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1.
Molecules ; 29(9)2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38731536

RESUMO

The quality of fat in infant milk is determined by the fatty acid profile and selected indices describing nutritional value. The aim of this study was to analyze the fatty acid profile and lipid quality indices of infant formulas and compare these data with breast milk. The study material included seven types of cow's milk-based follow-on infant formulas and samples of mature breast milk. The determination of fatty acids was performed using the gas chromatography (GC) technique. Lipid quality indices were calculated based on the relevant equations. Infant formulas contained more medium-chain fatty acids (MCFAs) and oleic acid. Moreover, they contained more than 30% more linoleic acid and more than twice as much α-linolenic acid and docosahexaenoic acid. In contrast, significant amounts of trans fatty acids (TFAs) were noted in breast milk, while infant formulas contained trace amounts. Infant formulas were characterized by a lower AI (Index of Atherogenicity) (0.49-0.98) and TI (Index of Thrombogenicity) (0.48-0.60) and a higher H/H (hypocholesterolemic/hypercholesterolemic) ratio (1.93-2.30) compared with breast milk (1.47, 1.60, and 1.21, respectively). The composition of infant formulas depended on the type of fat added at the production stage and differed significantly from breast milk, particularly in terms of polyunsaturated fatty acids and lipid quality indices.


Assuntos
Ácidos Graxos , Fórmulas Infantis , Lipídeos , Leite Humano , Fórmulas Infantis/química , Fórmulas Infantis/análise , Humanos , Ácidos Graxos/análise , Leite Humano/química , Lactente , Lipídeos/análise , Feminino , Valor Nutritivo , Animais
2.
BMC Public Health ; 24(1): 1264, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720256

RESUMO

BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) issues infant formula to infants who are not fully breastfed, and prior research found elevated obesity risk among children receiving lactose-reduced infant formula with corn syrup solids (CSSF) issued by WIC. This study was conducted to evaluate associations between a broader set of specialty infant formulas issued by WIC and child obesity risk, whether neighborhood context (e.g. neighborhood food environment) modifies associations, and whether racial/ethnic disparities in obesity are partly explained by infant formula exposure and neighborhood context. METHODS: WIC administrative data, collected from 2013-2020 on issued amount (categorical: fully formula fed, mostly formula fed, mostly breastfed, fully breastfed) and type of infant formula (standard cow's milk formula, and three specialty formulas: any CSSF, any soy-based formula, and any cow's milk-based formula with added rice starch) and obesity at ages 2-4 years (defined as a Body Mass Index z-score ≥ 95th percentile according to World Health Organization growth standard) were used to construct a cohort (n = 59,132). Associations of infant formula exposures and race/ethnicity with obesity risk were assessed in Poisson regression models, and modification of infant feeding associations with obesity by neighborhood context was assessed with interaction terms. RESULTS: Any infant formula exposure was associated with significantly higher obesity risk relative to fully breastfeeding. Receipt of a CSSF was associated with 5% higher obesity risk relative to the standard and other specialty infant formulas (risk ratio 1.05, 95% confidence interval 1.02, 1.08) independent of breastfeeding duration and receipt of other specialty infant formulas. The association between CSSF and obesity risk was stronger in neighborhoods with healthier food environments (10% higher risk) compared to less healthy food environments (null). Racial/ethnic disparities in obesity risk were robust to adjustment for infant formula exposure and neighborhood environment. CONCLUSIONS: Among specialty infant formulas issued by WIC, only CSSFs were associated with elevated obesity risk, and this association was stronger in healthier food environments. Future research is needed to isolate the mechanism underlying this association.


Assuntos
Fórmulas Infantis , Obesidade Infantil , Características de Residência , Humanos , Obesidade Infantil/epidemiologia , Feminino , Características de Residência/estatística & dados numéricos , Masculino , Fórmulas Infantis/estatística & dados numéricos , Lactente , Pré-Escolar , Estados Unidos/epidemiologia , Aleitamento Materno/estatística & dados numéricos , Assistência Alimentar/estatística & dados numéricos
3.
Food Res Int ; 186: 114317, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38729709

RESUMO

Lipids play a pivotal role in the nutrition of preterm infants, acting as a primary energy source. Due to their underdeveloped gastrointestinal systems, lipid malabsorption is common, leading to insufficient energy intake and slowed growth. Therefore, it is critical to explore the reasons behind the low lipid absorption rate in formulas for preterm infants. This study utilized a simulated in intro gastrointestinal digestion model to assess the differences in lipid digestion between preterm human milk and various infant formulas. Results showed that the fatty acid release rates for formulas IF3, IF5, and IF7 were 58.90 %, 56.58 %, and 66.71 %, respectively, lower than human milk's 72.31 %. The primary free fatty acids (FFA) and 2-monoacylglycerol (2-MAG) released during digestion were C14:0, C16:0, C18:0, C18:1n-9, and C18:2n-6, in both human milk and formulas. Notably, the higher release of C16:0 in formulas may disrupt fatty acid balance, impacting lipid absorption. Further investigations are necessary to elucidate lipid absorption differences, which will inform the optimization of lipid content in preterm infant formulas.


Assuntos
Digestão , Fórmulas Infantis , Recém-Nascido Prematuro , Leite Humano , Leite Humano/química , Leite Humano/metabolismo , Humanos , Fórmulas Infantis/química , Recém-Nascido , Ácidos Graxos/análise , Ácidos Graxos/metabolismo , Lipídeos/análise , Ácidos Graxos não Esterificados/análise , Ácidos Graxos não Esterificados/metabolismo , Metabolismo dos Lipídeos , Trato Gastrointestinal/metabolismo , Modelos Biológicos , Monoglicerídeos/metabolismo , Monoglicerídeos/análise , Gorduras na Dieta/metabolismo , Gorduras na Dieta/análise
4.
Food Res Int ; 186: 114348, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38729721

RESUMO

During production of soy-based infant formula, soy protein undergoes heating processes. This study investigated the differential impact of heating modes on the immunogenic potential of peptides in soy protein digests. Wet or dry heating was applied, followed by in vitro gastrointestinal infant digestion. The released peptides were analyzed by LC-MS/MS. Bioinformatics tools were utilized to predict and identify potential linear B-cell and T-cell epitopes, as well as to explore cross-reactivity with other legumes. Subsequently, the peptide intensities of the same potential epitope across different experimental conditions were compared. As a result, we confirmed the previously observed enhancing effect of wet heating on infant digestion and inhibitory effect of dry heating. A total of 8,546 peptides were detected in the digests, and 6,684 peptides were with a score over 80. Among them, 29 potential T-cell epitopes and 27 potential B-cell epitopes were predicted. Cross-reactivity between soy and other legumes, including peanut, pea, chickpea, lentil, kidney bean, and lupine, was also detected. Overall, heating and digestion time could modulate the potential to trigger peptide-induced immune responses.


Assuntos
Digestão , Temperatura Alta , Peptídeos , Proteínas de Soja , Espectrometria de Massas em Tandem , Humanos , Proteínas de Soja/imunologia , Proteínas de Soja/química , Peptídeos/imunologia , Peptídeos/química , Lactente , Fórmulas Infantis/química , Epitopos de Linfócito T/imunologia , Epitopos de Linfócito B/imunologia , Reações Cruzadas , Calefação , Cromatografia Líquida
5.
Food Res Int ; 187: 114343, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38763636

RESUMO

Human breast milk promotes maturation of the infant gastrointestinal barrier, including the promotion of mucus production. In the quest to produce next generation infant milk formula (IMF), we have produced IMF by membrane filtration (MEM-IMF). With a higher quantity of native whey protein, MEM-IMF more closely mimics human breast milk than IMF produced using conventional heat treatment (HT-IMF). After a 4-week dietary intervention in young pigs, animals fed a MEM-IMF diet had a higher number of goblet cells, acidic mucus and mucin-2 in the jejunum compared to pigs fed HT-IMF (P < 0.05). In the duodenum, MEM-IMF fed pigs had increased trypsin activity in the gut lumen, increased mRNA transcript levels of claudin 1 in the mucosal scrapings and increased lactase activity in brush border membrane vesicles than those pigs fed HT-IMF (P < 0.05). In conclusion, MEM-IMF is superior to HT-IMF in the promotion of mucus production in the young gut.


Assuntos
Filtração , Fórmulas Infantis , Muco , Animais , Fórmulas Infantis/química , Muco/metabolismo , Suínos , Proteínas do Soro do Leite/metabolismo , Intestino Delgado/metabolismo , Tripsina/metabolismo , Humanos , Células Caliciformes/metabolismo , Claudina-1/metabolismo , Claudina-1/genética , Lactase/metabolismo , Lactase/genética , Mucina-2/metabolismo , Mucina-2/genética , Mucosa Intestinal/metabolismo , Duodeno/metabolismo , Jejuno/metabolismo , RNA Mensageiro/metabolismo , RNA Mensageiro/genética , Proteínas do Leite/metabolismo , Proteínas do Leite/análise
6.
Food Res Int ; 187: 114389, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38763651

RESUMO

Ochratoxin A (OTA), zearalenone (ZEN), and deoxynivalenol (DON) are mycotoxins whose exposure is associated with various adverse health effects, including cancer and renal disorders, estrogenic effects, and immunosuppressive and gastrointestinal disorders, respectively. Infants (<2 years) are the most vulnerable group to mycotoxins, representing a unique combination of restricted food consumption types, low body weight, lower ability to eliminate toxins, and more future years to accumulate toxins. This study aimed to estimate the infant́s exposure to OTA, DON, and ZEN due to the consumption of milk formula and baby cereals in Chile. Milk formula samples (n = 41) and baby cereals (n = 30) were collected and analyzed using commercial ELISA kits for OTA, DON, and ZEA determination. Exposure was assessed by the Estimated Daily Intake (EDI) approach (mean and worst-case scenario, WCS) with the levels found in a modified Lower Bound (mLB) and Upper Bound (UB); ideal consumption (<6m, 7-12 m, and 13-24 m); adjusted by the weight of each group. The risk was estimated by comparing the EDI with a reference tolerable daily intake or by the margin of exposure (MOE) in the case of OTA. DON and OTA occurrence in infant formula were 34 % and 41 %, respectively. The co-occurrence between these mycotoxins was 22 %. Mycotoxin contents were below LOQ values except for OTA determined in one sample (0.29 ng/ml). No milk formulae were contaminated with ZEN. In the case of baby cereals, the occurrences were 17 % for OTA, 30 % for DON, and 7 % for ZEN, all below LOQ. Co-occurrence was seen in two samples between ZEN and OTA. According to exposure calculations, the MOE for OTA was less than 10,000 in all models for milk formula between 0 to 12 months of age and in the UB and WCS for cereal consumption. Health concerns were observed for DON in the WCS and UB for milk consumption in all ages and only in the UB WCS for cereal consumption. Considering the high consumption of milk formula in these age groups, regulation of OTA and other co-occurring mycotoxins in infant milk and food is strongly suggested.


Assuntos
Exposição Dietética , Grão Comestível , Contaminação de Alimentos , Fórmulas Infantis , Ocratoxinas , Tricotecenos , Zearalenona , Humanos , Zearalenona/análise , Fórmulas Infantis/química , Chile , Grão Comestível/química , Lactente , Tricotecenos/análise , Contaminação de Alimentos/análise , Ocratoxinas/análise , Exposição Dietética/análise , Exposição Dietética/efeitos adversos , Medição de Risco , Recém-Nascido , Alimentos Infantis/análise
7.
Food Res Int ; 187: 114412, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38763662

RESUMO

Lipid oxidation limits the shelf-life of dried microencapsulated oils (DMOs), such as infant formula. However, it is poorly understood how lipid oxidation is affected by different types of emulsifiers. To improve our understanding, we prepared DMOs with different emulsifiers (whey protein isolate (WPI), pea protein isolate (PPI), and non-proteinaceous CITREM) and studied lipid oxidation in both the free and encapsulated fat. Only a small difference in oxidation rate was observed between these fat fractions for all formulations. We ascribed this to a non-discrete distribution of the fractions and the subsequent low fractionation selectivity as shown by Raman microscopy. The DMO with PPI showed hardly any oxidation during a 7-week incubation at 40 °C, whereas the DMOs with WPI and CITREM both reached significantly higher contents of oxidation products (lipid hydroperoxides, aldehydes, and epoxides). The enhanced stability of DMO-PPI could not be ascribed to the presence of phytic acid. In conclusion, we demonstrate the potential of using PPI to produce oxidatively stable DMOs.


Assuntos
Emulsificantes , Emulsões , Oxirredução , Emulsificantes/química , Emulsões/química , Proteínas do Soro do Leite/química , Proteínas de Ervilha/química , Secagem por Atomização , Composição de Medicamentos , Lipídeos/química , Fórmulas Infantis/química
8.
J Chromatogr A ; 1726: 464967, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38749275

RESUMO

Infant formulas (IF) can contain harmful chemical substances, such as pesticides and mycotoxins, resulting from the contamination of raw materials and inputs used in the production chain, which can cause adverse effects to infants. Therefore, the quick, easy, cheap, effective, rugged, and safe (QuEChERS) methodology prior ultra-high performance liquid chromatography coupled to triple quadrupole mass spectrometry (UHPL-QqQ-MS/MS) analysis was applied for the determination of 23 contaminants, in 30 samples of Brazilian IF. The method was validated in terms of limit of detection (0.2 to 0.4 µg/kg), limits of quantification (1 and 10 µg/kg), and recovery (64 % to 122 %); precision values, in terms of relative standard deviation (RSD), were ≤ 20 %. Fenitrothion, chlorpyrifos, and bifenthrin were the pesticides detected in the samples, but the values did not exceed the limit set by the European Union (EU), and ANVISA, and they were detected under their limits of quantification. Additionally, suspect screening and unknown analysis were conducted to tentatively identify 32 substances, including some compounds not covered in this study, such as pesticides, hormones, and veterinary drugs. Carbofuran was identified, confirmed and quantified in 10 % of the samples.


Assuntos
Contaminação de Alimentos , Fórmulas Infantis , Limite de Detecção , Espectrometria de Massas em Tandem , Espectrometria de Massas em Tandem/métodos , Cromatografia Líquida de Alta Pressão/métodos , Brasil , Fórmulas Infantis/química , Contaminação de Alimentos/análise , Praguicidas/análise , Humanos , Resíduos de Praguicidas/análise , Reprodutibilidade dos Testes , Micotoxinas/análise , Lactente , Piretrinas/análise
9.
Pediatr Allergy Immunol ; 35(5): e14142, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38753422

RESUMO

Breastmilk is the optimal source of nutrition for infants and should ideally be provided exclusively for the first 6 months of life, and alongside complementary food until 2 years of life. However, there are circumstances where a breastmilk substitute (BMS) may be required. This includes maternal and/or child conditions or personal preference. Whilst these circumstances should never be used as an opportunity to promote BMS, healthcare professionals (HCPs) need to have the knowledge of suitable alternatives and should always be guided by scientific and health motives when recommending a BMS. The Task Force 'Milk Formula Industry Sponsorship' from the European Academy of Allergy and Clinical Immunology (EAACI), provides with this publication recommendations for EAACI interactions with the BMS manufacturers and how this will be supervised.


Assuntos
Leite Humano , Humanos , Lactente , Leite Humano/imunologia , Recém-Nascido , Fórmulas Infantis/economia , Substitutos do Leite , Europa (Continente) , Feminino , Aleitamento Materno , Indústria Alimentícia , Fenômenos Fisiológicos da Nutrição do Lactente
10.
Rev Paul Pediatr ; 42: e2023141, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38695418

RESUMO

OBJECTIVE: To evaluate the rates of exclusive breastfeeding (EBF) and growth of preterm and/or low birth weight newborns during the third stage of the Kangaroo Method (TSKM), at discharge. METHODS: Retrospective study in a reference public maternity hospital between Jan/2014 and Dec/2017, including the preterm (less than 37 weeks) and/or low birth weight (less than 2500 g) newborn infants. Information was collected from medical records. Statistics analysis was done in SPSS software. RESULTS: 482 infants were included and followed up at the TSKM ambulatory. The average gestational age was 33 weeks (variation: 24-39 weeks) and birth weight, 1715g (variation: 455-2830 g). EBF occurred in 336 (70.1%) infants at hospital discharge, and in 291 (60.4%) at TSKM discharge. Each additional day of hospital stay increased the chance of infant formula (IF) use by 9.3% at hospital discharge and by 10.3% at TSKM discharge. Staying in the Kangaroo Neonatal Intermediate Care Unit (KNICU) favored EBF at hospital discharge and TSKM discharge (p<0.001). Not performing the kangaroo position increased the chance formula administration to the newborn infant at hospital discharge by 11%. Weight gain and head circumference growth were higher in infants using formula (p<0.001). CONCLUSIONS: The length of hospital stay and not performing the kangaroo position favored the use of infant formula at hospital and TSKM discharge. Staying in the KNICU favored exclusive breastfeeding at hospital and TSKM discharge. Weight gain and HC growth were higher in newborns receiving infant formula.


Assuntos
Aleitamento Materno , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Método Canguru , Humanos , Recém-Nascido , Aleitamento Materno/estatística & dados numéricos , Estudos Retrospectivos , Método Canguru/métodos , Recém-Nascido Prematuro/crescimento & desenvolvimento , Feminino , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Masculino , Aumento de Peso , Idade Gestacional , Fórmulas Infantis/estatística & dados numéricos
11.
Sci Rep ; 14(1): 10384, 2024 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-38710791

RESUMO

Concerns exist about prolonged breastfeeding increasing dental caries risk, but evidence is mixed. This 2-year cohort study followed 486 toddlers, to examine the association between breastfeeding duration and caries at age 3. Caregivers reported feeding practices and potential confounders every 6 months. "Full breastfeeding" was defined as feeding breastmilk without formula milk regardless of other foods/liquids, whereas "any breastfeeding" was feeding breastmilk with/without formula milk. A calibrated dentist performed dental examinations. We used multivariable log-binomial and negative binomial regressions to estimate relative risks (RRs) and 95% confidence intervals (CIs) for caries prevalence and severity, adjusted for confounders. At 3-year-old, 60.3% of children exhibited caries (mean decayed-and-filled-teeth, dft: 3.3). Notably, full breastfeeding for 6-17 months reduced caries prevalence (RR = 0.84, 95%CI 0.73-0.98 for 6-11 months; RR = 0.78, 95%CI 0.63-0.96 for 12-17 months). Conversely, any breastfeeding ≥ 18 months significantly increased caries risk (RR = 1.45, 95%CI 1.31-1.60). Full breastfeeding ≥ 6 months or any breastfeeding 6-17 months was associated with lower dft scores in children. Our findings suggest a complex relationship between breastfeeding duration and caries. Full breastfeeding for moderate durations (6-17 months) offers protective benefits, while any breastfeeding ≥ 18 months increases risk in this population.


Assuntos
Aleitamento Materno , Cárie Dentária , Fórmulas Infantis , Humanos , Cárie Dentária/epidemiologia , Estudos Longitudinais , Feminino , Pré-Escolar , Masculino , Lactente , Prevalência , Fatores de Risco
12.
Luminescence ; 39(5): e4772, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38712470

RESUMO

The current study presents the first spectrofluorimetric approach for the estimation of lactoferrin, depending on the measurement of its native fluorescence at 337 nm after excitation at 230 nm, without the need for any hazardous chemicals or reagents. It was found that the fluorescence intensity versus concentration calibration plot was linear over the concentration range of 0.1-10.0 µg/mL with quantitation and detection limits of 0.082 and 0.027 µg/mL, respectively. The method was accordingly validated according to the ICH recommendations. The developed method was applied for the estimation of lactoferrin in different dosage forms, including capsules and sachets with high percent recoveries (97.84-102.53) and low %RSD values (<1.95). Lactoferrin is one of the key nutrients in milk powder and a significant nutritional fortifier. In order to assess the quality of milk powder, it is essential to rapidly and accurately quantify the lactoferrin content of the product. Therefore, the presented study was successfully applied for the selective estimation of lactoferrin in milk powder with acceptable percent recoveries (96.45-104.92) and %RSD values (≤3.607). Finally, the green profile of the method was estimated using two assessment tools: Green Analytical Procedure Index (GAPI) and Analytical GREEnness (AGREE), which demonstrated its excellent greenness.


Assuntos
Fórmulas Infantis , Lactoferrina , Espectrometria de Fluorescência , Lactoferrina/análise , Fórmulas Infantis/química , Fórmulas Infantis/análise , Espectrometria de Fluorescência/métodos , Preparações Farmacêuticas/análise , Preparações Farmacêuticas/química , Humanos , Lactente , Química Verde , Leite/química , Limite de Detecção , Animais
13.
Food Res Int ; 183: 114224, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38760143

RESUMO

During infant formula production, proteins are always heated, potentially affecting their digestibility and the bioactivities of resulting peptides. Although plant proteins are a promising dairy alternative for infant formula, they remain understudied, necessitating further investigations. Therefore, this research aimed to fill this gap by assessing the impact of different heating modes on soy protein (SP) and pea protein (PP), focusing on glycation levels, peptide formation during in vitro infant digestion, and immune protection potential (sRAGE-binding and antimicrobial activities) of the resulting peptides. Consequently, dry heating led to increased glycation and glycated peptide production, particularly with higher glycation in PP than SP. Moreover, PP exhibited an overall stronger sRAGE-binding capacity than SP, regardless of heating and digestion conditions. Regarding antimicrobial activity, both SP and PP-derived peptides displayed reduced effectiveness against Enterobacter cloacae after dry heating. Additionally, Staphylococcus epidermidis was differently inhibited, where PP-derived peptides showed inherent inhibition. The primary determinant of sRAGE-binding and antimicrobial potential in digestion-derived peptides was the protein source. Subsequent bioinformatics analysis predicted 519 and 133 potential antimicrobial peptides in SP and PP, respectively. This study emphasises the importance of protein source for infant formula to ensure infant health.


Assuntos
Digestão , Temperatura Alta , Fórmulas Infantis , Proteínas de Ervilha , Proteínas de Soja , Proteínas de Soja/metabolismo , Humanos , Fórmulas Infantis/química , Lactente , Proteínas de Ervilha/metabolismo , Proteínas de Ervilha/química , Receptor para Produtos Finais de Glicação Avançada/metabolismo , Peptídeos Antimicrobianos/metabolismo , Anti-Infecciosos/farmacologia
14.
Cochrane Database Syst Rev ; 5: CD013038, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38721883

RESUMO

BACKGROUND: Preterm infants (born before 37 weeks' gestation) are often unable to co-ordinate sucking, swallowing, and breathing for oral feeding because of their immaturity. In such cases, initial nutrition is provided by orogastric or nasogastric tube feeding. Feeding intolerance is common and can delay attainment of full enteral and sucking feeds, prolonging the need for nutritional support and the hospital stay. Smell and taste play an important role in the activation of physiological pre-absorptive processes that contribute to food digestion and absorption. However, during tube feeding, milk bypasses the nasal and oral cavities, limiting exposure to the smell and taste of milk. Provision of the smell and taste of milk with tube feeds offers a non-invasive and low-cost intervention that, if effective in accelerating the transition to enteral feeds and subsequently to sucking feeds, would bring considerable advantages to infants, their families, and healthcare systems. OBJECTIVES: To assess whether exposure to the smell or taste (or both) of breastmilk or formula administered with tube feeds can accelerate the transition to full sucking feeds without adverse effects in preterm infants. SEARCH METHODS: We conducted searches in CENTRAL, MEDLINE, Embase, CINAHL, and Epistemonikos to 26 April 2023. We also searched clinical trial databases and conference proceedings. SELECTION CRITERIA: We included randomised and quasi-randomised studies that evaluated exposure versus no exposure to the smell or taste of milk (or both) immediately before or at the time of tube feeds. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias, and extracted data according to Cochrane Neonatal methodology. We performed meta-analyses using risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data, with their respective 95% confidence intervals (CIs). We used GRADE to assess the certainty of evidence. MAIN RESULTS: We included eight studies (1277 preterm infants). Seven studies (1244 infants) contributed data for meta-analysis. The evidence suggests that exposure to the smell and taste of milk with tube feeds has little to no effect on time taken to reach full sucking feeds (MD -1.07 days, 95% CI -2.63 to 0.50; 3 studies, 662 infants; very low-certainty evidence). Two studies reported no adverse effects related to the intervention. The intervention may have little to no effect on duration of parenteral nutrition (MD 0.23 days, 95% CI -0.24 to 0.71; 3 studies, 977 infants; low-certainty evidence), time to reach full enteral feeds (MD -0.16 days, 95% CI -0.45 to 0.12; 1 study, 736 infants; very low-certainty evidence) or risk of necrotising enterocolitis (RR 0.93, 95% CI 0.47 to 1.84; 2 studies, 435 infants; low-certainty evidence), although the evidence for time to reach full enteral feeds is very uncertain. Exposure to the smell and taste of milk with tube feeds probably has little to no effect on risk of late infection (RR 1.14, 95% CI 0.74 to 1.75; 2 studies, 436 infants; moderate-certainty evidence). There were no data available to assess feeding intolerance. The included studies had small sample sizes and methodological limitations, including unclear or lack of randomisation (four studies), lack of blinding of participants and personnel (five studies), unclear or lack of blinding of the outcome assessor (all eight studies), and different inclusion criteria and methods of administering the interventions. AUTHORS' CONCLUSIONS: The results of our meta-analyses suggest that exposure to the smell and taste of milk with tube feeds may have little to no effect on time to reach full sucking feeds and time to reach full enteral feeds. We found no clear difference between exposure and no exposure to the smell or taste of milk on safety outcomes (adverse effects, necrotising enterocolitis, and late infection). Results from one ongoing study and two studies awaiting classification may alter the conclusions of this review. Future research should examine the effect of exposing preterm infants to the smell and taste of milk with tube feeds on health outcomes during hospitalisation, such as attainment of feeding skills, safety, feed tolerance, infection, and growth. Future studies should be powered to detect the effect of the intervention in infants of different gestational ages and on each sex separately. It is also important to determine the optimal method, frequency, and duration of exposure.


Assuntos
Nutrição Enteral , Recém-Nascido Prematuro , Leite Humano , Ensaios Clínicos Controlados Aleatórios como Assunto , Olfato , Paladar , Humanos , Recém-Nascido , Paladar/fisiologia , Olfato/fisiologia , Nutrição Enteral/métodos , Fórmulas Infantis , Fatores de Tempo
15.
Sci Rep ; 14(1): 11417, 2024 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-38763963

RESUMO

Associations between depressive symptoms and breastfeeding are well documented. However, evidence is lacking for subdivisions of feeding styles, namely exclusive breastfeeding, exclusive formula feeding and a mixed feeding style (breastfeeding and formula feeding). In addition, studies examining associations between mother-child-bonding and breastfeeding have yielded mixed results. The aim of this study is to provide a more profound understanding of the different feeding styles and their associations with maternal mental health and mother-child-bonding. Data from 307 women were collected longitudinally in person (prenatally) and by telephone (3 months postnatally) using validated self-report measures, and analyzed using correlational analyses, unpaired group comparisons and regression analyses. Our results from a multinomial regression analysis revealed that impaired mother-child-bonding was positively associated with mixed feeding style (p = .003) and depressive symptoms prenatal were positively associated with exclusive formula feeding (p = .013). Further studies could investigate whether information about the underlying reasons we found for mixed feeding, such as insufficient weight gain of the child or the feeling that the child is unsatiated, could help prevent impaired mother-child-bonding. Overall, the results of this study have promising new implications for research and practice, regarding at-risk populations and implications for preventive measures regarding postpartum depression and an impaired mother-child-bonding.


Assuntos
Aleitamento Materno , Depressão Pós-Parto , Depressão , Relações Mãe-Filho , Humanos , Aleitamento Materno/psicologia , Feminino , Relações Mãe-Filho/psicologia , Adulto , Depressão Pós-Parto/psicologia , Depressão/psicologia , Fórmulas Infantis , Lactente , Apego ao Objeto , Mães/psicologia , Estudos Longitudinais , Recém-Nascido , Gravidez , Alimentação com Mamadeira/psicologia
16.
Nutrients ; 16(7)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38613059

RESUMO

High protein intake during infancy results in accelerated early weight gain and potentially later obesity. The aim of this follow-up study at 12 months was to evaluate if modified low-protein formulas fed during early infancy have long-term effects on growth and metabolism. In a double-blinded RCT, the ALFoNS study, 245 healthy-term infants received low-protein formulas with either alpha-lactalbumin-enriched whey (α-lac-EW; 1.75 g protein/100 kcal), casein glycomacropeptide-reduced whey (CGMP-RW; 1.76 g protein/100 kcal), or standard infant formula (SF; 2.2 g protein/100 kcal) between 2 and 6 months of age. Breastfed (BF) infants served as a reference. At 12 months, anthropometrics and dietary intake were assessed, and serum was analyzed for insulin, C-peptide, and insulin-like growth factor 1 (IGF-1). Weight gain between 6 and 12 months and BMI at 12 months were higher in the SF than in the BF infants (p = 0.019; p < 0.001, respectively), but were not significantly different between the low-protein formula groups and the BF group. S-insulin and C-peptide were higher in the SF than in the BF group (p < 0.001; p = 0.003, respectively), but more alike in the low-protein formula groups and the BF group. Serum IGF-1 at 12 months was similar in all study groups. Conclusion: Feeding modified low-protein formula during early infancy seems to reduce insulin resistance, resulting in more similar growth, serum insulin, and C-peptide concentrations to BF infants at 6-months post intervention. Feeding modified low-protein formula during early infancy results in more similar growth, serum insulin, and C-peptide concentrations to BF infants 6-months post intervention, probably due to reduced insulin resistance in the low-protein groups.


Assuntos
Fórmulas Infantis , Resistência à Insulina , Humanos , Lactente , Peptídeo C , Seguimentos , Proteínas de Ligação ao GTP , Insulina , Fator de Crescimento Insulin-Like I , Lactalbumina , Aumento de Peso , Estudos Prospectivos
17.
Nutrients ; 16(7)2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38613084

RESUMO

Information on the effects of government nutrition programmes provided to socially vulnerable children to improve their nutritional status is scarce. We analysed the effectiveness of a nutritional programme, including food supplementation with infant formula, on the evolution of the weight and height of socially vulnerable children from Manaus in the Brazilian Amazon. This study included 7752 children aged 12-24 months admitted to the programme between 2017 and 2020. Weight and height measurements at admission and every three months thereafter were extracted from the programme database. Weight-for-age, weight-for-height, body mass index-for-age (BMI/A), and height-for-age z-scores were analysed using a multilevel linear regression model, which showed a statistically significant decrease in nutritional deficits toward nutritional recovery at follow-up. The programme's effectiveness was evaluated in 1617 children using a paired analysis comparing data from between 12 and 15 months of age at admission and follow-up after 6-9 months. Children admitted with wasting presented an increase in the BMI/A z-score, whereas children admitted with a risk of being overweight and obese had a statistically significant decrease in the BMI/A z-score. Children admitted with stunted growth also showed increased height-for-age z-scores. The nutrition programme was effective for children experiencing wasting and reducing excess weight.


Assuntos
Fórmulas Infantis , Estado Nutricional , Criança , Lactente , Humanos , Brasil , Índice de Massa Corporal , Caquexia , Suplementos Nutricionais
18.
Cell Host Microbe ; 32(4): 573-587.e5, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38569545

RESUMO

Microbiota assembly in the infant gut is influenced by diet. Breastfeeding and human breastmilk oligosaccharides promote the colonization of beneficial bifidobacteria. Infant formulas are supplemented with bifidobacteria or complex oligosaccharides, notably galacto-oligosaccharides (GOS), to mimic breast milk. To compare microbiota development across feeding modes, this randomized controlled intervention study (German Clinical Trial DRKS00012313) longitudinally sampled infant stool during the first year of life, revealing similar fecal bacterial communities between formula- and breast-fed infants (N = 210) but differences across age. Infant formula containing GOS sustained high levels of bifidobacteria compared with formula containing B. longum and B. breve or placebo. Metabolite and bacterial profiling revealed 24-h oscillations and circadian networks. Rhythmicity in bacterial diversity, specific taxa, and functional pathways increased with age and was strongest following breastfeeding and GOS supplementation. Circadian rhythms in dominant taxa were further maintained ex vivo in a chemostat model. Hence, microbiota rhythmicity develops early in life and is impacted by diet.


Assuntos
Fórmulas Infantis , Microbiota , Lactente , Feminino , Humanos , Fórmulas Infantis/microbiologia , Aleitamento Materno , Leite Humano , Bifidobacterium , Fezes/microbiologia , Oligossacarídeos/metabolismo , Ritmo Circadiano
19.
Compr Rev Food Sci Food Saf ; 23(3): e13337, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38578124

RESUMO

Whey protein hydrolysates are recognized for their substantial functional and biological properties. Their high digestibility and amino acid composition make them a valuable ingredient to hydrolyzed whey infant formulas, enhancing both product functionality and nutritional values for infant growth. It is important to understand the functional and biological properties of whey protein hydrolysates for their applications in infant formula systems. This review explored preparation methods of whey protein hydrolysates for infant formula-based applications. The effects of whey protein hydrolysate on the physicochemical and biological properties of hydrolyzed whey infant formulas were summarized. The influences of whey protein hydrolysates on the functional and nutritional properties of formulas from manufacturing to infant consumption were discussed. Whey protein hydrolysates are crucial components in the preparation of infant formula, tailored to meet the functional and nutritional demands of the product. The selection of enzyme types and hydrolysis parameters is decisive for obtaining "optimal" whey protein hydrolysates that match the intended characteristics. "Optimal" whey protein hydrolysates offer diverse functionalities, including solubility, emulsification and production stability to hydrolyzed whey infant formulas during manufacturing processes and formulations. They simultaneously promote protein digestibility, infant growth and other potential health benefits, including reduced allergenic potential, as supported by in vitro, in vivo and clinical trials. Overall, the precise selection of enzymes and hydrolysis parameters in the production of whey protein hydrolysates is crucial in achieving the desired characteristics and functional benefits for hydrolyzed whey infant formulas, making them critical in the development of infant nutrition products.


Assuntos
Fórmulas Infantis , Hidrolisados de Proteína , Lactente , Humanos , Fórmulas Infantis/química , Hidrolisados de Proteína/química , Soro do Leite , Proteínas do Soro do Leite/química , Alérgenos
20.
Food Chem Toxicol ; 188: 114677, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38641042

RESUMO

Consumption of rice-based foods provides essential nutrients required for infants and toddlers' growth. However, they could contain toxic and excess essential elements that may affect human health. The study aims to determine the composition of rice-based baby foods in the USA and outside and conduct a multiple-life stages probabilistic exposure and risk assessment of toxic and essential elements in children. Elemental concentrations were measured using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in thirty-three rice-based baby foods. This includes 2 infant formulas, 11 rice baby cereals, and 20 rice snacks produced primarily in the United States, China, and other countries. A probabilistic risk assessment was conducted to assess risks of adverse health effects. Results showed that infant formula had higher median concentrations of selenium (Se), copper (Cu), zinc (Zn), sodium (Na), magnesium (Mg), calcium (Ca), and potassium (K) compared to rice baby cereal and rice snacks. On the contrary, rice snacks had the highest median concentration of Arsenic (As) (127 µg/kg) while rice baby cereals showed the highest median concentration of Cd (7 µg/kg). A higher lifetime estimated daily intake was observed for samples manufactured in the USA compared to those from China and other countries. Hazard quotient (HQ < 1) values were suggestive of minimal adverse health effects. However, lifetime carcinogenic risk analysis based on total As indicated an unacceptable cancer risk (>1E-04). These findings show a need for ongoing monitoring of rice-based foods consumed by infants and toddlers as supplementary and substitutes for breast milk or weaning food options. This can be useful in risk reduction and mitigation of early life exposure to improve health outcomes.


Assuntos
Alimentos Infantis , Oryza , Oryza/química , Humanos , Estados Unidos , Alimentos Infantis/análise , Medição de Risco , Lactente , Contaminação de Alimentos/análise , Oligoelementos/análise , China , Fórmulas Infantis/química
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