Milk Formula Research Articles

Isolation and characterization of Bifidobacterium spp. From breast milk with different human milk oligosaccharides utilization and anti-inflammatory capacity

Breast milk is the best source of nutrition for infants. Human milk oligosaccharides (HMOs) and the corresponding HMOs-consuming Bifidobacterium positively influence infant health. This study aims to isolate and characterize Bifidobacterium from breast milk of healthy Chinese mothers, identifying the most efficacious strains for inclusion in simulated maternal milk formulas. Nine Bifidobacterium strains (two of B. breve and seven of B. infantis) were isolated, exhibiting a broad spectrum of probiotic potential. This included tolerance to simulated infant gastrointestinal conditions, notable adhesion, antibacterial, antioxidant activities, and HMOs utilization ability. Lacto-N-Tetraose (LNT) is preferred in early growth among Bifidobacterium isolates. B. breve showed a preference for LNT, whereas B. infantis showed a preference for fucosylated HMOs, and displayed reduced utilization of sialylated HMOs. They also exhibited robust safety profiles, including no hemolytic activity, an appropriate D/L lactate-producing ratio, and non-toxicity in an acute oral toxicity assay on mice. It is noteworthy that B. breve N-90, O-147, B. infantis O-161 and R-1 exhibited anti-inflammatory effects in LPS-induced RAW 264.7 cells. Specifically, a notable reduction in TNF-α levels was observed in pre-treatment, while a decrease in IL-1β and IL-6 levels in co-treatment. B. breve N-90 and B. infantis R-1 were identified finally as promising probiotic candidates. Their whole-genome sequencing analysis confirmed presence of functional genes associated with gastrointestinal colonization, antioxidation, and glycoside hydrolase activity on HMOs. The annotation for antibiotic resistance and virulence genes concurred with phenotypes, further validating the safety. Breast milk is a good source for Bifidobacteria isolation, while Bifidobacteria utilize HMOs in a strain-dependent manner. The two selected strains, B. breve N-90 and B. infantis R-1, are potential candidates for inclusion in simulated maternal milk formulas and deserved further in vivo investigation for their health-promoting effects.

Spousal Postpartum Social Support and Association with Sexual Function and Sexual Quality of Life among Breastfeeding Women

Background: The present study investigated the relationship between spousal support during postpartum period and the sexual function and sexual quality of life among lactating women. Methods: A cross-sectional study was carried out from October to March 2021 comprising 301 breastfeeding women referred to comprehensive health centers in Qazvin, Iran. The sampling method was performed in two stages. First, via cluster sampling, ten comprehensive health centers were randomly selected. Then based on the list of lactating mothers, 31 mothers in each center were randomly selected and invited to complete the survey. The survey included three psychometric instruments (i.e., Postpartum Partner Support Scale [PPSS], Female Sexual Function Index [FSFI] and Sexual Quality of Life-Female version [SQOL-F]) as well as a reproductive and demographic information questionnaire. The findings were analyzed using univariable and multivariable regression models at a significance level of p<0.05. Results: The participants had a mean age of 30.33 years and a mean length of marriage of 7.99 years. A total of 219 women were exclusively breastfeeding (72.8%), and 82 used a combination of breastfeeding and formula milk to feed their infants (27.2%). The mean (standard deviation) scores in the postpartum period were 61.34 out of 80 (SD=11.41) on the PPSS, 86.52 out of 108 (SD=19.68) on the SQOL-F, and 22.78 out of 36 (SD=6.20) on the FSFI. Based on adjusted multivariable regression models, spousal support in the postpartum period was a significant predictor of sexual quality of life (β=0.39, p<0.001) but not a significant predictor of sexual function. Sexual quality of life was a significant predictor of sexual function (β=0.44, p<0.001). Conclusion: Given the importance of spousal support during the postpartum period in relation to sexual quality of life and sexual function, designing and implementing counseling programs based on the role of spousal support during postpartum sexual life would be helpful.

In Vitro Lipid Digestion of Milk Formula with Different Lipid Droplets: A Study on the Gastric Digestion Emulsion Structure and Lipid Release Pattern.

In this study, the digestive properties of milk formulas (two concept milk formulas L1 and L2 with D4,3 ∼5 μm and a control milk formula S1 with D4,3 ∼0.5 μm) were evaluated using a dynamic digestion model simulating the infant gastrointestinal tract. The results showed that L1 and L2 had a lower lipolysis degree compared to S1 during gastric digestion and no significant difference at the end of the digestion process. Triacylglycerol lipolysis products were highly related to the lipid sources of milk formulas. At the end of digestion, glycerophospholipids in milk formulas were hydrolyzed to lysophospholipids (∼60-80%), while sphingomyelins were barely hydrolyzed. Concept milk formulas showed a complete spherical structure with a mean size of 3-5 μm during gastric digestion, while the control formula had large aggregates consisting of small lipid droplets. This study reveals that the structure of lipid droplets moderates the gastric digestion emulsion structure and further influences the digestive properties of milk formulas.

Stakeholder perspectives on supplemental milk for infants under six months with growth faltering

Abstract Background Growth faltering is a significant public health issue among infants aged <6 months (m). Supplemental milk is commonly used for infants with growth faltering, with variations in type and duration. We synthesized qualitative evidence on stakeholder perspectives about equity, feasibility, and acceptability of the type and duration of supplemental milk for infants aged <6m with growth faltering. Methods We conducted a comprehensive search of six electronic databases in addition to manual searches to identify all qualitative studies published during January 2000-June 2022. Identified articles were screened in two stages against an inclusion criteria with titles and abstract screened first followed by full-text screening. Included studies were quality appraised using the Critical Appraisal Skills Programme checklist. The primary outcome was equity, feasibility, and acceptability of various supplemental milk for infants <6mwith growth faltering. Results Eighteen studies, reporting perspectives of mothers, fathers, grandmothers and healthcare providers were included. Studies were conducted in North America (9), Africa (5) and Asia (3) and South Australia (1). Donor human milk (DHM) (13) and infant formula(9) were the main supplementary milk reported followed by cow/goat milk (2). Key sub-themes derived were: education/awareness, socio-economic status (SES), race and religion, practicality, availability of resources, sustainability, cost, affective attitude, perceived effectiveness and ethicality. Maternal/caregiver SES was a key sub-theme across all three supplemental milk feeds, acting either as a barrier or facilitator for uptake. Conclusions DHM and infant formula were the most commonly reported supplemental feed for infants aged <6m with growth faltering. Maternal/care giver factors were perceived as key to ensure equity, feasibility, and acceptability with respect to type and duration of supplemental milk for infants aged <6m with growth faltering. Key messages • Stakeholders perceived donor human milk and infant formula as main supplemental milk for infants aged <6 months with growth faltering. • Maternal/care giver factors are key to ensure equity, feasibility, and acceptability of supplemental milk for infants aged <6 months with growth faltering.

Heavy Metal Nanoparticle Detection in Human and Formula Milk.

Breast milk is the natural source of nutrition for infants, but while it supports their health, it can also be a potential source of toxic inorganic particulate matter, and this applies to both breast milk and industrially produced milk. The aim of the present study was to evaluate the presence of nanoparticles in both breast milk and formula milk samples. We collected and analyzed, via a new electron scanning microscopic procedure, 19 samples of breast milk from Italian women and 19 formula milk samples produced by different companies. Organic-inorganic agglomerates were detected in 58% of formula and in 63% of breast milk samples, respectively. In addition, a significantly (p < 0.05) greater size of nanoparticles was observed in formula milk samples. The results, showing the presence of inorganic nanosized particles in breast and artificial milk, may lead to future studies aimed at investigating possible nanosized contamination of milk and identifying early prevention strategies for women and animals involved in the food chain.

Profiling the differential phosphoproteome between breast milk and infant formula through a titanium (IV)-immobilized magnetic nanoplatform

Breast milk (BM) fulfills the nutritional needs of infants and sets the standard for infant formula (IF). However, profiling the differential phosphoproteome between BM and IF remains unclear. Herein, a titanium (IV) (Ti4+)-immobilized magnetic nanoplatform (Fe3O4@GO@PDA-Ti4+) was constructed by self-assembly polymerization of dopamine on magnetic graphene oxide, followed by immobilizing Ti4+ through chelation for phosphopeptide enrichment. Fe3O4@GO@PDA-Ti4+ possessed outstanding selectivity (1/1000, a molar ratio of β-casein digests to bovine serum albumin digests) and favorable sensitivity (2.5 fmol/μL), along with rapid magnetic separation. Excellent phosphopeptide capture efficiencies were obtained for BM and IF using Fe3O4@GO@PDA-Ti4+ as an adsorbent coupled with liquid chromatography-mass spectrometry/mass spectrometry. There were 191 and 239 phosphopeptides found in BM and IF, respectively, with 36 phosphoproteins identified in both. However, BM and IF shared only 17 phosphopeptides and 4 phosphoproteins. The variation in the phosphoproteome between BM and IF provides valuable insights into the optimization of IF humanization.

Pelatihan Metode SPEOS (Stimulasi Pijat Endhorpin, Pijat Oksitosin dan Sugesti) Ibu Nifas Pada Tim Pendamping Keluarga di Wilayah Puskesmas Danau Marsabut Kecamatan Sipirok

Based on the 2018 Riskesdas results, the proportion of breastfeeding patterns for babies aged 0-5 months in Indonesia is 37.3% exclusive breastfeeding, 9.3% partial breastfeeding and 3.3% predominant breastfeeding. Predominant breastfeeding is breastfeeding the baby but giving a little water or a water-based drink, for example tea, as a prelacteal food/drink before the milk comes in. Meanwhile, partial breastfeeding is breastfeeding a baby and giving artificial food other than breast milk such as formula milk, porridge or other food before the baby is 6 months old, whether given continuously or as prelacteal food. North Sumatra Province Nutrition Program Data in 2018. The percentage of exclusive breastfeeding for babies 0-6 months in North Sumatra in 2018 was 65.57 percent, an increase compared to the percentage of exclusive breastfeeding in 2017, namely 54.4 percent (Sumatra Provincial Health Service, 2017). 2018). In the breastfeeding process, problems sometimes arise that can prevent giving breast milk to babies. Problems that mothers often experience when breastfeeding include inverted nipples, swollen breasts, sore and painful nipples, blocked milk ducts, breast inflammation and insufficient milk production (Purwoastuti, 2015). There are many non-pharmacological methods that can help postpartum mothers increase breast milk production, ranging from marmet massage, oxytocin massage, Woolwich massage to areola and rolling massage. Currently, based on the results of related research, there are non-pharmacological methods that are cheaper, easier, non-invasive and acceptable to respondents and without side effects. Nursing interventions that can be applied to help increase lactation in post partum mothers are the SPEOS method (Endorphin, Oxytocin and Suggestive Massage Stimulation).

A Comprehensive Assessment of the Environmental Impact of Different Infant Feeding Types: The Observational Study GREEN MOTHER.

To observe and compare the environmental impacts of different types of infant feeding, considering the use of formula, infant feeding accessories, potentially increased maternal dietary intake during breastfeeding (BF) and food consumption habits. An observational cross-sectional multicentre study conducted in the Barcelona Metropolitan Area of the Catalan Institute of Health. Data were collected from 419 postpartum women on infant feeding type (formula milk and accessories), maternal dietary intake (24-h register) and food consumption habits from November 2022 to April 2023. The environmental impacts (climate change (CC), water consumption and water scarcity) of the infant feeding types and maternal diet were calculated using the IPCC, ReCiPE and AWARE indicators, respectively. The differences in impacts were calculated by Kruskal-Wallis test. Significant differences for the three environmental impacts were observed. The CC impact of formula milk and feeding accessories was 0.01 kg CO2eq for exclusive BF, 1.55 kg CO2eq for mixed feeding and 4.98 kg CO2eq for formula feeding. While BF mothers consumed an extra 238 kcal, no significant differences were found related to maternal diet across feeding types. Exclusive BF was the most sustainable type of infant feeding, considering formula and infant feeding accessories. In our study, the difference between the impacts of BF and non-BF mothers' diet was insignificant. Offer informative and educational support for midwives and other healthcare professionals on BF and a healthy, sustainable diet to transfer this knowledge to the general public. Raise the general public's awareness about BF and a healthy, sustainable diet. To reduce environmental impacts through behavioural changes. STROBE. Patients of the Catalan Health Service reviewed the content of the data collection tools. (for the whole GREEN MOTHER project): NCT05729581 (https://clinicaltrials.gov).

Strengthening nutrition policy and service delivery: Lessons learned from a six-country assessment of Alive and Thrive's technical assistance.

Alive & Thrive (A&T) provides strategic technical assistance (TA) to develop effective policies; improve maternal, infant, and young child nutrition (MIYCN) programme design and implementationand enhance system capacity to sustain quality MIYCN service delivery at scale. A qualitative assessment was conducted using document review and stakeholder interviews (n = 79) to describe a selection of A&T's TA in six countries and systematically assess the contextual and TA process-related factors that influenced the results achieved and document the lessons learned about MIYCN TA design and implementation. To facilitate the selection of different types of TA, we classified TA into two levels of stakeholder engagement and intensity. Under the Technical Advisor TA category, we assessed A&T's support to strengthen national policy formulation, monitoring, and implementation of the International Code of Marketing of Breast-milk Substitutes. For Capacity Development TA, we assessed A&T support to scale-up maternal nutrition services and to increase strategic use of data. Factors important for TA provision included identifying and engaging with the right people, using evidence to support advocacy and decision-making, using multiple ways to strengthen capacity, developing packages of tools to support programme scale-up, and reinforcing feedback mechanisms to improve service provision and data quality. Challenges included shifts in the political context, poorly functioning health systems, and limited resources to replicate or sustain the progress made. Continued investment in evidence-based and practical TA that strengthens the institutionalization of nutrition across all stakeholders-including government, medical associations, civil societyand development partners-is essential. Future TA must support governments to strengthen system capacity for nutrition, including financial and human resource gaps that hamper full scale-up.

A weighted and cumulative point system for accurate scoring of intestinal pathology in a piglet model of necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is a serious condition in premature infants, in which a portion of the intestine undergoes inflammation and necrosis. The preterm pig develops NEC spontaneously, making it a suitable model for exploring novel NEC treatments. We aimed to revise the intestinal scoring system to more accurately describe the diversity of NEC lesions in the preterm piglet model. We included 333 preterm piglets from four experiments, each delivered via cesarean section. The piglets were fed either a gently processed (GP) or harshly processed (HP) milk formula for 96 h before euthanasia. At necropsy, the gastrointestinal tract was assessed with 1) an established 6-grade score and 2) a descriptive approach focusing on the distribution and severity of hyperemia, hemorrhage, pneumatosis intestinalis (intramural gas), and necrosis. Subsequently, the descriptive registrations were converted into a weighted and cumulative point (WCP) score. Compared to the 6-grade score, the WCP score enabled a greater segregation of severity levels, especially among organs with more prominent NEC lesions. IL-1β in small intestinal lesions and both IL-8 and IL-1β in colon lesions correlated positively with the WCP scale. A histopathological grade system (0–8) was established and revealed mucosal pathology in lesion biopsies, which were not recognized macroscopically. Finally, the WCP score showed a higher NEC-promoting effect of the HP formula compared to the GP formula. The descriptive registrations and extended score range of this revised intestinal scoring system enhance the accuracy of describing NEC lesions in preterm pigs. This approach may increase the efficiency of preclinical NEC experiments.

Practice changes and infant health risks during the 2022 infant formula shortage: Results of a US healthcare provider survey.

In February 2022, an infant formula recall and closing of a major manufacturing center exacerbated a nationwide shortage initiated by COVID-19-related supply chain disruptions. The effects were far-reaching, impacting families and healthcare providers across the US. A 19-item web survey was developed to better understand how the infant formula shortage impacted healthcare provider practices, resources needed and those already used, and patient health, including malnutrition. Subjective data on providers' experience were also collected. Two hundred forty-one providers responded, primarily registered dietitians (94%) practicing in inpatient/academic hospitals in urban and metropolitan areas. Practice adjustments included increases in patient education (100%), communication with pharmacies/durable medical equipment companies (65%), and visit durations (28%). Feeding adjustments by caregivers included new infant formula (99%), toddler (55%) or homemade (23%) formula, cow's milk (46%) or milk alternatives (32%), formula dilution (41%), and early food introduction (14%). Providers indicated an increase in malnutrition (33%), related diagnoses (including failure to thrive [31%] and deceleration in z score [27%]), and associated symptoms. Of the providers who reported malnutrition and related diagnoses, 93% also reported caregiver feeding practices that are generally not recommended. Providers made practice adjustments to mitigate the consequences associated with formula unavailability and misuse yet saw an increase in malnutrition and related diagnoses or symptoms. Subjectively, providers reported frustration that greater workloads did not result in improved outcomes, contributing to burnout. These data underscore the essentiality of supporting healthcare providers as they guide families in safe infant feeding practices.

Influence of chemical forms and homogenization process on the stability of vitamin A in infant follow-on formulas

Vitamin A is an essential micronutrient for infant development, and its stability is crucial to ensure adequate intake. This study aimed to investigate the vitamin A stability in infant follow-on formulas (IFF) depending on its chemical forms and on the homogenization process. For this propose, model IFF representative of commercialized formulas were formulated with varying vitamin A forms (retinol, retinyl esters or carotenoids) and homogenization process applied. Losses of vitamin A were assessed either before or after the homogenization process, or after a storage of 20 days at 40 °C. The homogenization process led to a vitamin A loss up to 14.3% at high pressure (350/40 bars, 8 passes) explained by important shearing forces leading to local heating of molecules. The presence of carotenoids and especially β-carotene led to a stabilization effect with a loss of only 40.7% of vitamin A during storage compared to 84.9% without carotenoids. Carotenoids provide a better resistance to lipid oxidation due to their synergetic effect with vitamin E. This study highlights that a good knowledge of vitamin A reactivity during processing and selection of chemical form with potential synergy with other compounds can improve its stability in IFF.

Optimization of a Modified QuEChERS Method of Experimental Design for Vitamin B2, B3, B6 and B9 in Powder Formula Milk by HPLC/DAD

The purpose of this work is to use HPLC/DAD to ascertain the best extraction and cleanup conditions for various forms of vitamin B in powder formula milk. The QuEChERS method’s key variables were optimized using a Box-Behnken design with 3-level 4-variable and Minimum-Run Resolution IV Screening Design. Following the selection of the best experimental setup, the suggested approach was applied to quantify four vitamins B (B2, B3, B6, and B9) in powder formula milk matrix by HPLC/PDA in accordance with AOAC and ICH guidelines. When taking into account the performance standards given in this guideline, the approach presented recovery between 83.55 and 108.43 for 4 B vitamins, which is adequate. The intra-day and inter day percentage relative standard deviations were 1.66 to 2.75% and 0.47 to 4.78%, respectively. Furthermore, the technique enabled the determination of low detection limits in less than 25 minutes of analytical time. The proposed method’s excellent accuracy, precision, and efficiency made it acceptable for regular B vitamin analysis when applied to powder formula milk samples. The findings confirmed that the modified QuEChERS technique is appropriate for routinely assessing B vitamin levels in powder formula milk matrix.

A landscape analysis of investors in the global breast milk substitute industry to target for advocacy.

The International Code of Marketing of Breast-milk Substitutes and subsequent resolutions (the Code) was adopted to address increases in mortality and morbidity resulting from the practices of the breast-milk substitute (BMS) industry. The lack of success in ensuring company compliance with the Code has prompted advocates to consider engaging with investors to shape the governance of BMS companies. To support these efforts, this paper aimed to identify prominent investors in the global BMS industry and explore their Code-related policies and practices. Using multiple methods and data sources, we developed a novel approach to identify and rank investors in the world's leading publicly listed BMS companies. We also examined the policies and voting behaviour of a sample of investors using publicly accessible materials from 2020 to 2022. We found that a small number of large investors, led by BlackRock and Vanguard, hold a substantial share in the global BMS industry. Of the top-10 ranked investors, only Norway's Government Pension Fund (NBIM) reported policy information relating specifically to BMS marketing. Most of these large investors also opposed the sample of public health-related shareholder proposals analysed. In addition, we identified several investors that have reported engaging with BMS companies on Code-related issues, including NBIM, Pictet, and UBS, along with several potential investor targets for future advocacy efforts, including some North American public pension funds. The inclusion of Code-related issues as part of broader policies, disclosures and regulations related to environmental, social and governance oriented investment warrants increased attention.

Evaluation of growth and feeding tolerance in infants with single-ventricle physiology receiving retrospective standard of care feeding regimens compared with protocolised formula or exclusive human milk feeding regimens.

Determine whether weight gain velocity (g/day) 30 days after initiating feeds following cardiac surgery and other clinical outcomes improve in infants with single-ventricle physiology fed an exclusive human milk (EHM) diet with early fortification compared to non-protocolised "standard of care." This retrospective cohort study compares term infants with single-ventricle physiology who underwent neonatal surgical palliation. The retrospective control group (RCG) was fed according to non-protocolised standard of care at a single centre and was compared with infants in a previous protocolised multi-site randomised controlled trial assigned to either an EHM group or a control group (TCG). The primary outcome measure is weight gain velocity. Secondary outcomes include change in weight z-score, and incidence of feeding intolerance and necrotising enterocolitis. We evaluated 45 surgically palliated neonates with single-ventricle physiology compared to the prior trial patients (EHM = 55, TCG = 52). Baseline demographics were similar between groups, except the RCG had fewer patients with hypoplastic left heart syndrome (51% vs. 77% vs. 84%, p = 0.0009). The RCG grew similarly to the TCG (7.5 g/day vs. 8.2 g/day), and both groups had significantly lower growth than the EHM group (12 g/day). Necrotising enterocolitis/suspected necrotising enterocolitis were similar in the RCG versus TCG but significantly higher in the RCG compared to the EHM group (20.5% vs. 3.6%, p = 0.033). Incidences of other morbidities were similar. Neonates with single-ventricle physiology have improved short-term growth and decreased risk of necrotising enterocolitis or suspected necrotising enterocolitis when receiving an EHM diet after surgical palliation compared to non-protocolised feeding with bovine formula.

Mediating Roles of Perceived Quality and Perceived Behaviour Control in Shaping Chinese Consumer’s Purchase Intention for Domestic Infant Milk Formula (IMF)

The 2008 melamine crisis led to widespread consumer distrust of Chinese domestic infant milk formula (IMF), which was substituted through a surge of imported products. Recent studies, however, suggest a revival in consumer confidence in Chinese domestic products and regulatory supervision. This coincides with a rise in consumer ethnocentrism and increased concern about foreign IMF, which arose during the COVID-19 pandemic. This study aims to investigate the multifaceted factors that influence consumers’ intention to purchase domestic IMF, using a structural equation model based on a survey of 563 online consumers. Our findings challenge conventional thinking that food safety governance, consumer ethnocentrism, and COVID-19 have no significant direct impact on IMF purchase decisions. Instead, consumer purchase intentions are driven more indirectly by mediating factors of perceived product quality and perceived behavioural control. The findings have significant implications for Chinese policymakers and industry stakeholders seeking to rebuild trust and strengthen the market position of domestic IMF in the post-melamine and post-pandemic era. By understanding the nuanced dynamics and consumer preferences in this market, international stakeholders can also develop more effective strategies to navigate and compete in the ever-evolving landscape of the Chinese IMF industry.

Cloud point extraction and characterization of zinc oxide nanoparticles isolated from infant milk formulas

Cloud point extraction and characterization of zinc oxide nanoparticles isolated from infant milk formulas

Commercial milk formula marketing entry points: setting the course of infant and young child feeding trajectories

BackgroundThere is a limited understanding of the dynamic influences that shape infant and young child feeding (IYCF) decisions over time. We conducted an innovative qualitative study to reconstruct IYCF trajectories across early life course phases, in the context of the socioecological model (SEM) and the commercial determinants of IYCF.MethodsWomen of different socioeconomic status were interviewed in two large metropolitan areas in Mexico. Our specific goal was to allow us to better understand if and how the commercial milk formula (CMF) marketing influenced breastfeeding decisions in a complex dynamic way involving the individual, relational, community and societal levels.ResultsHospitals, health professionals, and interactions with social media were key category entry points throughout the prenatal, perinatal, early infancy period and beyond. The CMF industry interfered by engaging a wide array of actors across the different layers of the SEM, most prominently the health care system and the workplace. Through its marketing strategies the CMF operates subconsciously and its messages are most effective when health institutions, health care providers, workplace spaces and social norms are weak in their support for breastfeeding.ConclusionsThe cases in our study highlight how, together with a weak breastfeeding counseling system, and health professionals who lack training in breastfeeding and normal infant behavior, lead to the opportunity for CMF marketing to shape infant feeding, and ultimately to the decision to feed formulas that some mothers were not planning to use and cannot afford.

A Comparative Evaluation of the Acidogenic Potential of Lactose-based, Soy-based, Protein Hydrolysate-based, and Iron-based Milk Formulas Based on Dental Plaque pH, Salivary pH, and Buffering Capacity: An In Vivo Study.

Breastfeeding is the gold standard nutrition for infants. However, the inability of infants to latch on, maternal complaints of sore or painful nipples, and insufficient milk supply frequently result in early breastfeeding cessation. Hence, milk has subsequently been replaced by infant formula milks of high quality, which serve as an alternate source of nutrition for infants. There also has been a rising concern among parents and caretakers regarding the cariogenic potential of the various milk formulas available in the market due to the presence of fermentable carbohydrates in them, leading to an increase in nursing caries or early childhood caries. Hence, this study aims to comparatively evaluate the acidogenic potential of four different milk formulas based on dental plaque pH, salivary pH, and buffering capacity. This cross-sectional study was carried out to assess the acidogenic potential of various infant milk formulas using three main parameters of measurement of caries: evaluation of salivary pH, plaque pH, and buffering capacity.Baseline plaque and salivary pH and postconsumption plaque pH and salivary pH were assessed after 5, 10, 15, 20, 30, and 60 minutes in 60 healthy children (15 in each study group) aged 7-12 years after rinsing with group I (lactose-based), group II (soy-based), group III (protein hydrolysate-based), and group IV (iron-based) milk formulas. The pH was assessed using a precalibrated digital pH meter. Plaque pH was also further assessed based on its buffering capacity. Soy-based and protein hydrolysate-based milk formulas were found to be most cariogenic in both saliva and plaque. Lactose-based formulas were found to be the least cariogenic of all the milk formulas. Parents and caretakers must be made aware of the various types of milk formulas available, their composition, as well as their relative cariogenic nature. Feeding should always be supervised, and infants should not be left with milk-containing bottles as comforters. Milk feeds at bedtime, when salivary flow is reduced, should be discouraged. Dentists and pediatricians should be aware of the caries-related risk associated with different milk formulas before recommending them to children. Knowledge and awareness among parents and caretakers regarding the cariogenicity of various milk formulas available in the market. Mahanta A, Yadav G, Saha S, et al. A Comparative Evaluation of the Acidogenic Potential of Lactose-based, Soy-based, Protein Hydrolysate-based, and Iron-based Milk Formulas Based on Dental Plaque pH, Salivary pH, and Buffering Capacity: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(8):851-859.

Abstract A014: Racial and socioeconomic disparities in breast feeding and the impact of pregnancy-related medical conditions among a population-based sample of non-Hispanic Black and White women

Abstract Background: Breastfeeding has been associated with a reduced risk of breast cancer (BC), particularly with Triple Negative BC (TNBC). The risk of TNBC is higher among premenopausal women, Black/African American (AA) women, and poorer women. Notably there are significant disparities in breastfeeding, where non-Hispanic Black (NHB) women and poorer women are less likely to breastfeed in the United States. Studies have identified historical racial trauma, unsupportive work and hospital policies, breast milk formula advertising, and knowledge and beliefs about breast feeding as factors that contribute to breast feeding practices. However, there is a paucity of research on pregnancy related medical conditions (PMCs) that potentially impact initiation and duration of breastfeeding. The purpose of this study is to evaluate racial and socioeconomic differences in breastfeeding, and if PMCs impact breastfeeding practices in a population-based sample of non-Hispanic Black and White women. Method: Data are from the Young Women’s History and Health Study (YWHHS), a population- based case-control study of invasive BC among non-Hispanic Black (NHB) and non-Hispanic White (NHW) women aged 20-49 years residing in Metropolitan Detroit and Los Angeles County, 2010-2015. The analytic sample here includes the first pregnancy of control participants with singleton live births (n=675). Area-based control participants were sampled from the 2010 Census. Interviews assessed complete reproductive histories, including breastfeeding history (never, &amp;lt;6 months, and ≥6 months), PMCs experienced during pregnancy, self-reported race, and household financial struggles before age 13 years (to approximate childhood socioeconomic position (chSEP)). PMCs examined included: 1) premature birth, 2) diabetes or pre-diabetes related PMCs, 3) blood pressure-related PMCs, and 4) BMI ≥ 25 kg/m2 at age 18 years. Weighted percentages were evaluated with a chi-square test and considered significant at p &amp;lt; 0.05. Analyses were further stratified by race/ethnicity and chSEP. Result: NHB women were 2.4 times significantly more likely to never breastfeed than NHW women (W% =52.0 (NHB) and 21.3 (NHW), p=&amp;lt;0.0001). Similarly, women with lower compared to higher chSEP were 1.5 times significantly more likely to never breastfeed (W% = 42.7 (lower chSEP) and 28.5 (higher chSEP), p=0.003). Those with BMI ≥ 25 kg/m2 at age 18 years (p&amp;lt;0.001) alone, and with one or more PMCs (p=0.01) were also less likely to breastfeed. When stratified by race/ethnicity the pattern of breastfeeding did not differ significantly by any PMC within NHB and NHW women. When stratified by chSEP, however, BMI ≥ 25 kg/m2 at age 18 years (p = 0.004) and having one or more PMCs (p=0.03) were significantly associated with never breastfeeding among those with higher chSEP. Conclusion: NHB women and women with lower chSEP were substantially less likely to breastfeed. Additionally, BMI ≥ 25 kg/m2 at age 18 and PMCs were associated with lower frequency of breastfeeding overall and among those with higher chSEP. Citation Format: Meheret B. Gebreegziabher, Lydia R. Post, Chris C. Cho, Zhenzhen Zhang, Kelly A. Hirko, Dorothy R. Pathak, Ann S. Hamilton, Ann G. Schwartz, Ellen M. Velie. Racial and socioeconomic disparities in breast feeding and the impact of pregnancy-related medical conditions among a population-based sample of non-Hispanic Black and White women [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A014.