Hydrolyzed Formula Compared With Standard Formula for Preterm Infants.

CLINICAL QUESTION: For preterm infants, is hydrolyzed formula associated with lower rates of feeding intolerance, lower rates of necrotizing enterocolitis, and faster rates of growth compared with standard cow's milk formula? BOTTOM LINE: Compared with standard formula, feeding preterm infants hydrolyzed formula is not associated with a lower rate of feeding intolerance, a lower rate of necrotizing enterocolitis, or with faster growth.

[Clinical characteristics and risk factors for feeding intolerance in preterm infants].

OBJECTIVE: To investigate the clinical characteristics and risk factors for feeding intolerance (FI) in preterm infants and to provide evidence for early identification, effective prevention and treatment of FI.
 Methods: A total of 116 preterm infants were recruited in the Department of Neonatology, West China Second Hospital, Sichuan University, from July 2016 to December 2016. Self-designed "the clinical observation table for feeding intolerance of preterm infant" was used to find out the main risk factors of FI in preterm infants.
 Results: 1) There were 62 cases of FI. The incidence of FI in preterm infants was 53.45% (62/116). It was 44.93% (31/69) and 65.96% (31/47) for males and females, respectively, with significant difference between them (P<0.05). The incidence of FI in very low birth weight infants was 48.57% (34/70), and in the extremely low birth weight infant was 88.89% (8/9). FI in preterm infants mainly occurred in the period of being fed within 48-72 h. The symptoms included abdominal distension, gastric retention, vomiting and stomach brown color for clinical manifestations. Among them, abdominal distension was the main clinical manifestation. 2) The logistic multivariate regression analysis showed that birth weight <1 000 g (P<0.05), the use of caffeine citrate (P<0.05) and the formula feeding (P<0.05) were the main risk factors for FI.
 Conclusion: The incidence of FI is very high in preterm infants. Birth weight <1 000 g, the use of caffeine citrate, and formula feeding are main risk factors for FI.

[Improving the control of food allergy and intolerance risks in school settings: qualitative inputs from focus groups]. / Mejorando el control del riesgo por alergias e intolerancias alimentarias en los comedores escolares: aportaciones cualitativas de los grupos focales.

This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families.

Probiotics for preterm infants - time to end all controversies.

Mortality, necrotising enterocolitis (NEC), late onset sepsis (LOS) and feeding intolerance are significant issues for very preterm (< 32 weeks) and extremely preterm (< 28 weeks) infants. The complications of ≥ Stage II NEC [e.g. Resection of the gangrenous gut, survival with intestinal failure, recurrent infections, prolonged hospital stay, and long-term neurodevelopmental impairment (NDI)] impose a significant health burden. LOS also carries significant burden including long-term NDI due to adverse effects of inflammation on the preterm brain during the critical phase of development. Frequent stopping of feeds due to feeding intolerance is a significant iatrogenic contributor to postnatal growth failure in extremely preterm infants. Over 25 systematic reviews and meta-analyses of RCTs (~12 000 participants) have reported that probiotics significantly reduce the risk of all-cause mortality, NEC ≥ Stage II, LOS and feeding intolerance in preterm infants. Systematic reviews and meta-analysis of non-RCTs have also shown that the benefits after adopting probiotics as a standard prophylaxis for preterm infants are similar to those reported in RCTs. No intervention comes close to probiotics when it comes to significant reduction in death, NEC, LOS and feeding intolerance at a cost of less than a dollar a day irrespective of the setting and baseline incidence of NEC. The common controversies that are preventing the rapid uptake of probiotics for preterm infants are addressed in this paper.

Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance.

There are concerns around safety and tolerance of powder human milk fortifiers to optimize nutrition in preterm infants. The purpose of this study was to evaluate the tolerance and safety of a concentrated preterm formula (CPF) as a liquid human milk fortifier (HMF) for premature infants at increased risk of feeding intolerance. We prospectively enrolled preterm infants over an 18-month period, for whom a clinical decision had been made to add CPF to human milk due to concerns regarding tolerance of powder HMF. Data on feed tolerance, anthropometry, and serum biochemistry values were recorded. Serious adverse events, such as mortality, necrotizing enterocolitis (NEC), and sepsis, were monitored. A total of 29 babies received CPF fortified milk during the study period. The most common indication for starting CPF was previous intolerance to powder HMF. Feeding intolerance was noted in 4 infants on CPF. The growth velocity of infants was satisfactory (15.9 g/kg/day) after addition of CPF to feeds. The use of CPF as a fortifier in preterm babies considered at increased risk for feed intolerance seems well tolerated and facilitates adequate growth. Under close nutrition monitoring, this provides an additional option for human milk fortification in this challenging subgroup of preterm babies, especially in settings with limited human milk fortifier options.

Evaluación de la harina de chachafruto como ingrediente para la elaboración de un producto libre de gluten / Evaluation of chachafruto flour as an ingredient for the elaboration of a gluten-free product

Introducción: los productos de panificación utilizan harina de trigo la cual contiene gluten. Algunas personas son intolerantes específicamente a las proteínas del gluten que generan enfer-medades como colon irritable y problemas gastrointestinales.El chachafruto es el fruto del árbol llamado Erythrina edulis, planta catalogada como leguminosa y su fruto como legumbre. Esta le-gumbre se considera un alimento esencial ya que posee nutrientes y proteínas, y es una opción de alimentación porque no contiene gluten. Su contenido de grasa es bajo y de proteínas alto. Objetivos: evaluar la utilización de la harina de chachafruto en la elaboración de un producto libre de gluten. Materiales y métodos: la harina de chachafruto se consigue al separar las semillas de la vaina, luego se lavan y desinfectan para eliminar impurezas y se llevan a escaldado con agua caliente du-rante 5 minutos. Posteriormente se realiza el pelado mecánico y se remueve la testa manualmente; después se cortan las semillas en forma de rodaja en la cortadora con un espesor de 3 mm y se pasan a un deshidratador de bandejas. El secado se lleva acabo a temperaturas de 50 y 60°C aproximadamente por 12 horas. Resultados: la adición de harina de chachafruto cambió consi-derablemente algunos parámetros de las mezclas para 15% ha-rina de chachafruto y 85% harina de amaranto en las proteínas con 8,00±2,52% y cenizas con 1,80±0,02%, y para la mezcla de 15% harina de chachafruto y 85% harina de arroz cambió 7,38±2,16% y 1,39±0,00% respectivamente. Conclusiones: este estudio demostró que el empleo de harina de chachafruto puede utilizarse efectivamente como reempla-zante de la harina de trigo dado que los resultados obtenidos favorecen la fabricación de productos para reemplazar total-mente la harina de trigo por harinas sin gluten.

Mejorando el control del riesgo por alergias e intolerancias alimentarias en los comedores escolares: aportaciones cualitativas de los grupos focales / Improving the control of food allergy and intolerance risks in school settings: qualitative inputs from focus groups

Este trabajo describe la aplicación de la técnica de grupos focales a la evaluación de los programas de control de riesgos por alergias e intolerancias alimentarias (AIA) en los comedores escolares de Barcelona. Tras impulsar su implantación, y como un componente cualitativo de su evaluación, los servicios de salud pública realizaron dos grupos focales, uno con personas procedentes de escuelas que gestionan su propia cocina y otro con personas de empresas externas que gestionan este servicio. Participaron 28 personas de un 46% de los centros invitados. Todas las escuelas parecen haber implantado un programa de autocontrol de AIA. Aunque las empresas gestoras externas solían contar ya con él, la mayoría de las escuelas que gestionan su propia cocina no lo tenía y adoptó el programa propuesto por los servicios de salud pública. El número de escolares con alguna AIA notificada disminuyó tras el programa, al exigir este un mayor rigor en su documentación

This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families