Healthy Chinese Infants Research Articles

Restoration of gut microbiota with a specific synbiotic-containing infant formula in healthy Chinese infants born by cesarean section.

Birth by cesarean section (C-section) is associated with a delayed colonization of bifidobacteria and Bacteroidota species with potential negative health consequences. Previously, an infant formula with a synbiotic mixture of short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides (scGOS/lcFOS [9:1]) and Bifidobacterium breve M-16V was found to restore the timely colonization of bifidobacteria in C-section born infants. In this study, we investigated the effect of this synbiotic mixture on gut microbiota development in C-section and vaginally-born infants participating in a growth equivalence trial (NCT03520764). Healthy, fully formula-fed Chinese infants were randomized to receive a partially hydrolyzed whey-based protein formula with the synbiotic mixture (n = 112), or an intact protein formula with scGOS/lcFOS (prebiotic, n = 112). Breastfed infants served as reference group (n = 60). Gut microbiota profiling by 16S rRNA gene sequencing of stools collected at baseline, 17 weeks (end of intervention) and 12 months of age was complemented with analysis of stool pH, short-chain fatty acids, lactic acids, and secretory IgA concentrations. Both the prebiotic and the synbiotic formula supported a dominant and diverse infant-type bifidobacterial community, but with increased abundance of Bifidobacterium breve in the synbiotic group. In C-section born infants (54.8% of randomized) the synbiotic but not the prebiotic, enhanced the bifidobacterial species diversity and showed restoration of Parabacteroides at 17 weeks, and Bacteroides spp. at 12 months closer to that of the vaginally-born infants. The synbiotic was confirmed to support the restoration of important gut colonizers in infants born by C-section with effects observed even beyond the intervention period.

A Cross-sectional Study Assessing Gastrointestinal Symptoms, Eating Behavior and Parental Quality of Life in Chinese Infants Consuming Goat Milk-Based Formula or Cow’s Milk-Based Formula

Objectives: Gastrointestinal (GI) symptoms affect approximately half of infants and can adversely impact infants’ and parents’ quality of life. In this cross-sectional study, infants fed goat milk-based infant formula (GMF) and infants fed cow’s milk-based infant formula (CMF) were compared regarding milk-related symptoms, eating behavior and their parents’ quality of life (QOL). Methods: Healthy Chinese infants aged <6 months, who were either exclusively GMF- (n=303) or CMF-fed (n=464), were included. Parents completed four questionnaires: Cow’s Milk-related Symptom Score (CoMiSS®), Infant Gastrointestinal Symptom Questionnaire (IGSQ), World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, and Baby Eating Behavior Questionnaire (BEBQ). Composite scores were compared between infants consuming GMF and CMF using Poisson regression or ANCOVA models. Results: Infants, mean age 87.8 days, scored low on overall CoMiSS® (median 2, IQR 0-4) and IGSQ (median 16, IQR 14-20), indicating low occurrence of symptoms. The overall CoMiSS® was lower in GMF-fed infants compared to CMF-fed infants (p<0.001), specifically driven by crying (p=0.006), skin eczema (p=0.014) and urticaria (p=0.039). Parents of GMF-fed infants experienced better QOL regarding social relationships compared to parents of CMF-fed infants (p=0.038). Differences in eating behavior were seen in food responsiveness (p=0.003) and slowness in eating (p=0.005). No differences were seen on total IGSQ and total WHO-QOL. Conclusions: Both infants consuming GMF and CMF showed normal scores on GI symptoms, eating behavior and their parents’ quality of life. Infants consuming GMF experience less milk-related symptoms than infants consuming CMF, based on lower CoMiSS® scores.

Influence of Feeding Practices on Intestinal Microbiota Composition in Healthy Chinese Infants: A Prospective Cohort Study

IntroductionThis study investigates the impact of different feeding methods (direct breastfeeding, expressed milk feeding, formula feeding) on the infant microbiota at 6 weeks of age. MethodsA total of 217 healthy infants stool samples were collected from Hong Kong between August 2018 and December 2019. ResultsVarious microbial taxa, including the genera Enterobacter and Raoultella were identified in the expressed breast milk feeding group. The richness and composition of the major bacterial phyla showed similar abundance between direct breastfeeding and expressed breast milk. DiscussionThese findings suggests that these bacteria may have colonized the milk during expression or could be introduced from other external sources. The mode of breastfeeding did not significantly alter microbiota parameters in the infant gut at 6 weeks.

A phase 3 randomized, open-label study evaluating the immunogenicity and safety of concomitant and staggered administration of a live, pentavalent rotavirus vaccine and an inactivated poliomyelitis vaccine in healthy infants in China

ABSTRACT This open-label, randomized, phase 3 study in China (V260-074; NCT04481191) evaluated the immunogenicity and safety of concomitant and staggered administration of three doses of an oral, live, pentavalent rotavirus vaccine (RV5) and three doses of an intramuscular, inactivated poliomyelitis vaccine (IPV) in 400 healthy infants. The primary objective was the non-inferiority of neutralizing antibody (nAb) responses in the concomitant- versus the staggered-use groups. Antibody responses were measured at baseline and 1-month post-dose 3 (PD3). Parents/legal guardians recorded adverse events for 30 or 15 d after study vaccinations in the concomitant-use or staggered-use groups, respectively. At PD3, >98% of participants seroconverted to all three poliovirus types, and the primary objective was met as lower bounds of the two-sided 95% CI for between-group difference in nAb seroconversion percentages ranged from − 4.3% to − 1.6%, for all poliovirus types, p < .001. At PD3, geometric mean titers (GMTs) of nAb responses to poliovirus types 1, 2, and 3 in the concomitant-use group and the staggered-use group were comparable; 100% of participants had nAb titers ≥1:8 and ≥1:64 for all poliovirus types. Anti-rotavirus serotype-specific IgA GMTs and participants with ≥3-fold rise in postvaccination titers from baseline were comparable between groups. Administration of RV5 and IPV was well tolerated with comparable safety profiles in both groups. The immunogenicity of IPV in the concomitant-use group was non-inferior to the staggered-use group and RV5 was immunogenic in both groups. No safety concerns were identified. These data support the concomitant use of RV5 and IPV in healthy Chinese infants.

Eight Weeks of Bifidobacterium lactis BL-99 Supplementation Improves Lipid Metabolism and Sports Performance through Short-Chain Fatty Acids in Cross-Country Skiers: A Preliminary Study.

(1) Background: Probiotics in the form of nutritional supplements are safe and potentially useful for strategic application among endurance athletes. Bifidobacterium animalis lactis BL-99 (BL-99) was isolated from the intestines of healthy Chinese infants. We combined plasma-targeted metabolomics and fecal metagenomics to explore the effect of 8 weeks of BL-99 supplementation on cross-country skiers' metabolism and sports performance. (2) Methods: Sixteen national top-level male cross-country skiers were recruited and randomly divided into a placebo group (C) and a BL-99 group (E). The participants took the supplements four times/day (with each of three meals and at 21:00) consistently for 8 weeks. The experiment was conducted in a single-blind randomized fashion. The subject's dietary intake and total daily energy consumption were recorded. Blood and stool samples were collected before and after the 8-week intervention, and body composition, muscle strength, blood biochemical parameters, plasma-targeted metabolomic data, and fecal metagenomic data were then analyzed. (3) Results: The following changes occurred after 8 weeks of BL-99 supplementation: (a) There was no significant difference in the average total daily energy consumption and body composition between the C and E groups. (b) The VO2max and 60°/s and 180°/s knee joint extensor strength significantly increased in both the C and E groups. By the eighth week, the VO2max and 60 s knee-joint extensor strength were significantly higher in the E group than in the C group. (c) The triglyceride levels significantly decreased in both the C and E groups. In addition, the LDL-C levels significantly decreased in the E group. (d) The abundance of Bifidobacterium animalis increased two-fold in the C group and forty-fold in the E group. (e) Plasma-targeted metabolomic analysis showed that, after eight weeks of BL-99 supplementation, the increases in DHA, adrenic acid, linoleic acid, and acetic acid and decreases in glycocholic acid and glycodeoxycholic acid in the E group were significantly higher than those in the C group. (f) Spearman correlation analysis showed that there was a significant positive correlation between Bifidobacterium animalis' abundance and SCFAs, PUFAs, and bile acids. (g) There was a significant correlation between the most significantly regulated metabolites and indicators related to sports performance and lipid metabolism. (4) Conclusions: Eight weeks of BL-99 supplementation combined with training may help to improve lipid metabolism and sports performance by increasing the abundance of Bifidobacterium, which can promote the generation of short-chain fatty acids and unsaturated fatty acids, and inhibit the synthesis of bile acids.

Safety and tolerance assessment of milk fat globule membrane-enriched infant formulas in healthy term Chinese infants: a randomised multicenter controlled trial

BackgroundMilk fat globule membrane (MFGM), natural to breast milk, is essential for neonatal development, but lacking from standard infant formulas.ObjectivesTo evaluate the safety and tolerability of MFGM supplementation in formula for infants 0 to 12 months.MethodsIn a prospective, multicentre, double-blind, randomized trial, healthy term infants were randomized to a standard formula (SF, n = 104) or an MFGM-enriched formula (MF, n = 108) for 6 months and a corresponding follow-on formula until 12 months. Exclusively breast-fed infants (n = 206) were recruited as the reference group (BFR). Tolerance and safety events were recorded continuously. Anthropometric measurements were assessed at enrolment, 42 days and 4, 6, 8 and 12 months.ResultsInfants (n = 375) completed the study with average dropout of < 20%. Stool frequency, color, and consistency between SF and MF were not significantly different throughout, except the incidence of loose stools in MF at 6 months being lower than for SF (odds ratio 0.216, P < 0.05) and the frequency of green-colored stools at 12 months being higher in MF (CI 95%, odds ratio 8.92, P < 0.05). The BFR had a higher frequency of golden stools and lower rate of green stools (4–6 months) than the two formula-fed groups (P < 0.05). SF displayed more diarrhoea (4.8%) than MF (1%) and BFR (1%) at the 8-month visit (P < 0.05). BFR (0–1%) had significantly less (P < 0.05) lower respiratory infections than MF (4.6–6.5%) and SF (2.9–5.8%) at 6- and 8-months, respectively. Formula intake, frequency of spit-up/vomiting or poor sleep were similar between SF and MF. Growth rate (g/day) was similar at 4, 6, 8 and 12 months between the 3 groups, but growth rate for BFR was significantly higher than for SF and MF at 42 days (95% CI, P = 0.001).ConclusionsMFGM-enriched formula was safe and well-tolerated in healthy term infants between 0 and 12 months, and total incidences of adverse events were similar to that for the SF group. A few differences in formula tolerance were observed, however these differences were not in any way related to poor growth.

Efficacy, safety and immunogenicity of hexavalent rotavirus vaccine in Chinese infants.

A randomized, double-blind, placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a hexavalent live human-bovine reassortant rotavirus vaccine (HRV) against rotavirus gastroenteritis (RVGE). A total of 6400 participants aged 6–12 weeks were enrolled and randomly assigned to either HRV (n ​= ​3200) or placebo (n ​= ​3200) group. All the subjects received three oral doses of vaccine four weeks apart. The vaccine efficacy (VE) against RVGE caused by rotavirus serotypes contained in HRV was evaluated from 14 days after three doses of administration up until the end of the second rotavirus season. VE against severe RVGE, VE against RVGE hospitalization caused by serotypes contained in HRV, and VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were also investigated. All adverse events (AEs) were collected for 30 days after each dose. Serious AEs (SAEs) and intussusception cases were collected during the entire study. Our data showed that VE against RVGE caused by serotypes contained in HRV was 69.21% (95%CI: 53.31–79.69). VE against severe RVGE and RVGE hospitalization caused by serotypes contained in HRV were 91.36% (95%CI: 78.45–96.53) and 89.21% (95%CI: 64.51–96.72) respectively. VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were 62.88% (95%CI: 49.11–72.92), 85.51% (95%CI: 72.74–92.30) and 83.68% (95%CI: 61.34–93.11). Incidences of AEs from the first dose to one month post the third dose in HRV and placebo groups were comparable. There was no significant difference in incidences of SAEs in HRV and placebo groups. This study shows that this hexavalent reassortant rotavirus vaccine is an effective, well-tolerated, and safe vaccine for Chinese infants.

Immunogenicity and Safety of a Novel 13-Valent Pneumococcal Vaccine in Healthy Chinese Infants and Toddlers.

BackgroundTo determine the non-inferiority of the seven common serotypes (4, 6B, 9V, 14, 18C, 19F, and 23F) in the 13-valent pneumococcal conjugate vaccine (PCV13) with each serotype conjugated to a tetanus toxoid carrier protein and adsorbed on aluminum phosphate and the superiority of its six additional serotypes (1, 3, 5, 6A, 7F, and 19A) to the serotypes in the PCV7.MethodsParticipants were evenly randomized in a 1:1 ratio into either the PCV13 or PCV7 groups, to receive three doses of the vaccine at the age of 3, 4, and 5 months, respectively, and a booster dose between 12 and 15 months of age. Serotype-specific antibodies were measured using a standardized enzyme-linked immunosorbent assay (ELISA) and opsonophagocytic activity (OPA) microcolony assay method.ResultsA total of 1,040 healthy infants were enrolled. All the seven common serotypes in the PCV13 were non-inferior to those in the PCV7 in terms of the serotype-specific IgG production induced; however, non-inferiority was not shown for serotype 6B after the infant series. The proportion of subjects who reached OPA antibody titers ≥ 1:8 in the PCV13 group was 89.25% or higher. Local reactions and systemic events were mild or moderate in severity and similar between the two groups. No new safety signals were observed.ConclusionThe newly developed PCV13 was immunogenic for all serotypes and had a comparable safety profile to the marketed PCV7.

Neurodevelopmental outcomes of healthy Chinese term infants fed infant formula enriched in bovine milk fat globule membrane for 12 months - A randomized controlled trial.

Human milk fat globule membrane (MFGM) has multifunctional health benefits. We evaluated neurodevelopment and growth of healthy term infants fed bovine milk-derived MFGM-enriched formula (MF) over 12 months. A prospective, multi-center, double-blind, randomized trial was conducted in Fuzhou, China. Healthy term infants (n=212), aged <14 days, were assigned randomly to be fed MF or a standard formula (SF) for 6 months and then switched to stage 2 MF and SF formula until 12 months. A reference group (n=206) contained healthy breastfed infants (BFR). Neurodevelopment was assessed with Bayley-III Scales. At 12 months, the composite social emotional (+3.5) and general adaptive behaviour (+5.62) scores were significantly higher in MF than SF (95% CIs 0.03 to 6.79 and 1.78 to 9.38; p=0.048 and 0.004, respectively). Mean cognitive (+2.86, 95% CIs -1.10 to 6.80, p=0.08), language (+0.39, 95% CIs -2.53 to 3.30, p=0.87) and motor (+0.90, 95% CIs -2.32 to 4.13, p=0.49) scores tended to be higher in MF than SF, but the differences between the two groups were not significant. BFR scored higher on Bayley-III than either MF or SF at 6 and 12 months. Cognitive scores were significantly higher in BFR than SF (95% CI 0.05 to 7.20; p=0.045), but not MF (p=0.74) at 6 months. Short-term memory was significantly higher in MF than SF at 12 months (95% CI 1.40 to 12.33; p=0.002). At 4 months, serum gangliosides were significantly higher in MF and BFR than SF (95% CI 0.64 to 13.02; p=0.025). Milk intake, linear growth, body mass and head circumference were not significantly different between formula-fed groups. MFGM supplementation in early life supports adequate growth, increased serum gangliosides concentration and improves some measures of cognitive development in Chinese infants.

The Influence of Cesarean Section on the Composition and Development of Gut Microbiota During the First 3 Months of Life.

The intestinal microbiota has emerged as a critical regulator of growth and development in the early postnatal period of life. Cesarean section (CS) delivery is one of the strongest disrupting factors of the normal colonization process and has been reported as a risk factor for disorders in later life. In this study, we dynamically and longitudinally evaluated the impact of CS on the initial colonization pattern and development of gut microbiota by 16 healthy Chinese infants with fecal samples collected at 9 time points (day 5, day 8, day 11, week 2, week 4, week 6, week 7, month 2, and month 3) during the first 3 months of life. The V3–V4 regions of 16S rRNA gene were analyzed by Illumina sequencing. In comparison with vaginally delivered (VD) infants, infants born by CS showed decreased relative abundance of Bacteroides and Parabacteroides and enrichment of Clostridium_sensu_stricto_1, Enterococcus, Klebsiella, Clostridioides, and Veillonella. Most interestingly, Firmicutes/Bacteroidetes ratio was found to be significantly higher in the CS group than in the VD group from day 5 until month 3. Besides, the results of microbial functions showed that the VD group harbored significantly higher levels of functional genes in vitamin B6 metabolism at day 5, day 8, week 2, week 4, week 6, week 7, month 2, and month 3 and taurine and hypotaurine metabolism at day 5, while the phosphotransferase system and starch and sucrose metabolism involved functional genes were plentiful in the CS group at day 11, week 2, week 4, week 6, week 7, and month 2 and at week 2, week 7, and month 2, respectively. Our results establish a new evidence that CS affected the composition and development of gut microbiota in the first 3 months and provide a novel insight into strategies for CS-related disorders in later life.

Distinct gut microbiota and metabolite profiles induced by delivery mode in healthy Chinese infants

Delivery mode is recognized as an important determinant of gut microbiota composition. Vaginally delivered infants were colonized by maternal vaginal and fecal microbiota, while those delivered by cesarean section were colonized by environmental microorganisms. To reveal differences induced by delivery mode, we determined fecal microbiota and fecal metabolome from 60 infants in Northeast China region. Bacterial gene sequence analysis showed that the feces of vaginally delivered infants had the highest abundance of Bifidobacterium, Lactobacillus, Bacteroides and Parabacteroides, while the feces of cesarean section delivered infants were more enriched in Klebsiella. LC-MS-based metabolomics data demonstrated that the feces of vaginally delivered infants were associated with high abundance of DL-norvaline and DL-citrulline, while the feces of cesarean section delivered infants were abundant in trans-vaccenic acid and cis-aconitic acid. Moreover, the feces of vaginally delivered infants was significantly in positive correlation with tryptophan metabolism and pyruvate metabolism, however, the feces of cesarean section delivered infants was positively correlated with ABC transporters. Collectively, our study demonstrated that gut microbiota and metabolite profiles were significantly different between vaginally delivered and cesarean section delivered infants, and provided the theoretical basis for restoring the intestinal environment of cesarean section infants birthed in the study region. SignificanceThe intestinal microbiota and metabolites play important roles in infant development. To validate whether delivery modes influence the gut environment, we performed a detailed analysis of the earliest microbial colonization of the infant gut using a combination of 16S rRNA gene amplicon sequencing and LC-MS-based metabolomics. We found that the gut microbiota and metabolite composition were significantly different between vaginally delivered infants and cesarean section delivered infants. Our findings establish a vital baseline for studies tracking the infant gut microbiota and metabolite development following different delivery modes, and their associated effects on infant health. This study provides preliminary evidence that the observed differences due to delivery modes highlight their importance in shaping the early intestinal microbiota and metabolites.

Infantile phthalate metabolism and toxico/pharmacokinetic implications within the first year of life

BackgroundInfantile development of phthalate metabolism is crucial for risk assessment of endocrine disruption and has important toxico/pharmacokinetic implications. ObjectivesTo characterize temporal variability in urinary phthalate metabolites in infants and to examine their growth-dependent detoxification. MethodsIn this cohort study, urine samples (n = 876) from 155 healthy Chinese infants were collected serially at eight time points from birth to one year old. Free and total (i.e., free plus glucuronide conjugated) phthalate metabolites (PMEs) were measured by LC/MS/MS. Time variability in PMEs and PME metabolism capacity was characterized using intraclass correlation coefficients (ICCs) and linear mixed regression models. ResultsConcentrations of most PMEs changed significantly, with ICCs ranging from 0.213 to 0.318, and trends increased significantly over time (p < 0.001), while MEHP showed fair reproducibility (ICC = 0.480). Glucuronidation increased considerably (ICC ≤ 0.250; p < 0.001) for most PMEs but not for MMP or MEHP. Ester-chain ω-/ω-1-oxidation and α-/β-oxidation patterns of MEHP steeply increased from 3 months to 8 months, where they peaked, resulting in a molar percentage of MEHP in ΣDEHP showing the inversion pattern. MEHP detoxification through oxidation of the hydrophobic ester-chain is apparently a priority for carboxyl glucuronidation in infants. ConclusionsInfant phthalate exposure is prevalent, but they cannot metabolize or eliminate these compounds as efficiently as adults, especially during the first 6 months of life. From an environmental biomonitoring view, age-dependent phthalate metabolism provides crucial implications for infantile ontogeny and health risk assessment within the first year of life.

Efficacy, immunogenicity and safety of a trivalent live human-lamb reassortant rotavirus vaccine (LLR3) in healthy Chinese infants: A randomized, double-blind, placebo-controlled trial

BackgroundA randomized, double-blind, placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy, immunogenicity and safety of a novel trivalent live human-lamb reassortant rotavirus vaccine (LLR3) against rotavirus gastroenteritis (RVGE). MethodsHealthy children aged 6–13 weeks were enrolled and randomized (1:1) to either 3 oral doses of LLR3 or placebo according to a 0, 1, 2 month schedule. The objectives were to evaluate vaccine efficacy (VE) against RVGE of any-severity, severe RVGE (sRVGE) and inpatient caused by rotavirus serotypes contained in the vaccine and not contained in the vaccine after the third dose. Immunogenicity was also assayed in a subgroup. All adverse events (AEs) were collected from 30 min after each dose for immediate reaction, even to the entire study period, including the serious AEs (SAEs) and intussusception. ResultsVE against RVGE of any-severity, sRVGE and inpatient caused by any serotype was 56.6% (95% CI: 50.7, 61.8), 70.3% (95% CI: 60.6, 77.6) and 74.0% (95% CI: 57.5, 84.1) respectively. VE against RVGE of any-severity, sRVGE caused by serotypes not contained in vaccine were 54.2% (95% CI: 47.5, 60.1) and 70.4% (95% CI: 60.4, 77.9). The rate of seroconversion and four-fold increase of rotavirus serotype G2-, G3-, and G4-specific IgA is 60.8%, 58.0%, and 60.6% in vaccine group, which was higher than 21.35%, 22.7%, and 23.1% in placebo group (p < 0.0001 for G2, G3, G4), as well as the Geometric Mean Titer (GMT). Through the entire trial, 65.91% and 67.79% of participants reported at least one AE, and 0.02% and 0.02% reported SAEs in the vaccine and placebo groups, respectively. Two intussusception cases were reported both in vaccine and placebo group. ConclusionsIn Chinese infants, LLR3 provided a substantial protection against RVGE of any-severity, sRVGE and inpatient caused by any serotype, and showed well immunogenicity and safety.

Distinct Gut Microbiota and Metabolite Profiles Induced by Different Feeding Methods in Healthy Chinese Infants.

Human milk is closely correlated with infant gut microbiota and is important for infant development. However, most infants receive exclusively insufficient breast milk, and the discordance between effects of commercial formula and human milk exists. To elucidate the differences induced by various feeding methods, we determined microbiota and metabolites composition in fecal samples from 77 healthy infants in Northeast China and identified the differences in various feeding methods. Bacterial 16S rRNA gene sequence analysis demonstrated that the fecal samples of exclusively breastfed (BF) infants were abundant in Bifidobacterium and Lactobacillus; the mixed-fed (MF) infants had the highest abundance of Veillonella and Klebsiella; the exclusively formula-fed (FF) infants were enriched in Bacteroides and Blautia; and the complementary food-fed (CF) infants were associated with higher relative abundance of Lachnoclostridium and Akkermansia. Liquid chromatography–mass spectrometry (LC-MS)-based metabolomics data revealed that the fecal samples of BF infants had the highest abundance of dl-citrulline, threonine, l-proline, l-glutamine, guanine, and l-arginine; the MF infants were abundant in d-maltose, stearidonic acid, capric acid, and myristic acid; the FF infants were enriched in itaconic acid, 4-pyridoxic acid, prostaglandin B2, thymine, dl-α-hydroxybutyric acid, and orotic acid; and the CF infants were associated with higher relative abundance of taurine, l-tyrosine, adenine, and uric acid. Furthermore, compared with the BF infants, the MF and FF infants were more abundant in fatty acid biosynthesis. Collectively, these findings will provide probable explanations for some of the risks and benefits related to infant feeding methods and will support a theoretical basis for the development of infant formula.

Reduced Occurrence of Gastrointestinal Symptoms in Chinese Infants Fed Minimally Processed Commercially Available Formula: A Cross-Sectional Observational Study.

Healthy Chinese infants consuming one of four commercially available infant formulas (IF) were assessed on the occurrence of gastrointestinal symptoms associated with suboptimal digestion of processed milk proteins. The IF differed in blocked lysine (BL) levels, a proxy indicator of heat processing as well as the nutritional quality of milk. A cross-sectional, observational study of one week was conducted in healthy, term, exclusively formula-fed Chinese infants (n = 452) fed with one of four commercially available IF (IF A n = 106, BL 9%; IF B n = 119, BL 12%; IF C n = 113, BL 11%; IF D n = 114 BL 20%). Parents/caretakers were requested to report feeding quantity, gastrointestinal symptoms, crying behavior, and stool characteristics daily using subject dairy and Amsterdam Infant Stool Scale (AISS). Infants fed with IF A reported less “hard” and “watery” stools and more “soft/formed” stools. Higher percentages of score I (yellow/golden) or II (orange) and less green (score III) coloured stools were noted for IF A-fed infants compared to all other formulas according to AISS. Night time crying was also significantly lower in the IF A groups compared to all other formulas. Furthermore, a higher percentage of parents/caretakers of IF A-fed infants reported absence or no complaints of abdominal distension, burping, flatulence, diarrhea, and constipation. Results suggest lower occurrence of GI symptoms and lower crying time at night in infants fed with minimally processed formula (indexed by BL levels). Future studies are required to confirm the association between minimal processing of milk formula and improved gut comfort in healthy infants.

Age-related characteristics and normative values of F waves in healthy infants

ObjectiveTo establish age-related characteristics and normative values of F waves in healthy Chinese infants. MethodsWe studied median, ulnar and tibial nerves on one side distally in 229 healthy Chinese infants (108 males) ranging from 1 to 12 months old. ResultsMinimal F-wave latencies (Fmin) showed a strong negative correlation to the age for median, ulnar and tibial nerves (P < 0.01) but no correlation to the height. Statistical analyses revealed a significant (P < 0.01) decrease of Fmin during the second month of life and no change (P > 0.05) thereafter. Dividing the infants into 1 month old (Group 1) and 2–12 months old (Group 2), normal values (Mean ± SD ms) of Fmin for tibial, median and ulnar nerves consisted of 23.38 ± 1.68, 17.19 ± 0.95 and 16.47 ± 1.06 for Group 1 and 21.42 ± 1.25, 14.50 ± 1.15 and 14.52 ± 0.90 for Group 2. ConclusionF-wave latencies shorten in the 2nd month of life and change little thereafter when age-related maturation counters the concomitant growth of the nerve length. SignificanceF waves can assess infantile neuropathies as a reliable measure, complementing the technically difficult conventional nerve conduction study in short limbs.

Probiotic and Safety Properties Screening of Enterococcus faecalis from Healthy Chinese Infants.

The aim of this study was to evaluate the probiotic characteristics and safety of seven Enterococcus faecalis isolates from fecal samples of healthy Chinese infants. We evaluated the isolates' tolerance to low pH, survival in bile salts and NaCl, adhesion ability, biofilm formation, antimicrobial activity, toxin gene distribution, hemolysis, gelatinase activity, antibiotic resistance, and virulence to Galleria mellonella. All strains survived at pH5.0, in 7.0% NaCl, and in 3% bile salt. Adhesion to Caco-2 cells was above 10%. Strain A3-1 had higher adhesion ability toward mucin, collagen, and BSA in vitro, better antibacterial activity, and the strongest biofilm production. We detected seven virulence genes with a distribution of asa1 (100%), cylA (71.4%), esp (85.7%), hyl (14.3%), gelE (85.7%), ace (42.9%), and agg (71.4%). Although all strains were γ-hemolytic, none showed gelatinase activity based on physiological activity detection. All isolates were susceptible to benzylpenicillin, ampicillin, ciprofloxacin, levofloxacin, moxifloxacin, tigecycline, nitrofurantoin, linezolid, and vancomycin; they were not susceptible to erythromycin, quinupristin/dalofopine, and clindamycin. The virulence test of G. mellonella showed that, except for strains 106-1 and 113-1, the other strains had toxicity lower than 10%. Strain A3-1 may have the greatest potential to be developed as a probiotic.

O-31 Age related characteristics and normative values of F wave in 229 healthy Chinese infants

O-31 Age related characteristics and normative values of F wave in 229 healthy Chinese infants

Growth patterns from birth to 24\xa0months in Chinese children: a birth cohorts study across China

BackgroundAssessment of child growth is important in detecting under- and over-growth. We aimed to examine the growth patterns of healthy Chinese infants from birth to 24 months.MethodsThis study was based on six recent birth cohorts across China, which provided data (from 2015) on 4251 children (2174 boys, 2077 girls) who were born at term to mothers without gestational or preexisting diabetes, chronic hypertension, preeclampsia, or eclampsia. Analyses were performed using 28,298 longitudinal anthropometric measures in 4251 children and the LMS method to generate smoothed Z-score growth curves, which were compared to the WHO growth standards (which are based on data from 2003) and current Chinese growth references (which are based on data from 2005).ResultsMost (80.3%) of mother had college education or more, and maternal smoking was rare (0.4%). Compared to the WHO longitudinal growth standards for children aged 0 to 2 years, the growth references from this longitudinal study (length-, weight-, head circumference-, BMI-for-age, and weight-for-length) were significantly higher, for boys and girls; Specifically, the median length-, weight-, head circumference-, BMI-for-age, and weight-for-length was on average 0.9 (range 0.2–1.3) cm, 0.51 (range 0.09–0.74) kg, 0.17 (range − 0.24 to 0.37) cm, 0.70 (range 0.01 to 0.92) kg/m2, and 0.43 (range 0.01 to 1.07) kg higher in Chinese boys, and 1.3 (range 0.5–1.9) cm, 0.73 (range 0.10–0.91) kg, 0.45 (range 0.15–0.62) cm, 0.7 (range 0.0 to 1.0) kg/m2, and 0.42 (range 0.00 to 0.64) kg greater in Chinese girls, respectively. Compared to the current China cross-sectional growth references (based on data from a decade ago), growth references from this study were also higher, but the difference was less than that between growth references of this study and WHO growth standards.ConclusionsThis recent multicenter prospective birth cohort study examined early growth patterns in China. The new growth curves represent the growth patterns of healthy Chinese infants evaluated longitudinally from 0 to 24 months of age, and provide references for monitoring growth in early life in modern China that are more recent than WHO longitudinal growth standards from other countries and previous cross-sectional growth references for China.

Growth patterns of infants aged 0 to 24 months in China: a multicentre prospective birth cohort study across China

BackgroundAssessment of a child's growth is important for detecting aberrations, whether too much or too little or growth. Poor growth in early life may have long-lasting programming effects on later non-communicable diseases. We examined the growth patterns of healthy Chinese infants from birth to 24 months to provide a baseline from which to detect cases of too much or too little growth. MethodsThis study was based on six birth cohorts from across China in 2015, which provided data on 4251 infants (2174 boys, 2077 girls) who were born at term to mothers without gestational or preexisting diabetes, chronic hypertension, preeclampsia, or eclampsia. Analyses were performed using 28 298 longitudinal anthropometric measurements in 4251 infants and the LMS method, and smoothed Z-score growth curves were generated. These standards based on Chinese children were compared to WHO growth standards (which are based on data from 2003) and current Chinese growth references (which are based on data from 2005). The six birth cohorts were located in Shanghai (2 cohorts), Anhui, Guangdong, Hubei, and Jiangsu Provinces. Pregnant women were recruited at hospitals when they came for their routine prenatal care visits. Each cohort contributed longitudinal child growth data of 1000 single infants from birth to 24 months, or the maximum number available at the time of our data request in July, 2016 (261–1065). Infant anthropometric measurements were taken seven times (at 42 days, 3, 6, 8 [or 9], 12, 18 and 24 months). This project was approved by the institutional review board of Xinhua Hospital, affiliated to Shanghai Jiao Tong University School of Medicine (approval number XHEC-C-2017-060). FindingsCompared to the WHO longitudinal growth standards for children aged 0 to 2 years, the growth standards from this longitudinal study (length, weight, head circumference, BMI-for-age, and weight-for-length) were significantly higher, for both boys and girls. For example, in comparison with the corresponding WHO growth standard, the median length-for-age was on average 0·9 cm (range 0·2–1·3 cm) higher in Chinese boys and 1·3 cm (range 0·5–1·9 cm) higher in Chinese girls. growth references from this study were also higher than the current China cross-sectional growth references (based on data from a decade ago), but the difference was less than that between growth standards of this study and WHO growth standards. Compared to the China growth reference (data from 2005), the median length-for-age in our study (data from 2015) was on average 0·3 cm higher in boys, and 0·5 cm higher in girls across. InterpretationGrowth curves of healthy Chinese infants evaluated longitudinally from 0 to 24 months of age provide standards for monitoring growth in early life in China that are more recent than WHO longitudinal growth standards and the current cross-sectional growth references for China. FundingThis work was funded by the Bill and Melinda Gates Foundation Healthy Birth, Growth & Development knowledge integration (HBGDki) project (number OPP1153191).