Development of the immune system in the human embryo.

The fetal immune system is highly specialized which is to generate both tolerogenic and protective immune responses to tolerate both self- and maternal-antigens. Fetal T cells with pro-inflammatory potential are born in a tolerogenic environment and are tightly controlled by both cell-intrinsic and -extrinsic mechanisms. Fetal B-1 and B-2 B cells involved in innate and adaptive immune responses, respectively, arise in staggered waves of development from distinct progenitors. Innate immune responses are the key to the protection against infection and adaptive immunity creates memory after an initial response to a specific pathogen. This review aims to discuss the recent advances in understanding the development of immune system in fetus. IMPACT: During gestation, essential developmental changes occur to survive the neonates. At early stage, developmental signals and changes may be influenced due to immune deficiencies.

Assessment of complementary feeding of Canadian infants: effects on microbiome & oxidative stress, a randomized controlled trial.

BACKGROUND: The World Health Organization recommends exclusive breastfeeding until 6 months followed by introduction of iron-rich complementary foods (CFs). The aim of this study was to determine the impact of different iron-rich CFs on infant gut inflammation and microbiota. METHODS: Eighty-seven exclusively breastfed infants were randomly assigned to receive one of the following as their first CF: iron-fortified cereal (Cer), iron-fortified cereal with fruit (Cer + Fr), or meat (M). Urine and stool samples were collected to assess reactive oxygen species (ROS) generation, gut microbiota and inflammation. RESULTS: Fecal iron differed across feeding groups (p < 0.001); levels were highest in the Cer group and lowest in M group. A significant increase of fecal ROS formation (p < 0.002) after the introduction of CFs was observed, but did not differ across feeding groups. Fecal calprotectin increased within all groups after the introduction of CFs (p = 0.004). Gut microbiota richness increased after introduction of M or Cer + Fr. Regardless of feeding group, Coriobacteriaceae were positively correlated with ROS and Staphylococcaceae were negatively correlated with calprotectin. CONCLUSIONS: Choice of first CF may influence gut inflammation and microbiota, potentially due to variations in iron absorption from different foods. Further research is warranted to fully characterize these associations and to establish implications for infant health. This study was registered in the ClinicalTrial.gov registry (Identifier No. NCT01790542 ). TRIAL REGISTRATION: This study was registered in the ClinicalTrial.gov registry under the name "Assessment of Complementary Feeding of Canadian Infants" (Identifier No. NCT01790542 ) February 6, 2013.

Age of introduction of first complementary feeding for infants: a systematic review.

BACKGROUND: Despite a World Health Organization recommendation for exclusive breastfeeding of all full-term infants to 6 months of age, it is not clear what the health implications may be. Breast milk alone may not meet the nutrition needs for all growing infants, leaving them at risk for deficiencies. The objective of this study was to investigate the relationship between moderate (4 months) versus late (6 months) introduction of complementary foods to the full-term breastfed infant on iron status and growth. METHODS: An electronic search of peer-reviewed and gray-literature was conducted for randomized control trials (RCTs) and observational studies related to the timing of introduction of complementary foods. Iron status and growth data from the relevant RCTs were analyzed using RevMan 5.2.11. RESULTS: Three RCTs and one observational study met the inclusion criteria. Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95% CI: 1.5, 8.5 g/L; P = 0.005]. Meta-analysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 µg/L; 95% CI: -0.1, 52.1 µg/L, P = 0.050], [MD: 18.9 µg/L; 95% CI: 0.7, 37.1 µg/L, P = 0.040]. Short follow-up periods and small sample sizes of the included studies were the major limitations. CONCLUSIONS: RCT evidence suggests the rate of iron deficiency anemia in breastfed infants could be positively altered by introduction of solids at 4 months.

Awareness of celiac disease among the public in Kuwait: a cross-sectional survey.

OBJECTIVE: Health literacy levels among the general population predict better health outcomes and uptake of health services. Inequities in health literacy and uptake of health services are often observed in deprived neighborhoods. There is a paucity of data on literacy regarding celiac disease in Kuwait. Therefore, the present survey aims to address this paucity of data. RESULTS: We conducted a survey of 350 respondents in six governates of Kuwait. Although around 51% of respondents were aware of peanut allergy and gluten sensitivity, less than 15% were aware of celiac disease. More than 40% of respondents reported that a gluten-free diet should be promoted for everyone. Better awareness regarding CD was associated with Kuwaiti nationality, higher education levels and higher age. Among different governates, residents of Al-Asimah reported the highest awareness levels, while the rest of the governates did not differ significantly. While eating behavior did not significantly predict awareness regarding CD.

Effects of Total Enteral Nutrition on Early Growth, Immunity, and Neuronal Development of Preterm Infants.

The feeding of colostrum and mother's transitional milk improves immune protection and neurodevelopmental outcomes. It also helps with gut maturation and decreases the risks of infection. The supply of nutrients from human milk (HM) is not adequate for preterm infants, even though preterm mother's milk contains higher concentrations of protein, sodium, zinc, and calcium than mature HM. The human milk fortifiers, particularly those with protein, calcium, and phosphate, should be used to supplement HM to meet the necessities of preterm infants. The management of fluid and electrolytes is a challenging aspect of neonatal care of preterm infants. Trace minerals such as iron, zinc, copper, iodine, manganese, molybdenum, selenium, chromium, and fluoride are considered essential for preterm infants. Vitamins such as A, D, E, and K play an important role in the prevention of morbidities, such as bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage. Therefore, supplementation of HM with required nutrients is recommended for all preterm infants.

Evaluation of the Partial Replacement of Dietary Fish Meal With Fermented or Untreated Soybean Meal in Juvenile Silver Barb, Barbonymus gonionotus.

Fish meal (FM) has excellent protein and lipid profile. However, FM is losing its acceptability and substituted with plant protein due to FM has high price, high demand, and sustainability issues in global aquaculture production. In this study, experimental diets were prepared by substituting FM with fermented soybean meal (FSM) or normal and untreated soybean meal (SM) to assess the effects on growth, hematology, innate immunity, gut physiology, and digestive enzyme activities in juvenile silver barb, Barbonymus gonionotus. Five diets, that is, 40% FM (FM 40), 20% FM + 20% FSM (FM 20 + FSM 20), 20% FM + 20% SM (FM 20 + SM 20), 40% FSM (FSM 40), and 40% SM (SM 40) were fed to the fish two times daily for 90 days. After 90 days of feeding trial, FM 40, FM 20 + FSM 20, and FM 20 + SM 20 diet groups showed significantly higher weight gain (WG) and specific growth rate (SGR) compared to the FSM 40 and SM 40 diets. Hepatosomatic index (HSI) and viscerosomatic index (VSI) were significantly higher in fish fed with the FSM 40 and SM 40 diets than those of fish fed with the FM 40 diet. Hematocrit, hemoglobin, and erythrocyte count were significantly lower in fish fed with the SM 40 diet compared to fish fed with the FM 40 and FM 20 + FSM 20 diets. Superoxide dismutase and catalase activities in the liver were significantly higher in fish fed with the SM 40 diet compared to fish fed with the FM 40 diet. However, serum thiobarbituric acid reactive substances in fish fed with the experimental diets were unaltered. Fish showed significant reduction of villus height (Vh) in the anterior and posterior intestine of fish fed with the FSM 40 and SM 40 diets, whereas muscular thickness was opposite to the findings of Vh. Digestive enzyme activities in intestine were significantly higher in fish fed with the FM 40 diet compared to those in the SM 40 diet. The results of the present study revealed that the 50% of FM can be replaced by FSM or SM as a source of protein without affecting the growth of juvenile silver barb.

Iron and the Breastfed Infant.

The first 6 months of life is a crucial time in meeting iron needs. The purpose of this review is to examine iron in mother's milk and whether or not it meets the physiological needs of the growing infant. Key issues include iron content and iron transport from the mammary gland as well as when and what foods should be added to the solely breastfed infant. We examine these topics in light of new molecular biology findings in the mammary gland.

An Overview of Iron in Term Breast-Fed Infants.

BACKGROUND: Iron is an essential nutrient for normal growth and neurodevelopment of infants. Iron deficiency (ID) remains the most common micronutrient deficiency worldwide. There are convincing data that ID is associated with negative effects on neurological and psychomotor development. OBJECTIVES: In this review, we provide an overview of current knowledge of the importance of iron in normal term breast-fed infants with a focus on recommendations, metabolism, and iron requirements. CONCLUSIONS: Health organizations around the world recommend the introduction of iron-rich foods or iron supplements for growing infants to prevent ID. However, there is no routine screening for ID in infancy. Multicenter trials with long-term follow-up are needed to investigate the association between iron fortification/supplementation and various health outcomes.