Abstract
To investigate whether healthy term infants, fed an infant formula containing hydrolyzed whey protein (HWP-F, hydrolyzed whey/intact casein =63/37), differ in growth, gastrointestinal tolerance and stool characteristics from those fed an infant formula containing intact whey protein (IWP-F, intact whey/intact casein =61/39) or breast milk. Healthy term infants, born within 14 days of the study’s commencement, were randomly assigned to be fed IWP-F or HWP-F until 13 weeks of age, and breast-fed (BF) infants were enrolled as a reference group. Anthropometric measurements, gastrointestinal tolerance indexes and stool characteristics were assessed at baseline, and 7 and 13 weeks of age. There were no significant differences in any growth measurements and the occurrence of crying, spit-up and difficult defecation among the three feeding groups during the study period. However, daily feeding frequency was consistently lower in the formula-fed infants than in the BF group throughout the study (p < 0.05), and infants in the HWP-F group consumed more formula than those in the IWP-F group at 7 and 13 weeks of age (p ≤ 0.002). The HWP-F-fed infants had more similar stool characteristics to the breast-fed infants than infants in the IWP-F group at 13 weeks of age, regardless of frequency, volume, color or consistency of stool. This study demonstrates that the HWP-F could support the normal growth of healthy term infants, to a comparable extent to that of breast-fed infants during the first three months of life. Moreover, stool characteristics of HWP-F-fed infants are much closer to breast-fed infants than IWP-F-fed infants, but no significant gastrointestinal tolerance improvement was observed in HWP-F group.
Highlights
Breast milk provides unique benefits to both infants and mothers; only 37% of infants younger than 6 months are exclusively breastfed [1,2]
A total of 13 infants withdrew during study period, which yielded final group sizes of 59 for both the IWP-F and HWP-F groups and for study period, which yielded final group sizes of for both the IWP-F and HWP-F groups and 58 for the BF group (Figure 1)
IWP-F-fed and breastbreasttolerance improvement was observed in HWP-F-fed infants, compared with IWP-F-fed and fed infants
Summary
Breast milk provides unique benefits to both infants and mothers; only 37% of infants younger than 6 months are exclusively breastfed [1,2]. Infant formulas are designed to be a substitute for breast milk for infants who cannot be breast-fed because of metabolic diseases, maternal infectious diseases or maternal breast insufficiency [3]. Infants experience rapid growth and development and are sensitive to nutritional adequacy during the early postnatal period. Nutrients 2017, 9, 1254 formula processing—e.g., protein source and the degree of hydrolysis—may affect the bioavailability and stability of nutrients, and result in different growth patterns. Traditional formula, referring to the cow-milk based intact protein formula which is applied most extensively, occupies 83% of market share [4]. Infants with early exposure to cow-milk intact protein formulas are more likely to develop a cow milk protein allergy [5] and gastrointestinal intolerance symptoms [6,7]
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