Milk Formula Research Articles

Iron Absorption from an Iron-Fortified Follow-Up Formula with and without the Addition of a Synbiotic or a Human-Identical Milk Oligosaccharide: A Randomized Crossover Stable Isotope Study in Young Thai Children

BackgroundPrevious studies showed that pre- and probiotics may enhance iron absorption. Probiotics combined with prebiotics (synbiotics), including human-identical milk oligosaccharides (HiMOs), are commonly added to infant and follow-up formula (FUF). Whether these additions enhance iron absorption from iron-fortified commercial milk formula is uncertain. ObjectivesWe determined the effect of adding 1) a synbiotic [galacto-oligosaccharide [GOS] + Limosilactobacillus reuteri (L. reuteri)] or 2) the HiMO 2′-fucosyllactose (2′FL) to iron-fortified FUF on iron absorption in young Thai children. MethodsIn a randomized, controlled, single-blinded (participants) crossover study, 82 Thai children aged 8–14 mo were enrolled to consume single servings (235 mL) of FUF with isotopically labeled ferrous sulfate (2.2 mg iron) with 1) the synbiotic (400 mg/100 mL GOS and L. reuteri DSM 17938), 2) the HiMO 2′FL (100 mg/100 mL), and 3) without synbiotic and 2′FL (control) in random order and a 3-d washout period between administrations. Fractional iron absorption [FIA (%)] was assessed by measuring erythrocyte incorporation of isotopic labels 14 d (n = 26) and 28 d (n = 76) after consumption of the last test FUF. ResultsMedian (IQR) FIA from iron-fortified FUF with the synbiotic [8.2 (5.2, 12.9)%] and with 2′FL [8.4 (5.5, 14.1)%] did not differ from the control FUF [8.1 (4.8,14.7)%] (synbiotic compared with control, P = 0.24; 2′FL compared with control, P = 0.95). FIA from all FUF did not differ when measured after 14 and 28 d of erythrocyte incorporation (Time, P = 0.368; FUF, P = 0.435; Time × FUF, P = 0.937). Fecal pH and hemoglobin were negatively associated with FIA. ConclusionsIn young Thai children, the addition of a synbiotic (GOS + L. reuteri) or 2′FL to iron-fortified FUF did not impact FIA from a single serving.The study was registered at clinicaltrials.gov as NCT04774016.

Awareness about Neonatal Lactose Intolerance among Chinese Neonatologists in Outpatient Settings: A Multi-Center Survey.

This study aimed to identify the specific areas of knowledge gaps regarding lactose intolerance among neonatologists in Chinese outpatient settings as well as to assess the availability of lactose intolerance testing in hospitals. A total of 278 neonatologists in outpatient settings from 144 hospitals were surveyed. To explore the awareness level, diagnosis, and treatment of neonatal lactose intolerance among neonatologists in outpatient settings, a multicenter cross-sectional survey was designed. Descriptive analysis based on frequency and percent distribution was performed for all variables. Most respondents were senior doctors (256, 92.09%) from general hospitals and maternity/maternal and child health hospitals, had over 10 years of experience, and were dominantly associate chief physicians and chief physicians (211, 75.90%). A significant proportion of the participants (236, 84.89%) believed that neonatal lactose intolerance tends to be overlooked during clinical practice. When the most common symptoms of neonatal lactose intolerance were surveyed, diarrhea was selected by 142 (51.08%) respondents, followed by bloating and milk regurgitation or emesis (71, 25.54%). Other symptoms included unexplained crying (36, 12.85%), stool with milk flap or foam (15, 5.40%), and increased venting (14, 5.04%). Furthermore, the survey results indicated that the most common method for diagnosing neonatal lactose intolerance in the respondents' hospitals was qualitative test for urinary galactose (78, 28.06%). Of the respondents, 137 (49.28%) stated that their hospital could not test for lactose intolerance. For treating lactose intolerance, the neonatologists primarily opted for exogenous lactase rather than lactose-free formula milk. This study sheds light on Chinese neonatologists' awareness of neonatal lactose intolerance, revealing some knowledge gaps. The expeditious popularization and conduct of lactose intolerance-related examinations in hospitals will have a positive stimulative effect on the management of lactose intolerance in newborns.

Toxic risk assessment of selected metals in infant formula milk commercially available in Lebanon: A novel approach based on feeding parameters versus toxicity

Infant formula milk (IFM) is increasingly utilized as a substitute for natural breastfeeding despite the fact that breast milk has been always recognized as the optimal nourishment method. While IFMs are fortified with essential nutrients that are crucial for proper growth, they can also harbor non-essential toxic metal contaminants from various sources during the production process. Given the heightened vulnerability of newborns to such contaminants, it is imperative to thoroughly analyze, evaluate, and minimize the toxicity associated with the consumption of such IFMs. However, classical approaches to date, have been always adopted for assessing such risks by finding first the analytical concentration of metals in the IFMs followed by multiplying it by the average daily powder intake (ADI) then dividing by the average infant weight. The outcome is then compared to an established standard such a PTWI to assess the extent of toxicity. The drawback with such studies is the use of a fixed ADI for all samples as if all samples have the same and exact preparation directions while using somewhat different infant masses.Accordingly, this study aims at assessing the toxic risk amongst newborns from IFM consumption through the identification and application of various highly important and toxicity-contributing parameters from each IFM and its directions of preparation label separately which are discussed here for the first time while providing comparisons between the classical approach versus our new approach to highlight its importance.Seventy-three IFMs (0–6 months) were analyzed for lead (Pb), cadmium (Cd), arsenic (As), and aluminum (Al) levels and unlike previous studies, this work incorporated various feeding parameters from each IFM for calculating the intakes thus, revealing potential toxicity risks even in IFMs that are considered safe by the classical approach. Metal contamination was significant, with 97.3 % of samples containing detectable Pb, 41.1 % Cd, 16.4 % As, and 93.2 % Al while highlighting Pb in exceeding its maximum allowable level (MAL). This novel approach, which considers new diverse feeding schedules/parameters that are ironically suggested by manufacturers that have been previously overlooked elsewhere, emphasized IFMs' potential as sources of heightened metal toxicity in comparison to classical approaches. Results highlighted Pb and Al as major concerns, with As and Cd of lesser concern. Findings also emphasized the importance of such new parameters for safeguarding newborn health and should be payed attention to by caregivers. The study strongly and highly recommends adherence to minimum feeding schedules (MFS) and proper scooping techniques to reduce newborn exposure to toxic metals. It also suggests continuous monitoring and stricter regulations by health authorities at the production level of such products so as to provide a safer commodity in the first degree and to also provide better and somewhat uniform and specific feeding labels and precautions on such products.

Views on wet nursing and expressing breastmilk for sharing and human milk bank donation among mothers in two parenting social media communities in Vietnam.

Nutrition in early life plays a key role in shaping an infant's future health. There is limited understanding of the perspectives of Vietnamese mothers with children under 24 months of age regarding breastmilk expression, donationand use. In this cross-sectional study, an online survey was administered through two parenting social media communities to assess opinions on breastmilk expression, breastmilk donation including contributions from bereaved mothersand the use of donor human milk. A 4-point Likert scale was used to evaluate respondents' opinions, and demographic and breastfeeding information was collected. Among 375 respondents, almost 30% had received breastmilk from another woman, either through direct breastfeeding (14.7%), expressed breastmilk (12.5%)or from a human milk bank (2.7%). In this survey of 375 mothers, 84.0% indicated they would store excess breastmilk, while 75.7% and 69.6% would donate to a human milk bank or another mother, respectively. When faced with insufficient breastmilk, 88.5% of mothers would seek ways to increase supply, whereas 23.8% considered using commercial milk formula. Regarding milk expression among the 375 mothers, 78.4% preferred electric pumps, compared to 48.6% for manual pumps and 45.9% for hand expression. Additionally, 80.5% of the 375 mothers would suggest donating stored milk to bereaved peersand 85.6% would suggest mothers with mild COVID-19 to continue breastfeeding with precautions. These findings indicate that this sample has positive views on breastfeeding, breastmilk donationand the use of donor human milk.

An A2 β-casein infant formula with high sn-2 palmitate and casein phosphopeptides supports adequate growth, improved stool consistency, and bone strength in healthy, term Chinese infants: a randomized, double-blind, controlled clinical trial.

The aim of this randomized, double-blind, controlled trial was to examine the effects of infant formula on the growth, stool consistency, and bone strength of infants (n = 120) over a period of 4 months. The investigational group was fed an A2 β-casein cow's milk infant formula containing casein phosphopeptides (CPP) and high sn-2 palmitate (54% of total palmitate at sn-2). The control group was fed a standard cow's milk formula without CPP and with low sn-2 palmitate (29% of total palmitate at sn-2). The third group was fed human milk (HM) (n = 60). All three groups had similar baseline characteristics, and maintained similar BMI, sleep habits, and growth rates in body weight and length throughout the study. However, compared to the control group, infants in the investigational and human milk groups had significantly: (i) greater body length at 90, 120, and 150 days of age; (ii) greater growth rate in head circumference from 30 to 60 days of age, with larger head circumference at 60 days of age; (iii) larger daily stool frequency at 60, 90, and 120 days of age; (iv) softer stool at 60, 90, and 120 days of age; (v) higher bone quality index and bone speed of sound at 150 days of age; (vi) fewer hours of crying at 60 and 90 days of age; (vii) less abdominal distention, burp, and flatus at 60, 90, and 120 days of age; and (viii) less constipation at 90 days of age. At other time points, no significant differences were observed between the three groups. No serious adverse events (AEs) related to the study products were reported, and significantly fewer infants in the investigational and HM groups experienced at least one AE compared to the control group. The study suggests that the A2 β-casein formula with high sn-2 palmitate and CPP supports adequate growth, is well tolerated, and may have beneficial effects on stool consistency, gastrointestinal comfort, crying duration, and bone density, comparable to HM. Clinical trial registration: https://clinicaltrials.gov/, NCT04749290.

Political Economy of Maternal Child Malnutrition: Experiences about Water, Food, and Nutrition Policies in Pakistan.

This study examined access to water, food, and nutrition programs among marginalized communities in Southern Punjab, Pakistan, and their effects on nutrition. Both qualitative and quantitative data were used in this study. We held two focus group discussions (one with 10 males and one with 10 females) and conducted in-depth interviews with 15 key stakeholders, including 20 mothers and 10 healthcare providers. A survey of 235 households was carried out to evaluate water and food insecurity, with the data analyzed using Wilcoxon's rank-sum test, t-test, and Pearson's chi-square test. The results revealed that 90% of households experienced moderate-to-severe water insecurity, and 73% faced moderate-to-severe food insecurity. Household water and food insecurity were positively correlated with each other (correlation coefficient = 0.205; p = 0.004). Greater household water (p = 0.028) and food insecurity (p < 0.001) were both associated with higher perceived stress. Furthermore, lower socioeconomic status was strongly related to higher levels of water (p < 0.001) and food insecurity (p < 0.001). Qualitative findings highlight the impact of colonial and post-colonial policies, which have resulted in water injustice, supply issues, and corruption in water administration. Women face significant challenges in fetching water, including stigma, harassment, and gender vulnerabilities, leading to conflicts and injuries. Water scarcity and poor quality adversely affect sanitation, hygiene, and breastfeeding practices among lactating mothers. Structural adjustment policies have exacerbated inflation and reduced purchasing power. Respondents reported a widespread lack of dietary diversity and food quality. Nutrition programs face obstacles such as the exclusion of people with low social and cultural capital, underfunding, weak monitoring, health sector corruption, and the influence of formula milk companies allied with the medical community and bureaucracy. This study concludes that addressing the macro-political and economic causes of undernutrition should be prioritized to improve nutrition security in Pakistan.

Financial Feasibility of Service-Based Business

In Indonesia, over 6,300,000 toddlers are affected by stunting. Research indicates that the prevalence of stunting among children of working mothers is 30.6%. Despite the associated health risks, many working mothers prefer formula milk as a substitute for breast milk. Mengasihi, a health technology start-up providing breast milk powdering services for personal use, aims to offer babies a simple and effective nutritional solution. This study investigates the financial feasibility of Mengasihi as an early-stage start-up. It was found that cash flow plays a crucial role in start-up failure, impacting long-term organizational success. A feasibility study assessed Mengasihi's financial viability, analyzing internal and external financial conditions using criteria such as Payback Period, Net Present Value (NPV), and Internal Rate of Return (IRR) based on five-year financial projections. The results indicate that the Mengasihi project is financially viable, and an implementation plan was provided as part of the study.

A Review: Development of a Synthetic Lactoferrin Biological System.

Lactoferrin is an iron-binding glycoprotein with antibacterial, antitumor, and immunomodulatory functions derived from milk and mucosal secretions. Lactoferrin is used in various products, such as infant formula milk powder, nutritional supplements, and cosmetics. Researchers have developed new technologies to produce lactoferrin because there are limitations in the separation and purification of lactoferrin from milk that cannot compensate for the market demand. Therefore, synthetic systems of lactoferrin have been developed with the development of genetic engineering, and the structure of lactoferrin expressed in heterologous systems is very similar to that of natural lactoferrin. The structure and functions of lactoferrin and the design and construction of synthetic lactoferrin biological systems, especially microbial synthetic systems, including prokaryotic and eukaryotic host-expression systems, are described. On the basis of these results, we summarize the challenges and solutions for constructing systems of high-yield lactoferrin. The development directions of recombinant lactoferrin are discussed in this review. Overall, the design and development of these synthetic biological systems have allowed us to explore the great potential of the industrial large-scale preparation of lactoferrin.

The effect of exclusive breastfeeding on synaptogenesis and cell survival in mouse offspring

The first thousand days of life are critical for determining a child's cognitive development in humans. Breastfeeding may provide the nutrients needed for brain development. Cognitive function has been widely associated with neuronal turnover, driven by synaptogenesis and apoptosis. To explore this hypothesis, this study aimed to examine the effect of exclusive breastfeeding (EBF) on cognitive function and neuronal turnover in the dentate gyrus of the mice hippocampus. We conducted cognitive function assessments using the Morris Water Maze (MWM) test. We also examined neuronal apoptosis with TUNEL assay and synaptogenesis using PSD-95 antibodies. The newborn mice (mixed gender) aged 0 days were randomly divided into two groups. The first group received exclusive breastfeeding (EBF, n = 14), while the second group (MF, n = 14) received mixed breast milk and formula milk. At postnatal day 21 (PND21), the MWM test was performed, followed by an assessment of neuronal apoptosis and synaptogenesis. In the MWM test, the escape latency of the EBF group was shorter than the MF group. There was a significant increase in PSD-95 expression and a decrease in TUNEL expression in the EBF group (p &lt; 0.001) than in the MF group. In conclusion, exclusive breastfeeding is associated with higher cognitive function. Exclusive breastfeeding affects neuronal turnover by increasing synaptogenesis and decreasing apoptosis in the dentate gyrus of the hippocampus. This has both scientific and clinical implications, pointing to nutritional practices early in life that could optimise the attainment of cognitive potential.

Breastfeeding in PKU and Other Amino Acid Metabolism Disorders-A Single Centre Experience.

In addition to the numerous immunological and nutritional benefits that breast milk offers to infants, its proportion in the diet must be limited or even excluded in the case of inborn errors of amino acid metabolism (IEM). The objective of the study was to expand knowledge about breastfeeding and the degree of contribution of breast milk to the feeding of infants with IEM before and after the introduction of expanded newborn screening. A retrospective single-centre study was conducted on 127 infants born between 1997 and 2020: 66 with phenylketonuria (PKU), 45 with other IEM (non-PKU), all diagnosed through newborn screening (NBS), and 16 non-PKU diagnosed through selective screening (SS). The time of initiation of dietary treatment and the proportion of breast milk in the diet, both expressed and breastfed, with or without intake control, were analysed at 1, 3, and 6 months after birth. For 47% of the newborns in Groups 1 and 2, the dietary treatment was started before the 10th day of life; in Group 3, the dietary treatment was started after the 10th day of life for all children. During the first month of life, the proportion of infants receiving breast milk was higher in the NBS-PKU (74%) and the NBS non-PKU (80%) groups, compared with 38% in the SS non-PKU infants. In the subsequent months of life, the proportion of infants receiving human milk (either from the breast or a bottle) declined in all groups. This decline occurred more in bottle-fed rather than directly breast-fed infants. Our observations indicate that the model of feeding from a bottle with expressed milk may have had an adverse effect on maintaining lactation and may have contributed to a faster transition to formula milk. Maintaining lactation and extending the period of feeding the infant with human milk in the first 6 months of life is possible by breastfeeding on demand, under regular biochemical monitoring: preferably weekly in PKU infants, and at least every 2-4 weeks in infants with other IEM.

The efficacy of low/lactose-free milk powder in the treatment of lactose intolerance in infants: A protocol for systematic review and meta analysis.

The aim of this study was to evaluate the efficacy and safety of formula milk powder in the treatment of lactose intolerance in children, and to provide an evidence-based medicine basis for the rational use of drugs in children with lactose intolerance caused by various reasons by meta-analysis. Use computers to search major databases, including Web of Science, PubMed, CNKI, Wanfang Data Knowledge Service Platform, and other databases, the retrieval time is from the establishment of the database to April 2023. The collected literatures were screened, data extracted and processed, and then meta-analysis was performed by Review-Manager 5.4 statistical software. A total of 10 randomized controlled trials were included, with 1112 patients, including 562 patients in the treatment group and 550 patients in the control group. The control group was treated with conventional therapy, and the treatment group was treated with lactose-free/low-lactose milk powder on the basis of conventional therapy. The results of the meta-analysis showed that the clinical efficacy of the treatment group was significantly better than that of the control group [odds ratio=6.01, 95% confidence interval (CI): 3.94-9.18, P<0.00001], the course of disease in the treatment group was shorter than that in the control group (mean difference=-1.45, 95% CI: -1.76 to -1.13, P<0.0001). The antidiarrhea time of the treatment group was shorter than that of the control group, and the difference between the 2 groups was statistically significant (mean difference=-1.41, 95% CI: -1.67 to -1.15, P<0.0001). Low/lactose-free milk powder can improve clinical efficacy and shorten the course of treatment in infants with lactose intolerance, which can be demonstrated by further large-scale clinical studies.

Formulation optimization of a probiotic low-calorie chocolate milk and investigating its qualitative properties during storage

Due to concern regarding the consumption of high amount of sugar in diet and role of diet in combating overweigh and related disease, the aim of present study was to optimize a reduced calorie probiotic chocolate milk formula with suitable physicochemical properties. The formula comprising inulin, stevia (Stevia rebaudiana Bertoni), chia (Salvia hispanica L.) seed gum (CSG), and whey protein concentrate (WPC) which optimized using Box-Behnken design (BBD) and then enriched with an encapsulated probiotic strain Lactobacillus acidophilus (DSM1643). The independent variables included inulin (2–8%), CSG (0.1–0.5 %), stevia (50–100 % replacement of sugar), and WPC (1–3%). The dependent variables were selected as viscosity, average particle size, sedimentation percentage, and general acceptance. Optimization done toward achieving the highest viscosity and general acceptance and the lowest sedimentation percentage and average particle size. The optimal conditions were found to be 7.99 % inulin, 70 % stevia, 0.34 % CSG, and 1 % WPC. Under these conditions, the viscosity, sedimentation percentage, average particle size, and general acceptance of the product were equal to 40.69 mPa s, 2.2 %, 434.221 nm, and 5.1, respectively. Next, the chocolate milk was enriched with at 109 CFU/g probiotic bacteria and evaluated. The probiotic strain was resistant to simulated gastrointestinal conditions and under this condition the free bacterial cells count declined by 8 logCFU/g while the encapsulated cells decreased approximate 3 logCFU/g. The bacteria count did not undergo a significant change until the 5th day of storage. The results showed that the inulin, stevia, CSG, and WPC at optimal concentrations and encapsulated probiotic bacteria could be simultaneously applied to produce a product with good properties. This formula could be considered as a new product with health improving properties, low calorie which is suitable for people suffering from diabetes and obesity.

'It's far from the norm': breastfeeding beyond 1 year in the Republic of Ireland.

Breastfeeding is the optimal form of nutrition for infants and young children. The World Health Organization recommends that babies are breastfed exclusively for the first 6 months of life, and up to the age of 2 years or beyond in combination with complementary food. Breastfeeding initiation and continuation rates are suboptimal globally and very low in the Republic of Ireland where health promotion initiatives and healthcare professional support predominantly focus on the important phase of initiation and early months of the breastfeeding journey. This qualitative descriptive study aimed to explore the experiences of women who chose to breastfeed their children beyond 1 year of age in the Republic of Ireland. Fourteen women participated in semi-structured interviews. Interviews were transcribed verbatim and thematic analysis was conducted. The analysis generated three overarching themes: (1) Influences on breastfeeding beyond 1 year, (2) Sustaining breastfeeding and (3) Benefits of breastfeeding beyond 1 year. Family, friends, peers, culture and commercial milk formula marketing had an influence on breastfeeding journeys. Support, determination, knowledge, bed-sharing and Covid-19 pandemic social restrictions helped to sustain breastfeeding beyond 1 year. Benefits of breastfeeding beyond 1 year such as nutrition, strengthening of emotional bonds, development of a parenting tool, and protection of child and maternal health were identified. Our findings support the need for discussions and further research on the normalization of breastfeeding beyond 1 year in the Republic of Ireland, targeted health promotion initiatives and education programmes for healthcare professionals on supporting the continuation of breastfeeding.

Kajian Pengetahuan Ibu Tentang Autis dan Gizi Anak Autisdi Sekolah Luar Biasa (SLB) Negeri Nunumeu-Soe

Autism is a variant of autism spectrum disorder characterized by social communication difficulties and language barriers, narrow interests and rigid and repetitive behavior. This research aims to examine mothers' knowledge about autism and nutrition for autistic children at Nunumeu-Soe State Special School. This research is a qualitative research. Data collection was carried out using in-depth interview techniques with six informants who have autistic children at Nunumeu-Soe State Special School. The results of the research found that not all informants knew the symptoms of children with autism, so it was discovered that when children were 3-5 years old, the symptoms of autism that were often noticed were difficulty speaking and hyperactivity. Not all informants gave breast milk until the child was two years old due to work factors and replaced it with formula milk. All informants did not know the type of autistic behavior that influences children's consumption patterns, but the informants already knew the levels of autism. Mother's knowledge about nutrition for autistic children regarding types of food that adapt to the child's wishes containing gluten and casein. Food taboos in children are well known, but often escape the mother's attention due to permissive parenting, which causes serious symptoms in children. Barriers to health services and a lack of health workers in TTS district resulted in a lack of informant knowledge. Schools need to consult with local health services to educate parents about the nutrition of autistic children regarding the type of behavior and dietary restrictions of autistic children.

Changes in the Fatty Acid Profile of Lactating Women Living in Poland-A Comparison with the Fatty Acid Profile of Selected Infant Formulas.

The present study examined the fatty acid content of human milk from Polish women living in the Warmia and Mazury region with regard to different lactation periods and compared it with the fatty acid content of selected infant formulas. The analysis included samples of breast milk-colostrum (n = 21), transitional milk (n = 26), and mature milk (n = 22). Fat was extracted using the Rose-Gottlieb method, and the fatty acid profile was determined by gas chromatography with a flame ionization detector (FID). The proportion of SFAs (saturated fatty acids) > MUFAs (monounsaturated fatty acids) > PUFAs (polyunsaturated fatty acids) was determined in each fraction of breast milk and infant formula. Palmitic, oleic, and linoleic acids predominated in breast milk and infant formulas. Colostrum contained lower contents of selected SFAs (caprylic, capric, lauric) and higher contents of selected MUFAs (ercucic) and PUFAs (arachidonic and docosahexaenoic) (p < 0.05) relative to transitional and mature milk. Infant formulas were distinguished from human milk in terms of their SFA (caproic, caprylic, lauric, arachidic), MUFA (oleic), and PUFA (linoleic, α-linoleic) content. It should be noted that infant formulas contained significantly lower trans fatty acid (TFA) content-more than thirty-six and more than nineteen times lower than in human milk. Furthermore, human milk contained branched-chain fatty acids (BCFAs) at 0.23-0.28%, while infant formulas contained only trace amounts of these acids. The average ratio of n-6 to n-3 fatty acids for human milk was 6.59:1 and was close to the worldwide ratio of 6.53 ± 1.72:1. Both principal component analysis (PCA) and cluster analysis (CA) indicated significant differences in the fatty acid profile relative to lactation and a different profile of infant formulas relative to breast milk.

Gut microbiota in infants with food protein enterocolitis.

We explored the effects of two formulas, extensively hydrolyzed formula (EHF) and amino acid-based formula (AAF), on the gut microbiota and short-chain fatty acids (SCFAs) in infants with food protein-induced enterocolitis syndrome (FPIES). Fecal samples of thirty infants with bloody diarrhea receiving EHF or AAF feeding were collected at enrollment, diagnosis of FPIES, and four weeks after diagnosis. The gut microbiota and SCFAs were analyzed using 16 S rRNA gene sequencing and gas chromatography-mass spectrometry, respectively. Microbial diversity of FPIES infants was significantly different from that of the controls. FPIES infants had a significantly lower abundance of Bifidobacterium and a higher level of hexanoic acid compared with controls. In EHF-fed FPIES infants, microbial richness was significantly decreased over time; while the microbial diversity and richness in AAF-fed FPIES infants exhibited no differences at the three time points. By four weeks after diagnosis, EHF-fed FPIES infants contained a decreased abundance of Acinetobacter, whereas AAF-fed FPIES infants contained an increased abundance of Escherichia-Shigella. EHF-fed infants experienced significantly decreased levels of butyric acid and hexanoic acid at four weeks after diagnosis. Infants with FPIES had intestinal dysbiosis and different formulas differentially affected gut microbiota and SCFAs in FPIES infants. We firstly report the impacts of two different nutritional milk formulas on the gut microbial composition and SCFAs levels in infants with FPIES. We show that infants with FPIES have obvious intestinal dysbiosis and different formulas differentially affect gut microbiota and SCFAs in FPIES infants. Understanding the effects of different types of formulas on gut microbial colonization and composition, as well as the related metabolites in infants with FPIES could help provide valuable insights for making choices about feeding practices.

Determining nine fasciolicides and three metabolite residues in milk and infant formula using solid-phase extraction and liquid chromatography–tandem mass spectrometry

A new sensitive method of liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis for nine fasciolicides (closantel, rafoxanide, oxyclozanide, niclosamide, nitroxinil, ioxynil, 4-nitro-3-(trifluoromethyl)phenol, salicylanilide, and triclabendazole) and three metabolite residues (ketotriclabnedazole, triclabendazole sulfone, and triclabendazole sulfoxide) in milk and infant formula was established. The samples were extracted and purified through solid-phase extraction and analyzed using LC–MS/MS. The proposed method demonstrated high accuracy (the average recoveries ranged from 70.5 % to 107.4 %) and high sensitivity (the limits of quantification ranged from 1.0 to 25.0 µg/kg). This method was successfully applied to determine nine fasciolicides and three metabolite residues in 45 milk and infant formula, providing technical support for the safety and quality evaluation of dairy products.

Uji Daya Terima Formulasi Klepon dengan Substitusi Tepung Kacang Arab, Tepung Kelor, dan Tepung Katuk sebagai Kudapan Alternatif Ibu Menyusui

Exclusive breastfeeding in Indonesia is still relatively low. Intake of foods containing lactagogum for breastfeeding mothers is very necessary to facilitate breast milk and foods with sufficient protein and iron content can improve the quality of breast milk for babies. Utilizing local food ingredients with the nutritional content needed by breastfeeding mothers can help to increase the coverage of exclusive breastfeeding for babies. The aim of this research is to analyze the effect of substitution of local food ingredients, namely chickpeas, moringa, katuk and matcha on the acceptability, nutritional content, economic value and nutritional economic value of klepon cake as an alternative snack for breastfeeding mothers. This research is a pure experimental study on formula modification and quasi-experimental research on organoleptic tests with a completely randomized design (CRD) research design. There are five types of treatment with one control formula and four modified formulas with five repetitions. There were two types of panelists in this study, namely 3 panelists limited to preliminary research and 25 untrained panelists for follow-up research. Data collection techniques use organoleptic test forms and hedonic tests. Data analysis used the Friedman and Wilcoxson tests. The results of the research show that there is an effect of substitution of chickpea flour, moringa flour, katuk flour and matcha as alternative snacks for breastfeeding mothers.

The Influence of Premature Birth on the Development of Pulmonary Diseases: Focus on the Microbiome.

Globally, around 11% of neonates are born prematurely, comprising a highly vulnerable population with a myriad of health problems. Premature births are often accompanied by an underdeveloped immune system biased towards a Th2 phenotype and microbiota dysbiosis. Typically, a healthy gut microbiota interacts with the host, driving the proper maturation of the host immunity. However, factors like cesarean section, formula milk feeding, hospitalization in neonatal intensive care units (NICU), and routine antibiotic treatments compromise microbial colonization and increase the risk of developing related diseases. This, along with alterations in the innate immune system, could predispose the neonates to the development of respiratory diseases later in life. Currently, therapeutic strategies are mainly focused on restoring gut microbiota composition using probiotics and prebiotics. Understanding the interactions between the gut microbiota and the immature immune system in premature neonates could help to develop novel therapeutic strategies for treating or preventing gut-lung axis disorders.

Investigating factors influencing decision-making around use of breastmilk substitutes by health care professionals: a qualitative study

BackgroundBreastfeeding is recognized as the gold standard of infant feeding and nutrition. The World Health Organization recommends exclusive breastfeeding (EBF) of infants for the first 6 months of life. A variety of factors may impact breastfeeding practices in-hospital which may continue after hospital discharge, such as the use of breastmilk substitutes (BMS). The Baby-Friendly Initiative (BFI), which aims to promote and support breastfeeding practices, established a target rate of 75% for EBF from birth to hospital discharge. Currently, this target is not being met at The Ottawa Hospital (TOH), indicating there is room for improvement in EBF rates. The purpose of this study is to explore health care professionals (HCP) decision-making around use of BMS and identify factors that drive the use of BMS with and without medical indications.MethodsIn this qualitative study, semi-structured interviews were conducted with HCPs within TOH from January to June 2022. All participants had experience in maternity or postpartum care and were probed on factors influencing use of BMS at this institution. Interview transcripts were coded using an inductive approach.ResultsA total of 18 HCPs were interviewed including physicians, midwives, lactation consultants, and registered nurses. Multilevel barriers influencing the use of BMS were categorized into patient, HCP, and institution-level factors. Subthemes that emerged ranged from parental preferences, training differences amongst HCPs, to budget and staffing issues. Over half of HCPs were prepared to answer questions on EBF and were familiar with the BFI. Although most were supportive of this institution receiving BFI designation, a few providers raised concerns of its impact on parents who would like to supplement.ConclusionsSeveral modifiable factors influencing decision-making for use of BMS were identified. These findings will be used to inform unit leads, help identify effective strategies to address modifiable barriers, and develop tailored breastfeeding supports to improve EBF rates.