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PubMed2005

Increase of faecal bifidobacteria due to dietary oligosaccharides induces a reduction of clinically relevant pathogen germs in the faeces of formula-fed preterm infants.

UNLABELLED: In a previous study on formula-fed preterm infants, we were able to demonstrate that dietary oligosaccharides (a mixture of 90% galacto-oligosaccharides and 10% fructo-oligosaccharides in a concentration of 1 g/dl) stimulate the growth of faecal bifidobacteria. In the present explorative analysis of this study, we focus on the effect of the dominance of bifidobacteria on the presence of clinically relevant pathogens (Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Pseudomonas aeruginosa, Enterobacter, Klebsiella, Proteus, Streptococcus group B, Clostridium difficile, Bacillus subtilis and Acinetobacter). CONCLUSION: The data demonstrate that stimulation of bifidobacteria by prebiotic oligosaccharides reduces the presence of clinically relevant pathogens in the faecal flora, indicating that prebiotic substances might have the capacity to protect against enteral infections.

Bacterial Infections↗
PubMed2000

Dietary 20:4n-6 and 22:6n-3 modulates the profile of long- and very-long-chain fatty acids, rhodopsin content, and kinetics in developing photoreceptor cells.

The objective of this study was to determine whether addition of dietary 20:4n-6 and 22:6n-3 to a conventional infant formula fat blend influences membrane long-chain and very-long-chain fatty acid composition, rhodopsin content, and rhodopsin kinetics in developing rat photoreceptor cells. The dietary fats were formulated based on the fat composition of a conventional infant formula providing an 18:2n-6/18:3n-3 ratio of 7:1 (SMA, Wyeth Nutritionals), which served as the control fat blend. This dietary fat blend was modified to contain 20:4n-6 [arachidonic acid (AA)], 22:6n-3 [docosahexaenoic acid (DHA)], AA + DHA, or an 18:2n-6/18:3n-3 ratio of 4:1 (alpha-linolenic acid). Dams were fed diets from birth, and rat pups were fed the same diet after weaning. Retinas and rod outer segments were prepared in the dark from pups at 2, 3, and 6 wk of age for fatty acid analysis of individual phospholipids, rhodopsin content, and rhodopsin disappearance kinetics after light exposure. Feeding AA + DHA in the diet increased 22:6n-3 levels in phosphatidylcholine and phosphatidylethanolamine. In phosphatidylcholine, total n-6 tetraenoic very-long-chain fatty acids and total n-3 pentaenoic and n-3 hexaenoic very-long-chain fatty acids increased after feeding AA and DHA, respectively. Developmental changes were characterized by a decrease in 20:4n-6 in the major phospholipids, whereas 22:6n-3 increased with age in rod outer segments. The highest rhodopsin content occurred in the retina of rats fed diets containing AA and/or DHA. The kinetics of rhodopsin disappearance after light exposure was highest in rats fed DHA at 6 wk of age. This study demonstrates that small manipulations of the dietary level of 20:4n-6 and 22:6n-3 are important determinants of fatty acid composition of membrane lipid and visual pigment content and kinetics in the developing photoreceptor cell.

Animals↗
PubMed1987

[Study of infant milk formulas present on the Spanish market and its adaptation to the recommendations of the European Society of Gastroenterology and Pediatric Nutrition].

The aim of this study was to investigate energy as well as the protein and mineral composition of milk formulas available on the Spanish market. We studied 20 milk formulas, 14 of which were adapted milk formulas intended for feeding newborns during the first 4-6 months of life and the other 6 ones were follow-up milk formulas. Determinations of energy, total protein, osmolality, sodium, potassium, chloride, phosphorus and calcium were performed by adiabatic calorimetry, cryoscopy, flame photometry, photocolorimetry and flame atomic absorption spectrophotometry respectively. Experimental energy in all formulas was higher than that determined by nutrient contents and conversion factors. Three of the adapted formulas presented higher values of protein than those recommended by ESPGAN and some of them also high levels for sodium total electrolytes. However, the estimated renal solute load for each of the formulas was lower than the minimum renal concentration ability. All formulas, except one, showed normal values for calcium and the contents of phosphorus, were within normalcy. All the follow-up formulas agreed with the ESPGAN recommendations related with protein and mineral composition.

Energy Intake↗
PubMed2003

Absorption of enteral recombinant human erythropoietin by neonates.

BACKGROUND: Erythropoietin (EPO) is present in amniotic fluid, colostrum, and human milk. One possible function of ingested EPO might be to stimulate erythropoiesis. However, it is unclear whether human neonates absorb recombinant human erythropoietin (rhEPO) after oral administration. OBJECTIVE: To determine whether circulating EPO concentrations increase following enteral administration of rhEPO to neonates. METHODS: The study was designed as a 2-center prospective, blinded, randomized, 2 x 2 crossover study, with each infant receiving 1 dose of rhEPO 1000 units/kg and 1 dose of placebo. Serum EPO concentrations were measured at baseline, 2, and 4 hours following study drug administration. The rhEPO and placebo dosing were separated by a mean of 72 hours. Analysis was stratified by gestational age (< or =35 wk, >35 wk) and feeding type (human milk, infant formula). RESULTS: No significant change in serum EPO concentration was identified at 2 or 4 hours following enteral administration of rhEPO. CONCLUSIONS: Enteral administration of a large dose of rhEPO to neonates <4 months of age did not result in increased circulating EPO concentrations at 2 or 4 hours following dosing, regardless of whether it was administered in human milk or infant formula.

Analysis of Variance↗
PubMed2005

Performance of media for recovering stressed cells of Enterobacter sakazakii as determined using spiral plating and ecometric techniques.

A study was done to determine the performance of differential, selective media for supporting resuscitation and colony development by stressed cells of Enterobacter sakazakii. Cells of four strains of E. sakazakii isolated from powdered infant formula were exposed to five stress conditions: heat (55 degrees C for 5 min), freezing (-20 degrees C for 24 h, thawed, frozen again at -20 degrees C for 2 h, thawed), acidic pH (3.54), alkaline pH (11.25), and desiccation in powdered infant formula (water activity, 0.25; 21 degrees C for 31 days). Control and stressed cells were spiral plated on tryptic soy agar supplemented with 0.1% pyruvate (TSAP, a nonselective control medium); Leuschner, Baird, Donald, and Cox (LBDC) agar (a differential, nonselective medium); Oh and Kang agar (OK); fecal coliform agar (FCA); Druggan-Forsythe-Iversen (DFI) medium; violet red bile glucose (VRBG) agar; and Enterobacteriaceae enrichment (EE) agar. With the exception of desiccation-stressed cells, suspensions of stressed cells were also plated on these media and on R&F Enterobacter sakazakii chromogenic plating (RF) medium using the ecometric technique. The order of performance of media for recovering control and heat-, freeze-, acid-, and alkaline-stressed cells by spiral plating was TSAP > LBDC > FCA > OK, VRBG > DFI > EE; the general order for recovering desiccated cells was TSAP, LBDC, FCA, OK > DFI, VRBG, EE. Using the ecometric technique, the general order of growth indices of stressed cells was TSAP, LBDC > FCA > RF, VRBG, OK > DFI, EE. The results indicate that differential, selective media vary greatly in their abilities to support resuscitation and colony formation by stressed cells of E. sakazakii. The orders of performance of media for recovering stressed cells were similar using spiral plating and ecometric techniques, but results from spiral plating should be considered more conclusive.

Bacteriological Techniques↗
PubMed1981

Human milk feeding in premature infants: protein, fat, and carbohydrate balances in the first two weeks of life.

The nutritional adequacy of the premature infant's own mother's milk was assessed during the first two weeks of life. Studies were carried out in three groups (n = 8) of infants of less than 1,300 gm birth weight, matched for gestational age and weight, and fed either pooled breast milk, their mothers own milk, or infant formula (SMA20 or SMA24). Macronutrient balances at the end of the first and second postnatal weeks demonstrated differences in nitrogen and lipid absorption and retention between groups. Nitrogen retentions (mg/kg/day) were similar to normal fetal accretion rates only in the PT and SMA24 groups. Fat absorption was poorest from the heat-sterilized PBM (average of 64.0% of intake) when compared to PT (88.2%) and SMA groups (83.3%). Average gross and metabolizable energy intakes were similar among groups. Nutritional status as measured by plasma total protein and albumin concentrations and weight gain tended to be poorest in the PBM-fed infants. It was concluded that either PT milk or infant formula of a composition similar to SMA24 are more appropriate than pooled banked milk for feeding the premature infant during the first two weeks of life.

Anthropometry↗
PubMed1999

Lack of association between duration of breast-feeding or introduction of cow's milk and development of islet autoimmunity.

The hypothesis that early exposure to cow's milk or lack of breast-feeding predisposes to type 1 diabetes remains controversial. We aimed to determine prospectively the relationship of, first, duration of exclusive breast-feeding and total duration of breast-feeding, and second, introduction of cow's milk protein as infant formula, cow's milk, or dairy products, to the development of islet antibodies in early life. Some 317 children with a first-degree relative with type 1 diabetes were followed prospectively from birth for 29 months (4-73). Mothers kept a home diary and answered infant feeding questionnaires at 6-month intervals. No systematic feeding advice was given. Insulin autoantibodies (normal range <5.5%), anti-GAD antibodies (<5.0 U), and anti-IA2 antibodies (<3.0 U) were measured at 6-month intervals. Cox proportional hazards model of survival analysis detected no significant difference between children who did not develop islet antibodies (225 of 317 [71%]), children with one islet antibody raised once (52 of 317 [16.4%]), children with one antibody raised repeatedly (18 of 317 [5.7%]), or children with two or more antibodies raised (22 of 317 [6.9%]), in terms of duration of exclusive breast-feeding, total duration of breast-feeding, or introduction of cow's milk-based infant formulas, cow's milk, or dairy products (relative risk: 0.91-1.09). Four of the children with two or more islet antibodies developed type 1 diabetes. We conclude that there is no prospective association between duration of breast-feeding or introduction of cow's milk and the development of islet autoimmunity in high-risk children.

Aging↗
PubMed1997

A methodology for biokinetic studies using stable isotopes: results of repeated molybdenum investigations on a healthy volunteer.

A method for biokinetic studies in humans using stable isotopes is presented. The technique is based on double tracer administration and on proton activation as the analytical method. As an application, the results of investigations on molybdenum metabolism in humans are reported. The contents of 95Mo and 96Mo in biological samples were determined by inducing (p,n) reactions and by analysing the gamma-rays emitted by the radioactive products. The minimum detectable quantity was 2 ng/mL plasma for both Mo isotopes. Four investigations on molybdenum metabolism were performed on a healthy volunteer subject in the course of 3 yr. Two absorption studies with different amounts of tracers in aqueous solution were performed by giving 96Mo orally and 95Mo intravenously. Two investigations were performed with single oral administration of 96Mo in aqueous solution and of a 96Mo solution mixed with an infant formula respectively. The stability with time of the biokinetic parameters was tested. The fractional absorption values measured in this volunteer were 0.84, 0.98 and 0.95 for three studies with Mo in HCl and 0.51 for a single study with Mo administered in an infant formula, these data are discussed.

Humans↗
PubMed1982

Bottle feeding and ideology in colonial Malaya: the production of change.

Considerable attention has been paid to the correlation between high infant morbidity and mortality rates and the increased incidence of bottle feeding. The shift from prolonged breast feeding to a mixed regime or the exclusive use of sweetened condensed milk or infant formula has been related to the promotional activities of milk companies, and typically has been presented as a relatively recent development in Third World countries. However, the marketing of tinned and powdered milk only partially explains the increased use of these products. In colonial Malaya, condensed milk was marketed from the late 19th century. Infant formula was available from the turn of the century and was widely advertised, first in the English-language press and later also in the vernacular presses. At the same time, other social and cultural factors served to discourage breast feeding. There were changes in ideas regarding ideal body weight for both women and infants, and regarding infant care and diet; these ideas were presented in the mass media. In addition, maternal and child health clinics, established in the 1920s to reduce the high infant mortality rate, both propagated popular beliefs about infant weight and supplied milk and educated women to artificially feed their infants. Industry, the media, and health services all promoted, if not always intentionally, bottle feeding rather than breast feeding. Bottle feeding as an ideal, if not a reality, was thus well established before the intensive promotion of milk products by multinational corporations that followed the political independence of the colony.

Advertising↗
PubMed1997

The effect of triglyceride positional distribution on fatty acid absorption in rats.

BACKGROUND: Human milk contains palmitic acid predominantly in the triglyceride sn-2 position, and differs from the palmitic acid positional distribution found in most infant formulas (predominantly positions sn-1 and sn-3). Following lipolysis by pancreatic lipase, 2-monoglycerides and free fatty acids are produced. All 2-monoglycerides are well absorbed, including 2-monopalmitin, thus providing one reason for the efficient absorption of palmitic acid in breast-fed infants. If infants are fed fat blends with palmitic acid located in the sn-1 and sn-3 positions, the resulting free fatty acids may form poorly absorbed calcium soaps. Therefore, many infant formulas contain only modest levels of palmitic acid. METHODS: Fat absorption studies were conducted in rats with preparations containing various amounts of palmitic acid in the triglyceride sn-2 position. Determining total fat absorption, specific fatty acid absorption, and the presence of calcium-fatty acid soaps. RESULTS: Betapol, a new triacylglycerol, similar to human milk in its palmitic acid content and positional distribution, demonstrated excellent absorption characteristics compared to fat blends derived from either palm olein or oleo (similar in fatty acid profile to Betapol, but with most palmitic acid in the sn-1 and sn-3 positions). A five-point dose response was used to further evaluate the relationship of positional distribution and fat loss. Palmitic acid excretion and fecal fatty acid soaps were negatively correlated to the presence of palmitic acid in the sn-2 position. CONCLUSION: These studies provide evidence that palmitic acid can be efficiently absorbed, avoiding fatty soap formation of it is present in the sn-2 position.

Animals↗
PubMed1987

[Individualized supplementation of fluoride in primary pediatrics].

Problems found in the development of a program for individual supplementation of fluoride to infants and pre-school children in a primary pediatric outpatient unit are commented. Problems included knowledge of the level of fluoride in public water supply, in infant formulas and in mineral water used in their preparation and selection of a practical and regular method for supplying fluoride in the first year (having in mind other sources of fluoride) and in older children, and taking into account economic problems. Practical tables with the amount of fluoride in Spanish drinkable water, in commonly available infant formulas and mineral bottled waters, are shown.

Administration, Oral↗
PubMed2000

Risk of enamel fluorosis in nonfluoridated and optimally fluoridated populations: considerations for the dental professional.

BACKGROUND: Few studies have evaluated the impact of specific fluoride sources on the prevalence of enamel fluorosis in the population. The author conducted research to determine attributable risk percent estimates for mild-to-moderate enamel fluorosis in two populations of middle-school-aged children. METHODS: The author recruited two groups of children 10 to 14 years of age. One group of 429 had grown up in nonfluoridated communities; the other group of 234 had grown up in optimally fluoridated communities. Trained examiners measured enamel fluorosis using the Fluorosis Risk Index and measured early childhood fluoride exposure using a questionnaire completed by the parent. The author then calculated attributable risk percent estimates, or the proportion of cases of mild-to-moderate enamel fluorosis associated with exposure to specific early fluoride sources, based on logistic regression models. RESULTS: In the nonfluoridated study sample, sixty-five percent of the enamel fluorosis cases were attributed to fluoride supplementation under the pre-1994 protocol. An additional 34 percent were explained by the children having brushed more than once per day during the first two years of life. In the optimally fluoridated study sample, 68 percent of the enamel fluorosis cases were explained by the children using more than a pea-sized amount of toothpaste during the first year of life, 13 percent by having been inappropriately given a fluoride supplement, and 9 percent by the use of infant formula in the form of a powdered concentrate. CONCLUSIONS: Enamel fluorosis in the nonfluoridated study sample was attributed to fluoride supplementation under the pre-1994 protocol and early toothbrushing behaviors. Enamel fluorosis in the optimally fluoridated study sample was attributed to early toothbrushing behaviors, inappropriate fluoride supplementation and the use of infant formula in the form of a powdered concentrate. CLINICAL IMPLICATIONS: By advising parents about the best early use of fluoride agents, health professionals play an important role in reducing the prevalence of clinically noticeable enamel fluorosis.

Adolescent↗
PubMed2000

Cow's milk and immune-mediated diabetes.

Cow's milk-based infant formulas and cow's milk consumption in childhood have been suggested to promote the development of type 1 diabetes mellitus and other immune-mediated or neurological diseases. Epidemiological studies in man have led to the hypothesis that introduction of cow's milk-based infant formula within the first 3 months of life is associated with increased risk of type 1 diabetes mellitus. Furthermore, in animal models of type 1 diabetes mellitus, cow's milk proteins have been proven to be 'diabetogenic'. However, the issue seems far from being resolved. Several epidemiological studies and, more importantly, the first prospective trials did not show an association between early exposure to cow's milk and type 1 diabetes mellitus. In animal models, cow's milk proteins are modestly and variably diabetogenic, wheat or soybean proteins in the diet cause higher rates of autoimmune diabetes. In both man and rodents there is increasing evidence that the gut-associated immune system plays a major role in disease development, probably because of disturbed oral tolerance mechanisms. Oral tolerance depends on immunological homeostasis and normal maturation of the gut. These factors are influenced by growth factors and cytokines from breast milk, normal bacterial colonization, infections and diet. All these factors have been proposed as risk factors for type 1 diabetes mellitus. Hence, cow's milk proteins may provide mimicry epitopes relevant in autoimmunity, as well as destabilizing oral tolerance mechanisms by biologically active peptides. The concept of dietary regulation of autoimmunity does not apply only to cow's milk protein, but also to other dietary proteins.

Animals↗
PubMed1994

Bacillus cereus in infant foods and dried milk products.

Dried milk products and infant food are known to be frequently contaminated with Bacillus cereus. Sources of the organism and its behaviour in the product and in the equipment during processing are discussed. With regard to the incidence of B. cereus in infant food, 261 samples distributed in 17 countries were collected and examined for its B. cereus content. Fifty-four percent of the samples were contaminated with B. cereus reaching levels from 0.3 to 600/g. Counts higher than 10/g were found in only 27 samples (10%). Most of the positive samples (44%) contained 0.3 to 10 B. cereus/g. Four samples (1.5%) were contaminated with more than 100 organisms/g reaching a maximum level of 600 B. cereus/g. When classified into different types of products about 50% of the infant formulae based on milk, the follow-on formulae and the weaning foods were contaminated with B. cereus as well as 69% of those based on soy protein and 92% of the special dietetic foods. Compared to our earlier studies from 1982/83, the percentage of contaminated samples from Germany increased from 31% to 70% in the case of infant formulae, from 28% to 55% in the case of follow-on formulae, and from 40% to 100% in the case of special dietetic food. The percentage of weaning food contaminated with B. cereus remained nearly unchanged. It should be stressed, however, that the numbers of B. cereus were almost the same in both studies with the highest count in 1982/83 being 460 and in 1992 600/g. Samples naturally contaminated with counts of about 100 B. cereus/g were reconstituted and incubated at a room temperature of 27 degrees C. Levels of 10(5) B. cereus/g were reached after 7-9 h. Toxigenicity of B. cereus in dried milk products and infant food as well as food poisoning outbreaks attributed to B. cereus are discussed.

Animals↗
PubMed1982

Food for the suckling: revolution and development.

The 1970's saw a renaissance in child nutrition, a major revision of infant feeding practice and substantial changes in food for the suckling. Many more babies are breast fed, those who are not receive an infant formula specifically designed for this period of life, and solid foods are no longer introduced in the early weeks. These changes have contributed to the improvement in the suckling's health, particularly the reduction in neonatal tetany, and in deaths from gastroenteritis. Developments in the 1980's should improve our knowledge of breast milk and its properties, advisable intakes of specific nutrients and their interrelationships, and the immunology of infant feeding. Meanwhile, practice will be directed towards the enhancement of successful lactation, the processing of donor human milk, the establishment of standards for infant formulas and the special problems of the low birth weight baby.

Bottle Feeding↗
PubMed1999

Evaluation of single-cell sources of docosahexaenoic acid and arachidonic acid: 3-month rat oral safety study with an in utero phase.

Owing to the presence of the polyunsaturated fatty acids (PUFA) docosahexaenoic acid (DHA) and arachidonic acid (ARA) in human milk and their important biological function, several authorities recommend that they be added to infant formulas. This study assessed the safety of an algal oil rich in DHA and a fungal oil rich in ARA, blended to provide a DHA to ARA ratio similar to human milk. The oil blend was incorporated into diets and fed to rats such that they received 3, 11 and 22 times the anticipated infant exposure to DHA and ARA. Low-fat and high-fat control groups received canola oil. Rats received experimental diets over a premating interval and throughout mating, gestation and lactation. Pups born during this period (F1) consumed treatment diets from weaning for 3 months. Physical observations, ophthalmoscopic examinations, body weight, food intake, clinical chemistry, neurobehavioural evaluations and postmortem histopathology of selected tissues were performed. No statistically significant, dose-dependent adverse effects were seen in reproductive performance or fertility, nor in the neonates from birth to weaning. Mid- and high-dose treated F1 animals exhibited increased white cell count, neutrophil count and blood urea nitrogen; increased liver and spleen weights (absolute and relative to body weight) also were observed. There were no corresponding microscopic findings. The clinical pathology and organ weight differences at these treatment levels represent physiological or metabolic responses to the test substance rather than adverse responses. These single-cell oils produced no adverse effects in rats when administered in utero and for 90 days at dietary levels resulting in exposures up to 22 or 66 times higher than those expected in infant formulas when extrapolated on the basis of diet composition (g/100 Cal) or intake (g/kg body weight), respectively.

Administration, Oral↗
PubMed1980

Net absorption of starch in low birth weight infants.

Twelve 3-day metabolic balance studies were carried out in 12 low birth weight infants fed an infant formula providing 3.5 g of corn starch per kilogram body weight per day. The mean coefficients of net absorption were 88 +/- 6% for starch, 70 +/- 14% for fat and 90 +/- 4% for nitrogen. No relationship was found between starch absorption and nitrogen or fat absorption. There was no relationship between starch absorption and the duration of starch feeding. It is concluded that the ability of young infants to digest large quantities of starch is most likely limited resulting from low pancreatic alpha-amylase activity. Nevertheless, from a practical point of view, small amounts of starch in infant formulas can be considered not only as a thickener but also as a source of calories.

Absorption↗