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PubMed2004

Duration of long-chain polyunsaturated fatty acids availability in the diet and visual acuity.

BACKGROUND: Little is known about the critical period during which the dietary supply of long-chain polyunsaturated fatty acids (LCPUFAs) may influence the maturation of visual cortical function in term infants. AIM: To define the relationship between duration of dietary LCPUFA supply and visual acuity at 52 weeks of age. STUDY DESIGN: Data from 243 infants who participated in four randomized clinical trials of LCPUFA supplementation of infant formula at a single research center were combined. The primary outcome was visual acuity at 52 weeks of age as measured by swept visual evoked potentials (sweep VEP). RESULTS: Longer duration of LCPUFA supply was associated with better mean acuity at 52 weeks of age (r=-0.878; p<0.001). The relationship between duration of dietary LCPUFA supply and sweep VEP acuity at 52 weeks was similar whether the LCPUFAs were provided via formula containing 0.36% DHA and 0.72% ARA or human milk. Duration of breast-feeding was associated with individual infants' sweep VEP acuity outcomes at 52 weeks (r=-0.286; p<0.005). The duration of LCPUFA supply during infancy has a similar relationship to sweep VEP acuity at 52 weeks in breastfed infants regardless of birth order. CONCLUSION: A continued benefit from a supply of LCPUFAs is apparent in infants through 52 weeks of age, suggesting that the brain may not have sufficient stores of LCPUFAs from an early postnatal supply to support the optimal maturation of the visual cortex.

Evoked Potentials, Visual↗

PubMed2004

[The main principles of nutrition from 0 to 3 years of age].

Infants and toddler's nutrition must take into account growth speed, degree of maturation and development, and physical activity. In early infancy mother milk is still the matchless reference that milk companies try to imitate in terms of nutritional and functional efficiency. Alternatives to breast-milk are represented by several kinds of infant formula. The choice between this multitude must be made regarding the composition, the scientifically proven claim and the infant tolerance, being cautious of inopportune milk shifting which are useless and potentially deleterious. Up to 4 to 6 months, milk is sufficient by itself, except for vitamin D. Afterwards, servings must take into account progressive introduction of solid foods attempting to keep as long as possible an adapted milk (follow-on and growing-up formula). Clinical monitoring must focus on preventing deficiencies and overeating, with special regards to calcium and iron supplies and to obesity prevention.

Breast Feeding↗

PubMed2005

Long-chain polyunsaturated fatty acids and neurological developmental outcome at 18 months in healthy term infants.

AIM: Previously, we found a beneficial effect of 2 mo supplementation of infant formula with long-chain polyunsaturated fatty acids (LC-PUFA) on neurological condition at 3 mo in healthy term infants. The aim of the present follow-up study was to evaluate whether the effect on neurological condition persists until 18 mo. METHODS: A prospective, double-blind, randomized control study was conducted. Three groups were formed: a control (CF; n = 169), an LC-PUFA-supplemented (LF; n = 146) and a breastfed (BF; n = 159) group. Information on potential confounders was collected at enrolment. At the age of 18 mo, neurodevelopmental condition was assessed by the age-specific neurological examination of Hempel and the Bayley scales. The Hempel assessment resulted in a clinical neurological diagnosis, a total optimality score and a score on the fluency of motility. The Bayley scales resulted in mental and psychomotor developmental indices. Attrition at 18 mo was 5.5% and non-selective. Multivariate regression analyses were carried out to evaluate the effect of type of feeding while adjusting for confounders. RESULTS: None of the children had developed cerebral palsy and 23 (CF: n = 8; LF: n = 10; BF: n = 5) showed minor neurological dysfunction. The groups did not show statistically significant differences in clinical neurological condition, neurological optimality score, fluency score, and the psychomotor and mental development indices. Multivariate analysis confirmed that there was no effect of type of feeding on neurological condition. CONCLUSION: This study indicates that the beneficial neurodevelopmental effect of 2 mo LC-PUFA supplementation in healthy term infants can not be detected at the age of 18 mo.

Age Factors↗

PubMed1985

Feeding of very-low-birth-weight infants with special formula--continued use beyond 2000 g and effects on growth to 1 year.

Ten very-low-birth-weight (VLBW) infants fed a premature formula up to a weight of 2 000 g were randomized either to continue on the premature formula for a further 8 weeks or to change to a standard infant formula. Four infants in each group completed the 8-week study period, while growth and biochemical data were available on the other 2 infants for half the study period. No significant differences were seen at the end of the study. Infants on the premature formula showed a trend towards more rapid growth during the 8-week period, but this was no longer evident at a corrected age of 3 months. All infants were followed up to a corrected age of 1 year, during which time growth curves were similar to those previously described for VLBW infants. No long-term tendency towards obesity was evident in these infants, who had gained weight up to 2 000 g at a rate equivalent to the intra-uterine rate.

Growth↗

PubMed1988

Effect of mineral supplementation of human milk on bone mineral content and trace element metabolism.

We studied the effect of feeding mineral fortified human milk to preterm infants (birth weight less than or equal to 1500 gm). Serum concentrations of calcium, magnesium, phosphorus, zinc, cooper, alkaline phosphatase, and parathyroid hormone were determined, and bone mineral content was measured, in infants fed unfortified human milk (group 1), fortified human milk (group 1), fortified human milk (group 2), and a "humanized," mineral-enriched premature infant formula (group 3). Serum calcium, magnesium, phosphorus, zinc, copper, and parathyroid hormone concentrations did not differ significantly among the groups studied. Serum alkaline phosphatase concentrations increased significantly only in the infants fed unfortified human milk, and bone mineral content in this group was significantly lower than in formula-fed infants.

Bone and Bones↗

PubMed1997

Use of soy fiber in acute diarrhea in infants and toddlers.

Soy fiber has been shown to reduce the duration of watery stools during acute diarrhea caused by bacterial and viral pathogens in underdeveloped countries. A randomized blinded clinical trial was conducted with middle-class American children to assess the efficacy of soy fiber-supplemented infant formula. Stool characteristics, intake, and weight were recorded. Infants > 6 months of age (n = 44) fed soy fiber-supplemented formula (Isomil DF) had a significantly shorter estimated median duration of diarrhea (9.7 hours vs. 23.1 hours) than those fed soy formula (Isomil). The use of fiber-supplemented soy formula may reduce the duration of diarrheal symptoms in U.S. infants more than 6 months of age with acute diarrhea.

Acute Disease↗

PubMed1980

Bile acid excretion and patterns of fatty acid absorption in formula-fed premature infants.

Balance studies of individual fatty acid (FA) absorption and bile acid (BA) excretion were performed in 23 healthy premature infants fed proprietary formulas, utilizing gas-liquid chromatography. There was a direct correlation between the amount of BA excreted and absorption. This correlation was valid for total fat and for unsaturated dietary FA. Malabsorption of saturated FAs was in proportion to their hydrocarbon chain length and is best explained by their aqueous solubility, independent of BA. Assays of total FA absorption by gas-liquid chromatography and by the method of van de Kamer appear to be interchangeable.

Animals↗

PubMed1998

Direct detection and quantitative determination of bovine lactoferricin and lactoferrin fragments in human gastric contents by affinity mass spectrometry.

Lactoferricin (Lfcin) is a bioactive fragment of lactoferrin derived from the bactericidal and putative lymphocyte receptor binding domain(s) located within the N-lobe of lactoferrin. Although known to be liberated from at least three species of lactoferrin, conditions leading to Lfcin generation in vivo and factors affecting its distribution are still not known. Recently, we have developed a method of surface-enhanced laser desorption/ionization (SELDI) affinity mass spectrometry using n-butyl terminal groups for surface-enhanced affinity capture (SEAC) to quantify not only Lfcin generated in vivo but also other lactoferrin fragments. Unlike previous efforts to detect lactoferrin and Lfcin with specific antibodies, the SELDI affinity assay distinguished lactoferrin, lactoferrin fragments, Lfcin and unrelated peptides without their interference with each other. To evaluate Lfcin generation in vivo, the experimental design involved feeding 200 mL of 10 mg/mL (1.22 x 10(-4) mol/L) bovine lactoferrin to an adult. Gastric contents were recovered 10 min after ingestion. Lfcin produced in vivo was directly captured by the SEAC device. The amount of Lfcin in the gastric contents was 16.91 +/- 2.65 micrograms/mL (5.350 +/- 0.838 x 10(-6) mol/L). However, a large proportion of the ingested lactoferrin was not completely digested. Lactoferrin fragments containing the Lfcin region were analyzed by in situ hydrolysis with pepsin after being captured by the SEAC device. As much as 5.740 +/- 0.702 x 10(-5) mol/L of the partially degraded lactoferrin fragments were found to contain the Lfcin region, including peptide domains 17-43, 17-44, 12-44, 9-58, and 16-76 of bovine lactoferrin. These results show that bovine Lfcin can be produced in the human stomach after ingestion of an infant formula supplemented with bovine lactoferrin. It is now important to determine whether Lfcin is generated in the intestinal tract of formula-fed and breast-fed infants, and geriatric patients consuming foods enriched with lactoferrin.

Adult↗

PubMed2001

Association of postnatal dexamethasone use and fungal sepsis in the development of severe retinopathy of prematurity and progression to laser therapy in extremely low-birth-weight infants.

OBJECTIVE: The objective of this study was to evaluate the role of postnatal dexamethasone use and fungal sepsis in the development of severe retinopathy and progression to laser therapy. BACKGROUND: Postnatal steroids have been frequently used in the management of infants with chronic lung disease, airway edema, and hypotension, but their use is not free from adverse effects. Postnatal dexamethasone use has been associated with increased risk for the development of fungal sepsis, but the influence of glucocorticoid therapy on retinopathy of prematurity (ROP) is controversial. Candida sepsis has been shown to be associated with severe ROP and the need for laser therapy in some studies but not in others. STUDY DESIGN: Medical records of all <1000 g birth weight infants (n=158) admitted to Louisiana State University Health Sciences Center between July 1, 1996 and June 30, 1999 were reviewed. After exclusion of those infants who either died (n=25) or transferred (n=3) before eye examination, demographic and clinical data of 130 infants were analyzed by chi-squared analysis, Mann-Whitney U test, t-test, analysis of variance, and logistic regression. All data are mean+/-SD. RESULTS: Gestational age was 26.4+/-1.7 weeks; birth weight was 797+/-130 g. Twenty-six infants were Caucasian, the rest African-American. Seventy-five (58%) received antenatal steroids. Eighty-eight (68%) of the infants received postnatal steroids. All infants were exclusively fed premature infant formulae. Sepsis developed in 44 (34%) infants and fungal sepsis in 14 (11%). Incidence of ROP was 77% (100/130), severe ROP (stage > or =3) 52% (68). Severe ROP was more frequent in Caucasian infants (p=0.005) and in infants who received postnatal dexamethasone (p< or =0.0001). The development of threshold ROP (zone 1 or 2 with stage 3+, five contiguous or eight total clock hours of the retina) and requirement for laser therapy were higher in Caucasians (p=0.0002) and in infants with fungal sepsis (p=0.001). Antenatal steroids had no effect on the severity of ROP or the need for laser treatment. Postnatal dexamethasone use was significantly associated with fungal sepsis 13/14 (93%). After controlling for gestational age, race, days on supplemental oxygen, and fungal sepsis, cumulative postnatal dexamethasone use was independently associated with severe ROP [OR 1.2 (1.04-1.33)], and fungal sepsis [OR 8.2 (2.0-33.0)] was independently associated with the need for laser therapy. CONCLUSIONS: Postnatal steroid use is an independent risk factor for development of severe ROP. The risk of threshold ROP requiring laser treatment was higher in infants who developed fungal sepsis.

Analysis of Variance↗

PubMed2000

Dietary fat intakes in infants and primary school children in Germany.

We report dietary fat intake data in groups of infants and children in Germany. A group of 148 healthy infants was followed prospectively from birth through the first year of life. After birth, 78.9% of infants were breast-fed; 50% were breast-fed at 3 mo and 9. 8% were breast-fed at 12 mo. Infant formula was given to 22% of infants after birth, 53% at 3 mo, and 58% at 12 mo. Complementary foods were consumed by 16% of infants at 3 mo, 97% at 6 mo, and 98-100% at 7-12 mo. In non-breast-fed infants, mean dietary fat intakes were 44.8%, 42.9%, 37.4%, and 35.7% of energy intake at the ages of 1, 4, 6, and 12 mo, respectively. Calculated energy and nutrient intakes were within recommended ranges and weight gain was normal. Therefore, we see no compelling reason to actively modify total fat intakes at this age. In 158 primary school children aged 6-11 y, 7-d checklist protocols showed 41% of energy intake as fat with approximately 50% as saturated fat. Because German children of this age are experiencing increasing rates of obesity and high serum cholesterol concentrations, a stepwise reduction of total fat and saturated fat intakes in primary school children appears desirable to improve long-term health.

Adult↗

PubMed1983

Postprandial gastric acid secretion in infants.

Gastric acid secretion in response to meals of infant formula was studied in 8 healthy infants aged 4 to 24 weeks. The technique involved intragastric volume determinations using a marker and measurement of the acidity of the gastric contents. In the 2-hour postprandial period, pH declined from 7 to 5.2. The one-hour postprandial gastric acid output was 236 +/- 49 mumol/kg body weight.

Gastric Acid↗

PubMed1997

Prooxidant effects of maternal smoking and formula in newborn infants.

BACKGROUND: The purpose of this study was to use the breath ethane test to determine if either maternal cigarette smoking, formula, and/or deficiency of the antioxidant nutrients vitamins A and E was associated with oxidant stress in newborn infants. The rationale for this study was: (1) our observation that cigarette smoking was a source of oxidant stress in pregnant women, suggesting that it could be a source of oxidant stress for infants exposed in utero; (2) formula was predicted to be prooxidant compared to colostrum, which contains several compounds with antioxidant activity in vitro; and (3) deficiencies of vitamins A and E have been shown to promote oxidant stress in experimental animals. METHODS: Breath ethane, a volatile alkane produced by peroxide of n-3 fatty acids, was utilized as an index of oxidant stress status. Forty-five healthy full-term infants of the women mentioned above were studied at 18-24 h of age, after four to six feedings of breast milk (colostrum) or caseinbased infant formula. Relationships between infant breath ethane, maternal smoking, mode of infant nutrition, and serum concentrations of the antioxidant vitamins A and E of infants were examined. RESULTS: The breath ethane of the entire group of infants whose mothers smoked (n = 19) was increased compared to values of infants whose mothers did not smoke (n = 26): 97 +/- 16 versus 43 +/- 9 pmol/kg/min, p < 0.03. When infants of mothers who smoked were eliminated from the analysis in order to study effects of nutrition alone, formula appeared to be prooxidant compared to breast milk. Breath ethane of formula-fed infants (n = 16) was 62 +/- 13 versus 13 +/- 4 pmol/kg/min for breast-fed infants (n = 10), p < 0.04. For the group as a whole, there was no correlation between infant breath ethane and serum concentrations of vitamins A and E. CONCLUSIONS: Exposure to maternal smoking in utero is prooxidant in newborn infants. Formula also has a prooxidant effect compared to colostrum in newborn infants not exposed to maternal smoking in utero. Further investigations will be necessary to explore the clinical consequences of these observations.

Antioxidants↗

PubMed1999

Assessment of protein quality of infant milk food formula supplemented with lactulose.

To examine the protein quality of infant food formula supplemented with lactulose (bifidogenic factor), groups of 21 day male weanling rats were fed diet containing lactulose at 0.5% for 4 weeks. The gain in body weight of rats fed lactulose supplemented diet were similar to that of rats fed lactulose free and skim milk powder fed diet as controls. No difference in overall acceptability pattern was also observed in studies conducted with human subjects for organoleptic evaluation. The results suggest that supplementation of lactulose in infant food formula does not affect either the protein quality as indicated by protein efficiency ratio in rats as compared to control formulae or overall acceptability by human subjects.

Animals↗

PubMed2001

The role of polyunsaturated fatty acids in term and preterm infants and breastfeeding mothers.

DHA and AA, which are components of breast milk but not infant formulas marketed in the United States and some other countries, are important components of the brain, and DHA is a major component of the retina. Also, many studies have demonstrated advantages of breastfeeding versus formula-feeding on subsequent cognitive and visual function; however, available data are insufficient to justify the conclusion that the presence of DHA and AA in breast milk is partially or soley responsible for the apparent advantages of breastfeeding. On the other hand, many studies of DHA (and AA)-supplemented versus unsupplemented formulas have shown clear advantages of the supplemented formulas on visual acuity at 2 and 4 months of age or neurodevelopmental status at 12 to 18 months of age. Although one logically may assume that these early effects may have long-term effects, this assumption is not warranted by the available data. One of the major problems is the difficulty of assessing visual and cognitive function of infants. Scores on standard neurodevelopmental tests at 1 year of age, for example, are only weakly correlated with performance at school age (when more definitive assessments are possible), and little is known about the predictability of later visual function from behavioral or electrophysiologic assessments of visual function early in life. Even prematurely born infants can synthesize DHA and AA and other omega-3 and omega-6 LC-PUFAs from the dietary EFAs, LA and ALA. Nonetheless, plasma, erythrocyte and brain lipid levels of DHA are lower in infants whose diets do not contain DHA. Whether more optimal intakes of ALA result in higher plasma and tissue levels of this FA is unclear. The breast-milk content of LC-PUFAs is not regulated by the mammary gland but, rather, reflects the concentrations of LC-PUFAs in maternal plasma lipids that, in turn, are dependent on maternal diet and, probably, maternal activities of the desaturases and elongases involved in converting dietary LA and ALA to LC-PUFAs. This occurrence suggests that some infants receive sufficient LC-PUFA to support normal rates of deposition, whereas others may not. Also, some infants probably can synthesize additional LC-PUFAs from the LA and ALA contents of human milk. Thus, depending on maternal diet and maternal and infant desaturase and elongase activities, some breastfed infants may receive less than adequate LC-PUFAs to support normal rates of deposition. Clearly, the role of LC-PUFAs in infant development is not a simple issue. Also, no foolproof method exists to ensure an adequate but not excessive intake. Thus, because some evidence shows that dietary LC-PUFA (DHA, AA, or both) as components of breast milk or formula confers at least transient developmental benefits, supplementation of infant formulas with LC-PUFAs is supportable provided that the supplements used are safe. The safety of all available supplements is unknown; however, some trials reveal few reasons for major concerns about the safety of single-cell oils, low-EPA fish oil, or egg-yolk phospholipid or triglyceride fractions.

Breast Feeding↗

PubMed1995

Magnesium nutrition of infants.

Our knowledge of magnesium absorption in infants and dietary factors affecting magnesium bioavailability from infant diets is limited. The magnesium concentration of human milk is about 30 mg/litre, while infant formulas provide about 40-80 mg/litre and cows milk approximately 130 mg/litre. Most of the magnesium in these diets is present in soluble form and in vitro digestibility studies show the remainder to be easily solubilized. The soluble magnesium in infant diets is largely in a low molecular weight form, most likely explaining the high bioavailability of magnesium from infant diets in experimental animals (50-90 per cent). Limited studies in preterm and term infants also indicate a high level of magnesium absorption (55-75 per cent) from human milk and milk-based formulas. Thus, infant diets are likely to supply adequate amounts of magnesium for the growing infant. Magnesium deficiency and toxicity are therefore rare in term infants and usually a consequence of hormonal abnormalities and maternal use of pharmacological doses of magnesium. Low birth weight infants may exhibit hypomagnesaemia and benefit from magnesium supplementation.

Biological Availability↗

PubMed1982

The influence of dietary factors on the vitamin E requirements of the low birthweight infant.

The vitamin E requirements for the low birthweight (LBW) infant varies with other dietary factors such as iron and polyunsaturated fatty acids (PUFA). This interaction is caused by the influence of iron on the oxidative breakdown of lipids (lipid peroxidation). Thus the need for fortification of infant formulas with vitamin E increases if the formulas are iron fortified or have a high content of PUFA. A vitamin E/linoleic acid ratio of greater than 1 IU/g is currently recommended. The formulas on sale in Sweden satisfies this recommendation. In breastmilk we found a vitamin E/linoleic acid ratio of greater than 1 IU/g in colostral and transitional milk. In mature breastmilk, however, 9 out of 24 samples showed a ratio less than 1 IU/g. Thus it is possible, that the LBW infant fed mature human milk may need a larger supplement of vitamin E than the formula fed infant.

Biotransformation↗

PubMed2000

Blue babies and nitrate-contaminated well water.

The use of nitrate-contaminated drinking water to prepare infant formula is a well-known risk factor for infant methemoglobinemia. Affected infants develop a peculiar blue-gray skin color and may become irritable or lethargic, depending on the severity of their condition. The condition can progress rapidly to cause coma and death if it is not recognized and treated appropriately. Two cases of blue baby syndrome were recently investigated. Both cases involved infants who became ill after being fed formula that was reconstituted with water from private wells. Water samples collected from these wells during the infants' illnesses contained nitrate-nitrogen concentrations of 22.9 and 27.4 mg/L.

Environmental Exposure↗

PubMed1984

Effects of zinc and copper content of formulas on growth and on the concentration of zinc and copper in serum and hair.

We studied the effect of dietary zinc (Zn) and copper (Cu) on the levels of these elements in serum (at 1, 3, and 5 months of age) and in hair (at 5 months of age) of breast- and formula-fed infants. Three different formulas were used: (a) Commercially available standard infant formula containing 1.0 mg/L of Zn and 30 micrograms/L of Cu; (b) Zn supplemented formula, containing 3.2 mg/L of Zn and 30 micrograms/L of Cu; and (c) Zn- and Cu-supplemented formula, containing 3.2 mg/L of Zn and 400 micrograms/L of Cu. The median Zn content of breast milk was 4.8 mg/L at 1 week, 2.9 mg/L at 1 month, 1.1 mg/L at 3 months and 1.1 mg/L at 5 months. Breast milk Cu content was 510 micrograms/L at 1 week, 440 micrograms/L at 1 month, 270 micrograms/L at 3 months, and 200 micrograms/L at 5 months after delivery. All infants were healthy and full term, and weight and length velocities were similar in each of the four groups studied. Serum Zn levels were significantly higher both in the infants fed the Zn-supplemented formula and those fed the Zn-and-Cu-supplemented formula compared with the other two groups of infants at 3 and 5 months of age. Zn levels in hair were significantly elevated (invariably greater than 80 micrograms/g) only in infants fed Zn-supplemented formula.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Height↗