不同喂养方式对婴儿肠道菌群及湿疹的影响

目的探讨不同喂养方式对婴儿肠道双歧杆菌、大肠杆菌菌群的影响以及导致婴儿湿疹之间的关系。方法对到东莞市妇幼保健院儿童保健科进行健康体检的儿童中选取6月龄内尚未添加辅助食品的纯母乳喂养儿,以及6月龄内完全人工喂养的患湿疹的婴儿作为研究组;选取6月龄内尚未添加辅助食品的纯母乳喂养儿,以及6月龄内完全人工喂养的婴儿作为对照组。通过检测其在不同喂养方式下研究对象的肠道双歧杆菌、大肠杆菌水平,分析不同喂养方式对婴儿的肠道菌群的影响。同时通过分析婴儿湿疹与肠道菌群的关系发现其联系。结果纯母乳喂养婴儿肠道双歧杆菌数量比人工喂养婴儿高,湿疹的发生率低于人工喂养儿,差异有统计学意义(P﹤0.05)。结论母乳喂养方式对婴儿肠道益生菌的定殖有积极的影响,提倡纯母乳喂养有利于预防婴儿湿疹。     

新生儿肠道优势菌定量分析及其与内源性维生素K的关系

采用厌氧菌培养技术对不同阶段的３２名单纯母喂养儿和２４名混合喂养儿粪便的双歧杆菌和肠杆菌进行了分离、培养、计数和鉴定。结果显示：出生５～７天的母乳喂养儿粪便优势菌为双歧杆菌,肠杆菌数量远远低于双歧杆菌,而混合喂养儿粪便优势菌为肠杆菌,双歧杆菌数量明显少于肠杆菌。母乳喂养儿双歧杆菌数量主于混合喂养儿,肠杆菌则低于混合喂养儿。根据此结果,出生５～７天的母乳喂养儿肠道以无合成维生素Ｋ能力的双歧杆菌为优势菌,有维生素Ｋ２俣成量有限,又因母乳喂养,乳汁维生素Ｋ１提供不足,结果出现维生素Ｋ两个来源都匮乏的局面。混合喂养儿不仅外源性维生素Ｋ摄入量较多,而且优势菌肠杆菌内源性维生素Ｋ合成量亦丰富,因此,混合喂养儿维生素Ｋ来源充足     

不同喂养方式对婴儿肠道菌群的影响

【目的】　通过观察健康婴儿母乳及配方乳两种不同喂养方式下肠道菌群的定植过程 ,分析婴幼儿饮食与肠道菌群形成的关系并探讨其意义。　【方法】　采用荧光定量PCR技术测定细菌 16SrRNA ,经与标准曲线对照计算细菌数量 ,对 71名母乳喂养婴儿和 60名人工喂养婴儿粪便中乳酸杆菌、双歧杆菌和大肠杆菌进行了定量检测。　【结果】　婴儿肠道菌群处于动态定植过程。母乳喂养婴儿肠道乳酸杆菌、双歧杆菌数量较人工喂养婴儿高 (P<0 .0 5 ) ,而大肠杆菌数量较人工喂养婴儿低 (P <0 .0 5 )。　【结论】　荧光定量PCR法定量测定肠道菌群的数量是一种简便、快捷、特异性好的方法。婴儿期肠道菌群仍处于动态演替过程。不同的喂养方式对肠道菌群有影响 ,应大力提倡母乳喂养。     

婴幼儿腹泻、便秘吃糖不吃药--大豆低聚糖与儿童

新生儿出生后不久,肠道内即建立起以双歧杆菌占绝对优势的菌群。它们使糖类发酵,产生大量的乙酸和乳酸,从而抑制具有潜在致病性的肠杆菌等的生长繁殖,逐渐达到肠道微生态的平衡。足月儿,母乳喂养儿较易顺利完成这一过程,而早产儿、人工喂养儿双歧杆菌优势菌群的建立则较迟缓,因而容易出现微生态失调,导致营养不良,反复感染等一系列疾病的产生。 断奶前后的婴儿,其肠道发育尚     

母乳喂养对儿童哮喘的保护作用及肠道双歧杆菌的影响

哮喘是一种慢性非传染性疾病,现已成为影响儿童健康的全球性疾病,近年来患病率持续增加[1-2]。母乳通常被认为是婴儿最优的营养来源,而母乳喂养是婴儿最好的营养形式和最佳的健康成长方法,对母婴的健康和情感联系都有无可替代的作用[3-4]。母乳不但是新生儿的完全适应性营养的来源,而且还有一系列重要的免疫物质、抗炎因子和溶菌酶等免疫活性分子,能够抵抗感染并形成粘膜免疫反应,增强婴儿免疫能力,启动肠道免疫并促进免疫系统发育,参与机体主被动免疫,是婴儿接受的“第一次免疫”,有助于免疫器官的早期发育[5-6]。另外,婴儿肠道菌群的建立是一个渐进的过程,受母乳喂养的影响,可将微生物菌群由母体垂直转移给其喂养儿,有助于婴儿肠道中益生菌群的建立与定植,使双歧杆菌成为优势菌。因此,WHO和世界各国都大力提倡母乳喂养[7]。     

成都地区婴儿肠道双歧杆菌的组成及免疫特性

目的初探成都地区出生婴儿肠道双歧杆菌的种群构成特征,探索其调节机体免疫功能的可能性。方法收集成都地区41名0～4月龄健康婴儿的粪便样品,分离培养粪便中的双歧杆菌,根据双歧杆菌属及菌种特异性引物,采用PCR法及16S rRNA测序技术对分离菌株进行属及种水平的分类学鉴定;用20株分离的双歧杆菌与小鼠巨噬细胞系J774A.1细胞共培养,实时荧光定量PCR(quantitativeReal-time PCR,qPCR)测定细胞的白细胞介素-6,10,12(interleukin-6,10,12, IL-6,10,12)、肿瘤坏死因子-α(tumor necrosis Factorα,TNF-α)mRNA相对表达量,酶联免疫吸附法测定上清液IL-6、IL-10、IL-12、TNF-α的含量。结果从41份粪便样品中分离到132株双歧杆菌,包括短双歧杆菌(Bifidobacterium.breve)57株,长双歧杆菌(Bifidobacterium.longum)35株,链状双歧杆菌(Bifidobacterium.catenulatum)24株,婴儿型双歧杆菌(Bifidobacterium.infantis)14株和齿双歧杆菌(Bifidobacterium.dentium)2株。顺产婴儿肠道优势菌种为B. catenulatum和B. breve,剖腹产婴儿为B. breve和B. longum,母乳喂养和混合喂养婴儿粪便中均检出3个菌种,人工喂养婴儿检出1个菌种。受试菌株均可活化J774A.1细胞,菌株特异地诱导其产生不同水平的IL-6、IL-10、IL-12和TNF-α,经B. infantis、B. breve和B. longum刺激的J774A.1细胞具有IL-10分泌量高、TNF-α分泌量低的趋势,经B.catenulatum刺激后出现相反的趋势。结论成都地区0-4月龄婴儿肠道双歧杆菌优势菌种可能是B.breve、B.longum,双歧杆菌菌种组成受生产方式、喂养方式等影响并具有显著的个体差异;婴儿肠道来源双歧杆菌具有一定的免疫调节功能,并表现出菌种和菌株特异性。[营养学报,2019,41(6):568-575]     

富含α-乳清蛋白及AA/DHA配方奶粉对足月婴儿体格生长及耐受性的影响

[目的]评价富含α-乳清蛋白及AA/DHA但总蛋白含量略低的配方奶粉对婴儿生后前3个月体格生长的作用,并观察其喂养后胃肠道的耐受性.[方法]采用前瞻、随机、标签开放性的多中心研究.喂养母亲记录喂养最初3周每日耐受性指标,医生观察并记录1、2及3月龄时婴儿体重、身长和头围等生长指标.[结果]喂养3个月后,体重、身长和头围增值在母乳组、α-乳清蛋白组和对照配方组间差异均无显著性（P＞0.05）.婴儿的耐受性观察发现,肠胀气、大便性状和睡眠状况在三组间差异有显著性（P＜0.05）,α-乳清蛋白配方组婴儿大便性状和睡眠状况与对照配方组相比,更接近母乳喂养组;母乳喂养组婴儿肠胀气发生情况显著少于两个配方组.皮疹、腹痛等耐受性指标三组间差异无显著性（P＞0.05）.[结论]试验配方富含α-乳清蛋白及DHA/AA,能提供足够营养满足婴儿生长所需,其生后头3月生长速率同母乳喂养儿及对照配方喂养儿相似.且婴儿对这种新配方奶粉的耐受性良好,较标准配方奶粉更接近母乳喂养.     

婴幼儿肠道菌群与辅食添加状况的相关性研究

目的 探讨辅食添加种类及摄入营养素对耍幼儿肠道菌群及定植抗力的影响.方法 通过整群抽样对336名婴幼儿分5组进行3日膳食调查,并随机抽取55名母乳喂养儿进行粪便中双歧杆菌、乳酸杆菌、产气荚膜梭菌、拟杆菌、肠道杆菌培养测定;菌群定植抗力用粪便中双歧杆菌与肠杆菌数量的比值(B/E)表示.结果 婴幼儿肠道菌群总量在109cfu/g以上,拟杆菌属数量最高,其次为双歧杆菌属、肠杆菌、产气荚膜梭菌、乳酸菌属.肠道B/E值平均大于1.与肠道菌群及定植抗力有显著相关性或被多因素分析选入方程的膳食因素有辅食添加的豆类、蛋类、水果类食物及摄入的营养素辅食纤维、维生素、脂肪、碘、锰等,它们对提高肠道有益菌数量,促进肠道菌群平衡有很重要的作用.结论 应及时给婴儿添加优质的辅食,有利于促进儿童肠道有益菌的繁殖与菌群平衡.     

不同喂养方式对极低出生体重儿喂养及肠道菌群的影响

目的研究不同喂养方式对极低出生体重儿喂养状况和肠道菌群的影响。方法选择60例符合条件的住院早产儿并随机分为两组,分别为母乳喂养组(母乳组)及早产儿配方奶喂养组(配方奶组),在生后记录喂养状况,并于3、14及28天时分别留取患儿大便标本,采用实时荧光定量PCR技术检测标本中的肠道乳酸杆菌及双歧杆菌。结果母乳组喂养不耐受的发生率为5例(16.7%),配方奶组为13例(43.3%),两组比较差异有统计学意义(P0.05)。母乳组在14天时肠道乳酸杆菌和双歧杆菌的数量分别为(8.62±1.35)cfu/g、(9.10±1.33)cfu/g,配方奶组分别为(7.32±0.80)cfu/g、(7.62±1.22)cfu/g,两组比较差异均有统计学意义(P0.05)。母乳组在28天时肠道乳酸杆菌和双歧杆菌的数量分别为(9.43±0.26)cfu/g、(9.97±0.54)cfu/g,配方奶组分别为(8.31±0.58)cfu/g、(8.54±0.53)cfu/g,两组比较差异均有统计学意义(P0.05)。结论喂养方式对极低出生体重早产儿喂养及肠道菌群的形成有明显影响。母乳喂养组患儿肠道的双歧杆菌和乳酸杆菌数量高于早产儿配方奶喂养组,同时喂养不耐受发生率低于早产儿配方奶喂养组。     

初乳对新生儿肠道双歧杆菌和肠杆菌的影响

目的 探讨初乳对新生儿肠道双歧杆菌和肠杆菌生长的作用.方法 采用厌氧菌培养技术,对5～7天的32名初乳喂养儿和24名人工喂养儿的粪便做双歧杆菌和肠杆菌定量培养.结果 初乳喂养儿粪便双歧杆菌的数量明显高于肠杆菌;人工喂养儿粪便肠杆菌的数量高于双歧杆菌.结论 初乳对早期新生儿肠道菌群演替发挥了重要作用,它促进双歧杆菌生长,抑制肠杆菌生长.     

Milk feeding and dietary patterns predict weight and fat gains in infancy

Current guidelines recommend that infants are exclusively breast fed for the first 6 months of life, with particular solid foods being gradually introduced from 6 months. Our objective was to compare the growth of infants whose feeding most closely followed current guidelines with the growth of infants with other feeding practices. Participants were 1740 infants in a prospective cohort study in Southampton, UK. At 6 and 12 months, infants’ milk feeding was recorded, diets assessed using food frequency questionnaires (FFQ), and anthropometry performed. Principal components analysis was used to identify patterns of foods in the diet using the food intakes assessed by the FFQs. Two patterns (‘infant guidelines’ and ‘adult foods’) explained most variance in infant diet at 6 and 12 months of age. The main outcomes were conditional growth in weight, length and skinfold thickness from 0–6 and 6–12 months. Infants who were breast fed from 0–6 months gained weight, length and adiposity more slowly than formula‐fed infants, independent of age at introduction of solids and maternal factors: compared with infants who were breast fed from 0–6 months, formula‐fed infants gained 0.21 standard deviation scores (SDS) in weight [95% confidence interval (CI) 0.00, 0.42]. Infants whose dietary pattern was most similar to current feeding guidelines, with high frequencies of fresh fruit and vegetables, home‐prepared foods and breast milk, gained weight and skinfold thickness more rapidly from 6 to 12 months than other infants, independent of milk feeding, age at introduction of solids and maternal factors. Compared with infants in the lowest quarter, infants in the highest ‘infant guidelines’ score quarter gained 0.24 SDS [95% CI 0.06, 0.43] in weight and 0.26 SDS [95% CI 0.07, 0.45] in skinfold thickness. Conversely, infants whose diets had the highest frequencies of breads and processed foods gained weight less rapidly from 6 to 12 months than other infants. The extent to which the patterns of diet and growth we have described will influence the current or later health of infants is unknown. We are following up the infants in this study to assess the impact of these patterns beyond the first year of life. These associations should also be examined in other settings and populations.     

Contribution of complementary foods to the total daily water needs of urban Guatemalan infants

Background: Estimates of adequate intake (AI) for water only became available in 2005. The daily water AI for 6–12‐month‐old infants of both sexes is 800 mL. The present study aimed to estimate the water intake of urban infants receiving both breast milk and complementary feeding (CF) and to compare them with the reference AI. Methods: Sixty‐four infants, 42 boys and 22 girls, aged 6–12 months on enrolment, from a low‐income district of Guatemala City, were recruited to the study. Quantitative 24‐h recalls and breastfeeding histories were collected in three serial interviews. The quantity of water was estimated from recipes and food composition moisture values for the CF items reported. The amount of breast milk needed to complement foods and beverages in meeting the individual energy needs was calculated, and breast milk’s water contribution was derived accordingly. The total quantity of water in beverages, including human milk, liquids in recipes and moisture of foods, was tabulated as the infants’ daily intake. Results: Some 56.3% of the water needs for boys and 41.1% for girls were satisfied by just water obtained from plain water, other complementary beverages and moisture of foods within CF, exclusive of breast milk. Adding the estimated breast milk intake, the median water intake for the infant sample was essentially equal to the 800 mL of the AI. Conclusions: The infants in this low‐income community are approximating the recommended AI for daily water through the currently selected pattern of lactation and CF.     

Contribution of complementary food nutrients to estimated total nutrient intakes for urban Guatemalan infants in the second semester of life

Complementary foods (CF) are introduced earlier or later than appropriate in developing societies. They often contribute poorly to overall adequate micronutrient intake during the critical period for growth and development, which constitutes the period from 6 to 12 months of life. The objective of this study was to determine the contribution of the CF nutrients to the total estimated nutrient intake in infants in the second semester of life. Three non-consecutive 24-hour recalls interviews were conducted with mothers of 64 infants, aged 6-12 months on enrolment, from a convenience sample in a marginal urban settlement in Guatemala City. Retrospective recording of early introduction of pre- and post-lacteal feeding and introduction of first foods and beverages was included. Human milk intakes were estimated by a model based on assumptions that human milk plus CF exactly satisfied the infant's daily energy needs. The WHO/FAO Recommended Nutrient Intakes (RNI) were the standards for adequate nutrient consumption. Instances of exclusive breast feeding to 6 months were rare, with the introduction of CF earlier than recommended. Baby food in jars was mentioned most frequently as the first food offered. The contribution of CF increased with age through the second semester of life. CF contributed more of a nutrient than human milk in all instances. However,CF nutrient density for Ca, Fe, and Zn fell below international standard. Fortified sugar contributed excessive amounts of Vitamin A to the diets. We conclude that for most nutrients, intakes reached or exceeded recommendation levels, unusual within the CF experience in scientific literature.     

汉族、维吾尔族母乳喂养婴儿代乳品和辅食添加时间调查

目的 调查汉族、维吾尔族母乳喂养婴儿代乳品和辅食的添加时间。方法 采用队列研究，从出生到六个月，每月随访婴儿母亲。结果 配方奶粉的添加时间为1个月，一般乳类的添加时间为3个月，辅食的添加时间为4个月，家常饭的添加时间为5个月。维吾尔族婴儿乳类食品的添加时间早于汉族，辅食和家常饭的添加时问与汉族一致。结论 汉族、维吾尔族婴儿的乳类和辅食添加时间过早。维吾尔族婴儿的乳类添加时间早于汉族。     

婴幼儿牛奶蛋白过敏症68例诊治分析

目的研究分析婴幼儿牛奶蛋白过敏症的临床诊断与治疗方法。方法随机抽取本院2014年3月-2015年3月确诊为牛奶蛋白过敏症患儿68例,分析其临床症状、回避试验及治疗情况。结果 68例牛奶蛋白过敏症患儿的主要临床症状表现为呕吐、肠痉挛、腹泻腹胀、喷嚏、面部水肿、特应性湿疹等。采取食物回避的方法后患儿症状有所缓解或消失,取得家长同意后进行激发试验阳性者,采取氨基酸配方粉喂养方式后症状再一次好转或消失,体重逐渐恢复,营养状态明显改善。结论临床上可采用食物激发试验和食物回避方法诊断牛奶蛋白过敏症;确诊牛奶蛋白过敏症后可采用母乳喂养或游离氨基酸配方奶喂养,效果理想,值得临床应用推广。     

神经节苷脂对婴儿生长发育影响的研究进展

目的 综述神经节苷脂在母乳中的含量及其对婴儿早期生长发育的影响,为探讨神经节苷脂在婴幼儿配方食品中的强化补充提供科学依据。 方法 检索PubMed、Web of Science和CNKI数据库,收集相关文献。 结果 婴儿生长发育所需的神经节苷脂主要来源于母乳和婴儿配方粉,在生命早期的脑发育、认知能力发展和肠道免疫功能发育等方面发挥重要作用。 结论 神经节苷脂对婴儿的神经发育和肠道免疫发育至关重要,婴儿配方食品中神经节苷脂的添加对早产儿和人工喂养婴儿的早期发展具有潜在益处。     

Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy: Pilot Study

The incidence and prevalence of food allergy (FA) is increasing. While several studies have established the safety and efficacy of early introduction of single allergens in infants for the prevention of FA, the exact dose, frequency, and number of allergens that can be safely introduced to infants, particularly in those at high or low risk of atopy, are still unclear. This 1-year pilot study evaluated the safety of the early introduction of single foods (milk, egg, or peanut) vs. two foods (milk/egg, egg/peanut, milk/peanut) vs. multiple foods (milk/egg/peanut/cashew/almond/shrimp/walnut/wheat/salmon/hazelnut at low, medium, or high doses) vs. no early introduction in 180 infants between 4–6 months of age. At the end of the study, they were evaluated for plasma biomarkers associated with food reactivity via standardized blood tests. Two to four years after the start of the study, participants were evaluated by standardized food challenges. The serving sizes for the single, double, and low dose mixtures were 300 mg total protein per day. The serving sizes for the medium and high dose mixtures were 900 mg and 3000 mg total protein, respectively. Equal parts of each protein were used for double or mixture foods. All infants were breastfed until at least six months of age. The results demonstrate that infants at either high or low risk for atopy were able to tolerate the early introduction of multiple allergenic foods with no increases in any safety issues, including eczema, FA, or food protein induced enterocolitis. The mixtures of foods at either low, medium, or high doses demonstrated trends for improvement in food challenge reactivity and plasma biomarkers compared to single and double food introductions. The results of this study suggest that the early introduction of foods, particularly simultaneous mixtures of many allergenic foods, may be safe and efficacious for preventing FA and can occur safely. These results need to be confirmed by larger randomized controlled studies.     

Nonbreast-fed HIV-1-exposed Burkinabe infants have low energy intake between 6 and 11 months of age despite free access to infant food aid

In a WHO-coordinated, mother-to-child HIV transmission (MTCT) prevention trial in Burkina Faso, HIV-1-infected mothers were advised to either stop breast-feeding by 6 mo or totally avoid it. Participants were provided with cereal-based, infant fortified mix (IFM) from 6 to 12 mo postpartum along with infant feeding counseling. Our objective was to describe nonbreast-fed infants' food consumption and adequacy of nutrient intake. A 1-d weighed food record and one 24-h dietary recall were performed in 68 nonbreast-fed, non-HIV-infected 6- to 11-mo-old infants. Mean food energy density and feeding frequency were satisfactory in 6-8 mo olds [0.8 ± 0.2 kcal/g (3.3 ± 0.9 kJ/g) and 7.2 ± 1.6 times/d] and in 9-11 mo olds [0.9 ± 0.2 kcal/g (3.6 ± 0.8 kJ/g) and 7.7 ± 2.1 times/d]. Median energy intake was 523 kcal [range: 82-1053 (2187 kJ, range: 345-4401)] in 6-8- and 811 kcal [range: 34-1543 (3392 kJ, range: 144-6452)] in 9-11-mo-old infants, respectively. Approximately 75% of their energy intake was provided by subsidized foods (milk that mothers obtained from support networks and IFM). One-half of the infants had intakes < 80 kcal/kg (<334 kJ/kg) on the day of the survey, mainly because IFM and milk were consumed in amounts that were too low. Thus, coverage of energy needs required a diet with sufficient amounts of both IFM and milk in these vulnerable infants. These findings argue for the development of adequate, sustainable infant fortified foods and their rapid integration into MTCT prevention services. They also lend support to the recent revision of WHO infant feeding guidance for future MTCT prevention programming that recommends breast-feeding up to 12 mo postpartum (under cover of antiretroviral prophylaxis) as the safest feeding option for infants of HIV-infected mothers.     

Breast milk intake is not reduced more by the introduction of energy dense complementary food than by typical infant porridge

The effect of different energy densities of complementary foods on breast milk consumption is not well understood. In this study, we tested the hypothesis that provision of fortified spread (FS), a micronutrient fortified, energy-dense (22 kJ/g), ready-to-use food, to Malawian infants would not decrease their breast milk intake more than a traditional corn + soy blended flour (CSB). Forty-four healthy 6-mo-old infant and mother pairs were enrolled in a prospective, parallel group, investigator-blinded, randomized controlled complementary feeding trial. Infants were randomized to receive 25 g/d of FS, 50 g/d of FS, or 72 g/d of CSB. The primary outcome was the difference in breast milk intake after 1 mo of complementary feeding as measured by the dose-to-mother deuterium oxide dilution technique. Outcomes were compared using repeated measures ANOVA. A total of 41 mother-infant pairs completed the study. At enrollment, 88% of the infants had received corn porridge. At baseline, the infants consumed 129 +/- 18 g.kg body wt(-1) x d(-1) (mean +/- SD) of breast milk. After 1 mo of complementary feeding with 25 g/d FS, 50 g/d FS, or 72 g/d CSB, their breast milk consumption was 115 +/- 18 g.kg body wt(-1) x d(-1), a significant reduction; however, the effects of the complementary foods did not differ from one another (F-value model = 4.33, P = 0.0008 for effect of time and P = 0.69 for effect of type of food). The results suggest that complementary feeding of Malawian infants with FS has the same effect on their breast milk intake as complementary feeding with traditional CSB porridge.