Infant Diet Research Articles

Development and pilot testing of the Baby-Feed web application for healthcare professionals and parents to improve infant diets

BackgroundDiet is key in preventing rapid infant weight gain but adherence to infant dietary recommendations is difficult to follow and low in adherence. ObjectiveDevelop and pilot test the “Baby-Feed” web application for parents and healthcare professionals to easily evaluate infant diets and provide immediate feedback to promote adherence to current infant dietary recommendations. MethodsBaby-Feed was developed following the ADDIE (analysis, design, development, implementation, and evaluation) model. It was pilot tested among two clinicians and 25 parents of infants aged 4 to 12 months that had a scheduled well-child visit at a community health center in Miami. After 2 weeks of using Baby-Feed, parents completed a feasibility, acceptability, satisfaction, and usability questionnaire. Parents and clinicians were also asked to suggest improvements. Descriptive analysis included frequency and median (25th, 75th percentiles). One-sample binomial tests was used to evaluate if feasible, acceptable, satisfactory, and usable. Results: Twenty-three parents completed the evaluation (all were mothers), 31.0 (26.0, 33.0) years-old, 96% Hispanic, 83% had ≥ high school education, with 1.5 (1.0, 2.0) children. Infants’ age was 6.1 (4.0, 9.0) months and 57% were boys. Binomial tests indicated that most parents (greater than87%) agreed that Baby-Feed was easy to use, learn, quick, would use it again, rated it as 4/5 stars. They used it greater than 1 times per week (p < 0.001). Parents suggested improving the visuals (more icons, colors, and pictures) and images of portion sizes, highlighting missing fields, being able to view/open it on their phones, and adding recipes and more information. The two clinicians (a pediatrician and a physician assistant) suggested to be open-access and to add more infant nutrition information. ConclusionBaby-Feed was feasible, usable, satisfactory, and acceptable. It could be used as a tool to easily evaluate infant diets in the healthcare setting to provide immediate feedback.

Introduction of Egg White and Yolk to Infant Diets and Early Childhood Atopic Dermatitis.

This study investigated whether the introduction of allergenic foods in infancy is associated with atopic dermatitis (AD) in early childhood. Information regarding parental allergic histories, the introduction of six possible allergenic foods (fruits, egg white, egg yolk, fish, shellfish, and peanuts), and physician-diagnosed AD was obtained using age-specific questionnaires (0-2 years). Immunoglobulin E, specific to 20 food allergens, was also quantified at 12 months of age. Logistic regression analyses were used to determine the association between individual food introduction and the outcomes of food sensitization and AD. We found AD development by 2 years of age was significantly related to a parental history of allergy (adjusted odds ratio (aOR) = 1.29) and not being introduced to egg white and yolk during infancy (aORs = 2.27 and 1.97, respectively). Stratified analyses revealed that the introduction of both egg white and yolk was negatively associated with AD by 2 years of age, especially for those children where both parents had allergic diseases (aOR = 0.10). In summary, the introduction of egg white and yolk to an infant's diet may be a modifiable factor in reducing the risk of physician-diagnosed AD by 2 years of age, which may be particularly important for infants where both parents have allergies.

Food allergy prevention: Where are we in 2023?

Food allergy prevention involves recommendations to the maternal diet during pregnancy and breast feeding, early life feeding and introduction of solid foods. Pregnant and breastfeeding women are not recommended to exclude any food allergens from their diet, but data are lacking to support active consumption of food allergens for prevention of food allergy. Breastfeeding is recommended for the many health benefits to the mother and child but has not shown any association with reduction in childhood food allergies. There is currently no recommendation regarding the use of any infant formula for allergy prevention, including the use of partially or extensively hydrolyzed formulas. Once the introduction of solid food commences, based on randomized controlled trials, it is advised to actively introduce peanuts and egg early into the infant diet and continue with consumption of these. Although there are limited data with respect to other major food allergens and whether early introduction may prevent allergy development, there is no need to delay the introduction of these allergens into the infant diet. Interpreting food allergen consumption in the context of cultural food practices has not been studied, but it makes sense to introduce the infant to family foods by 1 year of age. Consumption of foods typical of the Western diet and foods high in advanced glycation end products may be associated with an increase in food allergies. Similarly, intake of micronutrients, such as vitamin D and omega-3 fatty acids in both the maternal and infant diet, needs further clarification in the context of food allergy prevention.

The Infant Diet Quality Index Predicts Dietary and Adiposity Outcomes in US Children 2 to 4 years old

BackgroundHealthy nutrition during the first year of life is critical for optimal growth and development. Limited techniques are available to assess diet quality in infancy, and few have been shown to be predictive of dietary and adiposity outcomes in low-income children. ObjectiveThe objectives of this study were to construct an Infant Diet Quality Index (IDQI) to assess the diet quality from birth to 12 mo and to determine whether the IDQI exhibits predictive validity by estimating the longitudinal associations of IDQI scores with diet quality and weight status at 2 to 4 y. DesignData were analyzed from the longitudinal Women, Infants, and Children Infant and Toddler Feeding Practices Study-2 (unweighted, n = 2858; weighted. N = 392,439) using one 24-h dietary recall and survey responses during infancy. The newly constructed IDQI consists of 16 equally-weighted components: 1) breastfeeding duration; 2) exclusive breastfeeding; age of first introduction of: 3) solids, 4) iron-rich cereals, 5) cow milk, 6) sugar-sweetened beverages, 7) salty/sweet snacks, 8) other drinks/liquids, and 9) textured foods; frequency of consuming 10) fruit or 11) vegetables; frequency of consuming different 12) fruit or 13) vegetables; 14) nonrecommended bottle-feeding practices; 15) use of commercial baby foods; and 16) number of meals and snacks. Regression analysis was used to estimate associations between the total IDQI score (range, 0–1) and Healthy Eating Index-2015 (HEI-2015) scores and body mass index z-scores (BMIz) at 2 to 4 y of age, adjusted for covariates (e.g., child age, sex and race/ethnicity; maternal education level, etc.) ResultsThe total IDQI score was positively associated with HEI-2015 at the age of 2 y (β = 16.7; 95% CI: 12.6, 20.9; P < 0.001), 3 y (β = 14.5; 95% CI: 8.1, 21.0; P < 0.001), and 4 y (β = 15.4; 95% CI: 8.4, 22.4; P < 0.001); and negatively associated with BMIz at the age of 2 y (β = -1.24; 95% CI: -2.01, -0.47; P = 0.002) and 4 y (β = -0.92; 95% CI: -1.53, -0.30; P = 0.003). ConclusionsThe IDQI has predictive validity for diet quality and weight status in low-income US children.

Complementary and Allergenic Food Introduction in Infants: An Umbrella Review.

Multiple systematic reviews examine the introduction of foods in relation to individual health outcomes, but the balance of harms and benefits has not been overviewed systematically. We aimed to perform an overview of systematic reviews on age of introduction of complementary and allergenic foods to the infant diet and long and short-term health outcomes. We searched Medline, Embase, Cochrane, and PubMed (July 25, 2022). Included systematic reviews examining the introduction of complementary or allergenic foods before age 1. Outcomes included allergic, autoimmune, and inflammatory diseases, neurodevelopment, nutrition, and weight. Extraction and quality assessment were performed in duplicate (A Measurement Tool to Assess Systematic Reviews) and strength of evidence was assessed. We screened 4015 articles and included 32 systematic reviews. There was moderate evidence that peanut and egg should be introduced from 4 to 11 months to prevent food allergy (6 of 10 reviews). Complementary food introduction was not associated with food allergy. Moderate certainty evidence suggested age of complementary food introduction was not associated with eczema. Age at introduction of gluten was not associated with celiac disease (high certainty evidence; 3 of 4 reviews). Low certainty evidence indicated that introducing solids before 4 months may increase the risk of childhood obesity, but not growth. There was insufficient evidence regarding an association between any food introduction and bone health, gastrointestinal diseases, autoimmune disorders, asthma, or allergic rhinitis. Gray literature was not included. Current evidence supports introducing complementary foods around 6 months and allergenic foods before 11 months.

Children of the grave: Investigating non-adult feeding practices in medieval and early modern Estonia through stable isotope analysis.

Studying infant diet and feeding practices through stable isotope analysis provides direct insight into the life and health of vulnerable population groups in the past. Although the general diet in medieval and early modern Livonia has been reconstructed from written sources, little is known about childhood diet during this tumultuous period of Eastern European history. This study presents a comparative investigation of the staple non-adult diet in urban/rural communities during the 13th-17th centuries AD, with a special focus on feeding practices. We aim to reveal the impact of socio-economic circumstances on early childhood nutrition, which affects the physical development and overall survival of this susceptible population group. Bone collagen samples from 176 individuals between the fetal and the 7-15 age categories from four urban/rural South-Estonian cemeteries were cross-sectionally analyzed via EA-IRMS (Elemental Analysis with Isotope Ratio Mass Spectroscopy) for δ13C and δ15N. Results suggest that South-Estonian children had a staple terrestrial C3 diet integrated with animal proteins. Significant divergences were observed between urban and rural sites and slight variation occurred among rural subgroups, possibly resulting from a wider food choice available in towns, different consumption of C4 foods, and/or secular changes. This study provides the first data regarding infant feeding practices in medieval and early modern Livonia. These practices were similar among the different contexts, indicating comparable cultural traditions in child rearing. Breastfeeding was likely practiced for 1-2 years, with supplementary foods introduced around 1 year of age. The weaning process was probably concluded around the age of 3. The δ13C and δ15N values of older children are comparable to those of the adults from the same sites, indicating their diets became similar after weaning, when they started working and obtained a more mature social status.

Immunonutrition: Diet Diversity, Gut Microbiome and Prevention of Allergic Diseases.

Allergic diseases are increasing both in morbidity and mortality. Genetic, environmental, and dietary factors may all be involved in this increase. Nutrition during pregnancy, breastfeeding, and early life may play a particularly important role in preventing allergic diseases. Based on current systematic reviews, the intake of specific nutrients has failed to prevent allergic disease. Prevention strategies have shifted their focus to the overall diet which can be described using diet diversity. Infant and maternal diet diversity in pregnancy has been associated with reduced allergy outcomes in childhood. Overall, diet also seems to have a marked effect on the microbiome compared to single foods. Factors that may negate the allergy-preventative effect of overall diet diversity include the addition of emulsifiers, advanced glycation end-product content, and overuse of commercial baby foods. There is a need to perform randomized controlled trials using overall dietary intake to support international food allergy guidelines. These studies should ideally be conducted by multi-professional teams.

Budget Impact of Early Introduction of Amino Acid Formula in Managing Infants with Cow Milk Protein Allergy: Arabian Gulf Countries' Experience.

This study estimates the budgetary impact of the introduction of amino-acid formula (AAF) as first-line management in the elimination diet of infants with suspected cow milk protein allergy (CMPA) in the Kingdom of Saudi Arabia (KSA), Kuwait, and the United Arab Emirates (UAE) from a health-care payer's perspective. A global decision tree model was adapted to compare estimated costs in current practice (extensively hydrolyzed formula [eHF] or soy formula [SF] with the proposed approach of early introduction of AAF as first-line treatment of CMPA in non-breast-fed infants). Model inputs were derived from explorative literature reviews and medical experts' opinions. All costs were reported in local currency, ie, Saudi Riyal (SAR) for KSA, Kuwaiti Dinar (KWD) for Kuwait, and United Arab Emirates Dirham (AED) for the UAE. Cost savings with the early introduction of AAF were 10% (SAR 15102542) in KSA, 10% (KWD 306565) in Kuwait, 17% (AED 1842018) in the UAE government sector and 13% (AED 4232932) in the UAE private sector. The highest cost reduction was observed in the cost of soy formula (SF), with a 58% reduction both in KSA (SAR 4204540) and UAE public sector (AED 110331). A significant cost reduction in medication costs in Kuwait (37%; KWD 5630) and medical examination costs in the UAE private sector (50%; AED 1508918) was observed. Results indicated that the introduction of AAF as the first line in the management of CMPA is a cost-saving strategy for the Gulf Cooperation Council (GCC) countries-KSA, Kuwait, and UAE- from a health-care payer's perspective.

Os efeitos da dieta FODMAP em crianças e adolescentes com a síndrome do intestino irritável - revisão sistemática

INTRODUCTION: Food is a triggering factor for irritable bowel syndrome (IBS) symptoms. One therapeutic management option that has had beneficial effects is a low-FODMAP diet (acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols). OBJECTIVE: To analyze the efficacy and effects of a low-FODMAP diet in pediatric patients with IBS. METHODS: Systematic review using data from PubMed, SciELO and BVS using the descriptors “(Irritable bowel syndrome) AND (FODMAP)”, age filter from 0 to 18 years, in English, Portuguese and Spanish, with a 10-year temporal filter. Duplicate articles, articles not in agreement with the theme and non-scientific work were excluded. RESULTS AND DISCUSSION: 445 articles were found, but only 3 articles were selected among the eligibility criteria. The studies analyzed make comparisons between the test group and the placebo group, or compare children on a typical American infant diet with a reduced FODMAP diet. It is evident that the low FODMAP diet reduces the symptoms of IBS, but it has factors that make it difficult to be practicable, such as: difficulty in being taught and understood, high cost, impact on the intestinal microbiota, presence of side effects such as constipation, in addition to the impact psychological impact of these restrictions for this age group. CONCLUSION: A low-FODMAP diet is a therapy that alleviates the clinical conditions manifested in IBS, but its applicability is limited. More clinical and experimental studies are needed in order to establish whether the benefits of inserting this restrictive diet outweigh the possible harms.

Food Taboos, Factors of Chronic Malnutrition in Bopa, South West Benin

The quality of the diet from the first hours of life is decisive. Any inappropriate diet for pregnant women or infants has an irreversible impact on a child's bio-morphological and cognitive levels, leading to chronic malnutrition. This study assesses the factors that explain adherence to dietary taboos or restrictions and the factors statistically significantly related to the choice of nutritional restrictions in households housing stunted children under five years of age in southwest Benin. Data were collected in December 2020 on a sample of 558 families in 40 villages in the commune of Bopa in southwest Benin. Socioeconomic data from families, and anthropometric data from children (498) are analyzed within univariate, bivariate and binary logit regression methods. Results show that 36.3% of children are stunted, and 76.2% of households with stunted children have food taboos. In addition, 69.6% of households have at least one taboo on consuming beef, goat, poultry, pork, eggs, and fish, reducing in-take of the required micronutrients child growth. The gender of the head of the household, their occupation, religion, level of education, age category, area of residence, level of education of the wife of the head of the household, and average monthly household income have statistically significant effects on adherence to food taboos and restrictions in the household diet. To effectively combat stunting, advocacy targeting religious leaders and the local elite is needed.

The Relationship Between Diet, Gut Microbiota, and Serum Metabolome of South Asian Infants at 1 Year

BackgroundDiet is known to affect the gut microbiota and the serum metabolome in adults, but this has not been fully explored in infants. Infancy is an important developmental period that may influence a person’s long-term health. Infant development can be affected by diet, which also interacts with the developing gut microbiota. ObjectivesThis study aimed to explore the associations between diet, the gut microbiota, and the serum metabolome of 1-y-old infants with the overarching goal of identifying serum biomarkers of diet and/or the gut microbiota. MethodsWe derived dietary patterns of 1-y-old infants (n = 182) participating in the Canadian South Asian Birth Cohort (START) study. We compared gut microbiota α-diversity and β-diversity and taxa relative abundance from 16S rRNA gene profiles with dietary patterns (PERMANOVA, Envfit) and investigated diet–serum metabolite associations using a multivariate analysis (partial least squares–discriminant analysis) and univariate analysis (t test). We explored the effect of nondietary factors on diet–serum metabolite relationships by incorporating diet, the gut microbiota, and maternal, perinatal, and infant characteristics in a multivariable forward stepwise regression. We replicated this analysis in White European infants, from the CHILD Cohort Study (n = 81). ResultsA dietary pattern characterized by formula consumption and negatively associated with breastfeeding most strongly predicted variation in the gut microbiota (R2 = 0.109) and serum metabolome (R2 = 0.547). Breastfed participants showed higher abundance of microbes from the genera Bifidobacterium (3.29 log2-fold) and Lactobacillus (7.93 log2-fold) and higher median concentrations of the metabolites S-methylcysteine (1.38 μM) and tryptophan betaine (0.43 μM) than nonbreastfed participants. Formula consuming infants showed higher median concentrations of branched-chain/aromatic amino acids (average 48.3 μM) than non–formula-consuming infants. ConclusionsFormula consumption and breastfeeding most strongly predicted the serum metabolites of 1-y-old infants, even when the gut microbiota, solid food consumption, and other covariates were considered.

Conceptualizing multi-level determinants of infant and young child nutrition in the Republic of Marshall Islands-a socio-ecological perspective.

The East and Pacific region includes 14 Pacific Island Countries where, between 2000 and 2016, indicators of stunting, wasting, and micronutrient deficiencies have plateaued or worsened, while rates of overweight, obesity, and associated disease have risen. The Republic of Marshall Islands (RMI) is no exception: maternal and child nutrition indicators have not improved in decades. A study of the contemporary factors shaping the RMI nutrition situation was needed for informing policy and tailoring interventions. This formative study had an iterative design utilizing qualitative methods. An exploratory Phase 1 included 59 semi-structured interviews with community members, 86 free lists with caregivers, 8 participatory workshops, and 20 meal observations (round 1). Findings were synthesized to inform a confirmatory Phase 2 where 13 focus groups, 81 pile sorts, 15 meal observations (round 2), and 2 seasonal food availability workshops were conducted. Textual data were analyzed thematically using NVivo while cultural domain analysis was conducted in Anthropac. RMI faces interrelated challenges that contribute to a lack of nutritious and local food availability, which is compounded by high food costs relative to household incomes. A decades-long cultural transition from local to processed diets has resulted in infant and young child diets now characterized by morning meals of doughnuts, bread, and ramen with tea, coffee, or Kool-Aid and afternoon meals that include rice with canned meats (e.g., store-bought chicken, hot dogs). Individual preferences for processed food imports have increased their supply. Low maternal risk perception toward nutrition-related illnesses may further explain sub-optimal diets. Improving the RMI food environment will require approaches that align with the multi-level determinants of sub-optimal diets found in this study. As the ten-year 2013 RMI Food Security Policy soon ends, study findings may be used to inform new policy development and investments for improving the nutrition situation.

Baby Food Purees Obtained from Ten Different Apple Cultivars and Vegetable Mixtures: Product Development and Quality Control

As is well known, apples are the most complex fruit in terms of nutritional compounds, with a high content of fiber, vitamins (vitamins C, A, B3), and minerals. Both fruits and vegetables are important sources of nutrients for infants’ nutrition and healthy development. The purpose of this study was to develop and analyze baby food purees obtained from apples and vegetables. Ten types of baby purees were obtained from the most-consumed varieties of apples from Romania, along with purees of carrots, pumpkin and celery. The resulting samples were analyzed in terms of moisture, ash content, titratable acidity, and vitamin C content. The total polyphenol content was assessed by the Folin–Ciocalteu method, while total antioxidant capacity was determined by the DPPH method; moreover, the color parameters and textural properties were also assessed. Following the results obtained, the purees can be introduced into the diet of infants and children, providing them with the necessary vitamins and minerals for optimal development. The analyses performed on both fresh and sterilized products highlighted the effects of heat treatment on the components of the product. The most important changes were observed in the vitamin C content, which was decreased by 50–70% in all ten purees. Total polyphenol content (TPC) increased in sterilized samples up to 70 mg GAE/100 g. Antioxidant capacity (AC) almost doubled its value in some samples after the thermal process application. Regarding the adhesiveness and deformation at hardness, which represented the main parameters for baby’s food, the value increased in the sterilized product, making the product more suitable for infants. This survey provides a detailed description of the development of baby food purees, showing the conveniences of developing purees for children based on fruits and vegetables.

Diets of infants and young children in two counties of Kenya: Key drivers and barriers to improvement.

Infant and young child feeding (IYCF) practices are influenced by many context-specific factors related to local food systems as well as social and cultural practices. Understanding these local contextual perspectives is essential for designing effective programs and policies. This paper uses focused ethnographic study methods to examine challenges experienced by mothers related to IYCF in two counties in Kenya, a country with considerable heterogeneity in agriculture, food systems, and cultures. A two-phase qualitative study was undertaken in each of Kilifi County and West Pokot County, entailing interviews and rating activities with mothers, health workers, and vendors. Interviews were audio-recorded, transcribed, translated into English, coded, and analysed by topic. Results show low levels of dietary diversity in both counties; in West Pokot, the level of adequate meal frequency is also low. Core foods in young child diets included maize porridge and family foods such as ugali (stiff maize porridge), vegetables, beans, fish, and plantains. Food safety, acceptability, and acquisition ease were the main drivers of food choice. Mothers generally felt that all core foods fed to young children are healthy and safe, but there was more variability regarding child acceptance, acquisition ease, cost, and convenience. Common barriers to feeding nutrient-dense foods to children included child illness, economic constraints, and limited knowledge of modification strategies, skills, or tools to make the foods suitable for young children. Potential actions to address these barriers include sharing information on child-appropriate recipes; raising awareness on local, affordable nutrient-dense foods; and improving WASH practices to reduce illness frequency.

Implementation and maintenance of infant dietary diversity in Zimbabwe: contribution of food and water insecurity

BackgroundInadequate food and water resources negatively affect child health and the efficiency of nutrition interventions.MethodsWe used data from the SHINE trial to investigate the associations of food insecurity (FI) and water insecurity (WI) on mothers’ implementation and maintenance of minimum infant dietary diversity (MIDD). We conducted factor analysis to identify and score dimensions of FI (poor access, household shocks, low availability & quality), and WI (poor access, poor quality and low reliability). MIDD implementation (n = 636) was adequate if infants aged 12 months (M12) ate ≥ four food groups. MIDD maintenance (n = 624) was categorized into four mutually exclusive groups: A (unmet MIDD at both M12 and M18), B (unmet MIDD at M12 only), C (unmet MIDD at M18 only), and D (met MIDD at both M12 and M18). We used multivariable-adjusted binary logistic and multinomial regressions to determine likelihood of MIDD implementation, and of belonging to MIDD maintenance groups A-C (poor maintenance groups), compared to group D, respectively.ResultsLow food availability & quality were negatively associated with implementation (OR = 0.81; 0.69, 0.97), and maintenance (ORB = 1.29; 1.07, 1.56). Poor water quality was positively associated with implementation (OR = 1.25; 1.08, 1.44), but inconsistently associated with maintenance, with higher odds of infants being in group C (OR = 1.39; 1.08, 1.79), and lower odds of being in group B (OR = 0.80; 0.66, 0.96).ConclusionFood security should be prioritized for adequate implementation and maintenance of infant diets during complementary feeding. The inconsistent findings with water quality indicate the need for further research on WI and infant feeding.

NOVEL PLANT-BASED PEDIATRIC FORMULA ALTERNATIVE FOR MANAGEMENT OF NON-IGE-MEDIATED FOOD ALLERGIES: A CASE STUDY

<h3>Introduction</h3> Traditional management of food protein-induced allergic proctocolitis (FPIAP) includes use of extensively hydrolyzed or elemental formula and/or the removal of dairy and soy from maternal diet for breastmilk-fed infants. This case outlines use of a novel plant-based pediatric formula in an infant diagnosed with dairy and soy-protein FPIAP. <h3>Case Description</h3> At 2 weeks of age, P presented with a dusky, distended belly and stridor within 24 hours of initial exposure to a polymeric cow milk-based infant formula. Following standard protocol for suspected FPIAP, he was transitioned to an elemental formula and his mother was placed on an elimination diet. Breastmilk was re-introduced after 10 days of elimination diet with formula supplementation. He was transitioned to supplemental extensively-hydrolyzed casein formula at 6 months. At age 10 months, due to U.S. infant formula shortages, P transitioned successfully to a novel plant-based pediatric formula sourced from almonds and buckwheat that is free of soy, rice, and pea proteins. P failed cow's milk challenge and subsequently pea-protein milk challenge upon turning 12 months, which both induced repeated gastrointestinal distress. Symptoms resolved upon re-introduction of the novel plant-based formula. <h3>Discussion</h3> This case demonstrates that an alternative protein-sourced formula has the potential to serve as a safe alternative therapy strategy to address patients with FPIAP unable to exclusively breastfeed and/or tolerate traditional formulas. These findings justify the need for further development and demonstration in a clinical setting of an alternative protein-sourced infant formula to be used in the standard management of food allergy disorders.

Oral Tolerance Induction-Opportunities and Mechanisms.

Oral tolerance is the active absence of response to food allergens, which involves complex mechanisms in the gut-associated lymphoid tissue. Food allergy results from the disruption of such tolerance or the absence of its establishment in the first place. It follows allergic sensitization with the production of allergen-specific IgE and results from the degranulation of basophils and mast cells on subsequent exposure to the allergen. Oral tolerance induction has been explored in the contexts of prevention and treatment of food allergy. Early introduction of allergenic foods (i.e., egg and peanut) in the diet of infants, before allergic sensitization occurs (i.e., via inflamed skin affected with eczema) has shown to be beneficial. Guidelines have changed to recommend the introduction of these allergenic foods by 6 months of age. For food allergic individuals, oral tolerance induction has been attempted using allergen-specific immunotherapy, which involves the administration of an allergen, modified or not, through various possible routes, including oral, sublingual, epicutaneous, and subcutaneous, with or without concomitant administration of antibody-based biologics. Further research into the immune mechanisms of food allergy and oral tolerance can lead to the identification of novel targets to suppress the food allergic response and reverse the current food allergy epidemic.

Support for healthy breastfeeding mothers with healthy term babies.

Support for healthy breastfeeding mothers with healthy term babies.

Bile acids profile and redox status in healthy infants.

At birth, human neonates are more likely to develop cholestasis and oxidative stress due to immaturity or other causes. We aimed to search for a potential association between bile acids profile, redox status, and type of diet in healthy infants. A cross-sectional, exploratory study enrolled 2-month-old full-term infants (n = 32). We measured plasma bile acids (total and conjugated), and red blood cell (RBC) oxidative stress biomarkers. The type of diet (breastfeeding, mixed, formula) was used as an independent variable. Plasma total bile acids medium value was 14.80 µmol/L (IQR: 9.25-18.00). The plasma-conjugated chenodeoxycholic acid percentage (CDCA%) correlated significantly and negatively with RBCs membrane-bound hemoglobin percentage (MBH%) (r = -0.635, p < 0.01) and with RBC-oxidized glutathione (r = -0.403, p < 0.05) levels. RBC oxidative stress biomarkers (especially MBH%) were predictors of conjugated CDCA%, and this predictive ability was enhanced when adjusted for the type of diet (MBH, r = 0.452, p < 0.001). Our data suggest that the bile acid profile might play a role in the regulation of redox status (or vice versa) in early postnatal life. Eventually, the type of diet may have some impact on this process. The conjugated CDCA% in plasma is negatively correlated with biomarkers of RBC oxidative stress in healthy infants. Specific biomarkers of RBC oxidative stress (e.g. MBH, GSH, GSSG) may be promising predictors of conjugated CDCA% in plasma. The type of diet may influence the predictive ability of hit RBC oxidative stress biomarkers (e.g. MBH, GSH, GSSG). Our findings suggest a link between plasma bile acids profile and the RBC redox status in healthy infants, eventually modulated by the type of diet. The recognition of this link may contribute to the development of preventive and therapeutic strategies for neonatal cholestasis.

Timing and social patterning of weaning practices in Cyprus: BrEaST start in life longitudinal study

Abstract Background Introduction of solids in the infant diet, according to WHO recommendations, should initiate onwards of sixth months. Evidence, however, suggests that solids introduction occurs earlier even if breastfeeding continues. With low breastfeeding rates, Cyprus is ranking last in Europe and little is known about the timing and socio-demographic pattern of solid introduction. Methods Using the retrospective event calendar method at the 4th and 6th month after birth, the timing of initiation of solids was estimated among a consecutive sample of 350 mother-baby dyads from all public (N = 5) and 29 (of 35) private maternity clinics. The likelihood of early introduction according to socio-demographic characteristics and breastfeeding self-efficacy (measured at birth and 1st month) was estimated in logistic regression models. Results Three out of ten women (30.8%) had initiated solids before the 4th month and only 20% hadn't by the 6th month. Almost half of non-Cypriot mothers (47.1%) initiated solids earlier than the 5th month, twice more likely compared to 25.1% of Cypriot mothers (OR: 2.45 95% CI: 1.30-4.57). There was a stepwise association with educational attainment with mothers with tertiary education more likely to initiate solids later (OR: 2.76 95% CI: 1.33-5.71) compared to those with at most secondary education. A similar social gradient was observed with income but was not statistically significant in multivariable models, while no association was observed with mode of birth (55.9% by C/S). Even though low breastfeeding self-efficacy at first month was predictive of earlier initiation, surprisingly, primiparous or multiparous mothers without previous breastfeeding experience were more likely to initiate solids later. Conclusions Early introduction of solids with a clear social gradient suggests the need for strengthening the currently weak community-based interventions to improve weaning practices, including screening for breastfeeding self-efficacy. Key messages • Four in five mums in Cyprus introduce solids before the 6th month with one in three introducing solids in the infant’s diet before the 4th month, with a clear social gradient in the patterning. • Community-based intervention programmes are needed to improve weaning practices, including screening for low breastfeeding self-efficacy in a country with low breastfeeding rates.