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PubMed1986

Response to RIT 4237 oral rotavirus vaccine in breast-fed and formula-fed infants.

Twenty-six full-term newborns (15 males and 11 females) were followed-up from birth to 5 months of age. During the first month of life, all of them were breast-fed. Thereafter those infants whose mothers produced enough milk continued breast-feeding (n = 16) while the remaining (n = 10) changed to an adapted milk formula supplying approximately 2 g/kg/day of protein and 100 Kcal/kg/day. At 4 months of life, all infants were vaccinated with one oral dose of RIT 4237 rotavirus vaccine of bovine origin. Before and one month after the vaccination, total protein immunoglobulin and IgM type antibodies against rotavirus were evaluated in serum. Growth, weight, length, head circumference and nutritional serum parameters were comparable in both groups of infants as well as the immune response to the RIT 4237 vaccine. Moreover, the "take" of RIT 4237 oral rotavirus vaccine was not lowered by the concomitant administration of human breast-milk which is known to contain rotavirus antibodies. Therefore, breast-feeding is probably not a contraindication for vaccination with RIT 4237, which is most important in developing countries where rotavirus infection is common in young infants and results in acute diarrhoea often leading to death.

Administration, Oral↗
PubMed2002

Hydrolyzed protein accelerates feeding advancement in very low birth weight infants.

BACKGROUND: Feeding intolerance is common in very low birth weight (VLBW; <1500 g) infants. Hydrolyzed protein preterm infant formula (HPF) has been shown to accelerate the gastrointestinal transit of formula. The aim of this study was to investigate whether HPF improves early feeding tolerance compared with standard preterm infant formula (SPF). We hypothesized that HPF would accelerate early enteral feeding advancement. METHODS: Primary outcome was the time from initiation of milk feeds until full feeds (150 mL/kg birth weight/d) were achieved in infants who received <10% human milk (HM) to exclude HM as a confounder. Because the availability of HM was not predictable at the time of enrollment, all eligible VLBW infants (n = 129) were randomly assigned in a randomized, controlled trial to receive HPF or SPF if HM was not available. Infants who received >10% HM (n = 42) were excluded. Milk bolus feeding every 2 to 3 hours was started at the discretion of the attending physician and advanced by 16 mL/kg/d. Preprandial gastric residuals were tolerated up to 5 mL/kg; otherwise, feedings were reduced or withheld. Data are shown as median (5th and 95th percentile). RESULTS: Forty-six and 41 (HPF vs SPF) infants received <10% HM. There was no significant difference with regard to birth weight, gestational age, and onset of milk feeds (day 3 [1-8] vs 4 [2-6]). The time from initiation of milk feeds to full feeds was significantly shorter with HPF feeding (10 [9-27] vs 12 [9-28] days). CONCLUSION: HPF improved the feeding tolerance and enabled a more rapid establishment of full enteral feeding in VLBW infants compared with SPF.

Double-Blind Method↗
PubMed1999

Phenotypic and genotypic typing of food and clinical isolates of Enterobacter sakazakii.

Enterobacter sakazakii, designated a unique species in 1980, has been implicated as the causative organism in a rare but severe form of neonatal meningitis. Dried infant formula milk has been identified as a potential source of the organism. E. sakazakii isolates from dried infant formula available in Canada and clinical isolates obtained from Canadian hospital culture collections were characterised by phenotypic (biotype and antibiograms) and genotypic (ribotyping, random amplification of polymorphic DNA and pulsed-field gel electrophoresis) methods. Three biotypes and four antibiogram patterns were observed in the 18 isolates examined. Ribotyping with the Dupont Riboprinter microbial identification system divided the 18 isolates into 10 ribotypes. Three isolates from the same hospital had indistinguishable ribotyping patterns although each was isolated in a different year, as did three food isolates from one company. Pulsed-field gel electrophoresis (PFGE) and random amplification of polymorphic DNA (RAPD) profiles indicated minor differences between the isolates that were indistinguishable by ribotyping. PFGE (with the restriction endonucleases Xba1 and Spe1) and RAPD gave discrete patterns that enabled easy comparison of E. sakazakii isolates, with a high degree of discrimination. The discriminatory index showed RAPD and PFGE were shown to be the most discriminatory typing schemes for E. sakazakii, followed by ribotyping, biotyping and antibiograms.

Bacterial Typing Techniques↗
PubMed1989

[Milk consumption in 10-month-old infants. Effects on iron intake].

A study was conducted in 278 10-month-old infants, examined in 2 health care centres in Paris. The dietary history method was used to evaluate their food consumption: 54.5% were receiving usual cow's milk (semi-skimmed or whole milk), 44% adapted infant formulas, and 1.5% cow milk products only. There was no relationship between the quality of milk consumption of these infants and the socio-economic level or the nationality of their parents. Infants receiving usual cow milk had an iron intake lower than the recommended daily amounts while those who were fed with the adapted infant formulas had an adequate daily iron intake.

Anemia, Hypochromic↗
PubMed1985

Daily intake of selenium by bottle-fed infants in Belgium.

The selenium content of commercial infant formulae, processed milk and beikost was measured by hydride generation atomic absorption spectrometry after previous wet acid digestion. The median daily intake by infants (1-6 months) fed milk, soya or cereal-based infant formulae was 3.0-7.8 micrograms/day; lower than the mean daily intake by Belgian breast-fed infants (6.1-8.6 micrograms/day) and cow's milk bottle-fed infants (7.6-10.8 micrograms/day).

Animals↗
PubMed1989

Taurine in pediatric nutrition: review and update.

Taurine was long considered an end product of the metabolism of the sulfur-containing amino acids, methionine and cyst(e)ine. Its only clearly recognized biochemical role had been as a substrate in the conjugation of bile acids. Taurine is found free in millimolar concentrations in animal tissues, particularly those that are excitable, rich in membranes, and generate oxidants. Various lines of evidence suggest one major nutritional role as protecting cell membranes by attenuating toxic substances and/or by acting as an osmoregulator. The totality of evidence suggests that taurine is nonessential in the rodent, it is an essential amino acid in the cat, and it is conditionally essential in man and monkey. Absence from the diet of a conditionally essential nutrient does not produce immediate deficiency disease but, in the long term, can cause problems. Taurine is now added to many infant formulas as a measure of prudence to provide improved nourishment with the same margin of safety for its newly identified physiologic functions as that found in human milk. Such supplementation can be justified by the finding of improved fat absorption in preterm infants and in children with cystic fibrosis, as well as by salutary effects on auditory brainstem-evoked responses in preterm infants. Experimental findings in animal models and in human cell models provide further justification for taurine supplementation of infant formulas.

Humans↗
PubMed2000

A rice starch added follow-on formula for infants with sleeping difficulty.

A total of 15 infants aged between 4-12 months with sleeping difficulty were enrolled in the study. All participants were given a test follow-on formula (cow's milk based), with added rice starch. The test formula was advised to be given at night-time for a 7-day period. Sleeping patterns were recorded 2 days prior to the study and during the 7-day study period. It was shown than 11 out of 15 cases (73.3%) had satisfactory results. Two cases (13.3%) were withdrawn from the study by their parents due to vomiting after taking the formula. We found that both cases developed concomitant respiratory tract infection one day after starting the study, and 2 cases (13.3%) were lost to follow-up. In conclusion, the majority of cases showed satisfactory results in terms of night sleeping pattern after switching to the rice starch added follow--on formula.

Bottle Feeding↗
PubMed1991

Physicians, formula companies, and advertising. A historical perspective.

The recent advent of new advertising campaigns for infant formulas aimed at the general public via television commercials, newspapers, free formula coupons, and lay periodicals has disrupted a comfortable symbiotic relationship between infant food manufacturers and the medical profession that has endured for more than 50 years. In the late 19th century, physicians were concerned about the advertising claims of these products and generally felt that indications and directions for their use should be the province of the physician. Between 1929 and 1932, the American Medical Association, through its Committee on Foods and "Seal of Acceptance," essentially required the entire formula industry to advertise only to the medical profession. Since 1932, the US formula industry has developed into a $1.6 billion market. In 1988, Nestlé (absent from the US infant formula industry since the 1940s) acquired the Carnation Company and launched an advertising campaign to the general public for its formula products. Bristol Myers/Mead Johnson, in cooperation with Gerber Products Company, quickly followed suit. These actions threaten to once again remove the realm of infant feeding from the exclusive supervision of the medical profession. The new multimedia public advertising campaigns may increase the cost of infant formula to the general public and have a negative impact on the incidence of breast-feeding. In addition, formula advertising campaigns will likely increase the danger of advertising hyperbole and affect the level of financial support by formula companies for scientific meetings, medical research, education, and social events at medical meetings.

Advertising↗
PubMed1998

The role of long chain polyunsaturated fatty acids (LCPUFA) in neonatal nutrition.

Exciting new research has shown that both preterm and term infants can actively convert the essential fatty acids linoleic acid (LA, 18:2n-6) and alpha-linolenic acid (ALA, 18:3n-3) to long chain polyunsaturated fatty acids (LCPUFA). However, the amount of LCPUFA being produced, particularly of docosahexaenoic acid (DHA, 22:6n-3), may not be sufficient to meet the developmental requirement of the infant. Because DHA is a major component of retinal and brain tissues, a number of studies have been initiated to test the effect of dietary LCPUFA on neural outcomes in infants. These studies have largely involved a comparison of neural responses from infants fed standard infant formula (no LCPUFA) with infants receiving LCPUFA from either supplemented formula or breast milk. The results have been equivocal and may be due to the variety of LCPUFA supplements and formula fat blends used, differing testing techniques as well as variations in clinical trial conduct, but are clearer in preterm than term infants. Overall the results indicate a possible role for LCPUFA in neurodevelopment.

Breast Feeding↗
PubMed2006

Effectiveness of disinfectants in killing Enterobacter sakazakii in suspension, dried on the surface of stainless steel, and in a biofilm.

The effectiveness of 13 disinfectants used in hospitals, day-care centers, and food service kitchens in killing Enterobacter sakazakii in suspension, dried on the surface of stainless steel, and in biofilm was determined. E. sakazakii exhibited various levels of resistance to the disinfectants, depending on the composition of the disinfectants, amount and type of organic matrix surrounding cells, and exposure time. Populations of planktonic cells suspended in water (7.22 to 7.40 log CFU/ml) decreased to undetectable levels (<0.30 log CFU/ml) within 1 to 5 min upon treatment with disinfectants, while numbers of cells in reconstituted infant formula were reduced by only 0.02 to 3.69 log CFU/ml after the treatment for 10 min. The presence of infant formula also enhanced the resistance to the disinfectants of cells dried on the surface of stainless steel. The resistance of cells to disinfectants in 6-day-old and 12-day-old biofilms on the surface of stainless steel was not significantly different. The overall order of efficacy of disinfectants in killing E. sakazakii was planktonic cells > cells inoculated and dried on stainless steel > cells in biofilms on stainless steel. Findings show that disinfectants routinely used in hospital, day-care, and food service kitchen settings are ineffective in killing some cells of E. sakazakii embedded in organic matrices.

Biofilms↗
PubMed1991

ELISA analysis of soybean trypsin inhibitors in processed foods.

Soybean proteins are widely used in human foods in a variety of forms, including infant formulas, flour, protein concentrates, protein isolates, soy sauces, textured soy fibers, and tofu. The presence of inhibitors of digestive enzymes in soy proteins impairs the nutritional quality and possibly the safety of soybeans and other legumes. Processing, based on the use of heat or fractionation of protein isolates, does not completely inactivate or remove these inhibitors, so that residual amounts of inhibitors are consumed by animals and humans. New monoclonal antibody-based immunoassays can measure low levels of the soybean Kunitz trypsin inhibitor (KTI) and the Bowman-Birk trypsin and chymotrypsin inhibitor (BBI) and the Bowman-Birk foods. The enzyme-linked immunosorbent assay (ELISA) was used to measure the inhibitor content of soy concentrates, isolates, and flours, both heated and unheated; a commercial soy infant formula; KTI and BBI with rearranged disulfide bonds; browning products derived from heat-treatment of KTI with glucose and starch; and KTI exposed to high pH. The results indicate that even low inhibitor isolates contain significant amounts of specific inhibitors. Thus, infants on soy formula consume about 10 mg of KTI plus BBI per day. The immunoassays complement the established enzymatic assays of trypsin and chymotrypsin inhibitors, and have advantages in (a) measuring low levels of inhibitors in processed foods; and (b) differentiating between the Kunitz and Bowman-Birk inhibitors. The significance of our findings for food safety are discussed.

Alkalies↗
PubMed2000

n-3 polyunsaturated fatty acid requirements of term infants.

The benchmarks for human nutrient requirements are the recommended dietary intakes (RDIs). However, the RDIs are set to prevent a clinical deficiency state in an otherwise healthy population and there are few nutrient recommendations set with the goal of achieving an optimal or maximal state of nutrition and health. This is becoming an increasing challenge with the introduction of many nutraceuticals and functional foods, a prime example being the debate surrounding the introduction of long-chain polyunsaturated fatty acids (LCPUFAs) into infant formulas. Most expert nutrition committees have used the fatty acid composition of breast milk as a basis for recommendations for infant formulas, with little information on the minimum absolute requirement for essential PUFAs. It has been difficult to determine a minimum requirement for fatty acids because 1) LCPUFAs can be synthesized from precursor fatty acids, 2) plasma n-3 LCPUFA concentrations representing deficiency and sufficiency are not clearly defined, and 3) there are no recognized clinical tests for n-3 LCPUFA deficiency and sufficiency. Therefore, there is a clear need to associate a measure of LCPUFA status with a specific functional outcome before any recommendations can be made for achieving optimal or maximal LCPUFA status.

Adult↗
PubMed1994

A double stable isotope technique for measuring iron absorption in infants.

A stable isotope technique has been developed which uses 57Fe and 58Fe as labels and which enables the simultaneous measurement of Fe absorption from two test meals in infants. The method was evaluated by measuring Fe absorption from a commercial whey-adjusted infant formula in nine healthy infants aged 13-25 weeks. Each infant was fed 210 ml formula, labelled with either 57Fe or 58Fe, on four consecutive mornings, in random order. The total Fe content in each feed was 2.5 mg Fe; either as 2.5 mg 57Fe, or 0.6 mg 58Fe plus 1.9 mg Fe with normal isotopic composition. Isotopic enrichment of Fe in erythrocytes was measured by thermal ionization mass spectrometry 14 d after the last administration, and Fe absorption was calculated based on isotope ratio shifts, total circulating Fe and intake of each isotope. Geometric mean absorption for the 57Fe and 58Fe labels was 6.72 and 6.58% respectively, and the absorption of the two isotopes was not significantly different (Student's paired t test). By this technique, paired comparisons of Fe absorption can be obtained and systematic studies of the influence of dietary factors on Fe absorption during infancy can be conducted.

Child, Preschool↗
PubMed1995

Effect of three levels of vitamin D intake in preterm infants receiving high mineral-containing milk.

Very low-birth weight (VLBW) infants fed high-calcium and high-phosphorus (10.74 and 6.93 mmol/MJ; 180 and 90 mg/100 kcal, respectively) infant formulas were randomized to one of three levels of vitamin D intake to approximate 200, 400, and 800 IU/day. Sixty-two infants completed the study (24 to 29 days), with actual mean daily vitamin D intakes of 161, 361, and 766 IU, respectively. Outcomes were not different by group: gains in body weight, length and head circumference, serum calcium, magnesium, phosphorus, alkaline phosphatase, osteocalcin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and urine calcium:creatinine and magnesium:creatinine ratios. There were no radiographic fractures and/or rickets. A subset of 19 infants was followed between 173 and 380 days to determine descriptively if there was any delayed effect of earlier manipulation of vitamin D intake. They were fed standard infant formulas with a vitamin D content of 400 to 420 IU/L. No significant differences were present among the three groups, and data were combined. Serum 25-hydroxyvitamin D increased (p < 0.05), osteocalcin decreased (p < 0.05), and 1,25-dihydroxyvitamin D decreased (p = 0.06) at follow-up. Thus, for VLBZW infants fed high-calcium and high-phosphorus milk, an average daily vitamin D intake as low as 160 IU maintains normal and stable vitamin D status and normal physical growth, biochemical and hormonal indexes of bone mineral metabolism, and skeletal radiographs versus randomized infants receiving about 400 or 800 IU of vitamin D per day. On follow-up, vitamin D status remained normal for > or = 6 months while infants received < 400 IU of vitamin D per day.

Animals↗