Bottle-fed Infants Research Articles

ANTIBODY PRODUCTION BY THE MAMMARY GLAND IN MOTHERS AFTER ARTIFICIAL ORAL COLONISATION OF THEIR INFANTS WITH A NON‐PATHOGENIC STRAIN E. COLI 083

Twenty five breast-fed and 25 formula-fed infants were colonised by oral administration of a living suspension of E. coli 083. Twenty breast-fed and 13 formula-fed infants were followed as controls. Specific antibody titres in serum, stool filtrates and milk, and secretory IgA levels in stool filtrates and milk were determined in samples taken fortnightly from birth until 20 weeks of age. The haemagglutinating antibody in serum and milk increased in the colonised groups, but in stool filtrates an inhibitory effect of breast-milk was demonstrated. Secretory IgA levels in stool filtrates were significantly higher in colonised infants and breast-fed controls than in bottle-fed infants during the period of breast feeding. Then levels in the colonised groups remained high, but in breast-fed controls they decreased to values found in bottle-fed controls. Artificial colonisation evoked local antibody and secretory IgA responses in the intestine, as well as an antibody response in the mother's mammary gland. The possible protective effect of those responses is discussed.

Human versus Cow's milk in infant nutrition and health: Update 1977

The contents of human milk and of cows milk and their effects on infant nutrition and health are examined in this literature review in an effort to determine whether breastfeeding has any real benefits other than psychological benefits. Initial attention is directed to substances that are inherent to milk followed by extraneous materials such as drugs pesticides toxic minerals sensitizing foods and microorganisms that may be carried along in the milk and may have no effect or may be harmful to the infant. The high-fat high-lactose low-casein and low-ash composition of human milk makes it easily digestible by the infant. It also encourages the development of nonpathogenic flora in the intestine. Breastfed infants in developing countries have a significantly lower morbidity and mortality than bottle-fed infants. This is partly because of the characteristics of human milk and partly because of the presence of specific protective factors in the milk. These protecctive factors include antibodies against many bacterial and viral pathogens a fatty-acid anti-staphylococcal factor lysozyme the C3 component of complement lactoferrin a high molecular weight vitamin B12-binding protein a nonspecific antiviral substance and white blood cells. Overall morbidity and mortality rates in the developing countries are now similar for breastfed and bottle-fed infants yet several diseases are absent or less common in breastfed infants. Cows milk protein allergy expressed as diarrhea vomiting eczema rhinorrhea bronchitis and asthma is found only in formula-fed infants. The primary disadvantage of human milk to the infant is the chemical and biologic agents he or she may inbibe with it.

Evidence for transmission of lymphocyte responses to tuberculin by breast-feeding.

The possibility that cell-mediated immunity could be acquired by breast-feeding was evaluated in a prospective study of 26 tuberculin positive and 9 negative puerperal mothers and their infants. 13 infants of the positive and all the infants of negative mothers were breast-fed. Tuberculin-reactive T cells were found in colostrum and early milk of most positive but in none of the negative nursing mothers. A significant number (8/13) of infants born to positive mothers had tuberculin-reactive peripheral blood T cells after 4 weeks of breast-feeding compared with bottle-fed infants (1/13) of positive mothers or breast-fed infants (0/9) of negative mothers. Examination of cord blood for tuberculin-reactive T cells provided no significant evidence of transplacental transmission of responsiveness to tuberculin. The results suggest that breast-fed infants may passively acquire T cell responsiveness to a specific antigen by ingestion of breast milk.

Effects of solid foods on growth of bottle-fed infants in first three months of life.

We studied 821 infants who were bottle-fed from birth to determine whether non-milk solids begun within the first 3 monts of life affect early growth. The infants were seen seven to 10 days and three months after birth. They were divided into three groups-those who had started solids before 6 weeks of age (657 infants); those who had started solids between the ages of 6 weeks and 3 months (124 infants); and those given cow's milk formulae alone during the first three months (40 infants). The infants were weighed and measured seven to 10 days after birth and at three months. Mean weekly rates of weight and length gain over the 3 months were calculated and did not differ significantly between the three groups. As no record was made of quantities of food taken we cannot explain the failure of solid foods to affect growth. Studies of how young infants utilise these foods are needed.

Identification of thetrans isomers of octadecenoic acid in human milk

The presence of trans octadecenoic acid isomers was detected and analyzed in 24 hr pooled samples of human milk. Amounts of the trans isomers of the C18 monoenes ranged from 2% to 4% of the total fatty acids. For purposes of comparison, three commonly used brands of infant formula were also analyzed and found to contain 0.1% to 1.3% of trans monoene isomers. Data indicate that breast-fed and bottle-fed infants are receiving minimal levels of trans fatty acids via milk.

Serum Zinc and Copper Levels in Healthy Japanese Infants

The serum zinc and copper concentrations were measured in 45 healthy Japanese infants with age ranging from 5 days to 12 months. At one month of age there was a significant decrease in serum zinc concentration, and this low level persisted until 6 months of age when a significant increase in serum zinc concentration was observed. Serum zinc concentrations remained relatively stable between 6 and 12 months of age. The concentration of serum copper in newborn infants was significantly lower than in healthy children (age: 6 to 12 years), but had risen by 5 months of age to the same levels. There were no significant differences in serum zinc and copper concentrations between male and female infants. However, there was a tendency for serum zinc levels in exclusively breastfed infants to be higher than those in bottlefed infants at 3 months of age and for serum copper levels in exclusively or partially breastfed infants to be higher than those in bottlefed infants at one month of age.

3Disorders of fructose metabolism

There are fundamental differences between the metabolic fate of fructose and of glucose. Whereas the metabolism of glucose is controlled by hormones such as insulin, fructose uptake and phosphorylation in the liver occurs independently of hormones and its ultimate metabolic fate is unpredictable. Essential fructosuria, a harmless inherited anomaly of fructose metabolism, is the least harmful of the disorders of fructose metabolism. Hereditary fructose intolerance and fructose-1,6-diphosphatase deficiency are discussed in greater detail with regard to biochemical abnormalities and clinical aspects. HFI is most serious in bottle-fed infants who cannot reject their sucrose-containing diet. Patients with HFI will have no clinical symptoms if kept on a fructose-free diet. In contrast, patients with fructose-1,6-diphosphatase deficiency can tolerate frucose. However, severe infections precipitate attacks of hypoglycaemia and lactic acidosis.

Bifidobacteria in the intestinal tract of infants: an in-vivo study.

Weekly faecal specimens from 18 babies were examined during the first 8 weeks of life. Eight infants were breast fed, ten were bottle-fed. All suckling infants received supplementary feeds for the first 8 days. A buffer consisting of acetic acid and acetate was demonstrated in the faeces of all the breast-fed infants at some time during the period of examination. This buffer was rarely detected during the 1st week of life when supplementary feeds were given, and buffer already present gradually disappeared with the introduction of mixed feeding. In contrast, at no time was an acetate buffer demonstrated in the faeces of bottle-fed infants. Babies receiving breast milk produced faeces with low pH, high counts of saccharolytic organisms including bifidobacteria and Streptococcus faecium, and low counts of Escherichia coli, bacteroides and clostridia. Bottle-fed infants on the other hand produced faeces with a high pH and high counts of E. coli and putrefactive bacteria, but with low counts of bifidobacteria.

Mother-Infant Transmission of Hepatitis B Antigen-Reply

In Reply. —Our article in theJournal, a preliminary report of a study of 43 infants in Taiwan, as well as an expanded study of an additional 158 infants, 1 presented evidence that the hepatitis B virus was commonly transmitted from chronic hepatitis B antigen (HB s Ag) carrier mothers to their offspring. Among the latter group of infants, 2 we found no relationship between breast feeding and the development of antigenemia in the babies. In further response to Dr Euler's questions, there was no relationship in antigen-positive babies between breast feeding and either (1) age when first found to be HB s Ag positive (mean, four months in both breast-and bottle-fed babies) or (2) persistence of HB s Ag (antigen persisted in 29 of 33 breast-fed infants, or 88%, and in 15 of 18 bottle-fed infants, or 83%). Because the blood samples taken from infants were small, we were

Birthweight Doubling Time: A Fresh Look

Infant birthweight doubling time is widely quoted as being achieved between 5 and 6 months. The purpose of this study was to determine the time of birthweight doubling and to identify important related variables. A total of 357 normal infants with birthweights between 2,500 and 4,100 gm were studied. Mean age of birthweight doubling for the entire group was 119 days (3.8 months). Bottle-fed infants doubled their birthweights earlier than breast-fed infants: 113 days vs. 124 days (P less than .05). Boys doubled their birthweights earlier than girls: 111 days vs. 129 days (P less than .0001). Solids were introduced earlier in bottle-fed infants (mean , 1.9 months) than in breast-fed infants (mean, 3.9 months). Harvard percentiles for mean group weight and length at the time of birthweight doubling were: for bottle-fed infants, 75th and 55th percentiles respectively: for breast-fed infants, 55th and 60th percentiles respectively; for boys, 75th percentile for both weight and length; for girls, 50th percentile for both weight and length. Thus, bottle-fed infants appear to have weight gains in excess of length gain and may be developing early obesity. In light of the poor prognosis in treating obesity, closer supervision of early infant feeding practices is indicated.

Effect of Breast-Feeding on Seroresponse of Infants to Oral Poliovirus Vaccination

Three hundred Indian infants between 6 and 51 weeks of age were divided into six groups and given three doses of trivalent oral polio vaccine (OPV) of known adequate potency. One group was on unrestricted breast-feeding with mandatory breast-feed during the interval between 30 minutes before and 15 minutes after each dose of OPV. In four groups of infants breast-feeding was withheld for three, four, five, and six hours both before and after each dose of OPV. The sixth group was bottle-fed. Samples of blood were collected from all infants before vaccination and from 227 infants further samples were collected four weeks after the first and/or third doses of OPV. Antibody responses to poliovirus types 1, 2, and 3 were determined following one dose and three doses of OPV, and the rates of response were found to be approximately equal in all groups of breast-fed infants irrespective of their feeding schedules, as well as in bottle-fed infants. Thus breast-feeding is shown to have no inhibitory effect on antibody response of infants beyond the newborn period to OPV.

Serum cholesterol and bowel flora in the newborn

Bottle-fed infants have a total serum cholesterol of 147 mg/100 ml on the fifth day of life and their stools contain more Escherichia coli than Lactobacilli organisms. The ratio of these bacteria can be reversed by adding bicarbonate or Lactobacilli to feeds. This change is associated with a decrease in total cholesterol to a mean 119 mg/100 ml over the next 3 days. Lactobacilli organisms predominate in the stools when serum cholesterol is low and may play a role in the metabolism of cholesterol.

ESCHERICHIA COLI SEROGROUPS IN BREAST‐FED AND BOTTLE‐FED INFANTS

1) Eighty-seven breast-fed and 95 bottle-fed infants were examined for differences in Escherichia coli serogroup pattern. 2) The serogroup composition was less complex in breast-fed infants. Fewer serogroups were found in the individual breast-fed child. However, with few exceptions, the same O groups were found in the two groups of infants. The prevalent O groups were among those also found most frequently in faeces from adults. 06 strains were more common in the breast-fed group, while 07 and 016 were not at all found in that group. 3) A special search for E. coli strains with Kl antigen showed that this antigen predominated in the bottle-fed infants. 4) Klebsiella and other Enterobacteriaceae were more frequently found among bottle-fed infants. 5) It is concluded that the intestinal milieu exerts a selective pressure which may result in a selection of different serotypes in two different intestinal milieus such as those examined.

A Comparative Study of Serum Lipid Fractions and Fatty Acid Patterns between Breast-fed and Bottle-fed Healthy Infants

A Comparative Study of Serum Lipid Fractions and Fatty Acid Patterns between Breast-fed and Bottle-fed Healthy Infants

The immunoglobulins and coproantibody formation in infants after artificial intestinal colonization with E. coli 083. Protective effect of orally administered antibody

8 breast-fed and 9 bottle-fed infants were colonized after birth with a non-enteropathogenic E.coli strain. 11 breast-fed and 10 bottle-fed infants were used as controls. In colonized infants the strain 083 was detected in the stool from the 2nd day and remained in predominance up to 16 weeks. The serum antibody against E. coli 083 increased between 4-16 weeks. The colonization did not influence significantly the serum immunoglobulin levels. In colonized bottle-fed infants the level of copro-antibodies was significantly higher from 4 up to 16 weeks than in controls, in breast-fed colonized infants between 2-6 weeks. The colonization induced a formation of secretory IgA in bottle-fed infants from the 4th up to the 16th week. In breast-fed infants this effect was masked due to passive transfer of IgA via maternal milk. In 24 cases of diarrhoea caused by E. coli an antibody against E.coli 055, 0111 and 026 was administered orally 7 times, 2ml/kg. In 19 infants the stools turned to normal.

Navajo jaundice: A variant of neonatal hyperbilirubinemia associated with breast feeding

A clinical and chemical appraisal of 47 newborn Navajo infants demonstrated a high incidence of unconjugated hyperbilirubinemia during the first week of life. Within this study population two subgroups were identified: (1) breast-fed infants in whom inhibition of bilirubin glucuronyl transferase activity was related to a substance in colostrum and breast milk in the first days of life and (2) a smaller subgroup of bottle-fed infants who had significant jaundice when compared with a control population from New York. The serum bilirubin concentrations of the Navajo bottle-fed infants never achieved those of the breast-fed subgroup. These data suggest that to some extent the neonatal unconjugated hyperbilirubinemia noted in the Navajo Indian is related to breast feeding, with earlier transmission of the presumed inhibitor substance than previously observed in a Caucasian population.

Possible Influence of Vitamin B12-Binding Protein in Milk on the Intestinal Flora in Breast-fed Infants

Gullberg, R. Possible influence of vitamin B12-binding protein in milk on the intestinal flora in breast-fed infants. II. Contents of unsaturated B12-binding protein in meconium and faeces from breast-fed and bottle-fed infants. Scand. J. Gastroent. 1974, 9, 287-292.The unsaturated vitamin B12-binding capacity (UBBC) was determined in meconium and faeces from breast-fed and bottle-fed infants. The UBBC values (ng B12 units/g of meconium or faeces) obtained were a mean of 154 ± S.D. 277 (range 2–1151) and a median of 49 in 21 examined samples from 15 infants, aged 1-3 days; a mean of 273 ± S.D. 352 (range 2-1300) and a median of 64 in 28 samples from 10 breast-fed infants, aged 4-51 days; and a mean of 72 ± S.D. 118 (range 0-468) and a median of 10 in 27 samples from 9 bottle-fed infants, aged 4-51 days. The results are discussed with reference to the theory that the large molecular size B12-binding protein, which is present in relatively large amounts in human digestive fluids and in human milk, may influence the intestinal flora by competing with microorganisms for vitamin B12 in the medium.

Breast feeding and serum bilirubin values during the first 4 days of life

One hundred ninety-nine breast-fed and bottle-fed infants were studied for the first 4 days of life to determine if breast feeding and hyperbilirubinemia were related, and to see if altering the standard hospital breast-feeding regimen would affect bilirubin levels. Breast feeding did not results in increased serum bilirubin concentrations. Regardless of feeding regimen, breast- and bottle-fed groups had similar mean bilirubin values, and a similar low incidence of hyperbilirubinemia. Incidental findings included an 8 per cent mean weight loss in infants who were breast fed without supplements, compared to a 4 per cent weight loss in all other infants. Hyperbilirubinemia was not related to weight loss.

Effect on neonatal jaundice of oestrogens and progestogens taken before and after conception.

Study of 182 newborn babies has shown that among bottle-fed infants the mean plasma bilirubin concentration was slightly but significantly higher (P <0.01) in those whose mothers had previously used steroid contraceptives. A similar finding was not noted among breast-fed infants.A further 16 infants whose mothers had received progestogen therapy during their pregnancy had a mean plasma bilirubin concentration which was significantly higher than each of the four other groups of infants studied (P <0.01). Icterus occasionally reached clinically important levels in these babies.

Letter: Urosepsis with jaundice due to hemolytic Escherichia coli.

To the Editor .—At the Cook County Children's Hospital, urinary tract infection continues to be a significant etiological factor causing jaundice in early infancy. 1 Our series now encompasses 22 bottle-fed infants who were discharged apparently normal from the nursery and returned with jaundice. There were 18 boys and 4 girls, with an age range of 8 to 56 days. The bilirubin value ranged from 6.0 to 48.2 mg/100 ml. In the two youngest infants, 8 and 9 days, there was little direct reacting bilirubin. The other infants had elevated levels of direct reacting bilirubin which accounted for 24% to 60% of the total bilirubin. The blood urea nitrogen value ranged from 18 to 153 mg/100 ml. Severe acidosis as judged by a low carbon dioxide combining power (