Abstract
BackgroundWhen breastfeeding is not possible, infants are fed formulas in which lipids are usually of plant origin. However, the use of dairy fat in combination with plant oils enables a lipid profile in formula closer to breast milk in terms of fatty acid composition, triglyceride structure and cholesterol content. The objectives of this study were to investigate the impact on growth and gastrointestinal tolerance of a formula containing a mix of dairy lipids and plant oils in healthy infants.MethodsThis study was a monocentric, double-blind, controlled, randomized trial. Healthy term infants aged less than 3 weeks whose mothers did not breastfeed were randomly allocated to formula containing either: a mix of plant oils and dairy fat (D), only plant oils (P) or plant oils supplemented with long-chain polyunsaturated fatty acids (PDHA). Breastfed infants were included in a reference group (BF). Anthropometric parameters and body composition were measured after 2 and 4 months. Gastrointestinal tolerance was evaluated during 2 day-periods after 1 and 3 months thanks to descriptive parameters reported by parents. Nonrandomized BF infants were not included in the statistical analysis.ResultsEighty eight formula-fed and 29 BF infants were enrolled. Gains of weight, recumbent length, cranial circumference and fat mass were similar between the 3 formula-fed groups at 2 and 4 months and close to those of BF. Z-scores for weight, recumbent length and cranial circumference in all groups were within normal ranges for growth standards. No significant differences were noted among the 3 formula groups in gastrointestinal parameters (stool frequency/consistency/color), occurrence of gastrointestinal symptoms (abdominal pain, flatulence, regurgitation) or infant’s behavior.ConclusionsA formula containing a mix of dairy lipids and plant oils enables a normal growth in healthy newborns. This formula is well tolerated and does not lead to abnormal gastrointestinal symptoms. Consequently, reintroduction of dairy lipids could represent an interesting strategy to improve lipid quality in infant formulas.Trial registrationClinicalTrials.gov Identifier NCT01611649, retrospectively registered on May 25, 2012.
Highlights
When breastfeeding is not possible, infants are fed formulas in which lipids are usually of plant origin
Formula D contained a mixture of dairy lipids and plant oils; formula P contained only plant oils and formula PDHA contained plant oils supplemented with arachidonic acid (ARA) and docosahexaenoic acid (DHA)
This study demonstrated that 4-month consumption of a formula containing dairy lipids was associated with normal growth in healthy term infants and was well tolerated
Summary
When breastfeeding is not possible, infants are fed formulas in which lipids are usually of plant origin. Lipids are major components in human milk, providing 45–55% of total energy intake They fulfill various metabolic and physiological functions critical for the development, growth and health of the newborn [1]. Human milk provides alpha-linolenic (ALA) and linoleic acids (LA) which are essential fatty acids (EFA) They can be endogenously converted by the newborn into longchain derivatives of Omega 3 and Omega 6 families, such as docosahexaenoic acid (DHA) and arachidonic acid (ARA), respectively [2]. Human milk contains preformed DHA and ARA, at levels strongly influenced by the mother’s diet These fatty acids (FA) constitute the main components of the brain and they have an important impact on neuronal and visual functions [3]
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