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PubMed1978

The science of infant nutrition and the art of infant feeding.

Using the recommendations of the Committe on Nutrition of the American Academy of Pediatrics for infant formulas as a scientific base, practical guidelines for feeding infants are given. Breast feeding or the use of a prepared formula meets these recommendations while evaporated milk, fresh cow's milk, and skimmed milk, despite widespread use for many years, do not. The feeding of strained foods and infants cereals should be begun when the infant has reached the stage of development appropriate for feeding from a spoon and swallowing nonliquid foods, usually between 3 and 6 months of age. Lifelong eating patterns begin during this period. Adjusting caloric intake to needs and learning to enjoy a variety of foods are major objectives of feeding practices.

Animals↗

PubMedDate not supplied

Solid-phase extraction of vitamins A and E from animal feeds: A substitute for liquid--liquid extraction.

A substitution was developed for the laborious liquid-liquid extraction method according to European Economic Community legislation for isolation of Vitamins A and E from feeds. A rapid method for the isolation of the 2 vitamins by means of solid-phase extraction on OASIS columns gave reproducible results comparable to those of the European Union-recommended method. The vitamins in the feed were extracted with a minor modification of the official method (KOH in ethanol). After filtration, a portion was applied onto the OASIS column and then washed. The vitamins were eluted in ethyl acetate. The eluate evaporated under nitrogen, and the precipitate was dissolved in methanol before liquid chromatography analysis. Recovery for this method was 80% for Vitamin A and 110% for Vitamin E, as calculated as the result for National Institute of Standards and Technology (NIST) Infant Formula. Day-to-day reproducibility for the method was 21 and 11% of the average results for Vitamins A and E, respectively.

Animal Feed↗

PubMed2002

Common issues in the care of sick neonates.

Newborn infants may be transferred to a special care nursery because of conditions such as prematurity (gestation less than 37 weeks), prolonged resuscitation, respiratory distress, cyanosis, and jaundice, and for evaluation of neonatal sepsis. Newborn infants' core temperature should be kept above 36.4 degrees C (97.5 degrees F). Nutritional requirements are usually 100 to 120 kcal per kg per day to achieve an average weight gain of 150 to 200 g (5 to 7 oz) per week. Standard infant formulas containing 20 kcal per mL and maternal breast milk may be inadequate for premature infants, who require special formulas or fortifiers that provide a higher calorie content (up to 24 kcal per mL). Intravenous fluids should be given when infants are not being fed enterally, such as those with tachypnea greater than 60 breaths per minute. Hypoglycemia can be asymptomatic in large-for-gestational-age infants and infants of mothers who have diabetes. A hyperoxia test can be used to differentiate between pulmonary and cardiac causes of hypoxemia. The potential for neonatal sepsis increases with the presence of risk factors such as prolonged rupture of membranes and maternal colonization with group B streptococcus. Jaundice, especially on the first day of life, should be evaluated and treated. If the infant does not progressively improve in the special care nursery, transfer to a tertiary care unit may be necessary.

Birth Weight↗

PubMed1990

Impact on iron status of introducing cow's milk in the second six months of life.

To determine the impact on iron status of introducing cow's milk (CM) into the diet during the second 6 months of life, nutrient intake was assessed and iron status measured in 100 infants. Nutrient intake for 40 of the 45 infants, age 8 to 13 months, fed CM as the primary beverage for at least 3 months prior to the study and for 45 of 55 infants the same age fed a milk-based infant formula (FF) as the primary beverage for at least 3 months were assessed. All infants in the study were healthy, and the majority were taking no medications or supplements other than vitamins or fluoride for 3 weeks prior to the assessment. Blood drawn by peripheral venipuncture was analyzed by Coulter Counter for complete blood count; plasma albumin, iron, ferritin, transferrin saturation, and total iron-binding capacity were measured in all infants. CM-fed infants had significantly lower mean iron and vitamin C intakes, plasma albumin, transferrin saturation, and ferritin than did FF infants. The frequency of low plasma iron, low transferrin saturation, and low plasma ferritin was significantly greater in CM-fed than in FF infants. The percentage of subjects with three or more abnormal iron indices was more than twice as great in CM-fed infants (58%) as in FF infants (23%). Feeding infants iron-fortified formula to 12 months of age appears to deter iron deficiency.

Anemia, Hypochromic↗

PubMedDate not supplied

Nutritional aspects of manganese homeostasis.

Manganese (Mn) is an essential mineral. It is present in virtually all diets at low concentrations. The principal route of intake for Mn is via food consumption, but in occupational cohorts, inhalation exposure may also occur (this subject will not be dealt with in this review). Humans maintain stable tissue levels of Mn. This is achieved via tight homeostatic control of both absorption and excretion. Nevertheless, it is well established that exposure to high oral, parenteral or ambient air concentrations of Mn can result in elevations in tissue Mn levels. Excessive Mn accumulation in the central nervous system (CNS) is an established clinical entity, referred to as manganism. It resembles idiopathic Parkinson's disease (IPD) in its clinical features, resulting in adverse neurological effects both in laboratory animals and humans. This review focuses on an area that to date has received little consideration, namely the potential exposure of parenterally fed neonates to exceedingly high Mn concentrations in parenteral nutrition solutions, potentially increasing their risk for Mn-induced adverse health sequelae. The review will consider (1) the essentiality of Mn; (2) the concentration ranges, means and variation of Mn in various foods and infant formulas; (3) the absorption, distribution, and elimination of Mn after oral exposure and (4) the factors that raise a theoretical concern that neonates receiving total parenteral nutrition (TPN) are exposed to excessive dietary Mn.

Diet↗

PubMed1995

[Mineral balance during nutritional recuperation of infants with protein deficiency].

Mineral requirements of normal infants change according to growth velocity. They are directly associated to needs for obtaining an adequate composition of new tissue, assure an optimal bone mineralization and for maintaining normal plasma mineral levels. Nutritional rehabilitation of malnourished infants determines increased mineral requirements, which may be not satisfied with usual infant formulas. We studied mineral retention (Ca, P, Mg, Zn and Cu) during nutritional recovery of 9 malnourished male infants (age: 2-7 mo; weight/age < 70%), fed two formulas, both with 85 Kcal/dL (356 KJoule/dL): the first based on whole cow's milk (LP) and the second on a modified cow's milk containing mineral recommendations for normal infants (LPM); balances were compared to normal for age and for length. Infants received each formula for 6 days, with the last 3 days on a metabolic balance Ca, Mg, and P showed high intakes and very low urinary excretions, calcium retention (68.5 +/- 22.7 and 61.4 +/- 16.7 mg/kg/d, for LP and LPM, respectively) were 3 times over normal mean for age (130 mg/d) and 2.5 times over the normal for length (155 mg/d). Mg retention (7.4 +/- 2.0 and 3.4 +/- 1.2 mg/kg/d)), for LP and LPM) were higher than normal for age (2.7 mg/d) or length (3.3 mg/d) and also those of P (LP: 74.8 +/- 7.1; LPM: 52.2 +/- 9.3 mg/kg/d), compared to a mean of 66 mg/d for the same age, or 79 mg/d for length. Zn retentions were comparable with both formulas (LP: 0.14 +/- 0.07 vs LPM: 0.18 +/- 0.06 mg/kg/d) and over normal requirements for age (0.3 mg/d) or length (0.5 mg/d). Copper retentions were significantly lower with LP than LPM (13.8 +/- 14.0 vs 40.0 +/- 13.2 micrograms/kg/d; p < 0.01), due to low intake with LP. We conclude that a high mineral retention is observed in infants recovering from malnutrition, when they are fed formulas with mineral content over its normal recommendations.

Calcium↗

PubMed2000

Types of drinks consumed by infants at 4 and 8 months of age: a descriptive study. The ALSPAC Study Team.

OBJECTIVE: To document the type and volume of drinks given to infants and investigate whether giving supplementary drinks leads to reduced milk consumption. DESIGN: Carers were asked to record all drinks consumed by the infants in a 24-hour period at two ages, detailing the types and volume taken. SETTING: The Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). SUBJECTS: A randomly chosen population sample of over 1000 infants at 4 and 8 months of age. RESULTS: The different types of milk feed were used to group infants, compare volumes consumed and look at the use of non-milk drinks. The average volume of drinks consumed over 24 hours at 4 months was 861 ml and at 8 months was 662 ml. At 4 months 69.7% consumed infant formula and 43.0% breast milk. The mean volume of milk consumed by those having only formula was 802 ml and for those having only breast milk was estimated at 850 ml. The volumes of milks consumed were slightly lower in the groups who also had supplementary drinks. A quarter of infants were given fruit drinks and 14.6% herbal drinks. Supplementary drinks and solids were more likely to be given to formula-fed than breast-fed infants. At 8 months, formula milk was consumed by 71.4% and breast milk use had decreased (22.9%) but fruit drink use had increased (squash/cordial: 55.8%, fruit juice: 14.9%), with 13.9% of infants having no infant milk at all. More infants were fed formula milk and less were fed cows' milk compared with a nationally representative British study conducted 5 years earlier. CONCLUSIONS: Many infants were given supplementary drinks by 4 months; there is some evidence that this led to a small reduction in milk intake. A minority were not being given infant milks at all by 8 months, contrary to British infant feeding recommendations.

Animals↗

PubMedDate not supplied

[Complex experimental assessment of potential allergenicity of various isolates of soy proteins].

The complex evaluation was carried out of potential allergenicity of three soya protein specimens - IPS, IPS-1 and IPS-2 manufactured by Ardex R, USA, which were attended for employment as protein component of specialized infant formulae. The content of total protein, amino-nitrogen, peptide fractions of molecular weight below 9000 D, precipitating protein antigens, trypsin inhibitor, was studied in the specimens. The apparent digestibility was measured by a multienzymatic system in vitro. The allergenicity of isolates was compared by means of histamine LD50 resistance test in guinea pigs and also by the reaction of active anaphylactic shock (AAS). The evidences have been obtained that IPS specimen containing the lowest levels of trypsin inhibitor and small peptide levels is characterized by the lowest sensitizing activity in AAS and simultaneously decreases the animals' resistance to histamine in the highest degree. Apparent digestibility of all the three specimens did not differ significantly. A conclusion has been made that the evaluation is necessary of infant hypoallergenic formulae components by a complex of independent experimental data.

Animals↗

PubMed2006

Disposable microfluidic ELISA for the rapid determination of folic acid content in food products.

A micro-analytical system for rapid and quantitative analysis by inhibition immunoassay is presented and applied to the detection of folic acid. Eight polymer microchannels of 65-nL volume each and containing microelectrodes are embedded in a cartridge so that they can be operated simultaneously. All fluidic steps as well as the amperometric detection in the channels are operated by an instrument and software developed in-house. The fluidic steps of the immunoassay occur through hydrodynamic loading of the different solutions through the channels. The speed and duration of the flow and incubation parameters can thus be adapted to the biological and testing requirements. The effectiveness of the system was demonstrated by analysing folic acid concentrations in real infant formula samples within 5 min. In an effort to get a fully monitored assay, each fluidic step is monitored thanks to continuous amperometric detection of oxygen in the microchannel.

Alkaline Phosphatase↗

PubMed1991

Refeeding of infants with acute diarrheal disease.

The purpose of this study was to determine which infant formula among five would be the most efficacious for the refeeding of infants during an acute episode of diarrhea. Fifty male infants less than 12 months of age with severe diarrhea and at least 5% dehydration were admitted to a metabolic unit and studied in a prospective, single-blind protocol. Ten infants randomly received one of five types of formula: two-thirds diluted cow milk, cow milk formula (Nanon, Nestle, Inc., São Paulo, Brazil), Portagen, Pregestimil, or Prosobee (Mead Johnson & Co. Division, Evansville, Ind.). They continued to receive the same formula for 72 hours unless dehydration occurred. There were no associated infections, and they received no prior antibiotic treatment. Oral hydration together with intravenous fluid therapy was given to all patients during the initial treatment. During the first 72 hours of refeeding, patients fed Portagen excreted the least amount of stool and required reduced quantities of intravenous fluids or oral hydration. In contrast, patients fed diluted cow milk or any other formula had more severe diarrhea. Nine of the 10 patients fed Portagen completed the 72-hour treatment, whereas only 2 of 10 fed diluted cow milk tolerated it. Similarly, the cumulative proportions for high purging rate, dehydration, carbohydrate intolerance, and vomiting were more favorable for Portagen and least acceptable for diluted cow milk. No differences were found among the remaining three formulas tested. These data show that diluted cow milk is poorly tolerated by infants with severe diarrhea, whereas Portagen is more effective.

Acute Disease↗

PubMed2003

Fermentable fiber reduces recovery time and improves intestinal function in piglets following Salmonella typhimurium infection.

Diarrhea is a leading cause of morbidity and mortality in infants. The addition of fiber to infant formulas reduces recovery time following pathogenic infection in infants > 6 mo old, but effects on neonates are unknown. The hypothesis that fermentable fiber reduces infection-associated symptoms and enhances intestinal structure and function in neonates was examined. Piglets (2 d old) were randomly assigned to receive formula alone (control) or formula containing methylcellulose (MCEL), soy polysaccharides (SPS) or fructooligosaccharides (FOS) for 14 d. On d 7, piglets were further randomly assigned to receive an oral gavage of Salmonella typhimurium or serve as noninfected controls. S. typhimurium infection produced diarrhea in controls and MCEL groups, but not in the SPS and FOS groups. Postinfection physical activity was lower (P = 0.0001) in the controls than in all other groups. Ileal lactase activity was reduced (P < 0.05) following infection in the control group but not in the MCEL, SPS and FOS groups. Ileal mucosal barrier function, measured as resistance, was impaired by infection (P < 0.05) in the control and SPS groups, but was unaltered in the jejunum and colon. Total ion transport and basal short-circuit current were higher (P < 0.05) in jejunum than in ileum and colon, irrespective of diet or infection. SPS and FOS increased (P < 0.05) ileal glutamine transport relative to piglets fed MCEL, irrespective of infection. Because fermentable fiber enhances intestinal function and reduces the severity of S. typhimurium infection-associated symptoms, it may be a cost-effective way in which to reduce the severity of pathogenic infection-associated symptoms in infants.

Animals↗

PubMed2005

Essential fatty acids and their derivatives.

PURPOSE OF REVIEW: This review will address recent research in metabolism of essential fatty acids and their long chain derivatives. Our main focus will be the association between essential fatty acid status and various disease states, as well as the effects of supplementation with essential fatty acids or their derivatives on a number of clinical outcomes. RECENT FINDINGS: There have been several papers over the last few years that show links between supplementation with fish oil (n-3 polyunsaturated fatty acids) and cardiovascular disease. Recent data suggest that the use of fish oil (containing n-3 fatty acids) in a variety of disorders such as cystic fibrosis, coronary disease and in the prevention of sudden death is beneficial. Several papers show reductions in systemic markers of inflammation. More widespread use of essential fatty acid derivatives in infant formula can certainly be questioned on the basis of the recent data. Fewer benefits are seen with ingestion of the essential fatty acids themselves, likely related to limited conversion to their long chain derivatives in humans. SUMMARY: Derivatives of essential fatty acids have the potential to modify a number of disease states, either ingested in greater quantities in the diet, or taken as supplements in the form of fish oil.

Animals↗

PubMed2004

Fluoride metabolism and fluorosis.

OBJECTIVES: This paper is primarily concerned with the only proven risk associated with water fluoridation: enamel fluorosis. Its purpose is to review current methods of measuring enamel fluorosis, its aetiology and metabolism. A further objective is to identify risk factors to reduce the prevalence of enamel fluorosis and employ methods to manage such risk factors. DATA: The prevalence of enamel fluorosis is increasing in Ireland and internationally. A critical period has been identified at which teeth are most at risk of developing enamel fluorosis: 15-24 months of age for males and 21-30 months of age for females. The data included took these two factors into account. SOURCE: A thorough narrative review of published literature was conducted to identify studies concerning the aetiology and metabolism of enamel fluorosis. Risk factors for fluorosis were identified from these studies. STUDY SELECTION: As it is the pre-eruptive phase of enamel development which represents the greatest risk to developing enamel fluorosis, studies examining sources of fluoride ingestion for young children were selected. These included studies on ingestion of fluoride toothpaste by young children, fluoride supplementation and infant formula reconstituted with fluoridated water. CONCLUSIONS: There is evidence that the age at which tooth brushing with fluoride toothpastes is commenced and the amount of fluoride placed on the brush are important risk factors in the incidence of dental fluorosis. It is recommended that brushing should not commence until the age of 2 and that a pea-sized amount (0.25 g) of toothpaste should be placed on the brush.

Adolescent↗

PubMed1979

Methionine fortification of a soy protein formula fed to infants.

Data from study of nine normal full-term infants fed a soy isolate-based formula unsupplemented with methionine were compared with similar data from study of 10 similar infants fed the same formula supplemented with L-methionine and with data from previous studies of larger groups of infants receiving various other feedings. Food intake, growth, and serum chemical values were studied from 8 through 111 days of age. In addition, nitrogen balance studies were carried out. Statistically significant differences were as follows: lesser weight gain per 100 kcal by infants fed the unsupplemented soy isolate-based formula than by infants fed milk-based or other soy isolate-based formulas; lesser serum concentrations of albumin at age 28 days by infants fed the unsupplemented soy isolate-based formula than by breast-fed infants; greater serum concentrations of urea nitrogen by infants receiving the unsupplemented soy isolate-based formula than by those receiving the same formula supplemented with L-methionine. A number of other differences was noted but were not statistically significant. The results suggest that normal infants fed a formula providing 2.25 /100 kcal of a soy protein isolate not fortified with methionine performed less well during the first 6 weeks of life than did breast-fed infants and infants fed milk-based formulas or other soy isolate-based formulas fortified with methionine. The limiting nutrient appears to have been methionine.

Aging↗

PubMed2004

Dose response of bone mass to dietary arachidonic acid in piglets fed cow milk-based formula.

BACKGROUND: The addition of arachidonic acid (AA) and docosahexaenoic acid (DHA) to infant formula was recently approved in North America. In piglets, dietary AA is linked to elevations in bone mass. OBJECTIVE: The objective was to investigate the effects of varied amounts of dietary AA on bone modeling and bone mass with the use of the piglet model for infant nutrition. DESIGN: Male piglets (n = 32) were randomly assigned to receive 1 of 4 formulas supplemented with AA (0.30%, 0.45%, 0.60%, or 0.75% of fat) plus DHA (0.1% of fat) from days 5 to 20 of life. Measurements included biomarkers of bone modeling, fatty acid status, and whole-body and femur bone mineral content; bone area was measured by dual-energy X-ray absorptiometry. Differences among groups were detected with two-factor analysis of variance. Regression analyses were used to determine factors responsible for bone mineral content after dietary AA was accounted for. RESULTS: Proportions of AA in plasma, liver, and adipose were modified by the dietary treatments, but bone modeling was not affected. Liver AA was positively related to plasma insulin-like growth factor 1 and calcitriol and urinary N-telopeptide. Whole-body bone mineral content was elevated in the piglets fed 0.60% and 0.75% AA and was best predicted by dietary AA and bone resorption. CONCLUSIONS: This study confirms that dietary AA alters bone mass and clarifies the best amount of AA to add to the diet of pigs born at term. Because the amount of dietary DHA was held constant, whether other amounts of DHA are related to bone mass requires investigation.

Animals↗

PubMed2005

Genetic and environmental risk factors for the development of food allergy.

PURPOSE OF REVIEW: To review recent clinical and experimental studies of genetic and environmental risk factors for the development of food allergy. RECENT FINDINGS: It may be true, although it is yet to be shown, that food allergies in early childhood are becoming more common and that the causes are the same as for later-developing respiratory allergies. The mother not only transfers 50% of her genes to her baby, but she is also the exclusive environment during gestation and continues to be a major environmental factor while breast-feeding her infant. Non-genetic maternal influences increasing the likelihood of food allergy include Caesarian section and high maternal age. Allergy to sesame seems to be increasing in children. This is possibly a consequence of increased use in processed foods. The search for dietary risk factors is not limited to allergenic foods, but may include other nutrients, for example excessive intake of vitamins. Two meta-analyses have seriously questioned the use of special infant formulas for allergy prevention. Novel prevention strategies, such as probiotic bacteria, have yet to be documented further. SUMMARY: The causes of food allergy are still unknown and no particular genes associated particularly with food allergy have been identified, although there is a strong association in general between genetic susceptibility to food allergy and that to IgE-mediated allergy. There are still no measures for general recommendation in order to prevent food allergy and no genes have been linked conclusively to disease. Further research concentrating on food allergy is obviously needed.

Cesarean Section↗

PubMedDate not supplied

[Nutrition in the first months of life with a new formula containing maltodextrins and enriched with long-chain fatty acids].

According to the recent acquisition about the biochemical properties of the carbohydrates contained in human milk, the addition of maltodextrins to infant formulas became recommended. We refer about the preliminary data of the first utilization of a new formula (Aptamil 1 "Nuova Formula") in which both maltodextrins and Long Chain Fatty Acids are added. Sixty-seven infants were enrolled to the study for the first 4 months of life. Forty-three of them (64%) completed the study and were grouped as follows: Group 1 = 15 subjects exclusively formula-fed (4F, 11M), Group 2 = 21 infants with mixed feeding (breast + formula), Group 3 = 7 cases in which Aptamil 1 "Nuova Formula" substituted another formula (4F, 3M). Auxologic parameters (weight, length, head circumference) were among the normal standard limits according to the percentile charts of the Boston Children's Medical Center. All infants enjoyed the taste of the milk we tested. The food regimen was changed in 4/67 (6%) infants because of alimentary intolerance suspicion but 2/4 infants were subsequently fed with soya milk formula and with an "hypoallergenic" milk respectively, the other 2 continued with another formula. The weight growth chart in infants of Group 1 tended to bend down a little bit between the 3rd and 4th month, reminding the breast-fed infants behavior. Considering the daily milk volume assumed by the same subjects, we found a statistical difference (p < or = 0.01) between the volumes of milk assumed in the 2nd and the 3rd month of life but from the 3rd to the 4th month there was no statistical difference in daily milk volumes. This resembles the breast-fed infants behavior as well. According to our preliminary results the new milk formula we tested seems a very good substitute when an infant can't be breast-fed for any reason.

Dextrins↗

PubMed1990

Comparison of breast-feeding and formula feeding on intestinal and hepatic cholesterol metabolism in neonatal pigs.

Infant formulas (IFs) contain reduced cholesterol concentrations compared with breast milk (SM); how neonatal cholesterol metabolism responds to this difference is largely unknown. The effect of exclusive feeding of SM vs low-cholesterol IF on intestinal and hepatic cholesterol concentrations and synthesis during early postnatal development were compared in piglets. Animals were killed at birth or on days 5, 10, 15, or 25 postpartum. Plasma cholesterol concentrations were higher in SM-fed than in IF-fed piglets on days 15 and 25. In intestine both HMG-CoA reductase activity and 3H2O incorporation rates into cholesterol were similar for both groups or reduced in the IF-fed group at days 15 and 25. In liver, HMG-CoA reductase activity was higher in IF-fed than in SM-fed piglets on days 5, 10, and 15. Results indicate that during the early postpartum period, response to lower cholesterol intakes with IF occurs by increasing hepatic sterol synthesis whereas intestinal synthesis is largely unaffected.

Animals↗