We investigated the selenium (Se) nutrition status in Korean infants. The mean serum Se concentration in infants was 66.9 ${\mu}g/L$, and it increased with increasing in infant age: 57.6 ${\mu}g/L$ at 0-5 months, 71.8 ${\mu}g/L$ at 6-11 months, and 75.5 ${\mu}g/L$ at 12-24 months. Serum glutathione peroxidase (GPx) activity also increased with infant age. Serum Se concentration in infants was positively correlated with serum GPx activity (r = 0.565, p < 0.01). At 0-5 months, human milk-fed infants tended to have higher Se concentrations and GPx activity than those of formula-fed infants, but the result was not significant. With the introduction of supplemental feeding at 6-24 months of age, serum Se concentration was not different between the groups. Therefore, human milk feeding seemed to be more appropriate for infant Se nutrition than infant formula feeding during the first 6 months of life, but supplemental feeding became more important later to maintain good Se nutrition status.
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%-5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.
This study was conducted to investigate the concentrations and infants intake of sodium and potassium from human milk during the first 5 months of lactation. The sodium concentrations of the milk during the lactation appeared 21.1, 18.1, 15.9, 12.4, 10.6 and 11.4 mg/100g at 0.5, 1, 2, 3, 4, and 5 months of lactation respectively. The potassium concentrations of the milk 48.5, 43.3, 40.8, 39.9, 40.5 and 38.5 respectively, Na/K ratio of the milk were 0.76, 0.75, 0.70, 0.56, 0.46 and 0.53(mEqu\\mEq). Sodium intakes of breast-fed infants were 106.9, 108.4, 90.6, 82.5 and 95.6mg/day during the lactation. Potassium intakes of the infants were 255.7, 276.0, 289.7, 294.6, 320.3 and 318.3mg/day. Sodium and potassium concentrations in infant formula averaged 23.62 and 67.61 mg/100g which was 1.90 and 1.69 times as those of breast milk at 3 month of lactation. Commercial whole milks had 39.53 and 135.22mg/100g of sodium and potassium respectively which was 3.19 and 3.39 times as those of the milk. From this study, reevaluation of sodium and potassium intakes if breast-fel infants was merited and the regulation of that minerals in infant formula is need to lower the renal solute load of formula-fed infants.(Korean J Nutrition 34(1):23-29, 2001)
The objectives of this study were to examine the growth pattern of infants by anthropometric measurement according to the 5 feeding practices of infants with the subject of two hundred healthy newborn babies from their birth till sixty month of age at intervals of two months. Breast group(BF, n=38), formula group(FF, n=102) and mixed group(ME, n=14) were fed breast milk, formula milk, breast and formula milk, from birth till 6 mo. of age, respectively. Convert 1 group (C1F, n=14) and covert 2 group(CF, n=32) were fed breast milk and mixed milk at 2 mo. of age afterthat switched to formula milk, respectively. From these, the following results were made. All the infants of this study showed superiority to Korean standard growth rate in regards to each growth item for each month age. In the case of males, at their birth, the subscapular skinfold thickness and the total skin fold thickness in the BF group was significantly larger than in MF group and FF group(p<0.05). At 6th month age, the chese circumference of MF group was 45.9cm, and significantly larger than those of BF, FF and C2F groups(p<0.05). In the case of females, at theri birth and 2nd month age, there was no difference among all the feeding groups in regards to each growth rate. At 4th month age, the Kauf index of C1F group was 16.21 and significantly lower than those of four groups(p<0.05). And total skinfold thickness in BF group was larger than in C1F group. The increase rate per month age of all growth items were larger at 2nd month age than at the later months both in males and in females. And until 2nd month age males showed more increase than females in regards to each growth item but after 2nd month age, this sapect did not show up. Multiple linear regression was used to determine predictive factors for infant growth. It was expected that at 6th month age, in the measurement of head circumference and chest circumference and cross-sectional fat area, BF-males were bigger by 22-39% of the explanation index than the infants of other groups. As a result, in spite of the significant lower intakes of energy and nutrients in breast-fed infants than in formula-fed infants, breast-fed infants showed more growth than the average of Korean infant standard growth rate at every month age, and showed no significant growth difference among feeding groups.
Purpose: The present study assessed the role of an amino acid-based formula (AAF) in the growth of infants with cow's milk protein allergy (CMPA). Methods: Non-breastfed, term infants aged 0-6 months with symptoms suggestive of CMPA were recruited from 10 pediatric centers in China. After enrollment, infants were started on AAF for two weeks, followed by an open food challenge (OFC) with cow's milk-based formula (CMF). Infants with confirmed CMPA remained on AAF until 9 months of age, in conjunction with a cow's milk protein-free complementary diet. Body weight, length, and head circumference were measured at enrollment and 9 months of age. Measurements were converted to weight-for-age, length-for-age, and head circumference-for-age Z scores (WAZ, LAZ, HCAZ), based on the World Health Organization growth reference. Results: Of 254 infants (median age 16.1 weeks, 50.9% male), 218 (85.8%) were diagnosed with non-IgE-mediated CMPA, 33 (13.0%) tolerated CMF, and 3 (1.2%) did not complete the OFC. The mean WAZ decreased from 0.119 to -0.029 between birth and enrollment (p=0.067), with significant catch-up growth to 0.178 at 9 months of age (p=0.012) while being fed the AAF. There were no significant changes in LAZ (0.400 vs. 0.552; p=0.214) or HCAZ (-0.356 vs. -0.284; p=0.705) from the time of enrollment to age 9 months, suggesting normal linear and head growth velocity. Conclusion: The amino acid-based study formula, in conjunction with a cow's milk proteinfree complementary diet, supported normal growth till 9 months of age in a cohort of Chinese infants with challenge-confirmed non-IgE-mediated CMPA.
Purpose : A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil $HMF^{(R)}$; Maeil Dairies Co., Ltd.). Methods : We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with $HMF^{(R)}$, and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. Results : Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day ($8.00{\pm}3.27d$ vs. $8.86{\pm}5.37d$) (P=0.99) and the number of days required to reach full feeding after start feeding ($41.78{\pm}20.47d$ vs $36.86{\pm}20.63d$) (P=0.55) were not significantly different in the group fed human milk fortified with $HMF^{(R)}$ when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with $HMF^{(R)}$ showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post-discharge follow up growth indices. Conclusion : Premature infants fed human milk fortified with $HMF^{(R)}$ showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.
To understand the formation of initial gut microbiota, three initial fecal samples were collected from two groups of two breast milk-fed (BM1) and seven formula milk-fed (FM1) infants, and the compositional changes in gut microbiota were determined using metagenomics. Compositional change analysis during week one showed that Bifidobacterium increased from the first to the third fecal samples in the BM1 group (1.3% to 35.1%), while Klebsiella and Serratia were detected in the third fecal sample of the FM1 group (4.4% and 34.2%, respectively), suggesting the beneficial effect of breast milk intake. To further understand the compositional changes during progression from infancy to childhood (i.e., from three weeks to five years of age), additional fecal samples were collected from four groups of two breast milk-fed infants (BM2), one formula milk-fed toddler (FM2), three weaning food-fed toddlers (WF), and three solid food-fed children (SF). Subsequent compositional change analysis and principal coordinates analysis (PCoA) revealed that the composition of the gut microbiota changed from an infant-like composition to an adult-like one in conjunction with dietary changes. Interestingly, overall gut microbiota composition analyses during the period of progression from infancy to childhood suggested increasing complexity of gut microbiota as well as emergence of a new species of bacteria capable of digesting complex carbohydrates in WF and SF groups, substantiating that diet type is a key factor in determining the composition of gut microbiota. Consequently, this study may be useful as a guide to understanding the development of initial gut microbiota based on diet.
Purpose: The aim of this study was to identify the minimally meaningful dosage of inulin leading to a prebiotic effect in Indonesian infants. Methods: In a randomized controlled double-blinded, parallel, 3-arm intervention study, 164 healthy formula-fed infants aged 3 to 5 months first obtained formula-A (without inulin) during a 4-week adaptation period. Subsequently, 142 subjects were subjected to a 4-week feeding period by administering either formula-A (no inulin), formula-B (0.2 g/100 mL inulin) or formula-C (0.4 g/100 mL inulin). The primary outcome parameter was %-bifidobacteria in faecal samples determined using quantitative polymerase chain reaction analyses. Secondary outcome parameters were faecal %-lactobacilli, pH and stool frequency, and consistency. Growth and tolerance/adverse effects were recorded as safety parameters. Results: Typical %-bifidobacteria and %-lactobacilli at the end of the adaptation period in the study population were 14% and 2%, respectively. For faecal pH, significant differences between formula groups A vs. C and A vs. B were found at the end of the intervention period. Testing for differences in faecal %-bifidobacteria and %-lactobacilli between groups was hampered by non-normal data set distributions; no statistically significant differences were obtained. Comparisons within groups revealed that only in formula group C, all the three relevant parameters exhibited a significant effect with an increase in faecal %-bifidobacteria and %-lactobacilli and a decrease in pH. Conclusion: A consistent prebiotic effect along with a decrease in pH and increase in %-bifidobacteria and %-lactobacilli was found only in the group administered 0.4 g inulin/100 mL.
This study compares the growth performance(weight-for-age Z-score, height-for-age Z-score, weight-for-height Z-score) of one- to three- month-old Korean infants(n=232) with the Korean standard(1994) and NCHS reference(1983). The weight-for-age Z-scores(WAZ) by the Korean standard were -2∼1,5 for males and -3∼1 for females. The NCHS reference, WAZ results were -1∼2.5 and -2.5∼3.5 for males and females, respectively. The WAZ compared Korean standard showed no subjects with overnutrition. But 1.3% of the infants showed signs of malnutrition. Comparison with NCHS reference revealed that 0.4% of the infants were malnourished and 7.0% of the infants were overnourished. The WAZ of formula-fed infants were distributed higher than breast-fed infants, but that was not significant. The height-for-age Z-score(HAZ) by the Korean standard were -4.5%∼1.5% for males and -4∼1.5% for females. According to the NCHS reference, HAZ were -2.5%∼2.5% and -3∼3 for males and females, respectively. When the WAZ was compared with the Korean standard, there was no overnutrition but 16% of the infants showed signs of malnutrition. The NCHS reference, revealed that 6.9% of the infants were malnourished and 1.8% of the infants were ovemourished. The weight-for-height Z-scores(WHZ) by the Korean standard were -2∼5 for males and -2.5∼5 for females. The NCHS reference WAZ scores were -1∼4 and -1.5∼4.5 for males and females, respectively. When the WHZ was compared with the Korean standard, 2.2% of infants were malnourished and 19.5% were overnourished. There were no malnourished subjects according to the NCHS reference and 19.1% of the infants were overnourished. When the three Z-scores are considered together, 92.0% of the infants should a normal growth status, there was no malnutrition, and 8.0% of the infants were overnourished. The growth performance was evaluated differently according to the type of standards. Thus, it is necessary to set proper growth standards for infants, according to which classification of feeding methods is chosen. A longterm and careful assessment of infants's growth performances to develop any group of standards.
Preterm infants are frequently discharged from the hospital with growth retardation. Given the potentially lifelong effects of growth impairmnet during a critical time of development, considerable effort should be focused on improving growth after discharge. Growth monitoring must be based on regular measurements of weight, length, and head circumference to identify those preterm infants with poor growth that may need additional nutritional support. Although prior studies vary in design and the intervention used, the evidence supports the use of fortified formulas in formula-fed preterm infants after discharge. The situation for infants fed human milk is much less clear, it seems prudent to concentrate our efforts on the encouragement of breast-feeding in this population. Catch up growth may have many benefits, and may lead to improved development. However, its long-term metabolic consequences are currently unclear. Understanding the optimal means of providing nutrition after discharge is an ongoing process.
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