[Laboratory evaluation of certain meals prepared according to formulas of infant feeding].
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Food Analysis↗
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Clinical trial of a milk formula for infants of low birth weight.
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Animals↗
Human milk and milk formulas for infant feeding.
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Animals↗
Levels of lead in the United States food supply.
As a result of the Food and Drug Administration's (FDA) concern about lead in the food supply, considerable data have been developed in recent years by FDA, other agencies, and industry on the levels of lead in foods. Data obtained on the lead content of milk, eggs, meat, fish, and shellfish indicate that the mean levels in these unprocessed foods varied from 0.02 to about 0.4 ppm, with the lowest level in milk. The major food processing source of lead in food is the lead-soldered can. FDA had assigned top priority to the reduction of lead in foods for infants because of their greater susceptibility to the toxic effects of this metal. The lead levels in foods for infants are now only 1/5 to 1/10 of what they were when FDA expressed its concern about lead to the manufacturers of canned infant formula, evaporated milk, canned infant juices, and glass-packed infant foods. FDA priority interest has now shifted to reduction of lead in adult canned foods, especially those eaten by young children. The mean levels in such foods have decreased from 0.35-0.40 ppm in 1974 to 0.20-0.25 ppm in 1980.
Adult↗
Serum bilirubin levels in breast-fed vs formula-fed infants during the first 3-5 days of life.
Breast feeding seems to be a cause of neonatal jaundice during the first five days of life; the mechanism of which needs further study. Thai infants appear to exhibit a higher level of "physiological jaundice" bilirubin level than Caucasians.
Adult↗
AAP issues recommendations for the use of soy protein-based formulas in infant feeding.
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Humans↗
[Adapted formulas...in infant dietetics].
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Animals↗
Blood lipid concentrations of docosahexaenoic and arachidonic acids at birth determine their relative postnatal changes in term infants fed breast milk or formula.
BACKGROUND: Factors other than dietary fatty acids could be involved in the variability observed in blood docosahexaenoate (22:6n-3) and arachidonate (20:4n-6) status in formula-fed infants. OBJECTIVE: We considered the 22:6n-3 and 20:4n-6 status at birth to be one of these factors and studied its influence on postnatal changes in term infants fed 4 different diets. DESIGN: The blood phospholipid composition was determined at birth and on day 42 of feeding in 83 term infants fed breast milk, nonsupplemented formula, or 2 different 22:6n-3-supplemented formulas. Relations between 22:6n-3 and 20:4n-6 status at birth and their relative postnatal changes, calculated by the difference between status at the end of the feeding period (6 wk of age) and at birth, were assessed. RESULTS: Postnatal changes in the plasma and erythrocyte phospholipids 22:6n-3 and 20:4n-6 were negatively related to their respective concentrations at birth (P < 0.01) and the slopes of the regression lines were not significantly affected by the type of milk ingested. Adjusted mean values for phospholipid 22:6n-3 in nonsupplemented-formula-fed infants and for 20:4n-6 in formula-fed infants decreased significantly more than they did in the other infant groups (P < 0.02). The status at birth and the type of milk ingested explained 33-64% and 7-47%, respectively, of the variability in postnatal changes. CONCLUSIONS: The status of 22:6n-3 and 20:4n-6 at birth in term infants is one of the major determinants of postnatal changes in these fatty acids. This finding indicates that research is required to characterize environmental, genetic, or both factors, which, in addition to maternal diet, could influence fatty acid status at birth.
Arachidonic Acid↗
Vegetable acceptance by infants: effects of formula flavors.
Individual differences in acceptance patterns are evident as early as the child's first experiences with a particular food. To test hypothesis that the flavor of formula fed to infants modifies their acceptance of some foods, we conducted a within- and between-subjects design study in which two groups of 6- to 11-month-old infants were tested on two separate days. One group was currently feeding a milk-based formula whereas the other was feeding a protein hydrolysate formula, a particularly unpleasant tasting formula to adults that contains similar flavor notes (e.g., sulfur volatiles) with Brassica vegetables such as broccoli. In counterbalanced order, acceptance of pureed broccoli/cauliflower was determined during one test session and pureed carrots on the other. Although there were no group differences in the amount of carrots consumed, hydrolysate infants consumed significantly less broccoli/cauliflower relative to carrots when compared to those who were currently fed milk based formulas (F(1,72 df)=4.43; p=0.04). The mothers of hydrolysate infants were significantly more likely to report that their infants did not enjoy feeding the broccoli/cauliflower (54.2%) when compared to mothers of infants being fed milk-based formulas (28.0%; Chi-Square (1 df)=4.79; p=0.03). Such findings are consistent with prior research that demonstrated a sensory specific satiety following repeated exposure to a particular flavor in milk. We hypothesize that when infants are experiencing a flavor in milk or formula, in the short term, the preference that develops is specific to the context it is experienced in (e.g., milk). Over the longer term, the preference may generalize to other contexts such as solid foods. Hydrolysate infants were also significantly more likely to be judged by their mothers as being more active (F(1,69 df)=3.95; p=0.05) and hesitant (F(1,69 df)=6.55; p=0.01) when compared to those infants who were feeding milk-based formulas, a finding that further supports the hypothesis that mother-child dynamics surrounding early feeding impacts upon mothers' perception of their children's temperament.
Adult↗
Arachidonic acid supply and metabolism in human infants born at full term.
Infants need arachidonic acid (AA; C20:4n-6) for eicosanoid synthesis and deposition in growing tissues, including brain. Human milk supplies preformed AA in amounts considered to meet accretion in membrane-rich tissues, but vegetable oil-based infant formulas do not contain AA. We studied two groups of ten healthy infants, each fed human milk or formula, and analyzed plasma lipid composition. Percentage contributions of AA to plasma phospholipids were stable over two months after birth in breast-fed infants, but infants fed formula developed significantly (P < 0.05) lower levels at the ages of two weeks (formula 6.9% vs. breast 9.4%, w/w), one month (6.2 vs. 9.1%), and two months (5.7 vs. 8.4%). In a second trial, we randomized infants to receive (from birth to age four months) formula without or with both AA and docosahexaenoic acid (DHA; C22:6n-3) at levels typical for mature human milk. Infants fed conventional formula showed a continuous decrease of phospholipid AA over time, whereas feeding of formula supplemented with AA and DHA led to significantly higher AA levels, similar to those in breast-fed infants (two months: supplemented 9.6% vs. unsupplemented 7.1%; four months: 8.7 vs. 6.6%). In order to estimate infantile capacity for endogenous synthesis of AA, we fed four term neonates with newly diagnosed phenylketonuria (mean age 18 d) a formula with all fat contributed by corn oil, which has a higher natural 13C-enrichment than European human milk or formula. Analysis of 13C-enrichment in plasma fatty acids over four days allowed us to estimate infantile AA synthesis. We found an increased 13C-value in plasma AA of all infants, which indicates that term neonates can synthesize AA. However, with a simplified isotope balance equation, we estimate that endogenous synthesis contributed only about 23% of total plasma arachidonic acid by day four. We conclude that full-term infants fed formula may require a dietary supply of some preformed AA if the biochemical status of breast-fed infants is to be achieved.
Arachidonic Acid↗
A multicenter long-term safety and efficacy trial of preterm formula supplemented with long-chain polyunsaturated fatty acids.
BACKGROUND: The tissue accretion of long-chain polyunsaturated fatty acids is compromised in infants born prematurely. Human milk contains long-chain polyunsaturated fatty acids, but most preterm infant formulas do not. The long-term effects of preterm formula supplemented with arachidonic acid and docosahexaenoic acid, in proportions typical of those in human milk, were therefore investigated. METHODS: In this double-blind, randomized study, 288 preterm infants received experimental formula (n = 77), unsupplemented (control) formula (n = 78), or human milk (n = 133) until 48 weeks postconceptional age (PCA). Term formula, without supplemental long-chain polyunsaturated fatty acids, was administered from 48 to 92 weeks PCA to formula-fed infants and to infants weaned from human milk. Anthropometric and fatty acid data were assessed by using analysis of variance. RESULTS: At 92 weeks PCA, no statistically significant anthropometric measurement differences were found except for midarm circumference, which was smaller in human milk-fed infants than in those fed formula. Phospholipid concentrations were similar in the experimental and human milk-fed groups, and docosahexaenoic acid levels were significantly greater than in the control group. The types and incidences of adverse events were similar among the feeding groups. CONCLUSIONS: The results of this study demonstrate the efficacy and long-term safety of preterm formula supplemented with long-chain polyunsaturated fatty acids.
Aging↗
Plasma lipids and apolipoproteins in breastfed and formula-fed Swedish infants.
This study was carried out to compare plasma lipid pattern in breastfed and formula-fed infants and the effects of exchanging breast milk for formula and of introducing weaning foods. Healthy infants, exclusively breastfed at least until 3 mo, were at this age randomly assigned to infant formulas with similar fat composition. Formula was gradually introduced when breastfeeding was discontinued. One group continued to breastfeed beyond 6 mo of age. All infants received the same weaning foods and were studied between 3 and 12 mo of age. Decreased plasma concentrations of total and low-density lipoprotein cholesterol (TC, LDL-C), apolipoprotein B (apo B) and A1 (p < 0.001), and of high-density lipoprotein cholesterol (p < 0.05) were found when breast milk was exchanged for formula before 6 mo. At this age plasma TC, LDL-C and apo B were lower in formula-fed than in breastfed infants (p < 0.001). These plasma lipids then increased (p < 0.01) when the intake of formula decreased and that of weaning foods increased. However, plasma TC and/or LDL-C remained lower at 12 mo in formula-fed than in breastfed infants (p < 0.05). Our results indicate that the plasma lipid profile of infants is highly responsive to the dietary nutrient intake, as indicated by the decrease in plasma lipids and apolipoproteins when breast milk was exchanged for formula and by the increase in these concentrations when the intake of weaning foods gradually increased.
Apolipoproteins↗
Formula feeding potentiates docosahexaenoic and arachidonic acid biosynthesis in term and preterm baboon neonates.
Infant formulas supplemented with docosahexaenoic acid (DHA) and arachidonic acid (ARA) are now available in the United States; however, little is known about the factors that affect biosynthesis. Baboon neonates were assigned to one of four treatments: term, breast-fed; term, formula-fed; preterm (155 of 182 days gestation), formula-fed; and preterm, formula+DHA/ARA-fed. Standard formula had no DHA/ARA; supplemented formula had 0.61%wt DHA (0.3% of calories) and 1.21%wt ARA (0.6% of calories), and baboon breast milk contained 0.68 +/- 0.22%wt DHA and 0.62 +/- 0.12%wt ARA. At 14 days adjusted age, neonates received a combined oral dose of [U-13C]alpha-linolenic acid (LNA*) and [U-13C]linoleic acid (LA*), and tissues were analyzed 14 days after dose. Brain accretion of linolenic acid-derived DHA was approximately 3-fold greater for the formula groups than for the breast-fed group, and dietary DHA partially attenuated excess DHA synthesis among preterms. A similar, significant pattern was found in other organs. Brain linoleic acid-derived ARA accretion was significantly greater in the unsupplemented term group but not in the preterm groups compared with the breast-fed group. These data show that formula potentiates the biosynthesis/accretion of DHA/ARA in term and preterm neonates compared with breast-fed neonates and that the inclusion of DHA/ARA in preterm formula partially restores DHA/ARA biosynthesis to lower, breast-fed levels. Current formula DHA concentrations are inadequate to normalize long-chain polyunsaturated fatty acids synthesis to that of breast-fed levels.
Animal Feed↗
Quantitation of oxidation of medium-chain triglycerides in preterm infants.
Medium-chain triglycerides, with a chain length of eight and 10 carbon atoms, form up to 50% of the total fat content in some preterm infant formulas. In 20 small preterm infants (birthwt: 1153 +/- 227 g; mean +/- SD) fed a special formula containing 40% MCT, a primed constant oral infusion study of 1-13C-potassium octanoate was conducted to quantify the oxidation of MCT. A plateau in 13C enrichment in breath CO2 was reached in all patients within 1-3 h. Simultaneously, substrate utilization was measured using a closed system indirect calorimeter. No significant difference was found between appropriate for gestational age (n = 8) and small for gestational age (n = 12) infants in the percentage of the administered tracer that was oxidized (44.9 +/- 9.1% versus 48.5 +/- 11.0%). In all patients, the recovery was calculated to be 47.1 +/- 10.2%, which is less than previously estimated and corresponds to a mean MCT oxidation of 1.26 +/- 0.27 g/kg/d. With indirect calorimetry, a total fat oxidation of 1.42 +/- 0.84 g/kg/d in appropriate for gestational age and 2.00 +/- 0.85 g/kg/d in small for gestational age infants was found, indicating that MCT accounted for around 85% of the total fat oxidation in appropriate for gestational age versus 65% in small for gestational age infants.
Breath Tests↗
Iron nutrition and iron status changes in Italian infants in the last decade.
Two groups of 9-15 month old Italian infants were studied, at a 9 years' interval, to evaluate and compare feeding practices and their effect on iron status. Nutritional iron supply has increased in the last decade, due to a larger use of breast milk and iron-fortified infant formulas. In 1983, 21.6% of infants were breast-fed for 5 months or more, compared with 50.6% in 1992. In 1983, 73.3% of infants were fed on fresh cow's milk by the age of 6 months, compared with 7.6% in 1992. Consequently, iron status is markedly improved. In 1983, 5% of the examined infants were anemic and 20.7% showed iron deficiency without anemia, compared with 1.3% and 10.3% respectively in 1992. Our study supports the following recommendations: after 5 months of age exclusively breast-fed infants should receive an additional 1 mg/kg/die iron supplement and iron fortified formulas should be used instead of fresh cow's milk during the first year of life.
Food, Fortified↗
Cases of emesis associated with bacterial contamination of an infant breakfast cereal product.
A commercial product for infants containing cereal mixed with dried infant formula was diagnosed as producing rapid projectile vomiting in two infants. Analysis of multiple samples of the cereal product revealed significant contamination with two spore-forming species, Bacillus subtilis and a strain of Bacillus cereus. The latter is the most likely cause of the emetic food poisoning, but we were unable to detect B. cereus emetic toxin. This raises the possibility of the cause being either a new cereulide-type toxin, or the bacterial load, in which case the presence of B. subtilis could have been a contributing factor.
Bacillus cereus↗
Early (in uterus and infant) exposure to mercury and lead.
Mercury and lead are toxic metals widely spread in the environment with bio-accumulative features that raises public health concerns. Both metals are equally dispersed in the human food chain but exposure and risk of toxicity during early human development are modulated by the diet and nutritional status. Understanding how Hg and Pb occur and interact with nutrients is fundamental to establish guidelines for diminishing exposure and the risk of toxicity. The risk of fetal and infant exposure to Hg can be influenced by maternal amalgam filling (inorganic Hg) and fish consumption (monomethyl Hg), whereas the risk of exposure to Pb is complex: maternal absorption depends on nutrient interactions (Ca and P); and maternal body Pb accumulation responds to all factors known to interact with bone and calcium metabolism. Maternal exposure to Hg and Pb is more important during fetal development than during breastfeeding. Moreover, these metals (especially Pb) are frequently higher in infant formulas which do not carry the nutritional and psychological advantages and protection of breastfeeding. Infant's reference dose is lower for Hg than for Pb, but risk of Pb contamination for fetuses and infant (breast- or formula-fed) is higher and lasts longer than Hg. Breastfeeding is essential to complete infant development. Interruption or suppression of breast-feeding with cow's milk-based formulas is not an option to environmental pollution.
Breast Feeding↗
Calcium and zinc retention from protein hydrolysate formulas in suckling rhesus monkeys.
OBJECTIVE: To determine calcium and zinc retention from infant formulas based on protein hydrolysates. DESIGN: Randomized, crossover. SETTING: Newborn nursery at the California Primate Research Center, Davis. PARTICIPANTS: Suckling infant rhesus monkeys (N = 7), aged 6 weeks at the beginning of the study. Each infant received seven different formulas. INTERVENTIONS: Fasted infant monkeys were fed diets radiolabeled with calcium 47 and zinc 65. Retention was determined by counting whole body radioactivity immediately after dosing and 7 days after dosing. MEASUREMENTS AND RESULTS: Retention of 47Ca was a mean (+/- SEM) of 79% +/- 4% from casein hydrolysate and 72% +/- 6% from the whey protein hydrolysate formula. Calcium 47 retention from hydrolysates based on whey protein/casein mixtures (a ratio of 60:40 or 50:50) was similar despite differences in protein sources and calcium content. Calcium 47 retention from two types of soy/collagen hydrolysate formula was found to be 68% +/- 6% and 59% +/- 4%, respectively, which is significantly lower than retention from casein hydrolysate. Considering the different calcium content of these formulas, total calcium retention from milk protein hydrolysates was higher than from soy/collagen products. Retention of 65Zn from milk protein hydrolysates ranged from 18% +/- 3% to 29% +/- 4% and was higher than that from soy/collagen formulas with a mean retention of 7% +/- 3% and 10% +/- 4%, respectively. Despite these differences in 65Zn retention, total zinc retention from all soy/collagen formulas was similar due to their higher zinc content. CONCLUSIONS: Calcium and zinc bioavailability was high from formulas based on milk protein hydrolysate, but was considerably lower from soy hydrolysates. Higher levels of calcium and zinc provided in soy hydrolysate formula compensated for the lower bioavailability and resulted in similar amounts of calcium and zinc retained.
Absorption↗