• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.sup1
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• pp.53-61
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• 2009

The mainstay in the management of mild to moderately dehydrated children is fast rehydration by using hypotonic ORS (oral rehydration solution) and complete resumption of normal diet, including lactose-containing formula after 4 hours rehydration. Since the majority of young children with uncomplicated acute diarrhea will tolerate large amounts of undiluted non-human milk, withholding food and milk from children during diarrhea is not recommended anymore, regarding time to resolution and diarrhea control. In addition, routine dilution of milk and routine use of lactose-free formula are not necessary after fast ORS therapy. Breastfed infants and children fed with solid foods may safely continue receiving their usual diets during diarrhea instead of gradual reintroduction of feeding. However, young infants or children with severe diarrhea or malnutrition should be carefully treated under supervision if fed with lactose containing, non-human milk exclusively.

• Journal of Dairy Science and Biotechnology
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• v.27 no.1
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• pp.1-12
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• 2009

In 2008, baby formula containing melamine was found to be responsible for a large outbreak of renal failure in infants in China. A total of 294,000 infants were hospitalized, and at least 6 babies died due to ingestion of the tainted formula. Melamine contains high levels of nitrogen (>60%), which is used as an indicator of protein content. Therefore, high levels of melamine in infant formula were thought to be the result of deliberate contamination m an attempt to increase its apparent protein content. Following inspections by China's national inspection agency, assorted products from at least 22 dairy manufacturers across China were found to have varied levels of melamine (range: 0.096196.61 mg/kg). Melamine co-exposure with cyanuric acid can induce acute melamine-cyanurate crystal nephropathy, which can lead to renal failure at much lower doses than if either compound were ingested alone. However, currently, there are very few data on melamine analogues other than cyanuric acid. At an expert meeting of the WHO and FAO held to review toxicological aspects of melamine and cyanuric acid on December 14, 2008, a new tolerable daily intake (TDI) of melamine was established that could be applied to the entire population, including infants. Therefore, a risk assessment of the various theoretical melamine contamination levels in infant formula and selected representative foods (other than infant formula and sole-source nutrition products) is urgently needed for Korean babies and children up to 7 years of age. Although the undetectable level regulation for infant formula may be low enough to guarantee the safety of babies under the age of 1 year (including premature babies), the melamine standard of 2.5 ppm for foods other than baby formula could be insufficient to protect the 95th percentile population aged 1~2 years because of this demographic's high consumption of milk, yogurt, and soy milk (hazard index = 1.79). Because TDIs are chronic values intended to protect an individual over his/her lifetime, occasional modest ingestion in excess of the TDI is not likely to be a health concern. However, children aged 1~2 years may have renal systems that are comparatively more sensitive to the crystallization of melamine and its analogues. Therefore, governmental jurisdictions may need to practice more prudent management of food items that could raise the melamine exposure for this population.

• Korean Journal of Community Nutrition
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• v.1 no.1
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• pp.47-60
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• 1996

This study was carried out to investigate growth performance, energy and protein metabolism of breast and formula fed infants from birth to 3 months postpartum. There were four groups : breast fed(BF) and three formula fed groups(FFM, FFN and FFP). There was no significant difference in the height of infants according to feeding method and formula brands. However, mean weight of FFM was significantly higher than that of FFP and BF at 1 and 3 months postpartum, respectively. Mean head circumference of FFN was lowest among groups. The average intake of breast milk was $781.4{\;}{pm}{\;}119.3m{\ell}/day$ and that of formula was $848.6{\;}{pm}{\;}118.5m{\ell}/day$. Mean apparent digestible energy intakes of formula-fed infants and breast-fed infants during 3months were 568.9 $\pm$146.9 kca1/day and 657.9$\pm$212.8 kca1/day, respectively. The average protein intake of brest-fed and formula-fed infants were 8.3$\pm$1.6g/day and 14.1$\pm$14.1 g/day, respectively. The protein intakes of formula-fed infants were significantly higher than those of breast-fed infants at 1, 2, 3 months. The apparent protein digestibility of breast-fed infants was singnificantly higher compared to formula fed infant. These data suggest that RDA for infants be established and breast feeding be encouraged.

• Clinical and Experimental Pediatrics
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• v.59 no.12
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• pp.466-470
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• 2016

Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the clinical course of the infant. During hospitalization, enteral nutrition with preterm formula and fortified human milk represent the best feeding practices for facilitating growth. After discharge, the enteral nutrition strategy should be individualized according to the infant's weight at discharge. Infants with suboptimal weight for their postconceptional age at discharge should receive supplementation with human milk fortifiers or nutrient-enriched feeding, and the enteral nutrition strategy should be reviewed and modified continuously to achieve the target growth parameters.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.5
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• pp.277-283
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• 2023

Purpose: Cow's milk protein allergy (CMPA) is a common condition in infants, but little is known about healthcare providers' clinical experience treating infants with CMPA. To address this gap, we analyzed prospectively collected data from healthcare providers (HCPs) who treated infants under six months old with suspected CMPA using hypoallergenic formulas. The study focused on a commercial extensively hydrolyzed formula containing Lactobacillus rhamnosus GG (ATCC53103) (eHF-LGG) or a commercial amino acid formula (AAF). Methods: In this secondary analysis of prospectively collected survey data, 52 HCPs treated 329 infants under six months old with suspected CMPA using hypoallergenic formulas. A series of two de-identified surveys per patient were collected by HCPs to assess short-term symptom relief in the patients and HCP's satisfaction with the management strategies. The initial survey was completed at the initiation of treatment of CMPA, and the second survey was completed at a follow-up visit. Results: The majority of HCPs (87%) in the study were general pediatricians, and most saw 2 to 10 CMPA patients weekly. Results showed that clinicians reported satisfaction with treatment in 95% of patients in the EHF cohort and 97% of patients in the AAF cohort and achieved expected clinical results in 93% and 97% of patients using eHF and AAF, respectively. Furthermore, few patients were switched from the hypoallergenic formula once initiated. Conclusion: The study provides new insights into HCP perspectives on treating infants with CMPA and supports using hypoallergenic formulas to manage this condition. However, additional prospective controlled studies are needed to confirm these initial findings.

• Food Science of Animal Resources
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• v.37 no.1
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• pp.79-86
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• 2017

Aflatoxin $M_1$ ($AFM_1$) after its bioconversion from aflatoxin $B_1$ in animal liver becomes the part of milk while heavy metals get entry into milk and milk products during handling in the supply chain. Aflatoxin $M_1$ and heavy metals being toxic compounds are needed to be monitored continuously to avoid any ailments among consumers of foods contaminated with such toxicants. Thirteen commercially available infant formula milk (IFM) brands available in Pakistani markets were analyzed for the quantitative determination of $AFM_1$ and heavy metals through ELISA and atomic absorption spectrophotometer, respectively. $AFM_1$ was found positive in 53.84% samples while 30.76% samples were found exceeding the maximum EU limit i.e. $0.025 {\mu}g/kg$ for $AFM_1$ in IFM. Heavy metals lead (Pb) and cadmium (Cd) were found below the detection limits in any of the sample, whereas the concentrations of iron (Fe), zinc (Zn) and nickel (Ni) ranged between 45.40-97.10, 29.72-113.50 and <$0.001-50.90 {\mu}g/kg$, respectively. The concentration of Fe in all the tested brands was found in normal ranges while the concentrations of Zn and Ni were found exceeding the standard norms. Elevated levels of $AFM_1$, Zn and Ni in some of the tested IFM brands indicated that a diet completely based on these IFM brands might pose sever health implications in the most vulnerable community i.e., infants.

• Journal of Nutrition and Health
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• v.28 no.4
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• pp.321-330
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• 1995

Concentrations of total vitamin B-6 in human milk as well as individual, B-6 vitamers have important implications for the nutritional management of breast-fed(BF) infants. Vitamin B-6 status was assessed in 3 groups of infants : two groups preterm (PT) BF infants whose mothers were supplemented with 2 or 27mg pyridoxine(PN)-HCI ; a sub group of formula-fed (FF) PT infants. Mothers and infants were assessed weekly during the 28-day post feeding. Throughout the neonatal period, levels of total vitamin B-6 and percentages of pyridoxal(PL) in breast milk were lower in PT than T mothers, even in mothers supplemented with 27mg PN-HCI. Total vitamin B-6 levels in PT milk paralleled maternal supplementation but percentage distributions of B-6 vitamers did not change. Vitamin B-6 intakes of BF preterm infants paralleled their mothers' level of infants in the 2mg group was suggested by vitamin status parameters. Vitamin B-6 inadequacy of infants correlated with their plasma pyridoxal-5-phosphate(PLP) levels and erythrocyte alanine aminotransferase(E-ALAT) activity; all parameters such as plasma PLP, PL/PLP ratio and stimulation % of E-ALAT were highest for FF PT infants. The positive correlation of vitamin B-6 levels in breast milk gestational age may contraindicate its adequacy for some PT infants.

• Journal of Nutrition and Health
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• v.30 no.3
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• pp.336-348
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• 1997

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.

• Nutrition Research and Practice
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• v.16 no.3
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• pp.344-353
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• 2022

BACKGROUND/OBJECTIVES: Hydrolyzed formula is often fed to infants with gastrointestinal or immune issues, such as malabsorption or cow's milk allergy, because enzymatic treatment has rendered it more digestible and less allergenic than standard cow's milk formula (SF). Partially hydrolyzed formula (PHF) should be considered for those infants who are intolerant to extensively hydrolyzed formula. However, there are concerns about the nutritional insufficiencies of PHF. We aimed to evaluate the effects of PHF on the growth and health indicators in infants who were at high-risk of allergic disease and potential candidates for consuming PHF. SUBJECTS/METHODS: A total of 83 infants aged 0-2 mon with a family history of allergies were assigned to consume either PHF or SF until 24 weeks of age. Anthropometric measures were obtained at baseline, 12 weeks, and 24 weeks; blood samples were drawn and evaluated at the end of the study. RESULTS: No significant differences were observed in weight, height, and weight-for-height at any time point in each sex between the PHF and SF groups. At 24 weeks of age, the weight-for-age and height-for-age z-scores of the SF group were higher than those of the PHF group, but there was no significant difference in the weight-for-height z-score. There were no significant differences in levels of white blood cells, hemoglobin, ferritin, protein, albumin, aspartate aminotransferase, alanine aminotransferase, eosinophil cationic protein, and immunoglobulin E. CONCLUSIONS: In this study, there were no differences in growth and blood panels between the infants consuming PHF or SF. Therefore, infants who are unable to tolerate SF can be fed PHF without nutritional concerns about growth.

• Journal of Life Science
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• v.17 no.12
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• pp.1689-1694
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• 2007

This study was conducted to investigate both fat-soluble and water-soluble vitamin contents of commercial powdered infant formula for obtaining basic data on infant nutrition. Ten commercial infant formula based on cow's milk were collected and the contents of fat-soluble vitamins (vitamin A, D, E, K) and water-soluble vitamins (vitamin C, thiamin, riboflavin, niacin, $B_6$, folate, $B_{12}$, pantothenic acid, biotin) were compared with Dietary Reference Intakes for Koreans (KDRIs). The overall vitamin contents in 100 g and in 100 kcal of infant formula satisfied the recommended formula regulation (KDRIs) and Codex. In infant formula during 0-5 monthly age, fat-soluble vitamin A, D, E, K could supply 178.6%, 205.3%, 208.4%, 976.3% of adequate daily vitamin intakes, respectively. Water soluble vitamins, vitamin C, thiamin, riboflavin, niacin, $B_6$, folate, $B_{12}$, pantothenic acid, biotin could supply 173.2%, 237.2%, 269.8%, 295.9%, 431.6%, 165.8%, 1186.3%, 203.8%, 408.3% of adequate daily vitamin intakes, respectively. In infant formula during 6-11 monthly age, all vitamins satisfied their adequate daily intakes as well. Vitamin A, D, E, K supplied 199.2%, 262.3%, 220.5%, 626.46% of adequate daily vitamin intakes. Vitamin C, thiamin, riboflavin, niacin, $B_6$, folate, $B_{12}$, pantothenic acid, biotin could supply 179.5%, 210.2%, 264.7%, 241.5%, 206.0%, 166.9%, 699.5%, 247.0%, 475.0% of adequate intake of KDRIs. From this study, evaluation of vitamin contents of commercial infant formula was established, which could strengthen the basic information on infant nutrition.