PREMATURE INFANTS FED TRANSPYLORICALLY GAIN WEIGHT SLOWLY

Nasojejunal feeding in hospital caused slow weight gain compared to nasogastric feeding in two similar groups of low-birth-weight babies. Because of faster catch up of growth in a nasojejunally fed group, both groups were of similar size at three months of age.     

0～6月龄纯母乳喂养儿每日母乳摄入量评估

母乳能为婴儿提供出生后最初6个月所需的能量和绝大多数营养素。健康、纯母乳喂养儿的平均每日母乳摄入量是制定婴儿营养素适宜摄入量的重要依据。称重法和氘标水法是估计婴儿母乳摄入量的主要方法。本文检索了近30年母亲健康的0～6月龄健康、纯母乳喂养儿的平均母乳(成熟乳)摄入量,估算为日均776.6±141.5 g,即749.6ml/d;取整数为780 g/d或750 ml/d。因此,在估计我国0～6月龄婴儿营养素适宜摄入量时,推荐采用婴儿母乳摄入量780 g/d(或750 ml/d)。[营养学报,2013,35(2):134-136,141]     

BONE MINERALIZATION AND GROWTH IN TERM INFANTS FED SOY-BASED OR COW MILK-BASED FORMULA

Infants fed a soy-based formula had significantly lower bone mineral content (BMC) and BMC to bone width (BW) ratio than infants fed a cow milk-based formula.     

DIETARY PHOSPHORUS AND SECONDARY HYPERPARATHYROIDISM IN INFANTS RECEIVING HUMANIZED COW'S MILK FORMULA

Infants fed humanized cow's milk formula developed hypocalcemic tentany with evidence of secondary hyperparathyroidism.     

VITAMIN E STATUS OF PREMATURE INFANTS

Serum vitamin E levels were higher in premature, low-birth-weight infants fed unsupplemented, preterm human milk than in controls given iron-supplemented, mature human milk or infant formula.     

Multifunctional Benefits of Prevalent HMOs: Implications for Infant Health

Breastfeeding is the best source of nutrition during infancy and is associated with a broad range of health benefits. However, there remains a significant and persistent need for innovations in infant formula that will allow infants to access a wider spectrum of benefits available to breastfed infants. The addition of human milk oligosaccharides (HMOs) to infant formulas represents the most significant innovation in infant nutrition in recent years. Although not a direct source of calories in milk, HMOs serve as potent prebiotics, versatile anti-infective agents, and key support for neurocognitive development. Continuing improvements in food science will facilitate production of a wide range of HMO structures in the years to come. In this review, we evaluate the relationship between HMO structure and functional benefits. We propose that infant formula fortification strategies should aim to recapitulate a broad range of benefits to support digestive health, immunity, and cognitive development associated with HMOs in breastmilk. We conclude that acetylated, fucosylated, and sialylated HMOs likely confer important health benefits through multiple complementary mechanisms of action.     

喂养方式对婴儿早期碘营养状态的影响

【目的】了解不同喂养方式对婴儿早期碘营养状态的影响。【方法】在非碘缺乏地区的上海随机选取68名母乳喂养儿和54名配方乳喂养儿进行观察性研究。分别于婴儿日龄42 d和90 d时测定其母乳或配方乳中的碘浓度,以及婴儿尿中的碘浓度,对乳母进行48 h回顾性膳食问卷调查。【结果】①母乳和配方乳喂养婴儿在42 d和90 d日龄时的尿碘浓度(中位数)分别为197.9、115.4μg/L和219.2、140.1μg/L;②母乳和配方乳的乳碘浓度(中位数)分别为109.14μg/L和88.9μg/L(P<0.01);③乳母膳食碘摄入量(中位数)为194.05μg/d,<200μg/d的占52.2%;④乳母膳食碘摄入量与母乳碘浓度呈正相关(r=0.558,P=0.000)。【结论】①母乳喂养婴儿的碘营养状态优于配方乳喂养的婴儿,积极鼓励母乳喂养;②母乳中的碘含量高于配方乳中的碘含量;③部分乳母膳食碘摄入不足。     

METABOLIC AND ENDOCRINE RESPONSES OF INFANTS TO BREAST MILK AND FORMULAS

Formula-fed neonates have different postprandial metabolic and hormonal responses from those who are breast-fed.     

Health, morality, and infant feeding: British mothers' experiences of formula milk use in the early weeks

The way mothers feed their babies is, internationally, the subject of research, health policy initiatives, and popular discussion, which commonly affirm the mantra 'breast is best'. On one level, this mantra reflects scientific evidence about nutrition and maternal and infant health. From a socio-cultural perspective, the pro-breastfeeding message has, however, been considered an aspect of morality, which influences maternal identity in important ways. This article explores this idea. It does so primarily by reporting and discussing some findings from a study about British mothers' experiences of using formula milk for infant feeding. The paper begins by contextualising this discussion by briefly outlining some aspects of the construction of infant feeding as a social problem in Britain, focusing in particular on the influence of 'the new paradigm of health'.     

FEEDING PRACTICES OF AMERICAN INFANTS AND CHILDREN

Surveys of infant feeding practices in the US indicate departures from recommendations for satisfactory or optimal nutrition. Do such departures adversely affect infants' current or future health and well-being?.     

Nutritional and physiologic significance of alpha-lactalbumin in infants

α-Lactalbumin is the major protein in breast milk (20 -25% of total protein) and has been described to have several physiologic functions in the neonatal period. In the mammary gland, it participates in lactose synthesis, thereby creating an osmotic "drag" to facilitate milk production and secretion. α-Lactalbumin binds divalent cations (Ca, Zn) and may facilitate the absorption of essential minerals, and it provides a well-balanced supply of essential amino acids to the growing infant. During its digestion, peptides appear to be transiently formed that have antibacterial and immunostimulatory properties, thereby possibly aiding in the protection against infection. A novel folding variant ("molten globule state") of multimeric α-lactalbumin has recently been discovered that has anti-infective activity and enhances apoptosis, thus possibly affecting mucosal cell turnover and proliferation. Cow milk also contains α-lactalbumin, albeit less than human milk (2-5% of total protein in bovine milk), and protein fractions enriched with α-lactalbumin may now be added to infant formula to provide some of the benefits of human α-lactalbumin.     

Human milk oligosaccharides: prebiotics and beyond

Human milk oligosaccharides (HMO) are complex glycans that are present at very high concentrations in human milk but not in infant formula. The significant energy expended by mothers to make these complex glycans suggests they must be important. How do maternal HMOs benefit the breast-fed infant? How are HMOs synthesized in the human mammary gland? How can we provide formula-fed infants with HMOs or HMO-like glycans? This article reviews current knowledge and open questions on the biosynthesis and functions of HMOs.     

Mixed Milk Feeding: A New Approach to Describe Feeding Patterns in the First Year of Life Based on Individual Participant Data from Two Randomised Controlled Trials

‘Mixed Milk Feeding’ (MMF), whereby infants are fed with both breastmilk and infant formula during the same period, is a common feeding practice. Despite its high prevalence, knowledge regarding MMF practices and their association with (health) outcomes is limited, potentially because MMF behaviours are highly variable and difficult to standardise longitudinally. In this paper, we applied a statistical clustering algorithm on individual infant feeding data collected over the first year of life from two clinical trials: ‘TEMPO’ (n = 855) and ‘Venus’ (n = 539); these studies were conducted in different years and world regions. In TEMPO, more than half of infants were MMF. Four distinct MMF clusters were identified: early exclusive formula feeding (32%), later exclusive formula feeding (25%), long-term MMF (21%), and mostly breastfeeding (22%). The same method applied to ‘Venus’ resulted in comparable clusters, building trust in the robustness of the cluster approach. These results demonstrate that distinct MMF patterns can be identified, which may be applicable to diverse populations. These insights could support the design of future research studying the impact of infant feeding patterns on health outcomes. To standardise this in future research, it is important to establish a unified definition of MMF.     

固相萃取-反相高效液相色谱法检测婴幼儿配方乳粉中叶酸的含量

目的建立了快速、灵敏的检测婴幼儿配方乳粉中叶酸含量的方法。方法使用高氯酸在超声波条件下提取配方乳粉中的叶酸,取一定量的滤液经过含有C18填料的固相萃取小柱进行除杂,再经过高锰酸钾衍生后利用反相高效液相色谱测定叶酸的含量。流动相选用pH5.0的浓度为0.1mol/L的磷酸二氢钠溶液,流动相流速为1.0ml/min,经BDSC18色谱柱进行分离(柱温为30℃)。结果方法在0.005～1.5μg/ml范围内线性良好,方法的平均回收率为91.7%～98.3%,RSD%为2.5%,检出限为0.005μg/ml,定量限为0.017μg/ml。结论应用本方法检测婴幼儿配方乳粉中的叶酸,具有操作简单、精密度高、准确度好、容易推广等优点。     

HYPERTONIC ELEMENTAL FEEDING OF VERY PREMATURE INFANTS AND NECROTIZING ENTEROCOLITIS

Recent studies on the possible relationship between diet and necrotizing enterocolitis in premature infants is reviewed.     

Patterns and Predictors of Breast Milk Feeding from Birth to Age 4 Months among Primiparous African American Mother–Infant Dyads

The health benefits of breast milk feeding have been well-established, yet disparities exist, with African American mothers having the lowest breast milk feeding rates in the United States. This prospective, longitudinal study examined infant feeding (breast milk and/or infant formula) from birth to age 16 weeks, predictors of any breast milk feeding by age 1 week, and predictors of cessation of any breast milk feeding by ages 3, 8, and 16 weeks among primiparous African American mothers. This secondary analysis included 185 mother–infant dyads from the Sleep SAAF (Strong African American Families) study, a randomized clinical trial testing a responsive parenting vs. child safety control intervention. Mothers reported sociodemographic and psychosocial characteristics at age 1 week and infant feeding practices at ages 1, 3, 8, and 16 weeks. Rates of any breast milk feeding decreased from 66.5% at 1 week to 23.3% at 16 weeks. Bivariate logistic regression models showed that prepregnancy BMI (OR = 1.09), working prepregnancy (OR = 2.25), and food insecurity (OR = 2.49) significantly increased the odds of mothers feeding any breast milk by 1 week, whereas Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation (OR = 0.21) significantly decreased the odds. Bivariate logistic regression models showed that Supplemental Nutrition Assistance Program (SNAP) participation (OR = 2.86) and racial discrimination (OR = 2.14) significantly increased the odds of cessation of any breast milk feeding by 3 weeks. SNAP (OR = 2.33) and WIC (OR = 2.38) participation significantly increased the odds of cessation of any breast milk feeding by 8 weeks, whereas higher prepregnancy BMI (OR = 0.95) decreased the odds. Higher mother’s age (OR = 0.92) significantly decreased the odds of cessation of any breast milk feeding by 16 weeks. The findings can be used to inform targeted interventions to promote mothers feeding any breast milk and help reduce breast milk feeding disparities among African American mothers.     

Exploring the Potential of Human Milk and Formula Milk on Infants’ Gut and Health

Early-life gut microbiota plays a role in determining the health and risk of developing diseases in later life. Various perinatal factors have been shown to contribute to the development and establishment of infant gut microbiota. One of the important factors influencing the infant gut microbial colonization and composition is the mode of infant feeding. While infant formula milk has been designed to resemble human milk as much as possible, the gut microbiome of infants who receive formula milk differs from that of infants who are fed human milk. A diverse microbial population in human milk and the microbes seed the infant gut microbiome. Human milk contains nutritional components that promote infant growth and bioactive components, such as human milk oligosaccharides, lactoferrin, and immunoglobulins, which contribute to immunological development. In an attempt to encourage the formation of a healthy gut microbiome comparable to that of a breastfed infant, manufacturers often supplement infant formula with prebiotics or probiotics, which are known to have a bifidogenic effect and can modulate the immune system. This review aims to elucidate the roles of human milk and formula milk on infants’ gut and health.     

Human Milk Fortifiers Do Not Meet the Current Recommendation for Nutrients in Very Low Birth Weight Infants

Background: Use of multinutrient fortifiers is standard of care for small preterm infants fed exclusively human milk. However, adequacy of human milk fortifiers (HMFs) to meet the recommended intake for macronutrients and micronutrients is now known. Materials and Methods: Nutrient content of human milk fortified according to manufacturer’s recommendations was compared at isocaloric levels for 1 human milk–based (HMF‐A), 2 bovine milk protein–based (HMF‐B, HMF‐C), and 2 preterm infant formulas (PTF‐B, PTF‐C). In addition, 4 multivitamin supplements were compared. Results: At 130 kcal/kg, intake of macronutrients was similar to the recommendation, although deficient and excess intake of micronutrient occurred with all fortifiers. Four to 9 micronutrients were absent in HMF or PTF (biotin, choline, inositol, carnitine, taurine, molybdenum, iodine, selenium, or chromium). For the remainder, HMF resulted in deficient intake for 1–13 micronutrients, occurring most frequently with HMF‐A. Excess micronutrients (3–15 at <50% and 1–3 at 109%–437%) occurred with all HMF and most frequently with HMF‐B and HMF‐C. At 150 kcal/kg, deficient intake improved but generally remained below recommendation, while excess intake became exaggerated. PTF and multivitamin formulations do not fully compensate for the deficiencies and can result in extremely high micronutrient intake. Conclusions: At the recommended energy intake for very low birth weight infants, many micronutrients are absent or are present in grossly inadequate amounts, and several micronutrients are in excess. Reformulation of HMF is urgently needed since PTF or multivitamin supplement only partially corrects some deficiencies while providing some nutrients in excess.     

INFANT GROWTH AND OBESITY IN SAMOA

Birth weights and growth rates of Samoan infants exceed values found in other nations, regardless of feeding regimen or rural and urban differences.     

Zinc status and growth of Korean infants fed human milk, casein-based, or soy-based formula: three-year longitudinal study

To evaluate the effect of feeding methods on growth and zinc nutritional status of infants early in life, we monitored from birth to 36 months in 51 infants who were exclusively fed human milk (HM, n = 20), casein-based formula (CBF, n = 12), or soy-based formula (SBF, n = 19) during the first five months of life. Zinc status was assessed by analyzing serum zinc concentrations and zinc intakes. Zinc contents in HM and formulas were measured. Zinc intake was estimated by weighing infants before and after feeding in the HM group and by collecting formula-intake records in the CBF and SBF groups. After solid foods were introduced, all foods consumed were also included to estimate zinc intake. The growth of infants in all groups was similar to that established for normal Korean infants. Human milk zinc concentrations declined as lactation progressed. Zinc concentrations in all formulas tested in this study were higher than HM and were also higher than those claimed by the manufacturers. During the first twelve months, mean serum zinc concentrations of infants were similar in all groups, although infants in the HM group consistently had the lowest zinc intake among the groups, and the overall zinc intake in infants fed SBF was highest. This finding could be explained by the different zinc bioavailability of HM and formulas. In conclusion, infants fed HM, CBF or SBF has normal growth up to three years of age, although HM contained the lowest zinc concentration followed by CBF, then SBF.