Infant Solid Foods Research Articles

Perinatal risk factors for fecal antibiotic resistance gene patterns in pregnant women and their infants.

Perinatal factors can shape fecal microbiome patterns among pregnant women and their infants. However, there is scarce information about the effect of maternal demographics and perinatal exposures on antibiotic resistance genes (ARG) and mobile genetic element (MGE) patterns in pregnant women and infants. We examined fecal samples from pregnant women during their third trimester of pregnancy (n = 51) and 6-month-old infants (n = 40). Of the 91 participants, 72 represented 36 maternal-infant dyads, 15 were additional pregnant women, and 4 were additional infants. We assessed the effects of demographics, pre-pregnancy BMI, smoking and parity in the pregnancy resistome and the effects of demographics, delivery mode, feeding habits and prenatal antibiotic treatment on the infancy resistome. ARG and MGE richness and abundance were assessed using a SmartChip qPCR-array. Alpha diversity (Shannon and Inverse Simpson index) and beta diversity (Sorensen and Bray-Curtis index) were calculated. The Wilcoxon and the Kruskal non-parametric test were used for comparisons. There is a high variability in shared resistome patterns between pregnant women and their infants. An average of 29% of ARG and 24% of MGE were shared within dyads. Infants had significantly greater abundance and higher diversity of ARG and MGE compared to pregnant women. Pregnancy and infancy samples differed in ARG and MGE gene composition and structure. Composition of the fecal resistome was significantly associated with race in pregnant women, with non-white women having different patterns than white women, and, in infants, with extent of solid food consumption. Our data showed that the pregnancy and infancy resistome had different structure and composition patterns, with maternal race and infant solid food consumption as possible contributors to ARG. By characterizing resistome patterns, our results can inform the mechanism of antibiotic resistome development in pregnant women and their infants.

Perceived food allergy, sensitivity, or intolerance and its impact on breastfeeding practices

The impact of suspected allergic disease on breastfeeding duration is not well defined. The purpose of this study was to examine the association of reported infant adverse reactions to food with breastfeeding duration, and the impact of infant age and specific symptoms on this relationship. 2,586 breastfeeding mothers who participated in the Infant Feeding Practices Study completed surveys at 4, 9, and 12 months postnatally regarding breastfeeding duration and infants’ adverse food reactions. Four groups were considered: no food reactions (84.6%), reaction to something the infant ate (10.6%), reaction to a food the infant was exposed to via breastmilk (2.4%), and reaction due to both sources (2.4%). Kaplan-Meier survival curves were utilized to compare breastfeeding duration between groups using Logrank Tests. Mothers who reported reactions due to food exposure, either alone (M=45.8 weeks) or in combination with food the infant ate (M=40.2 weeks), breastfed significantly longer than mothers who reported no reactions (M=32.0 weeks), and mothers who reported a reaction to a food the infant ate only (M=27.3 weeks); all ps<.01. Later symptom onset (p=.03) and eczema with food issues (p=.06) were associated with longer breastfeeding duration. Similar associations were noted using Cox Proportional Hazards Models adjusted for race/ethnicity, income, and maternal age. Mothers’ perceptions regarding infants’ adverse reactions to food appear to impact breastfeeding duration. Future work should explore how problems with food factor into mothers’ decisions about breastfeeding, their diet, and infant solid food introduction, especially in the context of allergen introduction in infancy.

Infant temperament, maternal feeding behaviours and the timing of solid food introduction.

Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty‐one women were recruited on low‐risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire‐Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez‐faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression).

Parental timing of allergenic food introduction in urban and suburban populations

BackgroundRecommendations on timing for introduction of allergenic foods in an infant diet have changed twice during the past decade. How families with different demographic characteristics implement the change has not been studied in the United States. ObjectiveTo compare the age of introduction of allergenic foods between an urban Medicaid-based population and a suburban private insurance–based population in Cincinnati, Ohio. MethodsTwo hundred parent surveys were distributed at well-child checkups between 4 and 36 months of age. Data were analyzed using distribution mapping to determine the difference in the age of introduction of infant formula, infant solids, whole cow's milk, eggs, peanut, and fish. Random forest analysis was used to determine the most important factors affecting the age of introduction for both populations. ResultsThere was no statistically significant difference in the age of infant solid introduction, but urban populations introduced allergenic foods earlier than suburban populations, with a statistically significant difference in the age of introduction of infant formula, whole cow's milk, eggs, peanut, and fish. The most important factor for the timing of all food introductions was the recommended age of introduction from health care professionals. ConclusionThere is a difference between urban and suburban populations in the timing of introduction of allergenic foods but not in other infant solid foods. The reliance on physician recommendation for both populations supports the need for education and guidance to health care professionals on up-to-date guidance and recommendations.

Risk Assessment of Arsenic in Rice Cereal and Other Dietary Sources for Infants and Toddlers in the U.S.

Currently, there are no set standards or quantitative guidelines available in the U.S. for arsenic levels in rice cereal, one of the most common first solid foods for infants. The objective of this study was to evaluate whether the detected levels of inorganic arsenic (Asi) in rice cereal in the U.S. market are safe for consumption by infants and toddlers. A risk assessment was conducted based on literature reviews of the reported Asi in rice cereal from the U.S. Food and Drug Administration’s (FDA) survey and the recommended daily intake of rice cereal by body weight, for infants and toddlers between four and 24 months old. As a part of risk management, a maximum contaminant level (MCL) for Asi in rice cereal was computed considering overall exposure sources including drinking water, infant formula, and other infant solid foods. Hazard quotients (HQs) for acute and chronic exposures were calculated based on the U.S. Agency for Toxic Substances and Disease Registry’s (ATSDR) Minimal Risk Level (MRL)acute (5.0 × 10−3 mg/kg/day) and MRLchronic (3.0 × 10−4 mg/kg/day). A cancer slope or potency factor of 1.5 mg/kg/day was used to predict an incremental lifetime cancer risk (ILCR). Exposure assessment showed that the largest source of Asi for infants and toddlers between four and 24 months old was rice cereal (55%), followed by other infant solid food (19%), and drinking water (18%). Infant formula was the smallest source of Asi for babies (9%) at the 50th percentile based on Monte Carlo simulations. While HQacute were consistently below 1.0, HQchronic at the 50 and 75th percentiles exceeded 1.0 for both rice cereal and total sources. ILCR ranged from 10−6 (50th) to 10−5 (75th percentile). MCLs for Asi in rice cereal ranged from 0.0 (chronic) to 0.4 mg/kg (acute exposures).

Associations between Infant Feeding Practices and Length, Weight, and Disease in Developing Countries

The health benefits of exclusive breastfeeding are well-known, but the relative detrimental impacts of other foods on infant health are unknown. Because infants in developing countries are fed a wide range of food, quantifying the burden of these diverse feeding practices on infant health is essential for public health policy. We used data from the Demographic Health Survey from 20 developing countries over multiple years to examine the independent association of six different types of food (exclusive breastfeeding, non-exclusive breastfeeding, infant formula, milk liquids, non-milk liquids, and solid foods) with five measures of infant health (length, weight, diarrhea, fever, and cough). We estimated associations with regression analysis, controlling for confounding factors with infant, mother, and household factors and community-year fixed effects. We used these estimates in a simulation model to quantify the burden of different combinations of food on infant health. We show that for an infant younger than 6 months old, following current guidelines and exclusively breastfeeding instead of giving the infant solid foods may increase length by 0.75 cm and weight by 0.25 kg and decrease diarrhea, fever, and cough prevalence by 8, 12, and 11%, respectively. We found that the burden on infant health of some feeding practices is less than others. Although all other feeding practices are associated with worse health outcomes than exclusive breastfeeding, breastfeeding supplemented with liquids has a lower burden on infant health than solid foods and infant formula has a lower burden than milk or non-milk liquids as measured by four of five health metrics. Providing specific quantified burden estimates of these practices can help inform public health policy related to infant feeding practices.

The Use of Whole Cow's Milk in Infancy

The pediatrician is faced with a difficult challenge in providing recommendations for optimal nutrition in older infants. Because the milk (or formula) portion of the diet represents 35% to 100% of total daily calories and because WCM and breast milk or infant formula differ markedly in composition, the selection of a milk or formula has a great impact on nutrient intake. Infants fed WCM have low intakes of iron, linoleic acid, and vitamin E, and excessive intakes of sodium, potassium, and protein, illustrating the poor nutritional compatibility of solid foods and WCM. These nutrient intakes are not optimal and may result in altered nutritional status, with the most dramatic effect on iron status. Infants fed iron-fortified formula or breast milk for the first 12 months of life generally maintain normal iron status. No studies have concluded that the introduction of WCM into the diet at 6 months of age produces adequate iron status in later infancy; however, recent studies have demonstrated that iron status is significantly impaired when WCM is introduced into the diet of 6-month-old infants. Data from studies abroad of highly iron-deficient infant populations suggest that infants fed partially modified milk formulas with supplemental iron in a highly bioavailable form (ferrous sulfate) may maintain adequate iron status. However, these studies do not address the overall nutritional adequacy of the infant's diet. Such formulas have not been studied in the United States. Optimal nutrition of the infant involves selecting the appropriate milk source and eventually introducing infant solid foods. To achieve this goal, the American Academy of Pediatrics recommends that infants be fed breast milk for the first 6 to 12 months. The only acceptable alternative to breast milk is iron-fortified infant formula. Appropriate solid foods should be added between the ages of 4 and 6 months. Consumption of breast milk or iron-fortified formula, along with age-appropriate solid foods and juices, during the first 12 months of life allows for more balanced nutrition. The American Academy of Pediatrics recommends that whole cow's milk and low-iron formulas not be used during the first year of life.

Vitamin E and C levels in infants during the first year of life

The considerably lower vitamin E level found in cord blood and in newborns at birth than those found in the venous blood of mothers at delivery are not yet fully explained. In a group of 217 not selected newborns, we attempted to establish the relation between vitamin E and C levels at delivery and the changes during the first year of life. The mean serum vitamin E level rose from 0.37 mg/ml at 3 days to 0.80 mg/100 ml at 6 months and to 0.72 mg/100 ml at 12 months. On the other hand vitamin C mean levels lowered from 0.93 mg/100 ml in cord blood to 0.77 mg/100 ml at 6 months and to 0.73 mg/100 ml at 12 months. The rise of vitamin E values could be explained by the early use of infant solid foods with high vitamin and mineral content and by the increase of serum lipoproteins. Except at 3 days after delivery there were no individual values of serum vitamin E below the acceptable 0.35 mg/100 ml limit. However, serum vitamin C levels compatible with a moderate risk were very often observed, i.e., in 27.1% of infants at 6 months and in 30.5% at 1 year. Thus, vitamin E intake in infants was satisfactory with the usual diet but not vitamin C for which blood levels were not adequate. In view of these findings it appears necessary to evaluate periodically the vitamin E as well as vitamin C status in the infant population.

Acceptance of a soya food by infants.

From October, 1955, to May, 1957, an investigation of a new protein food for infants was undertaken. Because of the paucity of published information of attempts to evaluate the acceptance of infant solid foods, it was thought of interest to report such an appraisal. A soya bean preparation was selected for the study because of its potentiality as an economic source of protein of good quality for the feeding of infants. The excellent quality of the protein of soya bean has been well established for the feeding of animals.¹Various preparations of this protein have been used widely for the feeding of infants with problems of an allergic nature. The purpose of the study was to ascertain the number of babies who would accept this new food, the length of time they would continue to take it, and the incidence of reactions to it. Additional studies, which will be