Infant Formula Research Articles

Multi-Drug Resistant Bacillus cereus: A Growing Concern for Powdered Infant Formula and Baby Foods (Cereals) in Bangladesh

Multi-Drug Resistant Bacillus cereus: A Growing Concern for Powdered Infant Formula and Baby Foods (Cereals) in Bangladesh

Trends and practices of weaning in infants across India: A comprehensive review.

Weaning is a critical phase in an infant's life, during which there is a transition from exclusive breastfeeding or formula feeding to consuming solid foods. Weaning is a critical step in determining a child's nutritional status, growth, and general health. India is a multiethnic and culturally diverse nation and has a variety of weaning practices that are affected by local customs, religious beliefs, and socioeconomic concerns. Malnutrition brought on by inadequate weaning methods used in infancy and early childhood may have an impact on cognitive, motor and social, development and productivity of the child, more importantly manifesting in later ages. Weaning customs in India have a long history of being ingrained in both family and cultural traditions. The variety of Indian cuisine is reflected in the meals that are offered to the infant during weaning. Homemade food commonly prepared like mashed fruits and vegetables, lentil soups, and rice porridge are the most popular. However, the inclination by parents toward professionally produced infant foods and formulas has increased because of urbanization and globalization; there have been observable changes in weaning practices over the past few decades because of changing lifestyles and easier access. These foods are frequently thought of as more convenient but may not be as nutrient-dense as homemade alternatives. Not following the medically recommended mandate of an exclusive diet of mother's breast milk to the infant, many parents often begin introducing complementary foods as early as four months. Still most concerningly also the timing of weaning commencement varies significantly across areas and communities. Overall, this review offers valuable insights into the current trends and practices of weaning in infants across India, underscoring the importance of culturally sensitive and informed strategies to ensure the well-being of the nation's youngest population.

Encapsulated pomegranate peel extract as a potential antimicrobial ingredient from food waste.

Pomegranate peel waste is a valuable reservoir of heat-sensitive total hydrolysable tannins (THT), with potential applications in food and pharmaceuticals. Preserving THT is challenging due to degradation post-extraction. We explore ionic gelation as an encapsulation method to optimize THT utilization. Through external gelation, we optimized the process variables using Box-Behnken design. At 40 g kg-1 sodium alginate, 25 g kg-1 calcium chloride, and 300 g kg-1 pomegranate peel extract (PPE), we achieved an 83.65% encapsulation efficiency. Compared to spray drying, external gelation demonstrated superior performance, with enhanced release percentages and stability. Physical, phytochemical, and release profiles of encapsulates were extensively analysed. External gelation achieved an 87.5% release in 30 min, outperforming spray-dried counterparts (69.7% in 25 min). Encapsulated PPE exhibited robust antibacterial activity against Staphylococcus aureus (ATCC 25923) in powdered infant formula, with a 32 ± 0.01 mm zone of inhibition and 300 μg mL-1 minimum inhibitory concentration. Insights into S. aureus growth curves underlined the mechanism of action via membrane potential alterations. The results of carried investigations also showed that the antibacterial activity of the encapsulated PPE extracts against the targeted organism was identical to the antibacterial activity exhibited by synthetic antibiotics used generally to kill microorganisms in food. Therefore, from the findings, it can be concluded that the PPE encapsulate produced using the external gelation technique at the optimized condition displayed superior storage stability possessing strong antimicrobial activity when compared to encapsulate produced using the spray drying technique. External gelation emerges as a potent technique for developing effective encapsulates enriched with natural antimicrobials or antibiotics. This approach holds promise for applications in food, pharmaceuticals, and nutraceuticals, enhancing stability and efficacy while reducing reliance on synthetic antibiotics. © 2024 Society of Chemical Industry.

Infant consumption of 100% lactose-based and reduced lactose infant formula in the United States: Review of NHANES data from 1999 to 2020.

An acceptable alternative to human milk is US Food and Drug Administration (US FDA)-registered infant formula, which must meet the requirements of the US FDA Infant Formula Act. Human milk contains lactose, but some infant formulas may contain alternative carbohydrate sources such as corn syrup solids, maltodextrin, and sucrose. Recent research shows that infant-formula made with corn syrup solids may be associated with increased obesity risk in the first 5 years of life. A previous study found that of all formulas purchased, 59.0% were lactose-reduced. More US infants consume infant formula with nonlactose carbohydrates more frequently than is medically necessary. The purpose of this study is to use National Health and Nutrition Examination Survey (NHANES) data to describe the type and prevalence of nonlactose carbohydrates consumed in infant formula. NHANES data from 1999 to 2020 was used to perform cross-sectional analyses and analyses of comparison of prevalence over time on consumption of nonlactose carbohydrate sources in infant formulas. We identified 3709 unique infant IDs associated with 36,084 feeding sessions. More than half of the feeding sessions involved a formula with at least one nonlactose carbohydrate. Feeding sessions involving a formula with at least one nonlactose carbohydrate increased by 163% from 1999-2004 to 2017-2020; formulas containing single or multiple nonlactose carbohydrate types account for the increase in prevalence. This study highlights an increase in the consumption of infant formula containing a nonlactose carbohydrate. More studies are needed to understand the short- and long-term effects of early exposure to these carbohydrates.

Vaccine response was higher in formula-fed infants compared to breastfed but not affected by lactoferrin or iron in a randomised controlled trial.

To examine how reduced iron content and added bovine lactoferrin in infant formula affect the antibody response following routine immunisation. In this randomised controlled trial, 180 Swedish formula-fed infants received, from 6 weeks to 6 months of age, a 2 mg/L iron formula with (n = 72) or without (n = 72) bovine lactoferrin, or a control formula with 8 mg/L iron and no lactoferrin (n = 36). Another 72 infants were recruited as a breastfed reference. Serum immunoglobulin G (IgG) levels against Haemophilus influenzae type b (Hib), diphtheria and tetanus were assessed at four, six and 12 months of age. With an equal gender distribution, 180 + 72 term infants were included with a mean age of 7.0 ± 0.7 weeks. At 12 months, infants fed low iron formula showed a significantly higher geometric mean Hib IgG (1.40 μg/mL [1.07-1.83]) compared to the control formula infants (0.67 μg/mL [0.42-1.07]). For all three vaccines, breastfed infants had significantly lower IgG levels at six and 12 months of age. Except for higher Hib IgG levels at 12 months in infants fed low iron formula, the interventions did not affect vaccine IgG response. Unexpectedly, breastfed infants had significantly lower vaccine IgG levels compared to formula-fed infants.

FLUOROSIS PREVALENCE AT DIFFERENT REGIONS OF THE EARTH (LITERATURE REVIEW)

The aim of the study is to analyze the literature about the fluorosis prevalence and the factors which lead to dental and bone fluorosis. The search for articles published in 2016-2023 was conducted by the authors in Scopus and Web of Science scientific data bases using the keywords “fluorosis”, “dental fluorosis”. To classify the severity of dental fluorosis, the index of developmental defects of enamel (DDE), the index of tooth surface fluorosis (TSIF), and mostly Dean’s index Thylstrup & Fejerskov Index (TFI) are used. The risk factors for dental fluorosis include living in regions with high level of fluoride, drinking water with high level of fluoride or salt fluoridation, drinking bottled water, use of fluoride toothpastes among preschool children, early weaning, and use of infant formula for long time, and, as well as, a hot climate and high fluoride content in soil and food. The studies from India and China demonstrated that the average concentration of dental fluorosis and skeletal fluorosis at fluoride contained 6 mg/l. The prevalence of dental fluorosis in NorthernTanzania, where the fluorine content in daily drinking water is 3.6 mg/l, reaches 75,22%. In Ethiopia, where fluorine content is 5.09 mg/l, the prevalence of skeletal fluorosis ranges from 55.1% to 72.4%. In Kenya, the fluoride content in drinking water reaches 72 mg/l, so the prevalence of dental fluorosis is 80%. The prevalence of dental fluorosis is lower in South Western Saudi Arabia and Iran where fluoride level is lower. In Jordan, the prevalence of dental fluorosis reaches 39.9% due to the high fluoride content in miner rocks. Skeletal fluorosis is wide spread in some areas of Pakistan due to the contamination of ground water by industrial production. The prevalence of mild dental fluorosis is 39% in New castle where water is fluoridated, and 24% in non-fluoridated Manchester in England. Dean’s index and TFI index are mostly used to classify these variety of fluorosis. Various factors affect the appearance of dental and bone fluorosis worldwide, so the prevalence of fluorosis varies from 11,1 up to 100%.

Simultaneous determination of semi-essential nutrients taurine, l-carnitine and choline in infant formulas and adult/pediatric nutritional formulas by hydrophilic interaction liquid chromatography-electrospray ionization-tandem mass spectrometry.

The nutritional intake of formula-fed newborns is often limited to a single source, so it must be supplemented with essential nutrients for the growth and proper development of infants. Taurine, l-carnitine, and choline are considered conditionally essential nutrients especially in newborns and infants. In this work, a simple routine hydrophilic interaction liquid chromatography-electrospray ionization-tandem mass spectrometry (HILIC-ESI-MS/MS) method was developed and validated for the simultaneous determination of these semi-essential nutrients in infant and adult/pediatric milk formulas. The extraction recoveries were between 90% and 114%. Precision of the method offered relative standard deviation below 5% and 7% for intra-day and inter-day precision, respectively. The proposed method was successfully applied to quantification of taurine, l-carnitine, and choline in milk formula. The contents found were in good agreement with those provided on the product label for almost all samples. In view of these results, it can be concluded that the developed method can be a useful approach for the simultaneous determination of taurine, l-carnitine and choline in powdered milk samples, so it can be useful in the routine quality control of this kind of samples. © 2024 The Author(s). Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Infant versus noninfant formulas and cow's milk: Transition based on age or weight?

Infant formulas are meant to be used until 1 year of age, at which point children are transitioned to non-infant formulas or cow's milk, depending on their remaining dietary intake. Noninfant formulas and cow's milk are appropriate for children who have an average weight at that 1-year mark (9-9.5 kg); however, can contribute significant protein and/or electrolytes to children who are underweight for age, particularly if they still rely heavily on formula feeding for their caloric intake. In this short communication, we present several cases of patients who received excessive amounts of nutrients for age following the formula transition at the 1-year mark. We also provide recommendations for clinicians to consider when faced with underweight infants who are meant to be transitioning off infant formulas.

Personalized Nutrition with Banked Human Milk for Early Gut Microbiota Development: In Pursuit of the Perfect Match.

The correct initial colonization and establishment of the gut microbiota during the early stages of life is a key step, with long-lasting consequences throughout the entire lifespan of the individual. This process is affected by several perinatal factors; among them, feeding mode is known to have a critical role. Breastfeeding is the optimal nutrition for neonates; however, it is not always possible, especially in cases of prematurity or early pathology. In such cases, most commonly babies are fed with infant formulas in spite of the official nutritional and health international organizations' recommendation on the use of donated human milk through milk banks for these cases. However, donated human milk still does not totally match maternal milk in terms of infant growth and gut microbiota development. The present review summarizes the practices of milk banks and hospitals regarding donated human milk, its safety and quality, and the health outcomes in infants fed with donated human milk. Additionally, we explore different alternatives to customize pasteurized donated human milk with the aim of finding the perfect match between each baby and banked milk for promoting the establishment of a beneficial gut microbiota from the early stages of life.

Study on the interaction mechanism of whey protein isolate with phosphatidylcholine: By multispectral methods and molecular docking.

The elucidation of the interaction mechanism between phospholipids and milk proteins within emulsions is pivotal for comprehending the properties of infant formula fat globules. In this study, multispectral methods and molecular docking were employed to explore the relationship between phosphatidylcholine (PC) and whey protein isolate (WPI). Observations indicate that the binding constant, alongside thermodynamic parameters, diminishes as temperature ascends, hinting at a predominantly static quenching mechanism. Predominantly, van der Waals forces and hydrogen bonds constitute the core interactions between WPI and PC. This assertion is further substantiated by Fourier transform infrared spectroscopy, which verifies PC's influence on WPI's secondary structure. A detailed assessment of thermodynamic parameters coupled with molecular docking reveals that PC predominantly adheres to specific sites within α-lactalbumin, β-lactoglobulin, and bovine serum albumin, propelled by a synergy of hydrophobic interactions, hydrogen bonding, and van der Waals forces, with binding energies noted at -5.59, -6.71, and -7.85kcal/mol, respectively. An increment in PC concentration is observed to amplify the emulsification properties of WPI whilst concurrently diminishing the zeta potential. This study establishes a theoretical foundation for applying the PC-WPI interaction mechanism in food.

Impact of a minimally processing route for the production of infant formulas on their sensory properties

Infant formulas (IFs), the sole adequate substitute to human milk, undergo several thermal treatments during production that can damage milk proteins and promote the formation of Maillard reaction products, modifying nutritional and sensory properties. The aim of this study was to determine the impact of a minimally processing route based on membrane filtration associated with different levels of heat treatment, on the odor, taste, texture and color attributes of IFs, then to compare with those of commercial milks. Three experimental IFs (produced with membrane filtration associated with low - T-, medium - T+, or high thermal treatments - T+++) were evaluated. Triangular tests conducted with a panel of 50 adults highlighted clear disparities between all the IFs. The same panel applied the Check-All-That-Apply method to evaluate the IFs: the range of variability between T- and T+++ was similar to that between the 2 commercial IFs, and the sensory characteristics of the experimental IFs were not far from the commercial brands for flavor and texture attributes. Analysis performed on the citation frequencies for each descriptor differentiated T-/T+ from T+++, but all the experimental IFs were described with positive sensory characteristics, unlike one commercial IF. Volatile organic compounds (VOCs) content of IFs with low and high thermal treatments were analyzed. Forty VOCs were identified by gas chromatography-mass spectrometry. T- contained a higher quantity of VOCs than T+++, except for benzaldehyde (Maillard reaction product), and aldehydes (oxidation-related products) were the most represented compounds. In conclusion, the processing was associated with sensory differences among IFs, but no marked difference in flavors was found according to CATA and physicochemical analysis. Additionally, no unpleasant sensory descriptors were noted. This shows that the minimally processed route leads to IFs that could fit well within the market from a sensory point of view.

High Concentrations of Immunoglobulin G Against Cow Milk Proteins and Frequency of Cow Milk Consumption Are Associated With the Development of Islet Autoimmunity and Type 1 Diabetes—The Trial to Reduce Insulin-dependent Diabetes Mellitus (IDDM) in the Genetically at Risk (TRIGR) Study

BackgroundThe Trial to Reduce IDDM in the Genetically at Risk (TRIGR) (NCT00179777) found no difference type 1 diabetes risk between hydrolyzed and regular infant formula. However, cow's milk consumption during childhood is consistently linked to type 1 diabetes risk in prospective cohort studies. ObjectiveOur primary aim was to study whether humoral immune responses to cow’s milk and cow’s milk consumption are associated with type 1 diabetes in TRIGR children. MethodsTRIGR comprised 2159 children with genetic susceptibility to type 1 diabetes born between 2002-2007 in 15 countries. Children were randomized into groups receiving extensively hydrolyzed casein or a regular cow’s milk formula and followed until age 10. Type 1 diabetes related autoantibodies and antibodies to cow’s milk proteins were analyzed. Infant formula intake was measured by structured dietary interviews and milk consumption with a food frequency questionnaire. Associations of milk antibodies and milk consumption with the risk to develop type 1 diabetes were analysed by Cox survival model. ResultsCow’s milk antibody levels both in cord blood [HR for islet autoimmunity 1.30 (95% CI 1.05-1.61); type 1 diabetes 1.32 (1.02-1.71)] and longitudinally from birth to 3 years [islet autoimmunity 1.39 (1.07-1.81); type 1 diabetes 1.43 (1.04-1.96)] were associated with increased risk of developing type 1 diabetes. The amount of regular infant formula was associated with a reduced islet autoimmunity risk in the regular infant formula group [0.92 (0.85-0.99)]. Furthermore, frequent liquid milk consumption after infancy was associated with an increased risk of islet autoimmunity or type 1 diabetes. ConclusionsElevated cow's milk antibody levels and high consumption of liquid milk after infancy are related to type 1 diabetes development in children with an increased genetic susceptibility to type 1 diabetes. Enhanced antibody levels to cow’s milk may provide a biomarker of immune system prone to develop islet autoimmunity. Trial registry numberNCT00179777

Use of baby food products during the complementary feeding period: What factors drive parents' choice of products?

It is recommended that infants are introduced to complementary foods from 6 months old, moving from a solely milk diet to eating a family diet by 12 months old. Although home cooking of family foods is recommended, a rapidly growing market producing baby food products (BFP) such as jars, pouches and snacks has developed. These are often accompanied by marketing claims around nutritional, health and developmental impacts despite research highlighting high sugar content. Although numerous studies have explored drivers of infant formula choice and use, little research has examined the drivers of BFP use. This study used an online survey for United Kingdom parents of infants aged 4-12 months to explore use of BFP alongside perceptions and drivers to purchase products. Overall, 271 parents participated (173 used BFP and 98 did not), with a descriptive analysis of closed items and a thematic analysis for open ended text conducted. The top motivators for using BFP were convenience, time saving, and baby's perceived enjoyment of products. The most purchased puree was fruit based and the most purchased baby snacks were vegetable puffs/sticks, with snack purchases being more common than purees in this sample. Aspects such as perceived healthiness drove choice, with snack foods being seen to enhance self-feeding skills, appetite regulation and motor development. Those who did not use BFP did not trust them and preferred to feed their baby home cooked foods. The findings are important for professionals working with parents, to support them through the transition to solid foods, particularly around raising awareness of marketing techniques and how to check content of foods to make a more informed choice.

A collectanea of food insulinaemic index: 2023

Background and AimsTo systematically update and publish the lnsulinaemic Index (II) value compilation of food/beverages. MethodsA literature search identified around 400 scholarly articles published between inception and December 2023. II values were pooled according to the selection criteria of at least 10 healthy, non-diabetic subjects with normal BMI. In addition, the II reported should have been derived from incremental area under the curve (iAUC) calculation of the insulin concentration over time. The reference food used from the pooled articles were either glucose or bread. ResultsThe II of 629 food / beverage items were found from 80 distinct articles. This is almost a five-fold increase in the number of entries from a previous compilation in 2011. Furthermore, these articles originated from 32 different countries, and were cleaved into 25 food categories. The II values ranged from 1 to 209. The highest overall recorded II was for a soy milk-based infant formula while the lowest was for both acacia fibre and gin. Upon clustering to single food, the infant formula retained the highest II while both acacia fibre and gin maintained the lowest recording. As for mixed meal, a potato dish served with a beverage recorded the highest II while a type of taco served with a sweetener, vegetable and fruit had the lowest II. Our minimum and maximum II data values replace the entries reported by previous compilations. ConclusionAcknowledging some limitations, these data would facilitate clinical usage of II for various applications in research, clinical nutrition, clinical medicine, diabetology and precision medicine. Future studies concerning II should investigate standardisation of reference food, including glucose and the test food portion. Although this collectanea adds up new food/beverages II values, priority should be given to populate this database.

Building resilience in the infant formula milk supply chain

In recent years, Infant Formula Milk (IFM), a vital source of nutrition for infants lacking breast milk in their first two years, has been plagued by diverse and severe global supply chain disruptions. These challenges have triggered shortages, compromised product quality, and threatened food security, leading to dire health consequences and even fatalities among infants. However, despite the criticality of IFM, current research is lacking in terms of how to build or improve the resilience of IFM supply chains. This paper presents a detailed framework for building a resilient IFM supply chain. A key pillar of this framework is a comprehensive analysis of potential hazards. Using the Hazard and Operability Analysis (HAZOP) method, 91 potential hazards were identified across the entire IFM supply chain. Subsequently, a clustering method identified 17 critical risks with irreversible consequences for infant health and supply chain flow. Finally, mitigation strategies that combine traditional approaches with 4.0 technology-enabled solutions are proposed. Adapting this framework can provide valuable insights for IFM supply chain stakeholders, enabling them to secure the vital flow of this life-sustaining product and safeguard the health and well-being of infants.

Targeted quantification and untargeted exploration of furan and derivatives in infant food by headspace extraction-gas chromatography-Q Exactive Orbitrap mass spectrometry

The aim of the present study was to assess the performance and complementarity of methods capable of both quantifying furan, 2-Methylfuran (2-MF) and 3-Methylfuran (3-MF) in infant foods, but also to comprehensively explore other furan derivatives. It is more particularly a question of validating and comparing the couplings of the two headspace extraction methods most used for the analysis of furan compounds − Headspace Solid Phase Microextraction (HS-SPME) and Static HeadSpace (SHS) – with gas chromatography hyphenated to a high-resolution mass detector (Q Exactive-Orbitrap MS) which allows both targeted quantification and suspect screening. Firstly, the accuracy profile approach was implemented to assess, validate and compare HS-SPME- and SHS-GC-Q Exactive-Orbitrap MS for the quantification of furan in two model infant foods, apple puree and first infant formula. SHS-GC-Q Exactive-Orbitrap MS, showed better accuracy (uncertainty < 17.2 % vs 22.5 % for HS-SPME GC-Q Exactive-Orbitrap MS) and better sensitivity (LOQ < 2.8 vs LOQ < 4.0 µg/kg) over a broader validation range (2–100 µg/kg vs 5–100 µg/kg in apple puree). Secondly, SHS-GC-Q Exactive-Orbitrap MS was assessed and validated by accuracy profile for the quantification of 2-MF and 3-MF, with performance close to those for furan except for 3-MF in apple puree. Thirdly, SHS-GC-Q Exactive-Orbitrap MS was used to quantify the levels of these compounds in 20 commercial samples (n = 3) belonging to the four main categories of infant food (infant formulae, fruit purees, infant cereals, vegetable/fish baby meals). Furan was quantified in 75 % of the samples, with maximum levels in the vegetable/fish-based infant foods (up to 127 µg/kg) while 2-MF and 3-MF were quantified in 45 % and 15 % of products respectively, with maximum levels of 14.1 µg/kg in follow-on formula 3rd age and 9.2 µg/kg in apple puree. Finally, SHS- and HS-SPME-GC-Q Exactive-Orbitrap MS data of the 20 infant products were processed in suspect screening mode using Compound DiscovererTM software. Coupling with HS-SPME, it made it possible to identify 13 additional furan derivatives, i.e. 5 more than with SHS. The relevance and safety status of the compounds identified are discussed.

Deep eutectic solvent-functionalized amorphous UiO-66 for efficient extraction and ultrasensitive analysis of perfluoroalkyl substances in infant milk powder

In this study, a convenient and effective method for determination of perfluoroalkyl substances (PFASs) in infant formula was developed based on a novel dispersive solid-phase extraction using deep eutectic solvent-functionalized amorphous UiO-66 (DES/aUiO-66) as sorbent. The synthesis of materials could be achieved without the use of complex and environmentally unfriendly procedures. Parameters were systematically investigated to establish a simple, fast, and efficient green pretreatment method. The method demonstrated high sensitivity, good precision, a detection limit of 0.330–0.529 ng·kg−1, and low matrix effects (< 12.8%). The mechanism for this material was elucidated by ab initio molecular dynamics (AIMD) simulations and quantum chemistry calculations. The presence of massive pore structures and collectively synergistic binding sites facilitated affinity adsorption toward PFASs. Finally, this method was applied to the monitoring of PFASs in 10 actual milk powder samples. This groundbreaking approach opens new possibilities for the advancement of analytical techniques and food safety monitoring.

Effects of soy protein on alleviating iron deficiency anemia in suckling rats with different iron supplements

Iron deficiency anemia (IDA) is common in infants and the fortification of infant formula with iron is an effective preventive strategy. Because of the severity of cow's milk allergy and the popularity of vegetarianism, soy-based infant formula has been widely used. However, whether soy-based infant formula is detrimental to iron absorption and increases the risk of IDA in infants requires further investigation. In this study, FeSO4 and its potential alternative encapsulated ferric pyrophosphate (FePP) were dissolved in soy protein and whey protein solution, and administered to IDA suckling rats by gavage to investigate the effects of protein system on the IDA remission by iron. Results showed that both types of iron supplement increased the body weight and improved the organ coefficients of IDA suckling rats irrespective of the protein system. In addition, for each type of iron supplement, both protein systems had the same recovery effects on hemoglobin, red blood cell count, hematocrit and body iron status. And, soy protein did not affect the expression of key iron absorption proteins or genes in the suckling rats. In conclusion, for IDA suckling rats, either FePP or FeSO4 in soy protein system has the same beneficial effect as whey protein system, and can effectively improve IDA. These findings provide a reference for the further application of soy-based infant formula and novel iron supplements.

Tolerance of Infants Fed a Hydrolyzed Rice Infant Formula with 2'-Fucosyllactose (2'-FL) Human Milk Oligosaccharide (HMO).

The purpose of this research was to assess the growth, tolerance, and compliance outcomes associated with the consumption of a hydrolyzed rice infant formula (HRF) enriched with 2'-Fucosyllactose (2'-FL) a Human Milk Oligosaccharide (HMO), and nucleotides in an intended population of infants. This was a non-randomized single-group, multicenter study. The study formula was a hypoallergenic HRF with 2'-FL, Docosahexaenoic acid (DHA), Arachidonic acid (ARA), and nucleotides. Infants 0-90 days of age who were formula fed and experiencing persistent feeding intolerance symptoms, symptoms of suspected food protein (milk and/or soy) allergy, or other conditions where an extensively hydrolyzed infant formula was deemed an appropriate feeding option were recruited by pediatricians from their local populations. The primary outcome was maintenance of weight-for-age z-score. Weight, length, head circumference, formula intake, tolerance measures, clinical symptoms and questionnaires were collected. Thirty-three infants were enrolled, and 27 completed the study, on study product. Weight-for-age z-scores of infants showed a statistically significant improvement from Visit 1 to Visit 4 (p = 0.0331). There was an adequate daily volume intake of 762 ± 28 mL/day, average daily number of stools of 2.1 ± 0.3, and mean rank stool consistency of 2.38 ± 0.18. After 28 days of switching to a HRF, 86.8 ± 5.9% of the symptoms resolved or got better by Visit 4 as reported by parents. HRF with 2'-FL HMO was safe, well tolerated, and supported weight gain in infants with suspected cow's milk allergy or persistent feeding intolerance.

An expert panel on the adequacy of safety data and physiological roles of dietary bovine osteopontin in infancy.

Human milk, due to its unique composition, is the optimal standard for infant nutrition. Osteopontin (OPN) is abundant in human milk but not bovine milk. The addition of bovine milk osteopontin (bmOPN) to formula may replicate OPN's concentration and function in human milk. To address safety concerns, we convened an expert panel to assess the adequacy of safety data and physiological roles of dietary bmOPN in infancy. The exposure of breastfed infants to human milk OPN (hmOPN) has been well-characterized and decreases markedly over the first 6 months of lactation. Dietary bmOPN is resistant to gastric and intestinal digestion, absorbed and cleared from circulation within 8-24 h, and represents a small portion (<5%) of total plasma OPN. Label studies on hmOPN suggest that after 3 h, intact or digested OPN is absorbed into carcass (62%), small intestine (23%), stomach (5%), and small intestinal perfusate (4%), with <2% each found in the cecum, liver, brain, heart, and spleen. Although the results are heterogenous with respect to bmOPN's physiologic impact, no adverse impacts have been reported across growth, gastrointestinal, immune, or brain-related outcomes. Recombinant bovine and human forms demonstrate similar absorption in plasma as bmOPN, as well as effects on cognition and immunity. The panel recommended prioritization of trials measuring a comprehensive set of clinically relevant outcomes on immunity and cognition to confirm the safety of bmOPN over that of further research on its absorption, distribution, metabolism, and excretion. This review offers expert consensus on the adequacy of data available to assess the safety of bmOPN for use in infant formula, aiding evidence-based decisions on the formulation of infant formula.