Preparation Of Infant Formula Research Articles

Multi-Omics Profiles of Small Intestine Organoids in Reaction to Breast Milk and Different Infant Formula Preparations.

Ensuring optimal infant nutrition is crucial for the health and development of children. Many infants aged 0-6 months are fed with infant formula rather than breast milk. Research on cancer cell lines and animal models is limited to examining the nutrition effects of formula and breast milk, as it does not comprehensively consider absorption, metabolism, and the health and social determinants of the infant and its physiology. Our study utilized small intestine organoids induced from human embryo stem cell (ESC) to compare the nutritional effects of breast milk from five donors during their postpartum lactation period of 1-6 months and three types of Stage 1 infant formulae from regular retail stores. Using transcriptomics and untargeted metabolomics approaches, we focused on the differences such as cell growth and development, cell junctions, and extracellular matrix. We also analyzed the roles of pathways including AMPK, Hippo, and Wnt, and identified key genes such as ALPI, SMAD3, TJP1, and WWTR1 for small intestine development. Through observational and in-vitro analysis, our study demonstrates ESC-derived organoids might be a promising model for exploring nutritional effects and underlying mechanisms.

Variability and error in measurement of infant formula powder and water: an experimental study.

Formula feeding is the only viable nutrition alternative for infants 0-6mos who cannot breastfeed. Among the drawbacks of formula feeding, however, is potential dilution or concentration errors in the formula during preparation that may lead to infant health issues. The present study aimed to investigate the accuracy of caregiver measurements as they prepared infant formula under multiple conditions, compared with manufacturer specifications. A diverse sample of caregivers (N = 84) participated in this cross-over experimental study. Participants hand-scooped infant formula powder and poured water to prepare 4oz. and 7oz. feedings, using both a standardized set of infant formula products and participants' own products. Linear mixed effects models were used to estimate fixed effects of target amount (4oz. versus 7oz) and products (participant versus researcher) on mean absolute percent error (MAPE) of measurement. Across all conditions MAPE was significantly greater for measuring powder than for water (9.0% vs. 4.4%; p < 0.001) with a combined powder and water MAPE at 13.0%. Greater measurement error was associated with the odd-sized 7oz. preparation and participants' own products. We observed considerable variability and substantial error during infant formula preparation, particularly for hand-scooping of powder, which tended toward higher values than the theoretical gold standard.

Preparation and characterization of infant formula concentrates: Simulation with human milk lipid composition and fat globule size and distribution

Preparation and characterization of infant formula concentrates: Simulation with human milk lipid composition and fat globule size and distribution

The safety of at home powdered infant formula preparation: A community science project.

Formula fed infants experience gastrointestinal infections at higher rates than breastfed infants, due in part to bacteria in powdered infant formula (PIF) and bacterial contamination of infant feeding equipment. The United Kingdom National Health Service (UK NHS) has adopted the World Health Organization recommendation that water used to reconstitute PIF is ≥70°C to eliminate bacteria. We used community science methods to co-design an at home experiment and online questionnaire ('research diary') to explore the safety of PIF preparation compared to UK NHS guidelines. 200 UK-based parents of infants aged ≤12 months were recruited; 151 provided data on PIF preparation, and 143 were included in the analysis of water temperatures used to reconstitute PIF. Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001). The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C). Many parents did not always fully follow NHS safer PIF preparation guidance, and parents did not appear to understand the potential risks of PIF bacterial contamination. Parents should be advised that the water dispensed by PIF preparation machines may be below 70°C, and could result in bacteria remaining in infant formula, potentially leading to gastrointestinal infections. PIF labelling shouldadvise that water used to prepare PIF should be ≥70°C and highight the risks of not using sufficiently hot water, per WHO Europe advice. There is an urgent need for stronger consumer protections regarding PIF preparation devices.

Assessing the effect of powder characteristics of infant milk on the compressibility of milk powder compression molding.

Infant formula is an important food for those infants who are deprived of breast milk. However, infant formula powder is prone to fly apart, moisture absorption, sticky spoon, and inaccurate measurement. Block infant formula can solve these problems well. In this study, the characteristics (including particle structure morphology, moisture content, particle size, etc.) of infant formula powder were investigated on the compressive strength and solubility of block infant formula after compression molding with infant formula powder as the object. The results showed that the compressive strength and solubility of the block infant formula made from milk powder with a moisture content of 4.75%, particle size larger than 80 mesh, and morphology of compact grape structure appendages were the best. Therefore, milk powder with this characteristic is the most suitable for the preparation of block infant formula. This study provides referenceable experimental data and theoretical basis for the preparation and application of block infant formula.

Infant burn injuries related to water heating for powdered infant formula preparation.

Guidance for preparing powdered infant formula (PIF) helps to ensure it meets the nutritional needs of infants and is safe to consume. Among safety concerns is Cronobacter sakazakii contamination which can lead to serious infections and death. PIF preparation guidance varies; there is a lack of consensus on whether there is a need to boil water to inactivate potential Cronobacter and for how long to let the water cool before reconstitution. We sought to quantify the burden of burn injuries among infants related to water heating for PIF preparation. Estimating this burden may help inform preparation recommendations. Burn injuries among infants <18 months of age were identified from 2017 to 2019 National Electronic Injury Surveillance System data collected from sampled hospital emergency departments. Injuries were classified as related to PIF water heating, potentially related to PIF water heating but with undetermined causation, related to other infant feeding aspects, or unrelated to infant formula or breast milk feeding. Unweighted case counts for each injury classification were determined. Across sampled emergency departments, 7 PIF water heating injuries were seen among the 44,395 injuries reported for infants <18 months. No reported PIF water heating injuries were fatal, but 3 required hospitalization. Another 238 injuries potentially related to PIF water heating but with undetermined causation were also seen. Preparation guidance should consider both the potential risk for Cronobacter infection and the potential risk for burns.

Informing Infant Nutrition: Timing of Infant Formula Advice, Infant Formula Choice and Preparation in the First 6 Months of Life

ObjectiveTo examine the sources and timing of advice formula feeding parents receive and how this and other factors influence the choice of formula product and formula preparation. DesignComponents of a cross-sectional survey. SettingA child and family health service in New South Wales, Australia. ParticipantsParents (n = 153) who were fully or partially formula feeding infants aged 0–6 months and who visited the service's facilities or its social media site. Variables MeasuredType of formula, preparation of formula, and use and sources of formula feeding advice. AnalysisDescriptive statistics, Mann-Whitney U or Pearson's chi-square tests, and inductive content analysis. ResultsThe most common source of formula feeding advice was the formula tin/packet (96.6%). Although 79.2% received advice from a health professional, only 18.9% reported receiving this advice before using formula. Approximately half (48.0%) of the parents chose a standard cow's milk-based formula. The most common reason for their choice of formula type/brand was a personal recommendation (53.0%). Parents’ responses indicated that nearly half (46.3%) incorrectly prepared the formula. Conclusion and ImplicationsAlthough health professional advice was widely received, this was rarely before starting formula. Despite the current national infant feeding regulations, parents who were not exclusively breastfeeding their infants did not always receive timely, health professional advice about formula feeding.

A Comparative Study of Milk Fat Extracted from the Milk of Different Goat Breeds in China: Fatty Acids, Triacylglycerols and Thermal and Spectroscopic Characterization.

Goat milk (GM) is an excellent alternative to cow milk and has recently been used in commercial infant formula preparation due to its superior fat composition. Here, the fatty acid (FA) composition, triacylglycerol (TAG) molecular species, thermal behavior and infrared spectra of extracted milk fat from the milk of the two main breeds of dairy goat bred in China (Guanzhong GM (GZG) and Xinong Saanen GM (XSG)) are investigated. Gas chromatography, Fourier-transform infrared spectroscopy, differential scanning calorimetry and ultra-performance convergence chromatography with quadrupole time-of-flight mass spectrometry are applied. The obtained results evidence significant fat compositional differences based on the breed that produced the considered GM. The major FAs in both GM fats were capric (C10:0), myristic (C14:0), palmitic (C16:0), stearic (C18:0) and oleic (C18:1 n-9c). GZG presented a higher content of medium-chain saturated FAs, while XSG had higher unsaturated FAs with higher ratios of L/Ln and n-6/n-3. A total of 339 and 359 TAGs were detected and quantified in GZG and XSG, and the major TAGs were those of m/z 740.6712 (14.10 ± 0.27%) and m/z 684.6094 (10.94 ± 0.02%), respectively. Milk TAGs of GZG and XSG showed 24–54 and 26–54 total acyl carbon numbers with a 0–4 and 0–5 double bond number at 68 and 72 various retention times, respectively. Thermal analysis showed that all GM fat samples melted below normal body temperature. Infrared spectra revealed higher absorption values of GZG milk fat. This study provides valuable information to the dairy industry sector about GM fat produced in China, assessing the appropriateness of Chinese GM fat to be applied in Chinese infant formula.

Insight into Bacillus cereus Associated with Infant Foods in Beijing.

This study was undertaken to investigate the prevalence, antimicrobial resistance, and virulence gene profiles of Bacillus cereus in different brands of infant formula in Beijing supermarkets. Eighty-eight Bacillus cereus isolates were recovered in sixty-eight infant formulas of five domestic brands and fourteen imported brands. The prevalence rate in domestic and imported samples were 70.6% and 52.9%, respectively. Lower mean prevalence level was found in domestic samples (1.17 MPN/g) compared with the imported samples (3.52 MPN/g). Twenty-four virulence gene profiles were found, and most strains carried at least one virulence gene. The prevalence of nheA, nheB, nheC, cytK, bceT, and entFM in domestic and imported brand samples was similar. The occurrence of enterotoxin genes hblA, hblC, and hblD in domestic samples were 22.2%, 27.8%, and 22.2%, respectively, which was significantly higher than imported samples. Antimicrobial drugs-susceptibility analysis showed that all isolates were susceptible to gentamincin, amikacin, and ciprofloxacin; 38%, 7%, and 2.3% were resistant to rifampin, tetracycline, and chloramphenicol, respectively; and only one isolate was resistant to trimethoprim-sulfamethoxazole. Moreover, the cell numbers of Bacillus cereus in prepared infant formula increased rapidly at room temperature. Thus, monitoring guidelines are needed for accepted levels of Bacillus cereus in infant formula.

Food Safety Knowledge and Practices of Pregnant Women and Postpartum Mothers in Slovenia.

Food safety during pregnancy and postpartum is important for preventing foodborne diseases, while pregnant women are considered vulnerable due to their immunomodulatory condition. The current study aimed to investigate the self-reported food safety knowledge and practices of pregnant women and postpartum mothers in Slovenia using an online questionnaire and to compare the results with nonpregnant women as a control group. The study was conducted with 426 women, of whom 145 were pregnant, 191 were not pregnant, and 90 were postpartum. The online questionnaire consisted of questions related to food safety risk perception, hand hygiene, food purchase, food storage, food preparation and handling of infant formula and breast milk. The results showed that women generally have basic knowledge of proper food handling and are aware of food safety, but some specific gaps were identified in food handling at home, especially concerning microbiological risks. However, the results showed that pregnant women performed better than the postpartum group, and both groups performed significantly better than the nonpregnant group. The media was most frequently cited as a source of food safety information, especially by the pregnant group. Trained health workers should also inform women on how to ensure food safety in the home environment.

Caregiver's Provision of Non-Recommended Commercially Prepared Milk-Based Drinks to Infants and Toddlers

ObjectiveAssess milk type provision (commercially prepared infant and toddler formula, cow's milk, and plant milk) to infants and toddlers, accounting for sociodemographic characteristics and marketing claims. ParticipantsCaregivers (N = 1,645) of children (aged 6–36 months) recruited through online panels in 2017. MethodsCross-sectional survey analysis (system of probit equations) estimated associations between sociodemographics and agreement with marketing claims (independent variables) with milk type provision in the past month (binary dependent variable). ResultsMost caregivers (63%) of infants (aged 6–11 months) provided only breastmilk and/or commercially prepared infant formula. Sixty-five percent of caregivers of 12-month-old infants provided commercially prepared infant formula, and 47% provided cow's milk. Most caregivers (64%) of toddlers (aged 13–36 months) provided cow's milk; some also provided other non-recommended milk types (51%).Associations between milk types suggested milk-based drink provision should be evaluated as a pattern and not as independent behaviors (all Ps < 0.048). Milk type provision was significantly associated with a child's age (months), household income, and race (all Ps < 0.049). Including agreement with marketing claims reduced the significance of associations between milk type provision and some sociodemographic characteristics. Conclusions and ImplicationsThese findings suggest the need for additional expert guidance to discourage inappropriate and unnecessary milk for young children, provide strategies to transition from breastmilk (or commercially prepared infant formula) to cow's milk, and conduct outreach to communities at risk for health disparities about the dangers of serving milk that is not recommended for their child's age. Research is needed to understand how diverse populations interpret product claims and how marketing may perpetuate health disparities.

Effect of Formula Type and Preparation on International Dysphagia Diet Standardisation Initiative Thickness Level and Milk Flow Rates From Bottle Teats.

Purpose The purpose of this study was to evaluate the effect of infant formula type and preparation (i.e., ready-to-feed vs. powder) on International Dysphagia Diet Standardisation Initiative (IDDSI) thickness level and milk flow rates from bottle teats/nipples. Method The ready-to-feed and powder formulations of the following products were tested for IDDSI thickness level, using IDDSI guidelines, and for milk flow rate, using established flow testing methods: Similac Advance, Similac For Spit-Up, Enfamil Infant, and Enfamil A.R. Analysis of variance was used to compare flow rates among formula types/preparations. Results Enfamil A.R. ready-to-feed was classified as IDDSI "slightly thick." All other formula types/preparations were found to be IDDSI "thin" liquids. The standard infant formulas (Similac Advance and Enfamil Infant) had comparable flow rates to each other, regardless of preparation (ready-to-feed and powder). The gastroesophageal reflux-specific formulas (Similac For Spit-Up and Enfamil A.R.) had slower flow rates than the standard formulas; within this category, there were significant differences in flow rates between ready-to-feed and powder. Enfamil A.R. powder had the slowest flow rate, but was the most variable. Conclusion For infants with difficulty coordinating sucking, swallowing, and breathing, clinicians and parents should consider the impact that changes to infant formula type and preparation may have on the infant's ability to safely feed.

Awareness about safe infant formula preparation, transportation, and storage in Medina, Saudi Arabia: a cross sectional survey

Awareness about safe infant formula preparation, transportation, and storage in Medina, Saudi Arabia: a cross sectional survey

Cleaning practices and contamination status of feeding bottles of admitted children in Rawalpindi, Pakistan

Background: Studies have pointed out that the majority of infants are fed with bottles either exclusively or in combination with breastfeeding in Pakistan and infant mortality rate of these children is significantly higher than the children who are exclusively breastfed. This is comparable to the statistics from the developed parts of the world. Infant feeding bottles can be easily contaminated through multiple sources. Studies in developing countries have found home prepared infant formula feedings frequently contaminated. Methods and materials: Mothers and caregivers of children being bottlefed and admitted in the indoor facility of department of Pediatrics, Benazir Bhutto Hospital Rawalpindi (BBH), Pakistan were consecutively sampled and interviewed. For the isolation of pathogens, the samples were taken from the teats of feeding bottles and evaluated in the microbiology laboratory of BBH. Results: Of 198 children (mean age: 8 ± 10 months), majority (61.1%) were males and admitted with respiratory problems. Mothers being the primary caretakers washed their hands before making food (93.4%), and used soap and water (90.9%) to wash the feeding bottles after every use. Boiled water was chiefly used (68.7%) for washing. The bottles were sterilized thorough boiling (100%) for <10 minutes (76.5%) once every day (60.8%). The bottle leftover contents were discarded by the bulk (92.2%) of the caretakers after feeding. In the majority of cases, the bottle contents were found contaminated (52.1%) largely with Klebsiella (42.9%), followed by Acinobacter baumini (26.3%), and Escherichia coli (17.3%). Conclusion: Most caregivers of children in our study washed their hands before making food, cleaned feeding bottles with soap and water after every use while the left-over contents of the food were discarded rather than stored. Most of them prepared formula milk in boiled water and tried to sterilize the feeding bottles by boiling them in water. Most bottles were contaminated, primarily by Klebsiella, Acinobacter baumini, and Eschericia coli.

Allergic proctocolitis causing hematochezia in preterm twins

Allergic colitis due to cow’s milk or soy protein in commercially prepared infant formula or due to ingestion of breast-milk of mothers who are ingesting cow’s milk is a known cause of colitis occurring in infants. Allergic colitis can occur within days, weeks or months of birth and should be considered as a differential diagnosis in any infant presenting with hematochezia. Typically, there is a significant delay in the onset of milk allergy in premature infants compared to full term infants. We report a case of premature twin neonates who presented with profuse rectal bleeding during second week of life. The infants had been feeding expressed breast milk since birth and the nursing mother had been drinking cow’s milk. The infants had pneumatosis coli suggestive of inflammation of the colon while biochemical and hematological markers of inflammation were normal. Expressed breast milk was re-introduced after eliminating dairy from mother’s diet for 5 days. The infants were fed on mother’s milk and top up of hydrolyzed infant formula as required. Both the twins remained well.

Microplastic release from the degradation of polypropylene feeding bottles during infant formula preparation.

Polypropylene-based products are commonly used for food preparation and storage, but their capacity to release microplastics is poorly understood. We investigated the potential exposure of infants to microplastics from consuming formula prepared in polypropylene (PP) infant feeding bottles (IFBs). Here, we show that PP IFBs release microplastics with values as high as 16,200,000 particles per litre. Scenario studies showed that PP IFB sterilization and exposure to high-temperature water significantly increase microplastic release. A 21-d test of PP IFBs showed periodic fluctuations in microplastic release. To estimate the potential global exposure to infants up to 12 months old, we surveyed 48 regions, finding values ranging from 14,600-4,550,000 particles per capita per day, depending on the region. We demonstrate that infant exposure to microplastics is higher than was previously recognized due to the prevalence of PP-based products used in formula preparation and highlight an urgent need to assess whether exposure to microplastics at these levels poses a risk to infant health.

A comparative study of lipid composition and powder quality among powdered infant formula with novel functional structured lipids and commercial infant formulas

Pancreatic lipase activity and bile salt concentration are very low in infants. Therefore, infant formula (IF) preparation with structured lipids (SLs) containing essential fatty acids and medium-chain fatty acids (MCFAs) with easy absorption features has attracted great attention. In this work, the lipid composition and physiochemical properties of novel SLs enriched with medium- and long-chain triacylglycerols (MLCTs) and their incorporation into a powdered IF compared to commercial IFs were evaluated. The obtained results showed that the SL contains arachidonic (ARA), caprylic, and capric as major fatty acids (FAs). Further, the evaluation of commercial IFs oil showed that oleic, linoleic, palmitic, and lauric were the most abundant FAs. A novel SL possessed highest levels of MCFAs (36.33 ± 1.05%) at sn-1,3 positions and LCUFAs (65.91 ± 1.32%) at the sn-2 position especially ARA (42.82 ± 0.89%). A total of 45, 38, and 25 triacylglycerols molecular species were revealed in a novel SL and commercial IFs available in China and the USA, respectively. Thermoprofile revealed that all IFs oil samples melted below the body temperature. The formula produced with microencapsulated SL and the dry-mixing process showed better optical properties and oxidative stability having lower moisture content. The study has potential applications in the development of IF with improved properties.

Comparative Proteomics of Milk Fat Globule Membrane (MFGM) Proteome across Species and Lactation Stages and the Potentials of MFGM Fractions in Infant Formula Preparation.

Milk is a lipid-in-water emulsion with a primary role in the nutrition of newborns. Milk fat globules (MFGs) are a mixture of proteins and lipids with nutraceutical properties related to the milk fat globule membrane (MFGM), which protects them, thus preventing their coalescence. Human and bovine MFGM proteomes have been extensively characterized in terms of their formation, maturation, and composition. Here, we review the most recent comparative proteomic analyses of MFGM proteome, above all from humans and bovines, but also from other species. The major MFGM proteins are found in all the MFGM proteomes of the different species, although there are variations in protein expression levels and molecular functions across species and lactation stages. Given the similarities between the human and bovine MFGM and the bioactive properties of MFGM components, several attempts have been made to supplement infant formulas (IFs), mainly with polar lipid fractions of bovine MFGM and to a lesser extent with protein fractions. The aim is thus to narrow the gap between human breast milk and cow-based IFs. Despite the few attempts made to date, supplementation with MFGM proteins seems promising as MFGM lipid supplementation. A deeper understanding of MFGM proteomes should lead to better results.

Use and understanding of labelling information when preparing infant formula: Evidence from interviews and eye tracking

There are various risks associated with incorrect preparation and storage of infant formula, including microbiological hazards. Preparing and storing reconstituted infant formula correctly can reduce potential risks. The product label on infant formula is often the main source of information for caregivers on the correct handling of infant formula. Caregivers’ ability to understand and follow preparation and storage instructions is, therefore, of high importance in the safe use of infant formula. This study aims to increase understanding of how Australian caregivers perceive, interpret and use mandatory and voluntary “on-pack” label information when preparing and storing infant formula. An eye-tracking task requiring caregivers (n = 30) to prepare an unfamiliar infant formula product while wearing Tobi Pro 2 Glasses revealed that almost all caregivers look at the preparation instructions (93%), though fewer look at the warning advice (43%) and storage instructions (27%). Findings from retrospective think-aloud and in-depth interviews conducted immediately after the eye-tracking task, revealed that while preparation instructions are generally understood, they are not always adhered to, with most caregivers making modifications for convenience. Lack of awareness and low perceived risk to the infant’s health were other reasons for non-adherence. These findings suggest that mandated food-safety elements on infant formula products need to be more noticeable, clearer and more specific with respect to potential infant health risks associated with non-adherence, to ensure safe preparation and storage by all caregivers. These findings will be used to inform a review of the labelling requirements for infant formula products.

Modifications to Infant Formula Instructions Improve the Accuracy of Formula Dispensing.

Readability of infant formula preparation instructions is universally poor, which may result in inaccurate infant feeding. Given that inaccurate formula dispensing can lead to altered infant growth and increased adiposity, there is an increased need for easy to follow instructions for formula preparation. We hypothesize that altering infant formula instruction labels using feedback from iterative focus groups will improve the preparation accuracy of powdered infant formula in a randomized controlled trial. Participants were recruited from the community, 18 years of age or older, willing to disclose demographic information for focus group matching, and willing to participate freely in the first (n = 21) or second (n = 150) phase of the study. In the second phase, participants were randomized to use the standard manufacturer instructions or to use the modified instructions created in the first phase. Accuracy was defined as the percent error between manufacturer-intended powder formula quantity and the amount dispensed by the participant. Participants who were assigned to the modified instructions were able to dispense the powdered formula more accurately than participants who used the standard manufacturer instructions (−0.67 ± 0.76 vs. −4.66 ± 0.74% error; p < 0.0001). Accuracy in powdered formula dispensing was influenced by bottle size (p = 0.02) but not by body mass index (p = 0.17), education level (p = 0.75), income (p = 0.7), age (p = 0.89) or caregiver status (p = 0.18). Percent error of water measurement was not different between the groups (standard: −1.4 ± 0.6 vs. modified: 0.7 ± 0.6%; p = 0.38). Thus, caloric density was more accurate in the modified instructions group compared to the standard manufacturer instructions group (−0.3 ± 0.6 vs.−2.9 ± 0.9%; p = 0.03). Infant formula label modifications using focus group feedback increased infant formula preparation accuracy.