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PubMed1992

Gastric emptying using three different formulas in infants with gastroesophageal reflux.

The role of delayed gastric emptying (GE) in the pathogenesis of gastroesophageal reflux (GER) in infants is controversial at present. GE has been shown to be altered by the composition and osmolality of the feedings. This prospective study was undertaken to assess the changes in the GE and the percentage of time GER was detected by scintigraphy using three different formulas on consecutive days in infants with GER. Twenty-eight infants under 1 year of age diagnosed to have GER by extended intraesophageal pH monitoring (pH being less than 4.0 for greater than 5% of the duration of the test), underwent scintigraphy on three consecutive days using the same volume per single feeding of a casein-predominant, soy, or a whey-hydrolysate formula in a randomized order. The formulas were isocaloric. Gastric emptying and percentage of GER into the esophagus were estimated for 60 min following these feedings. Mean GER percent during the study was 20.39, 17.68, and 16.34 on casein-predominant, soy, and whey-hydrolysate formulas, respectively, and was not significantly different. Mean values of GE were 39.7%, 44.6%, and 48.5% on casein, soy, and whey formula, respectively. No significant difference in GE was also observed between casein-predominant and soy formula. However, a significant difference was observed (p less than 0.05) on GE between casein-predominant and whey-hydrolysate feedings. Our data suggest that formula selection may be important in the treatment of conditions associated with delayed gastric emptying.

Gastric Emptying↗
PubMed1994

Postnatal changes in plasma chain-breaking antioxidants in healthy preterm infants fed formula and/or human milk.

Concentrations of chain-breaking antioxidants were studied in the first 6 postnatal weeks in 29 healthy preterm infants (gestational age 30-35 wk). Vitamin C, uric acid, and sulfhydryl groups declined, whereas vitamin E rose and bilirubin followed its typical biphasic postnatal course. The influence of these changes on the plasma peroxyl radical trapping capacity was assessed in vitro (TRAP assay). The trapping capacity decreased postnatally and this appeared to be related to the coincident fall in uric acid concentrations. Results did not differ between babies fed with only preterm formula (n = 12) and those fed predominantly with human milk (n = 6), except for higher bilirubin and TRAP values in the breast-fed infants. There are major postnatal changes in the concentrations of the plasma chain-breaking antioxidants and this may influence the susceptibility of the preterm baby to oxygen toxicity.

Aging↗
PubMedDate not supplied

Lead in milk and infant blood: a dose-response model.

As part of a longitudinal study of the sources and developmental effects of current urban lead exposure, lead was measured in tap water from the homes of 249 infants, in 100 breast milk samples, and in 73 samples of the infant formula used by non-nursing mothers. Also, the blood lead levels of the infants who received these fluids were determined at birth and at 6 months of age. Among the infants who were breast fed, the lead content of their milks correlated very well with their 6-month blood lead levels (r = .42, P = .0003). The mean lead content of infant formulas and breast milk were not significantly different, nor was the blood lead of children fed one or the other. Lead levels in maternal milk correlated poorly with umbilical cord blood lead (r = .18, P = .10). Tap water and infant blood lead levels correlated minimally (r = .11, P = .10). Since milk represents much of the diet of young infants and because breast milk lead levels are stable, it is possible to relate blood lead and daily dosage in this population.

Female↗
PubMed2002

The introduction of breast milk substitutes and solid foods: evidence from the 1995 National Health Survey.

OBJECTIVE: To report the introduction of breast milk substitutes and solid foods to Australian children between 1992 and 1995. METHODOLOGY: Analysis of data from the 1995 Australian National Health Survey. Infant feeding questions were asked by personal interview in respect to 3,252 children aged under four years of age. RESULTS: By the age of 26 weeks, the majority of children had been given infant formula (56.9%) and solid food (61.5%). More than one-quarter (27.1%) of children received cow's milk regularly during the first 12 months. Only 7% of children were given solids in the first 12 weeks of life. Soy milk was given to 14.2% of children aged less than four years. CONCLUSION: The majority of children in Australia are not being exclusively breastfed for six months as recommended by the World Health Organization (WHO). The intake of cow's milk before 12 months of age and the timing of introduction of solids needs to be monitored. Future surveys should collect more detail about type of infant formula so that the proportion of infants receiving soy-based formula and other formula can be assessed.

Animals↗
PubMed1990

Lack of sensitive period for lead-induced behavioral impairment on a spatial delayed alternation task in monkeys.

A total of 52 monkeys (Macaca fascicularis) were dosed orally with vehicle or 1.5 mg/kg/day of lead on one of four dosing regimens (13 monkeys/group): vehicle only; dosed with lead from birth onward; dosed with lead from birth to 400 days of age and vehicle thereafter; dosed with vehicle from birth to 300 days of age and lead thereafter. Blood lead concentrations averaged 3-6 micrograms/dl when monkeys were not being dosed with lead, 32-36 micrograms/dl when being dosed with lead and having access to infant formula, and 19-26 micrograms/dl when being dosed with lead after weaning from infant formula. When monkeys were 6-7 years old, they were tested on a spatial delayed alternation task. The task required the monkey to alternate responses between two push buttons. The initial delay was 0.10 sec and was increased in steps to 15 sec by the end of the experiment. All three treated groups were impaired to approximately an equal degree. Deficits were observed in the initial training procedure, and at the longer delay values. These results suggest that there is not an early critical period for lead-induced impairment on this task and that exposure only during infancy results in impairment comparable to ongoing exposure beginning at birth. These results are in contrast to previous findings on a series of nonspatial discrimination reversal tasks, in which the group exposed early in life only was unimpaired, while the group exposed beginning after infancy was less impaired that the group exposed continuously from birth.

Age Factors↗
PubMed1990

Lead-induced behavioral impairment on a spatial discrimination reversal task in monkeys exposed during different periods of development.

A total of 52 monkeys (Macaca fascicularis) were dosed orally with vehicle or 1.5 mg/kg/day of lead on one of four dosing regimens (13 monkeys/group): Group 1, vehicle only; Group 2, dosed with lead from birth onward; Group 3, dosed with lead from birth to 400 days of age and vehicle thereafter; Group 4, dosed with vehicle from birth to 300 days of age and lead thereafter. Blood lead concentrations averaged 3-6 micrograms/dl when monkeys were not being dosed with lead, 32-36 micrograms/dl when being dosed with lead and having access to infant formula, and 19-26 micrograms/dl when being dosed with lead after weaning from infant formula. When monkeys were 7-8 years old, they were tested on three spatial discrimination reversal tasks: no irrelevant cues, irrelevant form cues, and irrelevant form and color cues. Fifteen reversals were run for each task. Only Group 2 was impaired in the absence of irrelevant cues, while all three treated groups were impaired in the presence of irrelevant cues. These results are in contrast to results from a series of nonspatial discrimination reversal tasks in these monkeys in which Groups 2 and 4 were impaired and Group 3 was unimpaired. The present results are in agreement with results from another spatial task, delayed alternation, in which all three treated groups were impaired.

Aging↗
PubMed1992

Effect of lead during different developmental periods in the monkey on concurrent discrimination performance.

A total of 52 monkeys (Macaca fascicularis) were dosed orally with vehicle or 1.5 mg/kg/day of lead according to one of four dosing regimens (13 monkeys/group): Group 1, vehicle only; Group 2, dosed with lead continuously from birth; Group 3, dosed with lead from birth to 400 days of age and vehicle thereafter; Group 4, dosed with vehicle from birth to 300 days of age and lead thereafter. Blood lead concentrations averaged 3-6 micrograms/dl when monkeys were not dosed with lead, 32-36 micrograms/dl when being dosed with lead and having access to infant formula, and 19-26 micrograms/dl when being dosed with lead after weaning from infant formula. When monkeys were 8-9 years old, they were tested on two sets of concurrent discrimination tasks, each consisting of 6 stimulus pairs. Group 2 required more sessions on Task 1 for 5 of the 6 pairs to reach a criterion of 90% correct, while Groups 3 and 4 required more or marginally more sessions on 4 of the 6 pairs. On Task 2, Group 2 required more sessions to reach criterion for most pairs, Group 4 was marginally impaired, and Group 3 was unimpaired. All three treated groups made more perseverative errors than controls on Task 1, but not on Task 2. There were no differences between groups for response latency or position bias. This extends previous research with these monkeys, in which impairment was observed on spatial and nonspatial discrimination reversal, and spatial delayed alternation.

Animals↗
PubMed1991

Safety of casein hydrolysate formula in children with cow milk allergy.

The purpose of this study was to determine whether a new casein hydrolysate infant formula, Alimentum, could be administered safely to children with cow milk hypersensitivity. The formula was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and with a sensitive enzyme-linked inhibition immunoassay, and it was judged to be safe for clinical trials in children allergic to cow milk. Twenty-five such children underwent double-blind placebo-controlled oral food challenges with 10 gm of powdered cow milk and casein hydrolysate formula. All children were highly atopic and had positive skin prick reactions to cow milk. No patient reacted to placebo during a double-blind, placebo-controlled food challenge. Two patients lost their allergy to cow milk and did not react during the challenge; the remaining patients reacted with a variety of cutaneous, respiratory, and gastrointestinal symptoms within 15 to 90 minutes of challenge. All children tolerated the blinded challenge to the casein hydrolysate and were fed the hydrolysate openly without difficulty. We conclude that this casein hydrolysate is generally safe to feed to children with immediate hypersensitivity to cow milk. We recommend that all infant formulas promoted as "hypoallergenic" be tested in milk-allergic patients to assess their allergenic potential, in addition to standard nutritional evaluation and animal testing for antigenicity.

Caseins↗
PubMed2003

Predicting iron status in low birthweight infants.

OBJECTIVE: To determine the iron status of a selected group of low birthweight infants at approximately 9 months of age, and examine the feasibility of predicting iron status by examining the history of supplementary iron intake. METHODS: All live low birthweight infants recorded in the Dunedin Hospital Queen Mary Maternity Unit birth register who reached 9 months of age between November 1995 and September 1996 were eligible to participate. Infants were categorized into 'high' or 'low' iron intake groups depending on their consumption of infant formula or medicinal iron for one month prior to the study, and their iron status compared. RESULTS: Eighty-one infants of 73 mothers, with an average age of 10 months (range 8-13 months), participated. Thirty-three per cent (n = 27) were iron deficient: 19% (n = 15) had latent iron deficiency and 15% (n = 12) had iron deficiency anaemia. Those with a 'low' iron intake were 13-fold more likely to be iron deficient than infants with a 'high' iron intake (95% confidence interval: 4.4-41.5). Screening for iron deficiency using categories based on supplementary iron intake had a positive predictive value of 66% and a negative predictive value of 88%. CONCLUSIONS: The risk of iron deficiency was considerably greater for infants who had not received supplementary iron daily over the course of the previous month. Current preventative methods for avoiding poor iron status in this group of high risk infants are not effective. Screening for iron deficiency in low birthweight infants on the basis of iron intake from infant formula or medicinal iron provides a useful method for identifying infants whose iron status should be investigated.

Anemia, Iron-Deficiency↗
PubMed1997

Infant and child feeding practices: a preliminary investigation.

The objective of this preliminary investigation was to examine the feeding practices of infants and pre-school children in Adelaide, and thereby contribute to the development of appropriate preventive dental strategies. A stratified random sample of 160 two year old and three year old pre-school children in the Adelaide Statistical District was obtained. Information about feeding practices and use of comforters or 'dummies' was obtained through a self-administered questionnaire completed by parents of the selected children. Information was collected for the age periods of 0-3 months, 4-6 months, 7-12 months, 13-24 months and 25-36 months. Most of the children (81.8 per cent) were breast-fed at some stage. However the percentage of children being breast-fed decreased markedly across age periods, particularly to 13-24 months, when only 15.9 per cent of children were being breast-fed. Over half of the children, had been bottle-fed with infant formula at some stage. The highest percentage of children being bottle-fed with infant formula occurred in the 4-6 months (42.6 per cent) closely followed by the 7-12 months age period (37.4 per cent). Nearly two-thirds of children were bottle-fed with cow's milk at some stage. The highest percentage of children being bottle-fed with cow's milk occurred in the 13-24 months age period (49.6 per cent). A quarter (24.5 per cent) of the children were put to bed at some stage with a bottle containing cariogenic fluids. The majority of children used a 'dummy' at some stage during both day-time and night-time. Parents are in need of advice on appropriate feeding patterns for infants and young children.

Australia↗
PubMed1987

Predigested formula for infants with cystic fibrosis.

The object of this study was to assess the growth rates of patients with cystic fibrosis fed various diets and test the hypothesis that the weight of infants could be normalized by 1 year of age if they were placed on predigested formula before age 6 months. A group of 19 newly diagnosed patients placed on Pregestimil were compared with a group who were fed standard formula. At 1 year of age, the Pregestimil group showed significantly greater length and weight and a twofold higher average weight percentile. Growth velocity determined for the period between diagnosis and 12 months of age was better (p less than .001) for babies raised on Pregestimil (556 compared with 423 gm/month). Using weight percentile as the major growth index and values less than the fifth percentile as abnormal at age 12 months, we found that all 19 babies were normal in the group fed Pregestimil, whereas nine were below the fifth percentile in the group fed regular formula (p = .0006).

Birth Weight↗
PubMed2002

Perceptions of mothers and use of breastmilk substitutes in Dhaka, Bangladesh.

To explore the actual practices and perceptions of giving breastmilk and breastmilk substitutes (BMS), this cross-sectional study was conducted among 326 mothers of low (income/month < Tk 4,000, n = 163) and middle (income/month > Tk 4,000, n = 163) socioeconomic status (SES) with infants aged 6-12 months in Dhaka city during February-April 2001. Qualitative data on perceptions of mothers on appropriate breast-feeding practices were also documented through focus-group discussions (FGDs). The prevalence of exclusive breast-feeding was low in both the socioeconomic groups but was comparatively higher among the mothers of middle SES (3.1% vs 12.3%, p < 0.001), although predominant breast-feeding was high among the mothers of low SES. In addition, the use of BMS was higher among the mothers of middle SES than among the mothers of low SES (55.8% vs. 43.5%, p < 0.001). The majority (62.3%) of the mothers mentioned insufficiency of breastmilk as the main reason for introducing BMS. Perception on appropriate feeding practices was also significantly different between the two groups. Approximately, 90% of the mothers of low SES could not differentiate between infant formula and milk powder compared to 70% of the mothers of middle SES (p < 0.001). The findings of FGDs revealed that some middle-class mothers thought that infant formula was the best food for their infants. Programmes to impart proper knowledge on breast-feeding practices should be strengthened.

Adult↗
PubMed1988

Serum insulin and blood glucose levels in breast-fed and formula-fed infants in the first week of life.

Serum insulin and blood glucose levels were measured in newborns aged four to eight hours and those aged seven days who were either breast fed or formula fed. With both types of feeding, the maximum serum insulin levels occurred 60 minutes postprandially in four- to eight-hour-old infants and 30 minutes postprandially in seven-day-old babies. Between breast-fed and formula-fed groups, no statistically significant difference was found in postprandial serum insulin levels or (except for the 90-minute values on the seventh day) in blood glucose levels. It may be necessary to examine the metabolic-endocrine responses to formula administered as the only feeding over a long period to determine whether formula feeding alters such physiologic mechanisms as pancreatic function and immunity in early life and thereby affects the development of the child.

Blood Glucose↗
PubMed2000

Soluble form of ICAM-1, VCAM-1, E- and L-selectin in human milk.

In breast milk and paired serum from 70 lactating women and 40 of their term, infection-free neonates, on the 2nd and 5th day postpartum slCAM-1, sVCAM-1, sE- and sL-selectin were measured by ELISA and compared with those in 26 healthy adults (controls). Seven infant formulas and fresh milk from five cows were also analyzed. Human colostrum values of slCAM-1, sVCAM-1 (similar to those in maternal and control serum), sE-selectin and sL-selectin (-10 and -100 times lower than in maternal and control serum) were significantly higher than those in milk, while they varied widely. None of the adhesion molecules was detected in fresh cow's milk or infant formulas. Exclusively breast-fed infants showed significantly higher values of slCAM-1 and sL-selectin on the 2nd day of life than those supplemented also with formula. Only slCAM-1 values correlated positively between colostrum and time-matched maternal serum. These findings show in human milk important amounts of slCAM-1 and sVCAM-1 but minimal amounts of sE- and sL-selectin, which could affect the immune system of the neonate.

Adult↗
PubMed2004

Supplementation of milk formula with galacto-oligosaccharides improves intestinal micro-flora and fermentation in term infants.

BACKGROUND: Oligosaccharides in human milk may protect infants by improving the intestinal micro-flora and fermentation. This study was to investigate effects of infant formula milk consisting of galacto-oligosaccharide (GOS) on intestinal microbial populations and the fermentation characteristics in term infants in comparison with that of human milk. METHODS: The test formula (Frisolac H, Friesland, Netherland) was supplemented with GOS at a concentration of 0.24 g/dl. Human milk and another formula without oligosaccharides (Frisolac H, Friesland, Netherland) were used as positive and negative control respectively. Growth, stool characteristics, and side effects of the recruited infants were recorded after 3 and 6 months' follow-up, and the fecal species were collected for the analysis of intestinal micro-flora, short chain fatty acid (SCFA) and pH. RESULTS: At the end of 3- and 6-month feeding period, intestinal Bifidobacteria and Lactobacilli were significantly increased in infants fed with GOS supplemented formula and human milk when compared with infants fed with negative control formula; however, there was no statistically significant difference between GOS supplemented formula and human milk groups. Stool characteristics were influenced by the supplement and main fecal SCFA (acetic), and stool frequency were significantly increased in infants fed with GOS supplemented formula and human milk, while the fecal pH was significantly decreased as compared with that of negative control (P < 0.05). Supplementation had no influence on incidence of side effects (including crying, regurgitation and vomiting). CONCLUSIONS: Supplementing infant formula with GOS at a concentration of 0.24 g/dl stimulates the growth of Bifidobacteria and Lactobacilli in the intestine and stool characteristics are similar to in term infants fed with human milk.

Bifidobacterium↗
PubMed1997

Digestion of proteins in human milk, human milk fortifier, and preterm formula in infant rhesus monkeys.

BACKGROUND: There is limited information in the literature on the capacity of the preterm infant to digest human and bovine milk proteins. We therefore studied in vivo the luminal phase of the hydrolysis of proteins in human milk, human milk fortifier, and preterm formula in preterm rhesus monkeys and in infant rhesus monkeys at 6 weeks and 7 months of age. METHODS: Protein hydrolysis was followed by polyacrylamide gradient gel electrophoresis and electroimmunoassay. The serum level of absorbed unhydrolyzed human alpha-lactalbumin was measured by a radioimmunoassay method. Trypsin and elastase activities in duodenal contents were measured before and after the meal. RESULTS: In 6-week-old monkeys, the enzyme activities decreased by 50% postprandially, whereas they increased in 7-month-old monkeys. In preterm and in 6-week-old monkeys, hydrolysis of human and bovine whey proteins was slow, and in 6-week-old monkeys, 30-50% of the proteins could still be detected immunochemically in duodenal contents after 60 min. At these ages, serum level of absorbed alpha-lactalbumin were high. At 7 months of age, no or small (lactoferrin and bovine serum albumin) amounts of the proteins could be detected in duodenal contents after 15 min. At this age alpha-lactalbumin was not measurable in serum. CONCLUSIONS: The low capacity to digest whey proteins in suckling monkeys may depend upon an immaturity of the exocrine pancreas to respond to secretogogues.

Age Factors↗