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.     

Breast-fed infants have higher leptin values than formula-fed infants in the first four months of life

BACKGROUND: Leptin is a hormone present in breast milk, which regulates food intake and energy metabolism. AIM: To investigate whether leptin levels are different in breast-fed (BF) or formula-fed (FF) infants in the first months of life. METHODS: We evaluated serum leptin by radio-immunoassay and anthropometric parameters in 51 infants at the average age of 62.8+/-30 days, 25 exclusively BF and 26 exclusively FF. RESULTS: Leptin serum values were higher in BF (7.1+/-10.4 ng/ml) than in FF (3.7+/-3.87 ng/ml) infants (p <0.05). Leptin values were higher in females (6.9+/-9.87 ng/ml) than in males (3.5+/-3.88 ng/ml) (p <0.05). No differences were found in anthropometric measurements and body mass index. CONCLUSION: The kind of feeding might be a factor affecting serum leptin concentration in term infants. The long-term consequences of this difference between BF and FF infants and leptin's role in promoting obesity later in life are unknown.     

Breastmilk ghrelin,leptin, and fat levels changing foremilk to hindmilk: is that important for self-control of feeding?

The aim of this study was to evaluate the changes in the ghrelin, leptin, and fat levels in the foremilk and hindmilk and the possible relationship between these levels with the age and growth of term healthy infants. Sixty-two babies were subdivided (according to their nutrition) into breastfed (BF), formula-fed (FF), and BF plus FF (BF + FF) groups. The total and active ghrelin and tryglyceride levels and the total cholesterol levels in the foremilk and hindmilk were studied at the first and second visits (mean of the second and fifth months, respectively). At both visits, the total and active ghrelin and the total cholesterol levels were lower in the hindmilk than in the foremilk. However, the triglyceride levels were higher in the hindmilk than in the foremilk (p < 0.001). The leptin levels were also higher in the hindmilk, but this difference was not statistically significant. At the second visit, the mean total foremilk ghrelin (p < 0.01), leptin (p < 0.05), tryglyceride (p < 0.001), and cholesterol (p < 0.01) levels in the BF group were decreased compared with the levels at the first visit, whereas the active ghrelin levels increased (p < 0.001). At the second visit, we observed a 3.5% increase in the body mass index in BF infants, a 14.6% increase in FF infants, and an 11.8% increase in BF + FF infants (p < 0.01). The foremilk leptin levels were lower in the BF + FF group than in the BF group at both visits. In conclusion, at the first and second visits, the decreased ghrelin and increased tryglyceride and leptin levels in the hindmilk might be associated with the important role of self-control when feeding BF infants. The stable content of formulas might be associated with a lack of self-control during feeding and increased nutrition. Changing the breast milk ghrelin, leptin, and fat levels between the foremilk and hindmilk and between the first and second visits might explain the differences in the weight gain patterns of BF and FF infants.     

Adiponectin in breast milk: relation to serum adiponectin concentration in lactating mothers and their infants

Aims: The aims of the study were to determine human breast milk adiponectin concentration and to investigate its relationship with serum adiponectin concentration in lactating mothers and their infants and also to evaluate the relationship between serum adiponectin concentration and anthropometric parameters in nurses and infants. Methods: We enrolled 60 healthy term breastfed (BF) infants and their lactating mothers. Adiponectin was determined by radioimmunoassay test in serum and by enzyme‐linked immunosorbent assay test in human milk (HM). Infants’ and mothers’ anthropometric parameters were measured. Results: Median (25‰, 75‰) adiponectin concentration in HM was 9.99 (3.59, 20.52) ng/mL. Serum adiponectin concentration in infants was 60.49 (45.76, 74.24) μg/mL and in lactating mothers 21.14 (12.61, 29.66) μg/mL. Adiponectin concentration in HM correlated positively with adiponectin in mothers’ serum; r = 0.60 (p < 0.001) and in infants’ serum r = 0.37 (p = 0.015). Adiponectin in HM correlated negatively with infants’ age r = ?0.3 (p = 0.04). Infants’ serum adiponectin correlated negatively with their weight r = ?0.35 (p = 0.005), length r = ?0.35 (p = 0.006) and age r = ?0.46 (p < 0.001) and mothers’ serum adiponectin with their weight r = ?0.37 (p = 0.02) and body mass index r = ?0.45 (p = 0.004). Conclusions: The observed correlations between adiponectin in mothers, HM and BF infants may be suggestive for a metabolic link between nurses and infants through milk.     

Infant feeding and growth: A study on Turkish infants from birth to 6 months

BACKGROUND: To evaluate the impact of various feeding patterns on the physical growth and mental development of infants, particularly during the first 6 months of life, and to compare growth patterns of Turkish infants with those of infants living in various countries. METHODS: One hundred and seventy-two healthy newborn infants were included in the study and were divided into three feeding groups: (i) 62 infants were exclusively breast-fed (BF); (ii) 58 infants were mixed-fed (MF) with both breast milk and formula; and (iii) 52 infants were formula-fed (FF). Infants were assessed at birth and at 1, 2, 3, 4, 5 and 6 months of age. Anthropometry was repeated on each occasion. The weight and length of the infants was also recorded. Analysis of variance and modified t-test were used for statistical evaluation of the results. RESULTS: Values in the BF group were the closest to the tabular norms for weight. Infants in the FF group tended towards a lower weight during the first 3 months (P < 0.05). During the second 3 months, weight gain observed in the FF group was significantly higher than that of BF infants. In comparison with MF infants, a significant progressive weight gain was detected in BF infants (P < 0.05). The values obtained for length increments were consistent with those for weight (P < 0.05 for BF vs FF). No significant difference was found between the length increments detected for BF and MF infants from birth to 6 months. CONCLUSIONS: These results suggest that exclusive breast-feeding is the most appropriate feeding pattern for newborn infants in Turkey and is sufficient during the first 6 months, the most important fraction of life.     

Serum ghrelin concentration and weight gain in healthy term infants in the first year of life

OBJECTIVES: Ghrelin, a recently discovered hormone mainly secreted by the stomach, has several metabolic functions including regulation of food intake, energy homeostasis and body weight. There are few studies on this hormone in healthy infants during the first year of life. The aim of this study was to examine the correlations between ghrelin and weight gain in healthy term infants in the first year of life. METHODS: 104 healthy term infants aged 0 to 12 months were included in a cross-sectional study. Anthropometric measurements were assessed and mean weight gain was calculated. Serum ghrelin concentrations have been determined at least 3 hours after feeding by radioimmunoassay test. RESULTS: Ghrelin concentrations were correlated negatively to weight gain (r=-0.302; P=0.003) and positively to age (r = 0.412; P < 0.001), weight (r = 0.374; P < 0.001) and length (r=0.387; P<0.001). In breastfed infants a statistically significant negative correlation between ghrelin concentration and infant weight gain (r=-0.407; P=0.001) was observed, whereas in formula-fed infants this correlation was not statistically significant (r=-0.067; P=0.719). CONCLUSIONS: The negative correlation observed between ghrelin concentration and infant weight gain suggests that ghrelin might also play a role in the regulation of body weight in healthy infants with a physiologic energy balance. Further studies are needed to clarify how ghrelin might be involved in both short-term and long-term energy balance.     

Changes in the serum lipids and apolipoproteins in the first four weeks of life

The neonatal serum lipid transport system was monitored in the 1st month of life to determine the impact of oral feeding (breast versus formula). Lipid and apolipoprotein levels were measured in the serum of normal newborn infants collected at birth, 3, 14, and 28 days of age. Fatty acid and neutral lipid studies were determined by gas-liquid chromatography and apolipoprotein levels were done by electroimmunoassay. Following collection of data, the results were divided into two groups corresponding to breast-fed (BF) or formula-fed (FF) infants. Only triacylglycerols at 3 days of age were significantly higher (p less than 0.04) in FF infant serum when compared to BF levels. Unesterified cholesterol levels in both groups were similar at all intervals, the cholesterol esters were higher at 14 and 28 days in BF infants. ApoA-I and ApoB levels were higher at 3 days in FF, but ApoC-III levels were the same. At all other sampling times, no discernible differences in these parameters were found between BF and FF. For the infants as a group, changes in levels with increasing age were similar for both ApoA-I and cholesterol esters, as was the case for ApoB and triacylglycerols. However, numerous differences between BF and FF were seen in molecular forms of triacylglycerols and cholesterol esters, reflecting the dietary fatty acid differences between breast milk and formula. Analyses of the fatty acid content of these two diets demonstrated that human breast milk contained twice as much palmitic and oleic acid but only one-half the linoleic acid of formula.(ABSTRACT TRUNCATED AT 250 WORDS)     

The Nutritional Role of Breast-Milk IgA and Lactoferrin

ABSTRACT. The nutritional enigma concerning the extent to which breast-milk immune proteins are digested has been investigated by measuring the intakes and faecal outputs of IgA and lactoferrin over 7 days in 10 exclusively breast-fed (BF) and 9 formula-fed (FF) fullterm infants at 6 and 12 weeks post-partum. BF outputs (mg/day) greatly exceeded FF values ( p <0.001): at 6 weeks secretory-IgA BF=160±28, FF=14±2, lactoferrin BF=M±2, FF=0.9±0.1; at 12 weeks secretory-IgA BF=94±17, FF=25±5, lactoferrin BF=7±1, FF=1±0.3. Secretory-IgA represented 42% and 27% of BF faecal protein at 6 and 12 weeks compared with 6% for FF infants at both ages. BF secretory-IgA outputs were highly correlated with intakes ( r =0.83, p <0.001). IgA and lactoferrin outputs and the presence of faecal secretory-IgA fragments in BF and FF infants were influenced by defaecation rate, suggesting that partial degradation occurred in the large intestine. By 6 weeks post-partum only 1% lactoferrin and 17% secretory-IgA intakes appeared in the faeces and 95% breast-milk protein could be regarded as nutritionally available. The elevated BF outputs of IgA and lactoferrin relative to endogenous excretion suggest, however, that breast-milk may still make a considerable contribution to intestinal defence mechanisms after the neonatal period despite the small proportion of daily intake which escapes digestion. The protective action of IgA and lactoferrin may also depend on their site of degradation and the nature of fragments.     

Maternal BMI and serum leptin concentration of infants in the first year of life

Aim: To evaluate the relationship between serum leptin concentration in infants and infant and maternal BMI. Methods: 75 healthy term infants aged 0-12 mo, 51 exclusively breastfed (BF) for at least 4 mo and 24 formula fed (FF), were included in a cross-sectional study. Weight, length and cranial circumference of infants and their mothers were measured, body mass index (BMI) was calculated using the formula weight (kg)/height (m)² and infant serum leptin concentration was determined. Results: A significant positive correlation between infant serum leptin concentration and maternal BMI was observed in BF infants (r = 0.389, p = 0.005), confirmed in a multiple regression model adjusted for infant age and infant BMI (β = 0.065, p = 0.006), but not in FF infants. As regards the first 4 mo of life, we have already observed a positive correlation between infant serum leptin concentration and maternal BMI in BF infants (β = 0.113, p = 0.005), but not in FF infants.

Conclusion: In BF infants, serum leptin concentration correlates positively with maternal BMI. Higher maternal BMI values might increase leptin levels in breast milk, and maternal adiposity could be involved in infant energy balance.     

The nutritional role of breast-milk IgA and lactoferrin

The nutritional enigma concerning the extent to which breast-milk immune proteins are digested has been investigated by measuring the intakes and faecal outputs of IgA and lactoferrin over 7 days in 10 exclusively breast-fed (BF) and 9 formula-fed (FF) fullterm infants at 6 and 12 weeks post-partum. BF outputs (mg/day) greatly exceeded FF values (p less than 0.001): at 6 weeks secretory-IgA BF = 160 +/- 28, FF = 14 +/- 2, lactoferrin BF = 14 +/- 2, FF = 0.9 +/- 0.1; at 12 weeks secretory-IgA BF = 94 +/- 17, FF = 25 +/- 5, lactoferrin BF = 7 +/- 1, FF = 1 +/- 0.3. Secretory-IgA represented 42% and 27% of BF faecal protein at 6 and 12 weeks compared with 6% for FF infants at both ages. BF secretory-IgA outputs were highly correlated with intakes (r = 0.83, p less than 0.001). IgA and lactoferrin outputs and the presence of faecal secretory-IgA fragments in BF and FF infants were influenced by defaecation rate, suggesting that partial degradation occurred in the large intestine. By 6 weeks post-partum only 1% lactoferrin and 17% secretory-IgA intakes appeared in the faeces and 95% breast-milk protein could be regarded as nutritionally available. The elevated BF outputs of IgA and lactoferrin relative to endogenous excretion suggest, however, that breast-milk may still make a considerable contribution to intestinal defence mechanisms after the neonatal period despite the small proportion of daily intake which escapes digestion. The protective action of IgA and lactoferrin may also depend on their site of degradation and the nature of fragments.     

Active and total ghrelin concentrations increase in breast milk during lactation

AIM: To assess ghrelin status in breast milk and maternal serum for up to 180 days during lactation and to determine relationships between the concentrations of ghrelin in mother's milk and in serum of breastfed infants. METHODS: Blood and breast milk samples were collected from 159 breastfeeding women enrolled either in the first 3 days, or in days 4-14, 15-30, 31-90 and 91-180 postpartum. Blood samples were also collected from 49 breastfed infants at 4-30 days of age. Milk and serum active and total ghrelin concentrations were measured by radioimmunoassay. RESULTS: Active and total ghrelin concentrations in breast milk were lowest (450 +/- 25 and 880 +/- 80 pg/mL, respectively) at 0-3 days, whereas they increased progressively during 180 days of lactation period to 801 +/- 43 and 3250 +/- 380 pg/mL at 91-180 days postpartum. Milk total ghrelin concentrations correlated with serum concentrations of active (r = 0.503; p < 0.001) and total ghrelin (r = 0.331; p < 0.05) in breastfed infants at 4-30 days of age. In breastfeeding women, serum total ghrelin concentrations increased whereas serum active ghrelin concentrations decreased significantly during the next 4-180 days. CONCLUSION: Active and total ghrelin concentrations in breast milk increase with time during lactation and show significant relations with serum ghrelin concentrations in breastfed infants.     

Development of serum IgA and IgM levels in breast-fed and formula-fed infants during the first week of life

Background

IgA and IgM antibodies play important roles to protect infants in early life

Aim

To study the effects of breast milk feeding versus formula feeding in early infancy on the development of serum IgA and IgM.

Methods

A group of 220 healthy infants born after uncomplicated pregnancies and deliveries were enrolled. The infants were divided into three groups according to feeding type: breast-fed (BF), formula-fed (FF), and mixed-fed (MF). Capillary blood was collected for serum IgA and IgM detection at the first week of life.

Results

The average concentrations of serum IgA and IgM in all infants were 1.171 ± 1.079 and 256.2 ± 165.8 μg/ml, respectively. There were significantly higher concentrations of serum IgA in the FF group than MF group at 3, 4 and 6 days of age and BF group at 5 and 6 days old. Paired serum IgA concentrations revealed that IgA significantly decreased in the BF group, but not in the FF and MF groups. Meanwhile, paired serum IgM concentrations revealed that IgM increased significantly during early infancy in all groups. However, the IgM levels had no difference among the 3 groups within 7 days of age.

Conclusions

Our study demonstrated the development of serum IgA and IgM in early life. Formula feeding induced higher serum IgA concentrations than breast‐feeding within 7 days of age. However, serum IgM concentration was significantly increased in early life in all groups but had no differences between the different feeding types. Breast‐feeding may protect antigen loading in early life.     

Angiotensin converting enzyme activity in infancy is related to birth weight

AIMS: (a) To measure infant angiotensin converting enzyme (ACE) activity in healthy term infants at birth and during the first three months of life. (b) To determine the relation between serum ACE activity and infant feeding practice during this period. (c) To investigate the relation between serum ACE activity and birth weight and other potential contributing factors including acid-base status at birth, gestation, and maternal ACE genotype. METHODS: Prospective study of term infants, with clinical and feeding data collected from parents and medical records, and serum ACE measured in the infant at birth and 1 and 3 months of age, and in the mother at the time of birth and one to three months after birth. RESULTS: At birth and 1 and 3 months of age, infant serum ACE activity was twice that of maternal ACE activity. Infant ACE activity at birth and 1 and 3 months did not significantly differ between breast and formula fed infants. There was a highly significant negative correlation between infant ACE activity at 3 months and birth weight (r = -0.52; p < 0.001). This persisted after the conversion of birth weights to z scores (r = -0.34; p = 0.03). ACE activity at 3 months was also related to placental weight (r = -0.30; p = 0.02) and maternal age (r = -0.30; p = 0.05). The strong correlation between serum ACE activity and birth weight z score persisted after adjustment for maternal age and placental weight (r = -0.34; p = 0.03). CONCLUSION: As ACE is increasingly identified as a risk factor for cardiovascular disease, serum ACE activity in infancy may contribute to the link between low birth weight and later cardiovascular events.     

Ghrelin concentrations reflect body mass index rather than feeding status in obese girls

Ghrelin stimulates both appetite and secretion of growth hormone (GH). We hypothesized that fasting should increase ghrelin, thereby increasing GH concentrations in obesity. Eight obese girls underwent a 48-h fast, receiving 25% of calories for ideal body weight. Blood was obtained every 15 min for the last 24 h of the fast. Four months later, six obese girls had blood obtained in the fed state. Two additional obese and five lean girls had blood obtained in the fed state. Ghrelin was determined in 3-h pools. Mean ghrelin concentrations were 0.41 +/- 0.03 ng/mL for lean girls and 0.16 +/- 0.01 ng/mL in obese fed girls (p < 0.0001). Lean fed girls had diurnal variation of ghrelin whereas obese fed girls did not. Fasting neither increased ghrelin (0.18 +/- 0.01 ng/mL) nor restored diurnal variation. Ghrelin concentrations were related to the body mass index (BMI) SD score (SDS) (r = 0.45, p = 0.005). For the six obese girls who participated in both fasting and fed studies, change in mean ghrelin concentration between studies was related to change in BMI SDS but not fed or fasting state. Ghrelin concentrations are, thus, a function of BMI rather than feeding status in obese girls.     

Evaluation of full-term infants fed an evaporated milk formula

The objective of this prospective, cohort study was to compare the nutritional status of full-term infants who were fed human milk (BF, n = 29). formula (FF, n = 30) or evaporated milk formulae (EM, n = 30) for at least 3 months. Infants were seen at enrollment, 3 and 6 months, at which times a blood sample, diet record and anthropometric data were collected. Infants in the EM group received solids earlier (12 ± 5 weeks) than did FF infants (15 ± 4 weeks), and both were earlier than BF infants (19 ± 4 weeks). Only 26% of the EM fed group received iron supplements as ferrous sulphate drops. Seven BF, 12 FF and 20 EM had abnormal ferritin values (<10ngml^-1) at 6 months. Copper intake was lower in the EM infants at 3 and 6 months. However, plasma copper and erythrocyte copper zinc superoxide dismutase (ZnCuSOD) levels did not differ between groups. Selenium intake was lower in the EM group (5 ± 1 and 10 ± 5 μg d^-1; 3 and 6 months) than in the FF infants (13 ± 4 and 19 ± 7 μgd^-1; 3 and 6 months). Erythrocyte SeGHSPx levels in EM infants were lower at 6 months (EM, 33.2 ± 3.4; FF, 35.2 ± 3.9; BF, 36.1 ± S.SmUmgHb^-1). Thiamin intake (0.99 ± 0.08 and 1.24 ± 0.32; 3 and 6 months, mg 1000 kcal^-1) was higher in the FF group than in EM infants (0.38 ± 0.39 and 0.66 ± 0.38; 3 and 6 months). There were more (13%) abnormal thiamin assays in the EM group at 6 months than in the BF and FF infants (0%). In conclusion, infants fed evaporated milk formula receive adequate copper but may not receive enough thiamin or selenium. Unless supplemented from birth with medicinal iron, intakes of iron will be inadequate.     

Ghrelin and motilin concentration in colicky infants

Aim: To evaluate serum ghrelin and motilin concentration in infants with infantile colic. Methods: A case-control study was conducted on fasting blood venous samples obtained from 18 infants with infantile colic and 20 healthy infants to measure ghrelin (RIA test) and motilin (RIA test). Results: Colicky infants showed higher ghrelin serum levels (2534.2±600.0 pg/ml; ln 7.8±0.2) than controls (2126.1±281.3 pg/ml; ln 7.6±0.1) (p = 0.011). Serum motilin concentration was significantly higher in colicky infants (94.6±23.2 pmol/l) than in controls (64.1±30.1 pmol/l) (p=0.001). Motilin concentrations were higher in formula-fed colicky infants (104.5±20.4 pmol/l) than in breastfed ones (82.2±21.3 pmol/l) (p = 0.038).

Conclusion: Our finding shows that ghrelin and motilin concentrations are higher in infants with colic than in controls, supporting an organicistic aetiopathogenesis of this disorder. Furthermore, the role of ghrelin on gastrointestinal motility may open new doors to better understand the aetiology of infantile colic.     

Taurine supplementation prevents hyperaminoacidemia in growing term infants fed high-protein cow's milk formula

Blood urea nitrogen (BUN) and plasma and urine amino acid concentrations were compared between three cohorts of healthy growing term infants who were breast-fed (BF) or randomly assigned to one of two formulas either taurine non-supplemented (FF) or taurine supplemented (FF + T). The infants were studied from 2 to 12 weeks of age. Weight gain and growth in length was normal and similar in all three feeding groups during the study interval. At 12 weeks BUN was significantly higher in the FF group than in the BF and FF + T groups, 16.5 mg/dl vs 7.0 and 7.3 mg/dl, respectively. Total plasma amino acids (FF group: 240.5 ± 110.1 μmoles/dl; BF group: 180.1 ± 28.7 μmoles/dl; FF + T group: 182.3 ± 89.4 μmoles/dl) and total essential amino acids (FF group: 89.8 ± 37.3 μmoles/dl; BF group: 56.1 ± 16.3 μmoles/dl; FF + T group: 53.0 ± 24.2 μmoles/dl). The urine amino acid concentrations reflected the plasma levels in all groups. These results indicate that taurine supplementation to a high protein formula lowers BUN levels and the plasma and urine amino acid concentrations by some yet unknown mechanism to concentrations similar to those found in breast-fed infants with a much lower protein intake.     

Occult blood in stool in exclusively formula fed infants versus exclusively breast fed infants in the first six months of life

BackgroundSince most of infant’s formula are based on cow’s milk to which allergy can occur, and considering the neurodevelopmental consequences of iron deficiency during infancy; we aimed to verify the occurrence of occult intestinal blood loss during the first 6 months of life in response to being fed cow’s milk based formula versus breast milk. We also studied the iron status in order to assess prevalence of iron deficiency anemia.MethodsHealthy full term infants from birth to 6 months who were either exclusively breast fed (BF) (n = 50) or formula fed (FF) (n = 50) were considered for enrollment. Detailed questionnaire describing perinatal period was taken from the mothers. Complete blood count, serum iron, total iron binding capacity (TIBC), serum transferrin and occult blood in stool were requested for each infant.ResultsWe reported no significant differences in hemoglobin, hematocrit and MCV between both groups. FF infants had higher levels of TIBC. We found that 4/50 FF infants had positive occult blood in stool; while only 1/50 BF infants was positive. The prevalence of iron deficiency anemia was higher in the FF group (14%) rather than in the BF group (8%).ConclusionAlthough iron content in formula is higher than breast milk, BF infants attained better iron status than FF infants and the prevalence of anemia among the FF group was higher.     

Hepatic iron storage in very low birthweight infants after multiple blood transfusions

OBJECTIVE: To investigate the effect of multiple blood transfusions on hepatic iron storage in preterm, very low birthweight (VLBW) infants. METHODS: Seventeen VLBW infants who died within the first six months of life and underwent postmortem examination were studied. Serum ferritin, iron, and total iron binding capacity were measured within the week before the infants' death. Liver iron concentration was quantitatively determined by atomic absorption spectrophotometry and semiquantitatively assessed by histochemical liver iron grading. The clinical characteristics and the iron results were compared between infants receiving < 100 ml of blood (group A) and those receiving >/= 100 ml (group B). Spearman's correlation coefficient was used to evaluate the relation between the volume of blood transfused and serum/liver iron concentrations. Statistically significant variables associated with liver iron concentration were further subjected to multivariate stepwise regression analysis. RESULTS: Infants in group B had significantly higher serum iron (p < 0.01), serum ferritin (p < 0.01), and liver iron concentration (p < 0.01) than those in group A. The total and net volume of blood transfused were significantly associated with liver iron concentration (p < 0.001, r = 0.86; p < 0.001, r = 0.71 respectively), semiquantitative histochemical liver iron grading (p < 0.001, r = 0.80; p < 0.005, r = 0.71 respectively), and serum ferritin (p < 0.001, r = 0.84; p < 0.01, r = 0.69 respectively). In addition, both liver iron concentration and liver iron grading were found to be significantly associated with serum ferritin (p < 0.001, r = 0.76; p < 0.005, r = 0.68 respectively). Multivariate stepwise regression analysis indicated that the (log) liver iron concentration was significantly associated with the (log) volume of blood transfusion (p < 0.001; regression coefficient 0.39, SE 0.09), after adjustment for gestational age (R(2) = 0.84). CONCLUSIONS: This study showed a significant positive relation between the volume of blood transfused and the liver iron concentration in preterm VLBW infants. Although the transfusional blood volume correlated closely with the amount of iron deposited in hepatic tissues, clinical manifestations of iron overload were not observed. Carers should be aware of this potential harmful effect before prescribing blood or routine iron supplement to vulnerable preterm infants.     

Plasma vitamin E concentrations of older infants fed cow's milk or infant formula.

Nutrition of older infants, though important for optimal brain development, is inadequately studied. The beverage choice markedly influences nutrient intake, but little is known regarding nutrition status of older infants, particularly for vitamin E. This study assessed vitamin E intakes and plasma tocopherol concentrations in two groups of healthy infants, 8 to 13 months of age, who had consumed either cow's milk (n = 45) or milk-based formula (n = 55) for a minimum of the 3 preceding months. Mean (+/- SEM) vitamin E intake was significantly lower (p < or = 0.001) by the infants who had consumed cow's milk (CMF) than by infants who had consumed formula (FF); 4.1 +/- 0.25 mg/day and 10.9 +/- 0.57 mg/day, respectively. Mean (+/- SEM) intake of linoleic plus linolenic acids was significantly lower (p < or = 0.005) by CMF infants (3.4 +/- 0.2 g) than by FF infants (9.9 +/- 1.0 g), although mean (+/- SEM) dietary vitamin E to polyunsaturated fat ratio (E/PUFA ratio) was the same in both FF and CMF infants (1.3 +/- 0.1). Plasma alpha-tocopherol concentration (mean +/- SD) was significantly lower (p < or = 0.005) in CMF than in FF infants (0.86 +/- 0.28 mg/dl vs. 1.14 +/- 0.42 mg/dl, respectively). Dietary vitamin E intakes were positively correlated (p < or = 0.05) with plasma alpha-tocopherol concentrations. No correlations were found between plasma alpha-tocopherol concentrations and total fat intake, dietary E/PUFA ratios, erythrocyte polyunsaturated fatty acids > or = C18:2, or number of hours postprandial that blood was drawn.(ABSTRACT TRUNCATED AT 250 WORDS)