeding↗

PubMed1994

Effects of human milk or formula feeding on the growth, behavior, and protein status of preterm infants discharged from the newborn intensive care unit.

The growth, behavior, and protein status of 59 healthy preterm (mean gestational age 30 wk) infants fed either human milk or one of three infant formulas were studied post-discharge from the hospital. Formula-fed infants received either a standard term formula, a standard preterm formula, or an experimental preterm formula from discharge to 8 wk of age. From 8 to 16 wk, all formula-fed infants received the standard term formula. At 2, 8, and 16 wk, anthropometric, dietary intake, blood biochemistry, amino acid, and Brazelton Neonatal Behavioral Assessment measurements were evaluated. Weights, lengths, and head circumferences were similar for all feeding groups at discharge. After discharge all formula-fed infants were heavier than human milk-fed infants. Length and head circumference values and plasma urea nitrogen and retinol-binding protein concentrations were not different among dietary groups. Formula-fed infants had higher plasma concentrations of numerous amino acids compared with those of human milk-fed infants during the first 8 wk but not at 16 wk. There were no differences among the feeding groups in the Brazelton assessment. This study found little effect on the growth or behavioral or protein status of preterm infants discharged from the hospital who were fed either human milk or formulas designed for term or preterm infants.

Amino Acids↗

PubMed1982

Serum bilirubin levels in breast- and formula-fed infants in the first 5 days of life.

A prospective study was conducted in a level II maternity unit to investigate the incidence of hyperbilirubinemia in healthy, term, breast-fed and formula-fed infants. Serum bilirubin levels were determined for 176 breast-red and 164 formula-fed infants in cord blood and on days 1, 2, 3 and 5 after birth. The mean total bilirubin levels were significantly higher on each postnatal day in the breast-fed infants, as was the proportion of infants with peak levels above 12 mg/dl (205 mumol/l; 28% v. 6%). The breast-fed infants also had significantly higher proportional weight losses on each postnatal day than the formula-fed infants. However, there was no correlation between the cumulative weight loss on day 3 and bilirubin levels on the same day with either feeding regimen. None of the infants required an exchange transfusion or prolonged care in hospital for hyperbilirubinemia.

Bilirubin↗

PubMed1986

Evaluation of test-weighing for the assessment of milk volume intake of formula-fed infants and its application to breast-fed infants.

Test-weighing (TW) was evaluated in formula-fed (FF) infants by comparison with direct measurement (DM) of formula intake during a 24 h period at 1, 2, 4 and 6 mo of age. Formula intakes estimated by TW ranged from 87 to 93% of those determined by DM over the 6-mo period. During the study period the number of feedings per day decreased but were not significantly different for FF and BF infants. Volume of intake per feeding by FF infants increased significantly during the 6-mo period whereas milk intakes of BF infants were not different at the four ages studied. These data indicated that when the number of daily feedings decreased with age, FF infants increased their volume of intake per feeding whereas BF infants did not adjust their intakes. Mean volume of milk intake at 4 and 6 mo, estimated by TW, was significantly greater in FF infants compared to breast-fed (BF) infants matched for age and size. Data from this study indicated clearly that when milk intakes of BF infants are compared to those of FF infants, both groups of infants should be test-weighed.

Aging↗

PubMed1990

Vitamin D and mineral metabolism in the very low birth weight infant receiving 400 IU of vitamin D.

STUDY OBJECTIVE: To examine (1) the effect of vitamin D intake (380 to 480 IU daily) on plasma 25-hydroxyvitamin D (25-OHD) and 1,25-dihydroxyvitamin D (1,25-(OH)2D) concentrations and (2) the relationship of 1,25-(OH)2D to calcium and phosphorus absorption and retention in the very low birth weight infant receiving a preterm infant formula. SUBJECTS: Eleven "well" infants with a birth weight and gestational age (mean +/- SD) of 1078 +/- 128 gm and 29 +/- 1.9 weeks, respectively, were studied for a 3-week period. Weight and postnatal age (mean +/- SD) at the beginning of the study were 1132 +/- 56 gm and 16 +/- 6 days, respectively. All infants were fed a preterm infant formula and tolerated a full enteral intake (120 kcal/kg/day) for the duration of the study. INTERVENTIONS: Plasma 25-OHD and 1,25-(OH)2D concentrations were measured at the beginning of the study and at the beginning of each 48-hour balance period. Calcium and phosphorus balance studies (n = 33) were performed weekly. MAIN RESULTS: Plasma 25-OHD (30 +/- 10 ng/ml) and 1,25-(OH)2D (54 +/- 14 pg/ml) concentrations were normal at the beginning of the study. Plasma 25-OHD values did not change, but 1,25-(OH)2D values increased (p less than 0.001) throughout the study. Plasma 1,25-(OH)2D concentrations were not related to calcium or phosphorus absorption and retention, but were a linear function of postconceptional age. CONCLUSIONS: Normal vitamin D status and activity are maintained in the very low birth weight infant fed a high calcium formula (380 to 480 IU of vitamin D daily). Plasma 1,25-(OH)2D concentrations are not related to calcium absorption but are linearly related to maturity.

Calcium↗

PubMed2001

Immune modulation in suckling rat pups by a growth factor extract derived from milk whey.

Oral tolerance to foreign enteral antigens is not fully developed in early neonatal life. Epidemiological evidence supports a role for maternal milk in the development of immune responses, including oral tolerance. Formula fed infants have an increased susceptibility to food allergy and the later development of autoimmune disease. This may relate to the lack in infant formula of growth factors found in maternal milk. Bovine milk contains proteins, growth factors and cytokines. Various studies have outlined the immune modulating potential of bovine milk-derived products. Fractionated whey extracts have therapeutic potential in disease states where there is an excessive inflammatory reaction, and disease preventive potential for infants who are not breast-fed. We have shown that daily oral administration of a growth factor-enriched fraction from milk whey to naturally suckling rat pups between days 4-9 postnatal can down-regulate immune activation to a specific orally administered food antigen, ovalbumin, assessed by lymphocyte proliferation. In addition, non-specific down-regulation in the intestine was observed as assessed by the expression of MHC I. Treatment of rat pups with whey extract at the time of oral sensitisation to ovalbumin also resulted in an increased secretion of TGF-beta into the culture supernatant of spleen cells incubated with specific antigen. TGF-beta is an immuno-down-regulatory cytokine involved in tolerance induction. Immune modulation by extracts derived from milk whey could be of potential benefit for formula-fed and pre-term infants in reducing susceptibility to inappropriate activation to food antigens.

Animals↗

PubMed1991

Heart rates of breast-fed and formula-fed infants.

Heart rates of 46 breast-fed and formula-fed infants were monitored continuously for approximately 18 h at 1 or 4 months of age. Heart rate differed significantly by age (1 month greater than 4 months; p less than 0.001) and feeding mode (breast-fed less than formula-fed; p less than 0.001). Approximately 58% of the variability in heart rate could be attributed to feeding mode, sex, and age. Heart rate was correlated significantly with energy intake (r = 0.60; p less than 0.001), but not sleeping metabolic rate or total daily energy expenditure. Energy intake accounted for none of the variability in heart rate beyond that explained by feeding mode, sex, and age.

Age Factors↗

PubMed2006

Growth, motor, and social development in breast- and formula-fed infants of metformin-treated women with polycystic ovary syndrome.

OBJECTIVES: To test the hypothesis that metformin during lactation versus formula feeding would have no adverse effects on infants' growth, motor-social development, or intercurrent illness. STUDY DESIGN: Growth, motor-social development, and illness requiring a pediatrician visit were assessed in 61 nursing infants (21 male, 40 female) and 50 formula-fed infants (19 male, 31 female) born to 92 mothers with polycystic ovary syndrome (PCOS) taking a median of 2.55 g metformin per day throughout pregnancy and lactation. RESULTS: Within sex, at 3 and 6 months of age, weight, height, and motor-social development did not differ (p > or = .06) between breast- and formula-fed infants. No infants had retardation of growth, motor, or social development. Intercurrent illnesses did not differ. CONCLUSIONS: Metformin during lactation appears to be safe and effective in the first 6 months of infancy.

Adult↗

PubMedDate not supplied

Intake and fecal excretion of PCDDs, PCDFs, HCB and PCBs (138, 153, 180) in a breast-fed and a formula-fed infant.

Intake and fecal excretion of PCDDs, PCDFs, HCB and PCBs (IUPAC Nos. 138, 153, 180) were measured in a breast-fed and a formula-fed infant at the age of 1 and 5 months. As expected, the intake of these compounds was clearly higher in the breast-fed infant. In this baby an almost complete absorption was observed for lower chlorinated PCDDs and PCDFs and also for HCB and PCBs, whereas for hepta- and octachlorinated PCDDs and PCDFs fecal excretion was considerably higher (from 20% up to nearly 100% of the intake). Due to low concentrations in diet and feces of the formula-fed infant an evaluation was possible only for a few compounds at the age of 5 months. These values were in the same range when compared with those of the breast-fed infant. For collection of feces new cotton diapers were used which were pre-extracted in order to reduce the levels of polychlorinated compounds. Unexpectedly, after washing the tissue a much higher contamination was observed which made a calculation of fecal excretion rates in the formula-fed infant at the age of 1 month impossible.

Breast Feeding↗

PubMed2002

The allergenicity of soybean-based products is modified by food technologies.

BACKGROUND: Numerous products based on soybean are available and various food technologies are applied for their production. The allergenicity of natural soybean may be modified by these treatments. OBJECTIVES: To compare the allergenicity of native soybean proteins with those of soy milk and texturized protein products. To show additional allergens. METHODS: Three commercial products and two infant formulas were studied: Soybean flour, soy milk, texturized soy proteins, two infant formulas; the first containing total proteins and the second containing a soy protein hydrolysate. Sera from 9 patients allergic to soy protein were tested by immunoblotting (IB). IB inhibition was achieved by incubating sera with protein extract from soybean flour. RESULTS: The SDS-PAGE profile of soybean flour protein and soy milk showed a difference in the proportions of the various protein fractions, with a higher concentration of 37-kD protein in flour and 33-kD protein in milk. Infant formula 1 contained proteins with a molecular weight below 28 kD. The texturized extract contained high proportions of 31- to 34- and 38-kD proteins. Immunoblotting revealed a lack of allergenicity in infant formula. Sera recognizing the 38- and 50-kD proteins in texturized soy protein also recognized the 37- and 49-kD proteins in soybean flour and in soy milk, suggesting a protein glycation by texturization processes. The 30- to 34-kD band in texturized proteins was devoid of any allergenicity. This study seems to indicate that the 30-kD allergen (Gly m Bd 30) disappears during the production of texturized soy protein. CONCLUSION: All technologies applied to soybean-based products induce striking variation in the protein profile and allergenicity. Texturized protein could lack the major allergen Gly m Bd 30. Further studies or texturization might generate modified technologies in order to create hypoallergenic texturized proteins.

Adolescent↗

PubMed1992

Sleep organization and energy expenditure of breast-fed and formula-fed infants.

Sleep organization of infants may be influenced by differences in nutrient intakes from human milk and formula. Because sleep/awake and sleep stage patterns affect energy expenditure, we hypothesized that differences in sleep organization between breast-fed and formula-fed infants might account in part for differences in energy expenditure between feeding groups. Sleep stages and cycling of 4-mo-old breast-fed (n = 10) formula-fed (n = 10) infants were studied with simultaneous measurements of energy expenditure. EEG, electrooculogram, body movement by triaxial accelerometry, heart rate, and oxygen saturation were monitored during an overnight sleep session. Sleep stages, nonrapid eye movement (NREM), and rapid eye movement (REM) were determined. Behavioral observations were recorded by video tape and by a technologist. Oxygen consumption and carbon dioxide production were measured with an indirect calorimeter. Total number and duration of sleep cycles, REM latency, number of NREM and REM epochs, and duration of NREM epochs did not differ between feeding groups. Sleep latency was shorter (p < 0.05) and duration of REM epochs longer (p < 0.01) in the formula-fed group. Formula-fed infants spent a higher percentage of sleep time in REM compared with the breast-fed infants (42 versus 34%) (p < 0.003). Conversely, breast-fed infants spent a higher percentage of sleep time in NREM sleep and their heart rates during sleep were lower (114 versus 126 bpm; p < 0.01). Energy expenditure during REM sleep was 13.0 +/- 4.4% higher than during NREM sleep (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Feeding↗