Human milk intake and growth in exclusively breast-fed infants

Milk intake and growth in 45 exclusively breast-fed infants were documented during the first 4 months of life. Energy and protein intakes were substantially less than current nutrient allowances. Energy intake declined significantly from 110 +/- 24 kcal/kg/day at 1 month to 71 +/- 17 kcal/kg/day at 4 months. Protein intake decreased from 1.6 +/- 0.3 gm/kg/day at 1 month to 0.9 +/- 0.2 gm/kg/day at 4 months. Infant growth progressed satisfactorily, compared with National Center for Health Statistics standards. A reevaluation of energy and protein intakes and allowances during infancy is merited.     

The relationship between breast milk leptin and neonatal weight gain

Aim: To investigate whether change in leptin content of breast milk during lactation acts on neonatal body weight gain.
Methods: In total 15 lactating women and their 15 term infants were involved in the study. Breast milk and neonatal serum samples were obtained from the same women and their neonates on the 1st day and any day between the 21st and 30th days after birth. Breast milk and serum leptin concentrations were determined by radioimmunoassay. Anthropometric indexes of the infants were recorded.
Results: The study was completed with 15 multiparious mothers aged 19–37 years and their infants. The mean collection time of the first samples after birth was 6.07 ± 1.94 h. The leptin level in the mature milk was significantly higher than in the colostrum (p < 0.001). Neonatal weight and height were significantly increased on 21–30 lactation days compared to 1st day of lactation (p < 0.05 and p < 0.001, respectively). The leptin concentration in the mature milk was negatively correlated with delta BMI (r =−0.53; p < 0.05). The delta breast milk leptin concentration was also found to be inversely correlated with delta BMI (r =−0.529; p < 0.05).
Conclusion: The results of this study have suggested that change in the leptin content of breast milk during lactation might play a role in the regulation of weight gain in healthy neonates.     

双歧杆菌对母乳成分的影响及其与婴儿过敏性疾病的关系

目的通过给孕母、乳母补充益生菌双歧杆菌,观察双歧杆菌对母乳成分的影响及其与婴儿过敏性疾病发病的关系。方法选择知情同意的孕妇,自孕36周开始口服双歧杆菌,分娩后继续服用直到母乳喂养结束,同时选择对照组口服安慰剂,取初乳及成熟乳测细胞因子及免疫球蛋白(IgA、sIgA、TGF-β1、TGF-β2、IL-10、sCD14);婴儿随访到2岁以确定湿疹及其他过敏性疾病。结果口服双歧杆菌的孕妇初乳中TGF-β1、TGF-β2水平低于对照组,IL-10水平高于对照组,成熟乳中sCD14高于对照组。母乳中TGF-β水平低的孕妇的孩子2岁内患过敏性疾病率低。口服双歧杆菌对母乳中IgA、sIgA水平无影响。结论在怀孕晚期及哺乳期口服双歧杆菌可降低母乳中TGF-β1、TGF-β2水平,母乳中后两者水平降低与母乳喂养婴儿低敏感性有关。     

Longitudinal zinc balances in breast-fed and formula-fed infants

Longitudinal zinc (Zn) balance studies were performed under domestic conditions in term breast-fed (n = 10), term formula-fed (n = 5; Zn concentration in the formula: 4 mg/l) and preterm formula-fed (n = 3) infants during the first 17 weeks of life. Samples of milk, urine and feces were analyzed by atomic absorption spectrometry. The median daily Zn intake in breast-fed infants decreased from 0.592 (0.457-0.829) mg Zn/kg body weight to 0.151 (0.095-0.304) mg Zn/kg body weight in the first 17 weeks of life; comparable values for bottle-fed term infants were 0.58 (0.511-0.701) and 0.674 (0.529-0.731) mg Zn/kg body weight. The median percent retention of Zn intake was 27 (-60 to 81.4)% in breast-fed infants and 21.5 (-42 to 64)% in formula-fed infants. In view of the urinary and fecal Zn losses measured, a daily intake of 0.3-0.5 mg Zn/kg body weight is considered to be sufficient to ensure a Zn retention equivalent to breast-fed infants. This requires a Zn concentration of 2-3 mg/l of Zn depending on milk volume intake.     

Resistin and leptin in breast milk and infants in early life

Background

The role of adipokines in early life is considered an emerging topic issue in nutritional researches.

Aims

To evaluate serum resistin and leptin concentrations and their relations in infants and in breast milk.

Study design

We enrolled 41 term, AGA, healthy infants, of which 23 exclusively breast-fed (BF) and 18 formula-fed (FF), aged less than 6 months. Breast milk (BM) samples were collected from 23 breastfeeding mothers of the infants enrolled. Resistin concentration in serum and BM was determined by ELISA test (Human-Resistin-ELISA, Mediagnost, Reutlingen, Germany). Leptin concentration was determined by Radioimmunoassay method (LEP-R40, Mediagnost, Reutlingen, Germany). Infants weight, length and body mass index were measured. We used Mann–Whitney test. Spearman correlation was applied. Statistical significance was set at p < 0.05. Data are reported as median and interquartile range (IR).

Results

Infants serum resistin concentration was 9.30 (5.02) ng/ml. Breast milk resistin concentration (n = 23) was 0.18 (0.44) ng/ml. Leptin concentration was 3.04 (3.68) ng/ml in infants serum and in BM was 2.34 (5.73) ng/ml. Serum resistin concentrations in BF infants correlated positively with BM resistin (r = 0.636, p = 0.035). We have shown a positive correlation between resistin and leptin in total group of infants (r = 0.44, p = 0.05), confirmed in breastfed subjects (r = 0.65, p = 0.02). No correlations were found between serum hormones and anthropometric parameters of infants.

Conclusion

Our findings show interestingly a positive correlation between resistin concentrations in BF infants serum and in BM and between resistin and leptin in infants.     

Ghrelin, leptin and IGF-I levels in breast-fed and formula-fed infants in the first years of life

AIM: To establish ghrelin, leptin and IGF-I serum levels in breastfed (BF) and formula-fed (FF) infants during the first period of life. METHODS: A cross-sectional study was conducted on fasting blood venous samples obtained from exclusively BF (n=106) and FF (n=100) infants to measure total ghrelin (RIA test), leptin (RIA test) and IGF-I (chemiluminescence). Anthropometrical measurements of weight, length and cranial circumference were performed. RESULTS: During the first 4 mo of life, FF infants compared to BF ones showed higher ghrelin levels (2654.86 vs 2132.96 pg/ml; p<0.032), higher IGF-I levels (3.73 vs 3.15 ng/ml; p=0.00) and lower leptin levels (0.68 vs 1.16 ng/ml; p<0.04). Leptin values were higher in females than in males (0.80 vs 0.47 ng/ml; p<0.03), while no gender-related difference was found for ghrelin and IGF-I. No differences were found in anthropometrical measurements comparing the two groups of infants. A multiple regression analysis showed an inverse correlation between ghrelin and leptin values (p<0.04) and between IGF-I and leptin levels (p=0.00). CONCLUSION: Our finding suggests that breastfeeding influences hormones such as ghrelin, leptin and IGF-I in infancy, mainly during the first 4 mo of life. Further evidence is needed to confirm and clarify the role of a protective link from mother to infants as seen in our observations.     

母乳成分与纯母乳喂养婴儿体重增长速率的关系

目的 探讨母乳成分对纯母乳喂养婴儿体重生长速率的影响。方法 选取定期进行儿童保健的138 例纯母乳喂养足月单胎婴儿及其乳母作为研究对象。在定期儿童保健时间点进行婴儿体重、身长及头围的测量,采用Z 积分计算生长速度,并根据ΔZ 积分将研究对象分为生长不良组（ΔZ 积分 ≤ -0.67）、生长速度低下组（-0.67 结果 生长不良组、生长速度低下组体重ΔZ 积分显著低于正常对照组（P P 结论 成熟乳母乳成分可短时间内在一定程度上影响纯母乳喂养婴儿的体重增长速率,乳母应均衡膳食,提高成熟乳质量以维持婴儿良好的体格生长速率。     

Measurement of the milk intake of breast-fed infants

Infant test weighing and maternal test weighing are two independent methods for determining milk intake by the breast-fed infant. The sources of error in both these test weighing methods were examined with particular emphasis on the importance of evaluating and correcting for evaporative water loss (EWL). EWL ranged from 3 to 94% of the mother's change in weight after a single breast feed and from 3 to 55% of the infant's change in weight after a single breast feed. Correcting for EWL during a breast feed involved determining the time between the pre- and postfed weighings and measuring the rate of EWL after breast feeding. Significant correlations (p less than 0.001) were found between milk volume intake measured by test weighing the mother and correcting for maternal EWL, and milk volume intake measured by test weighing the infant and correcting for infant EWL. An improved method for measuring 24-h milk intakes by maternal test weighing using a sensitive electronic balance and correcting for EWL is described. The milk intakes, corrected for EWL, ranged from 690-1,041 g/24 h. If no correction for EWL was made then the average overestimate of milk intake by maternal test weighing was 14 +/- 6%.     

Leptin levels in breast-fed and formula-fed infants

Aim: Leptin, a hormone that regulates food intake and energy metabolism, is present in breast milk and thus may be involved in body composition differences between breastfed and formula-fed infants. The aim of this study was to evaluate whether diet and gender affect plasma leptin concentration in breastfed and formula-fed infants during the first months of life. Methods: Anthropometric and bioelectrical impedance measurements [total body water (TBW) calculated with the Fjeld equation] were made and venous blood plasma samples were analysed for leptin concentration in healthy, exclusively breastfed or formula-fed Italian infants in the first year of life. Infants were subdivided in two ways: three groups (periods) in relation to age, and five groups in relation to weight. Results: The average serum concentration of leptin was 7.35 ng ml -1 . Serum leptin values were higher in breastfed than in formula-fed infants. Breastfed infants in group 1 had a statistically higher serum leptin concentration (2500-3749 g). There were no significant differences in anthropometric measurements, body mass index or skinfold thickness between breastfed and formula-fed infants. In the periods I and II, breastfed infants had a significantly higher TBW than formula-fed infants. Males had a significantly higher TBW than females in periods I and II. Breastfed infants in group 2 (3750-4999 g) had a significantly higher TBW than formula-fed infants.

Conclusion: The data on TBW, weight and skinfold thickness suggest that the higher leptin concentration observed in breastfed infants in the first months of life may be due not only to adipose tissue production but also to human milk.     

母乳中瘦素、脂联素及胃饥饿素与纯母乳喂养婴儿生长的关系

目的 探讨母乳中生物活性成分瘦素、脂联素及胃饥饿素与纯母乳喂养婴儿体重增长速率之间的关系。方法 选取定期儿童保健的67例纯母乳喂养的单胎足月婴儿及其乳母作为研究对象,根据测量所得的婴儿体重、身长进行营养状态评价（低体重、生长迟缓、消瘦、超重、肥胖）;采用Z积分计算生长速度,并根据ΔZ积分将研究对象分为生长不良组、生长速度低下组和生长速度正常组。采集婴儿母亲成熟乳,用ELISA法检测成熟乳中瘦素、脂联素及胃饥饿素水平。结果 消瘦组的母乳瘦素水平低于非消瘦组（P < 0.05）,超重/肥胖组的母乳脂联素水平低于非超重/肥胖组（P < 0.05）。相关性分析显示,母乳胃饥饿素水平与目前体重Z积分、较出生体重相比的ΔZ积分呈正相关关系（分别r _s=0.280、0.290,P < 0.05）。回归分析显示母乳胃饥饿素水平是影响当前体重Z积分的重要因素（β=0.161,P < 0.05）。结论 母乳当中的多种活性成分（瘦素、脂联素及胃饥饿素）可能在一定程度上调节婴儿的生长发育,但与子代生长发育的相关性及母乳对子代的健康促进效应原因还有待长期的研究观察。     

母乳营养成分与早产儿脑发育的研究进展

母乳是早产儿的首选食品。近年来，母乳在早产儿脑发育中的作用越来越多地受到学者重视。研究表明，母乳喂养对早产儿神经发育、远期认知结果的影响可能一直持续到儿童、青少年，甚至成人时期。母乳中的营养成分在其中起着决定性作用，涉及低聚糖、多不饱和脂肪酸、乳铁蛋白等。该文将母乳中营养成分在早产儿脑发育中的最新研究进展作一综述，具体阐述每种营养成分的概念和作用。     

母乳强化剂在母乳喂养早产儿中的应用

目的 通过前瞻性对照试验评价强化母乳对住院早产儿短期生长、营养状况的影响.方法 出生胎龄≤34周、出生体重≤1 800 g的24例早产儿分为强化母乳组(试验组,11例)和早产配方奶组(对照组,13例).试验组早产儿的母乳喂养量均超过总奶量的50%,当喂养量达到100 ml/(kg·d)时开始添加FM85母乳强化剂,不够的奶量用早产配方奶补足;对照组全部用早产配方奶喂养.对两组的生长速度、血生化指标、肠内外营养情况、合并症进行比较.结果 试验组出生胎龄(30.6±2.9)周,平均出生体重(1 80±286)g;对照组出生胎龄(31.6±1.9)周,平均出生体重(1 436±201)g.试验组在住院期间,平均母乳量占总喂养量81.6%,母乳强化剂在平均胎龄34.1周、生后24.6 d时开始添加.试验组与对照组的体重[18.9 vs 7.1 g/(kg·d),P=0.364]、身长(1.16 vs .00 cm/周,P=0.308)、头围(0.79 vs .61 cm/周,P=0.057)的增长速度近似,差异无统计学意义.出院时两组血尿素氮水平相似,试验组血清白蛋白、前白蛋白、血磷水平较对照组低,血清碱性磷酸酶和血钙值较对照组高,喂养不耐受、坏死性小肠结肠炎、院内感染的发生率无统计学意义.结论 强化母乳喂养与早产配方奶喂养的早产儿在住院期间的生长速度相似.     

母乳瘦素与新生儿体格发育的关系

目的:探讨母乳瘦素对新生儿体格发育的影响.方法:选择2007年1月至2009年6月在本院顺产的健康产妇及其新生儿各120名,根据喂养方式分为纯母乳喂养组、混合喂养组和纯配方奶喂养组,测定分娩时脐血及产后第3、28天新生儿血清和母乳瘦素水平,测量新生儿出生时、生后28天体重和身长,并计算Ponderal指数(PI),比较各组瘦素变化及新生儿体格发育情况,探讨二者之间的关系.结果各组新生儿血清瘦素水平出生时差异无统计学意义(P>0.05),第3天纯配方奶组低于纯母乳组[(1.7±1.2)μg/L比(2.6±1.4)μg/L,P<0.05],第28天纯配方奶组低于纯母乳组和混合喂养组[(2.3±1.1)μg/L比(3.2±1.3)μg/L、(2.9±1.4)μg/L,P均<0.05].新生儿出生时各组PI值差异无统计学意义(P>0.05),第28天纯配方奶组高于纯母乳组和混合喂养组[(2.9±0.3)g/cm3比(2.7±0.2)g/cm3、(2.8±0.3)g/cm3,P均<0.05].产妇母乳瘦素水平第3天各组差异无统计学意义(P>0.05),第28天混合组低于纯母乳组[(11.7±3.8)μg/L比(13.5±4.6)μg/L,P<0.05].结论:不同喂养方式影响新生儿瘦素水平,并进而影响新生儿期体格发育,母乳瘦素是新生儿瘦素的主要来源.     

25-Hydroxycholecalciferol serum levels in breast-fed infants.

Serum 25-hydroxycholecalciferol levels were measured longitudinally in a series of breast-feeding mothers and their healthy, term infants for up to 6 months after birth. Although levels both in mothers and infants were lower at 6 weeks'' postpartum than at delivery and in cord blood, there was little change thereafter with unsupplemented breast feeding. These findings do not support recommendations for routine supplementation of breast-fed term infants with vitamin D.     

CoQ10 plasmatic levels in breast-fed infants compared to formula-fed infants

BACKGROUND: Coenzyme Q10 has been recognized as an important antioxidant factor besides its main role in bioenergetic metabolism. CoQ10 tissue levels depend both on exogenous dietetic intake and on endogenous biosynthesis, as this compound can be partly synthesized in human cells. Q10 plasma levels reflect the tissue content of the coenzyme and can be used to evaluate the presence of this compound in the human organism. DESIGN/METHODS: Aim of the study was to measure CoQ10 plasmatic levels in a newborn breast-fed population and to compare them to CoQ10 levels in a newborn formula-fed population in order to verify whether changes in CoQ10 plasmatic contents could be related to a different dietetic intakes. We measured CoQ10 plasmatic levels in 25 healthy term neonates with different dietetic intakes: 15 breast-fed and 10 bottle-fed with a common infant formula. These infants were evaluated prospectively during the first month of life. The analyses were performed on the mothers' blood samples and cord blood samples at the time of delivery, then on infants at 4 and 28 days of age. RESULTS: Our results showed markedly reduced Q10 levels in cord blood samples compared to maternal Q10 plasmatic levels at the time of delivery, suggesting placental impermeability towards this molecule or increased fetal utilization during labor and delivery. At 4 days of age Q10 levels had increased in both groups of neonates, but significantly more in breast-fed infants compared to formula-fed babies (p <0.05). At 4 weeks of age no significant changes occurred in breast-fed infants, while values increased significantly in formula-fed infants (p <0.05). The content of Q10 in breast milk samples was lower than in infant formula. CONCLUSIONS: The results of this study show that CoQ10 plasmatic levels are at least partly influenced by the exogenous dietetic supply.