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PubMedDate not supplied

Evaluation of the International Organization for Standardization-International Dairy Federation (ISO-IDF) draft standard method for detection of Enterobacter sakazakii in powdered infant food formulas.

As a result of the growing recognition of Enterobacter sakazakii as an emergent pathogen, the International Dairy Federation (IDF) and the International Organization for Standardization (ISO) have standardized a reference method for the detection of E. sakazakii in milk powder products and powdered infant food formulas (IFF). The objectives of this study were to assess the applicability of the ISO-IDF draft standard, and to compare several chromogenic selective media for E. sakazakii [ready-to-use ESIATM, homemade E. sakazakii isolation agar, and Druggan-Forsythe-lversen (DFI) agar], and a selective media for Enterobacteriaceae Violet Red Bile Glucose (VRBG). We found that the method is sensitive, selective, and applicable to the analysis of powdered IFF, provided that some modifications are added. In particular, definition of typical colonies on chromogenic media should be less restrictive, and the possibility of using chromogenic media other than ESIA should be introduced. Any of the chromogenic media tested here could be used initially, since their performances were similar. In these media, alpha-glucosidase-positive but non-yellow-pigmented isolates should be also considered. Consequently, the yellow pigmentation test should be abandoned, or completed with another test in order to select colonies to confirm. Although the specificity of VRBG was relatively poor, it could be used as a second nonchromogenic medium.

Bacteriological Techniques↗

PubMed1986

Comparative biological availability of manganese from extrinsically labelled milk diets using sucking rats as a model.

1. Very little is known about the biological availability of manganese from human milk and other infant milk diets. To determine the relative Mn availability, and to examine whether the age and the duration of previous fasting affect Mn absorption, sucking rats were given human milk, bovine milk and infant formula (regular Similac; Ross Laboratories, Columbus, OH) extrinsically labelled with 54Mn. 2. Milk diets were given by gastric intubation and the radioactivity of the carcass, liver and digestive tract was measured 3 h after feeding. 3. The concentration of endogenous Mn was lowest in human milk (7-10 micrograms/l) and highest in rat milk (140-165 micrograms/l). Increasing the non-radioactive total Mn concentrations of either human milk or bovine milk up to 150 micrograms/l did not affect the absorption of 54Mn by 10-d-old rats. 4. No significant (P greater than 0.05) difference in 54Mn absorption was found among the three milk diets (human milk, bovine milk, infant formula) in 8- to 11-d-old rats. However, significantly more (P less than 0.05) 54Mn was absorbed from human milk and infant formula than from bovine milk when 13-d-old rats were used. 5. 54Mn radioactivity detected in carcasses of 8-, 9-, 10- and 11-d-old rats ranged from 25 to 27% of the dose from various milk diets. The activities of 54Mn in the carcasses of 13-d-old rats were 15, 11, and 16% of the dose from human milk, bovine milk and infant formula respectively. 6. The trend of 54Mn incorporation into liver was similar to that of the carcass and over 60% of the absorbed 54Mn was incorporated into the liver regardless of the type of milk used. 7. Absorption of 54Mn from extrinsically labelled rat milk using 9- or 10-d-old sucking rats was similar to its absorption from infant formula. 8. The absorption of 54Mn from the three milk diets decreased with age of the neonatal rats and 54Mn absorption from human milk, bovine milk, infant formula as well as rat milk was affected similarly by duration of previous fasting.

Animals↗

PubMedDate not supplied

Food protein-induced enterocolitis syndrome: report of one case.

We report a 76-day old infant who got diarrhea within the first week of life. He was treated as acute gastroenterocolitis and kept on feeding with regular infant formula. Because the symptoms persisted, the feeding formula was shifted to soy-based formula then to the highly-hydrolyzed formula and got improvement. But severe bloody diarrhea, vomiting, dehydration and fever developed after feeding with regular infant formula again. Based on the history and clinical presentations, cow's milk allergy was suspected. He received total parenteral nutrition for 5 days then fed with highly-hydrolyzed formula with slowly increasing amount. Thereafter tests for total eosinophil counts, total serum IgE, milk specific IgE antibodies and milk extract skin prick test were all unremarkable. Under the impression of food protein-induced enterocolitis syndrome (FPIES), a double-blind placebo-controlled food challenge (DBPCFC) with infant formula was performed. Regular infant formula induced severe vomiting, diarrhea, fever, acidosis and elevation of absolute neutrophil counts (ANC) of peripheral blood by 27,640/mm3. Based on the laboratory findings and challenge results, the patient fit the diagnostic criteria of food protein-induced enterocolitis syndrome.

Enterocolitis↗

PubMed1993

Effect of dietary cholesterol on cholesterol synthesis in breast-fed and formula-fed infants.

The fractional synthesis rate (FSR) of cholesterol was measured in 6 breast-fed and 12 formula-fed infants (ages 4 to 5 months) using the 2H2O method. The breast-fed infants had higher cholesterol intakes (18.2 +/- 4.0 vs. 3.4 +/- 1.8 mg/kg per day, P = 0.001), plasma total cholesterol (183 +/- 47 vs. 112 +/- 22 mg/dl, P = 0.013), and plasma low density lipoprotein (LDL)-cholesterol (83 +/- 26 vs. 48 +/- 16 mg/day, P = 0.023) than the formula-fed infants (6.9 +/- 2.6 vs. 2.1 +/- 0.6%/day, P < 0.001). Among all infants, there was a significant inverse relationship (P = 0.002, r = 0.66) between the FSR of cholesterol and dietary cholesterol intake. Our findings indicate that the greater cholesterol intake of the breast-fed infants was associated with elevated plasma LDL-cholesterol concentrations and that cholesterol synthesis in human infants may be efficiently regulated via HMG-CoA reductase when infants are challenged with high intakes of dietary cholesterol.

Breast Feeding↗

PubMed2007

Changes in public attitudes toward breastfeeding in the United States, 1999-2003.

Data from the HealthStyles survey, an annual national mail survey to US adults, were examined to understand changes in public attitudes toward breastfeeding. The 1999 and 2003 HealthStyles surveys included four breastfeeding items related to public attitudes toward breastfeeding in public and toward differences between infant formula and breastmilk. The percentage of respondents in agreement with the statement, "Infant formula is as good as breastmilk," increased significantly from 14.3% in 1999 to 25.7% in 2003. The increase was particularly large among people of low socioeconomic status. The percentage increase in agreement that "feeding a baby formula instead of breastmilk increases the chances the baby will get sick" grew at a statistically significant level, but the total change was small (2.7 percentage points). No significant total changes were found for the other two survey items. The perception that infant formula is as good as breastmilk would be expected to soften a woman's commitment to breastfeeding should she be faced with obstacles to doing so. The findings underscore the need to educate the general public that breastfeeding is the best method of feeding and nurturing infants. Pediatricians and other health professionals should recommend human milk for all infants for whom breastfeeding is not specifically contraindicated.

Adolescent↗

PubMed2001

Gastric electrical activity and gastric emptying in preterm newborns fed standard and hydrolysate formulas.

BACKGROUND: Because infant formulas containing hydrolyzed cow milk protein are used to reduce feeding intolerance and to improve gastric emptying, the effect on gastrointestinal motility of a hydrolysate formula was compared with that of a standard preterm formula. METHODS: Thirty-six preterm newborns with a gestational age of 32.2 +/- 2.3 weeks were assigned randomly to standard formula or hydrolyzed formula. Cutaneous electrogastrography and ultrasound examination of gastric emptying were performed simultaneously to evaluate gastrointestinal motility before and after the test meal. All recording sessions were performed 1 week after infants had reached full enteral feeding. RESULTS: No significant difference in gastrointestinal symptoms was noted in the newborns fed the different formulas. In particular, regurgitation and vomiting were observed in 78% versus 64% of preterm newborns after standard and hydrolyzed formula, respectively (Fisher exact test, not significant). No differences were found in terms of gastric electrical activity and gastric emptying time between the two groups. CONCLUSIONS: It seems unnecessary to use hydrolysate formulas to improve motility in preterm infants.

Electromyography↗

PubMed2001

Trace elements and their distribution in protein fractions of camel milk in comparison to other commonly consumed milks.

Studies on camels' milk, whether with respect to concentration or bioavailability of trace elements from this milk, are limited and warrant further investigation. The object of this study was to analyse the concentration and distribution of zinc, copper, selenium, manganese and iron in camel milk compared to those in human milk, cows' milk and infant formula under similar experimental conditions. Camels' milk and cows' milk were collected from local farms, human milk samples were obtained from healthy donors in Kuwait and infant formula was purchased locally. Milk fractionation was performed by ultra-centrifugation and gelcolumn chromatography. The concentration of trace elements was analysed by atomic absorption spectrometry and that of protein was determined spectrophotometrically. The concentration of manganese and iron in camels' milk was remarkably higher (7-20-fold and 4-10-fold, respectively) than in human milk, cows' milk and infant formula. The zinc content of camels' milk was higher than that of human milk but slightly lower than in cows' milk and infant formula. The concentration of copper in camels' milk was similar to that of cows' milk but lower than in human milk and infant formula. The selenium content of camels' milk was comparable to those of other types of milk, Approximately 50-80% of zinc, copper and manganese in camels' milk were associated with the casein fraction, similar to that of cows' milk, The majority of selenium and iron in camels' milk was in association with the low molecular weight fraction, It is recommended that camels' milk be considered as a potential source of manganese, selenium and iron, perhaps not only for infants, but also for other groups suspected of mild deficiency of these elements. Further investigations are required to confirm this proposal.

Animals↗

PubMed2006

Breastfeeding plus infant zidovudine prophylaxis for 6 months vs formula feeding plus infant zidovudine for 1 month to reduce mother-to-child HIV transmission in Botswana: a randomized trial: the Mashi Study.

CONTEXT: Postnatal transmission of human immunodeficiency virus-1 (HIV) via breastfeeding reverses gains achieved by perinatal antiretroviral interventions. OBJECTIVE: To compare the efficacy and safety of 2 infant feeding strategies for the prevention of postnatal mother-to-child HIV transmission. DESIGN, SETTING, AND PATIENTS: A 2 x 2 factorial randomized clinical trial with peripartum (single-dose nevirapine vs placebo) and postpartum infant feeding (formula vs breastfeeding with infant zidovudine prophylaxis) interventions. In Botswana between March 27, 2001, and October 29, 2003, 1200 HIV-positive pregnant women were randomized from 4 district hospitals. Infants were evaluated at birth, monthly until age 7 months, at age 9 months, then every third month through age 18 months. INTERVENTION: All of the mothers received zidovudine 300 mg orally twice daily from 34 weeks' gestation and during labor. Mothers and infants were randomized to receive single-dose nevirapine or placebo. Infants were randomized to 6 months of breastfeeding plus prophylactic infant zidovudine (breastfed plus zidovudine), or formula feeding plus 1 month of infant zidovudine (formula fed). MAIN OUTCOME MEASURES: Primary efficacy (HIV infection by age 7 months and HIV-free survival by age 18 months) and safety (occurrence of infant adverse events by 7 months of age) end points were evaluated in 1179 infants. RESULTS: The 7-month HIV infection rates were 5.6% (32 infants in the formula-fed group) vs 9.0% (51 infants in the breastfed plus zidovudine group) (P = .04; 95% confidence interval for difference, -6.4% to -0.4%). Cumulative mortality or HIV infection rates at 18 months were 80 infants (13.9%, formula fed) vs 86 infants (15.1% breastfed plus zidovudine) (P = .60; 95% confidence interval for difference, -5.3% to 2.9%). Cumulative infant mortality at 7 months was significantly higher for the formula-fed group than for the breastfed plus zidovudine group (9.3% vs 4.9%; P = .003), but this difference diminished beyond month 7 such that the time-to-mortality distributions through age 18 months were not significantly different (P = .21). CONCLUSIONS: Breastfeeding with zidovudine prophylaxis was not as effective as formula feeding in preventing postnatal HIV transmission, but was associated with a lower mortality rate at 7 months. Both strategies had comparable HIV-free survival at 18 months. These results demonstrate the risk of formula feeding to infants in sub-Saharan Africa, and the need for studies of alternative strategies. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00197587.

Anti-HIV Agents↗

PubMed1981

Changing feeding trends as a cause of electrolyte depletion in infants with cystic fibrosis.

Between June 1979 and June 1980, 16 infants with cystic fibrosis (CF) were cared for at the James Whitcomb Riley Hospital for Children. Five of these children (average age 5.8 months) had a total of eight episodes of electrolyte depletion, with six episodes unassociated with high environmental temperature, fever, or significant gastrointestinal symptoms. Their primary symptoms were poor weight gain and anorexia. According to their dietary records, these five infants, at the time of their initial presentation, had an average electrolyte intake of 8 mEq of sodium, 12 mEq of potassium, and 10 mEq of chloride per day. All infants had been fed either standard infant formula or breast milk. Infant feeding surveys indicate that the estimated average sodium intake of 6-month-old infants has decreased from 45 mEq/day in 1965 to 15 mEq/day since 1977 when manufacturers stopped adding salt to baby foods. In addition, since 1971 the percentage of infants 6 months age receiving breast milk or standard infant formula rather than cow's milk, which is higher in sodium content, has increased from 33% to 72%. This decreased salt intake places the infant with CF at greater risk for electrolyte depletion than in the past. It is expected that a larger percentage of infants with CF will have electrolyte depletion as their initial symptom especially during periods of increased sweating or when electrolyte losses are experienced during gastrointestinal illnesses. CF should be suspected in any infant with electrolyte depletion, and infants known to have CF need daily salt supplementation. Serum electrolytes should be measured if the infant is experiencing weight loss or anorexia, particularly during periods of excessive salt losses.

Breast Feeding↗

PubMed1985

Folate intake and blood concentrations of term infants.

Folate nutrition of 67 full-term infants was studied longitudinally from birth to 1 year. Infants were grouped according to type of milk consumed during early infancy: group I (n = 14) received human milk; group II (n = 31), a standard cow-milk infant formula; and group III (n = 22), the same formula with added iron (12.3 mg/L). Solid foods were introduced after 3 months. Folate status, as indicated by serum and red blood cell folate concentrations, and folate intake were measured periodically. Blood folate concentrations of all groups were higher than or similar to adult control values. No differences in indices of folate status were observed between formula-fed groups at any time frame. At 6 weeks and 3 months formula-fed infants had folate intakes and blood concentrations significantly greater than human milk-fed infants. With the introduction of solid foods, decreases in blood folate concentrations paralleled decreases in milk folate intake within each group. Serum folate concentrations correlated with both total folate intake and milk folate intake, whereas RBC folate concentrations correlated with only milk folate intake. The results indicate that milk, regardless of type (human milk, formula, and cow milk), is an important dietary source of folate during the first year of life and that both human milk and proprietary formula feeding during early infancy provide more than sufficient folate to maintain blood folate concentrations well above acceptable limits.

Animals↗

PubMed2005

Essential fatty acid transfer and fetal development.

Docosahexaenoic acid (22:6n-3) and arachidonic acid (20:4n-6) are important structural components of the central nervous system. These fatty acids are transferred across the placenta, and are accumulated in the brain and other organs during fetal development. Depletion of 22:6n-3 from the retina and brain results in reduced visual function and learning deficits: these may involve critical roles of 22:6n-3 in membrane-dependent signaling pathways and neurotransmitter metabolism. Transfer of 22:6n-3 across the placenta involves specific binding and transfer proteins that facilitate higher concentrations of 22:6n-3 and 20:4n-6, but lower linoleic acid (18:2n-6) in fetal compared with maternal plasma, or in the breast-fed or formula-fed infant. However, human and animal studies both demonstrate that maternal diet impacts fetal 22:6n-3 and 20:4n-6 accretion. After birth, parenteral lipid, human milk and infant formula feeding all result in a marked decrease in plasma 22:6n-3 and 20:4n-6 and an increase in 18:2n-6. Estimation of fetal tissue fatty acid accretion suggests that current preterm infant feeds are unlikely to meet in utero rates of 22:6n-3 accretion. Consideration needs to be given to whether fetal plasma 22:6n-3 and 20:4n-6 enrichment and the low 18:2n-6 facilitates accretion of 22:6n-3 and 20:4n-6 in developing tissues.

Animals↗

PubMed1997

[Nutritional needs of the preterm infant after hospital discharge].

The authors report their experience in the Division of Neonatology of the Catholic University of Rome about the choice of milk alimentation and mineral and vitamin supplementation before discharge and during the subsequent follow-up, with particular reference to very low-birthweight preterm infants (< 1500 g). Basing on empirical experiences, the authors emphasize the importance in current practice of post-conceptional age, with special regard to the kind of milk to choose after discharge and the time and terms of the weaning. Furthermore they stress nutritional, immuno-allergic and psychological advantages of human milk before and after hospital discharge, particularly related to the presence of long-chain polyunsaturated fatty acid (LCP), recently known to be essential on retina and brain development in the preterm infant. When breast milk is not available, the authors confirm the efficacy, before discharge, of preterm infant formulas and subsequently of infant formulas and after of follow-up formulas. The authors hope that the directions proposed by the American Academy of Pediatrics in 1983 will be modified in order to recommend cow-milk only after the first year of life of the infant. They finally suggest specific mineral and vitamin supplementations (iron, calcium, phosphorus, fluoride; vitamins K, D, E and folic acid), to be started after hospital discharge.

Animals↗

PubMed1982

Reservoir and emptying function of the stomach of the premature infant.

Gastric emptying of meals of human milk and infant formula was studied in 11 healthy preterm (AGA) infants using a marker dilution technique. Gastric emptying rate and gastric half-emptying time were compared with data from 17 healthy infants aged 4 weeks to 6 months. The amounts of human milk emptied from the stomach per 0.1 m2 of body surface area were 19.4 +/- 4.5 ml in preterm infants and 29.5 +/- 4.6 ml in term infants. The corresponding amounts with meals of infant formula were 13.8 +/- 2.8 and 22.7 +/- 4.2 ml, respectively. With the volumes given gastric half-emptying times for meals of human milk and infant formula were 25.1 +/- 11.5 and 51.9 +/- 9.8 min, respectively, in preterm infants. The corresponding half-emptying times for term infants were 48 +/- 15 and 78 +/- 14 min, respectively. The differences in gastric emptying rate as well as in gastric half-emptying time between the two meals were significant (p less than 0.01) both in preterm and term infants.

Body Surface Area↗

PubMed2005

Quantification of Bifidobacterium spp., Escherichia coli and Clostridium difficile in faecal samples of breast-fed and formula-fed infants by real-time PCR.

To determine the influence of either exclusive breast-feeding or formula feeding on both composition and quantity of the gut microbiota in infants, we have developed real-time, quantitative PCR assays for the detection of Bifidobacterium spp. and Clostridium difficile. Furthermore, we have monitored the prevalence and counts of Escherichia coli by applying a previously described real-time PCR assay. We found all 100 infants tested to be colonized by Bifidobacterium spp. The bifidobacterial counts were comparable between the 50 breast-fed and 50 formula-fed infants with median values of 10.56 log10 and 10.24 log10 CFU g(-1) wet weight faeces, respectively. C. difficile was detected in 14% of the breast-fed and 30% of the formula-fed infants. In addition, the C. difficile counts were significantly lower in breast-fed infants than in the formula-fed group (median values of 3.28 log10 and 7.43 log10 CFU g(-1), respectively; p=0.03). The prevalence of E. coli in the breast-fed and formula-fed group was 80% and 94%, respectively. Also, the E. coli counts in colonized infants was significantly lower in the breast-fed infants than in the formula-fed group (median values of 9.11 log10 and 9.57 log10 CFU g(-1), respectively; p=0.004). We conclude that the prevalence and counts of C. difficile as well as E. coli are significantly lower in the gut microbiota of breast-fed infants than in that of formula-fed infants, whereas the prevalence and counts of Bifidobacterium spp. is similar among both groups.

Bifidobacterium↗

PubMed1993

In vitro allergenicity of cows' milk substitutes.

There are numerous alternatives to cows' milk formula for allergic children. We have investigated the allergenicity of several of these using RAST and RAST inhibition on serum from 16 patients with a known history of cows' milk protein intolerance (CMPI) and 16 atopic controls. A RAST grade of > or = 3 for cows' milk was present in all those with CMPI, whilst all the controls gave RAST of < or = 1. Modified cows' milk formula, goats' infant formula, sheep and goats' milk produced similar results to cows' milk. Only two patients had RAST > or = 3 for soya milk and the soy/beef hydrolysate gave positive results in only three patients. One had positive RAST to Nutramigen and two to Pregestimil. Of the whey hydrolysates investigated, Pepti-junior gave seven positive RASTs whilst we were unable to bind Alfare to the sepharose in sufficient quantities to interpret the results which were negative in all cases. RAST inhibition data on pooled sera from the same patients agreed with the RAST results. The inhibition curves showed high inhibition with goats', sheep, modified cows' milk formula and the casein formula, AL110 (50%). Soy and soy/beef hydrolysate showed a much lower inhibition pattern. Casein hydrolysates showed low inhibition while the whey hydrolysate produced higher inhibition. We have shown that despite claims of low allergenicity, some of these alternative formulae are antigenically recognized in vitro by some cows' milk intolerant patients.

Adolescent↗

PubMed1982

Effect of low-content zinc and copper formula on infant nutrition.

The zinc (Zn) content of commercially available formula milks in Japan is less than that of breast milk obtained during the first three months of lactation, but is similar to that at five months of lactation. The copper (Cu) content of the formula milks is much lower than that of breast milk obtained during the five months. These two trace elements were measured in serum (at birth, one, three, and five months of age), hair (at birth and at five months of age) and urine (at one, three and five months of age) of twenty-one breast fed and twenty formula fed full term infants. Despite the differences in Zn and Cu intakes, these parameters were similar in these two infant groups, except for urinary Zn at one and three months of age. These were significantly higher in breast fed infants (P less than 0.005 and P less than 0.05). Weight and length increments were not different in either infant group. It appeared that normal, full term infants tolerated low-content Zn and Cu formula milks well. This observation, however, is not at variance with the FAO/WHO recommendation for prevention of Zn and Cu deficiency.

Age Factors↗

PubMed2005

Cadmium, lead and mercury in human milk from Slovakia.

The objective of this study was to investigate Cd, Pb, and Hg levels in the breast milk of 158 lactating healthy women who were not occupationally exposed and living in eight environmentally different polluted locations of the Slovak Republic. Levels of these metals were examined in relation to selected parameters, such as: location, mother's age, parity, number of mother's teeth fillings, newborn's gender and birth weight, and smoking habits in the family. Cd and Pb levels in human milk and reconstituted infant formula were determined by GFAAS. Hg levels were measured by amalgamation technique AAS. The average concentrations of Cd, Pb and Hg in breast milk samples, taken on the 4th postpartum day, were 0.43, 4.7 and 0.94 microg/kg, respectively, and those in infant formula (n = 10) were 0.40, 5.0 and 0.25 microg/kg, respectively. Dietary weekly intakes of Cd, Pb, and Hg from breast milk and infant formula in newborn babies were also estimated. Whereas the calculated average dietary intakes of Cd, Pb, and Hg in newborn babies from breast milk and infant formula were all far lower than the appropriate PTWI values recommended by WHO/FAO, two individual breast milk samples for Pb and one breast milk sample for Hg exceeded the PTWI values. Regarding the studied parameters, only the active/passive smoking of the mother at home significantly increased Pb levels in breast milk and amalgam teeth fillings increased Hg levels in breast milk.

Adolescent↗

PubMed1998

Energy utilization and growth in breast-fed and formula-fed infants measured prospectively during the first year of life.

This study is the first to report approximations of energy requirements for male and female breast-fed and formula-fed infants based on individual estimates of total daily energy expenditure (TDEE) and energy deposition derived from total body fat (TBF) and fat-free mass (FFM) gain as determined by total-body electrical conductivity. In 46 healthy, full-term infants the effect of > or = 4 mo of exclusive breast-feeding compared with formula feeding on macronutrient and energy intake, TDEE, energy deposition, and growth were investigated prospectively. Metabolizable energy intake (MEI) was assessed from macronutrient intake by test weighing (MEI-TW) and from the sum of TDEE and energy deposition (MEI-Pred). At 1-2, 2-4, 4-8, and 8-12 mo of age MEI-Pred averaged 431 +/- 38, 393 +/- 33, 372 +/- 33, and 355 +/- 21 kJ x kg(-1) x d(-1) for boys, and 401 +/- 59, 376 +/- 25, 334 +/- 33, and 326 +/- 17 kJ x kg(-1) x d(-1) for girls. No significant difference between breast-fed and formula-fed infants was found with respect to weight, length, head circumference, TBF, FFM, and TDEE at all ages, or for gain in length, weight, TBF, and FFM. MEI-TW was significantly different between feeding groups at 1-4 mo of age (formula-fed being greater than breast-fed, P < 0.005). This feeding effect, however, was not significant for MEI-Pred (MJ/d). MEI-TW differed from MEI-Pred only in breast-fed infants at 1-4 mo (P < 0.05 at 2-4 mo). The data from this study indicate that energy requirements in infants are lower than the recommendations in guidelines currently in use.

Age Factors↗