Status In Term Infants Research Articles

Dose Effect of Bovine Lactoferrin Fortification on Iron Metabolism of Anemic Infants.

To evaluate the effect of iron-fortified formula with different concentrations of bovine lactoferrin (bLF) on improvement of anemic status in term infants who were previously breast-fed. A randomized, controlled, open, and post-market intervention study. A total of 108 infants aged 6-9 mo who were previously breast-fed and weaned were selected. The subjects were divided into three groups with the sequence of outpatient: fortified group 1 (FG1) with a bLF concentration of 38 mg/100 g, FG2 with 76 mg/100 g bLF, FG0 with no bLF. The intervention duration was 3 mo. Weight, height, head circumference and the concentration of hemoglobin (Hb), serum ferritin (SF), serum transferring receptor (sTfR) were measured and sTfR-SF index (TFR-F index) and total body iron content (TBIC) were computed before and after intervention. The primary outcome measures were obtained from 96 infants (35, 33 and 28 for FG0, FG1 and FG2, respectively). After 1 mo of intervention, the changes of Hb level showed no significant difference (p>0.05) among the three groups, however, the Hb level of infants in FG2 were significantly higher than those of infants in the other two groups after 3 mo of intervention (p<0.05). The present data indicated that the formula fortified with 76 mg/100 g bLF positively affected the Hb of anemic infants who were previously breastfed when compared with fortification with 38 mg/100 g bLF and no bLF fortification.

Fatty Acid Composition of the Erythrocyte Membranes Varies between Early-Term, Full-Term, and Late-Term Infants in Japan

Background: Term infants can be categorized into 3 sub-groups: early term (37w0d to 38w6d), full term (39w0d to 40w6d), and late term (41w0d and beyond). However, the fatty acid composition among the 3 groups of term infants has not been investigated. The association between fatty acid composition and gestational period of term infants in Japan is unclear. Methods: We assessed the fatty acid composition of maternal erythrocyte membranes in the third trimester and of cord erythrocyte membranes at birth in 212 healthy term Japanese infants using data from a prospective hospital-based cohort study. Results: In maternal erythrocyte membranes, docosahexaenoic acid (DHA) levels and omega-3 index were significantly higher in the late-term group than in the early-term group. In cord erythrocyte membranes, DHA levels were not significantly different between the 3 groups; late-term infants showed significantly higher DHA/arachidonic acid (ARA) and lower 20: 3n-6 and ARA levels compared to early-term infants. Gestational period positively correlated with the DHA status in maternal and cord erythrocyte membranes. Conclusions: Fatty acid composition in maternal and cord erythrocyte membranes varies between early-, full-, and late-term infants, and the greater gestational period may contribute to the relatively high n-3 polyunsaturated fatty acids status in term infants. Furthermore, maternal DHA status in the third semester directly correlates with gestational period in pregnant Japanese women.

Bone measurements of infants with hyperbilirubinemia by quantitative ultrasound: the influence of phototherapy

Objective: The purpose of the current study was to investigate the possible effects of phototherapy on bone status of term infants evaluated by measurement of tibial bone speed of sound (SOS).Materials and methods: The phototherapy group (n = 30) consisted of children who had undergone phototherapy for at least 24 h and the control group (n = 30) comprised children who had not received phototherapy. Blood samples were obtained from all infants for serum calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone and vitamin D concentrations. The left tibial quantitative ultrasound (QUS) measurements were performed using a commercial device.Results: There was no statistically significant difference between phototherapy-exposed and nonexposed infants in terms of Ca, P, ALP, PTH and vitamin D levels. Comparison of bone SOS between the phototherapy-exposed and control group revealed no statistically difference. Also, no significant difference in Z-score for SOS was observed between those with or without exposure.Conclusion: The data of our study indicate that phototherapy treatment has no impact on bone status in the hyperbilirubinemic infants. Although there is no statistically significant evidence of an excess risk of bone damage following phototherapy, studies with larger sample sizes and longer duration of follow-up are needed to gain a better understanding of its effects.

Bone ultrasound backscatter in the detection of bone nutritional status in term infants

Objective To establish a reference range of cancellous bone ultrasonic backscatter coefficient (BSC) in term neonates, and to determine the significance of BSC in bone nutritional status in term newborns and infants. Methods Six hundred and sixty-five term newborns, who were born in Shanghai First Maternity and Infant Hospital from July 2014 to August 2014, were enrolled. On the third day and the 42nd day after birth, all infants underwent ultrasonic measurement of the calcaneum bone using a broadband–non-focus ultrasonic transducer at three frequencies (2.25, 3.5 and 5 MHz). MATLAB software was used to analyze the backscatter signals. Clinical data of the infants, including gestational age, birth weight and birth age, were recorded at the same time. Statistical analyses of the data included variance analysis, Tukey's test, rank sum test, Dunn test and Pearson or Spearman correlation analysis. Results (1) Of the 665 infants, 335 were male. The mean gestational age at birth was (38.0±1.9) weeks, and the mean birth weight was (3 152±226) g. (2) On the third day, there were significant differences in BSC values acquired at 2.25 and 3.5 MHz among the groups with different gestational ages or birth weights (2.25 MHz: H=9.842 and 17.271; 3.5 MHz: H=6.275 and 21.450, respectively, all P<0.05). At 3.5 and 2.25 MHz, BSC values were positively correlated with gestational age (r=0.047 and 0.035, respectively, both P<0.05) and birth weight (r=0.125 and 0.186, both P<0.05). (3) On the 42nd day, significant differences in BSC were observed at each frequency among the groups with different gestational ages or birth weights (gestational age: H=76.832, 16.498 and 32.756; birth weight: H=70.014, 18.095 and 34.126; all P<0.01). Gestational age and birth weight were positively correlated with BSC value acquired at each frequency (r=0.397, 0.286 and 0.272 for gestational age, 0.451, 0.223 and 0.196 for birth weight; all P<0.01). Conclusions A preliminary BSC reference percentile in term-born infants is established. There are positive correlations between BSC value and newborn gestational age and birth weight at certain frequencies, which can reflect the status of the newborn's cancellous bone. Determination of BSC value should be performed during the follow-up period to assess the nutritional status of neonatal bone. Key words: Bone density; Bone and bones; Ultrasonography; Infant, newborn; Nutritional satus

Iron metabolism in infants: influence of bovine lactoferrin from iron-fortified formula

ObjectiveThe aim of this study was to evaluate whether an iron-fortified formula with a concentration of lactoferrin would significantly improve the hematologic indexes and iron status in term infants compared with those same values in infants fed an iron-fortified formula without lactoferrin. MethodIn this prospective, multicenter, controlled intervention study, 260 infants ages 4 to 6 mo were selected from six maternal and children's health care hospitals in the area. All infants were divided into two groups with the sequence of outpatient: lactoferrin-fortified formula milk group (fortified group, FG, containing lactoferrin 38 mg/100 g milk and iron element 4 mg/100 g milk) and no lactoferrin fortified milk (control group, CG, containing lactoferrin 0 mg/100 g milk and iron element 4 mg/100 g milk) for 3 mo. The levels of weight, height, and head circumference and the concentration of hemoglobin (Hb), serum ferritin (SF), and serum transferring receptor (sTfR) were measured and sTfR-SF index (TFR-F index), total body iron content (TBIC) and low height for age (HAZ), low weight for age (WAZ), and low weight for height (WHZ) were computed before and after the intervention, respectively. ResultsIn all, 213 (115 in FG and 98 in CG) infants completed the intervention trial and all measurements of biochemical indicators. There were no significant differences in the average amount of daily intake of formula milk (94.3 ± 9.8 g versus 88.2 ± 8.7 g for FG and CG; P > 0.05) and iron element (3.8 ± 0.4 mg versus 3.7 ± 0.6 mg for FG and CG; P > 0.05). The average amount of daily intake of lactoferrin for infants in FG group was 35.8 ± 3.7 mg. The levels of weight, WAZ, WHZ, Hb, SF, TFR-F index, and TBIC after intervention of infants in FG were all significantly higher than those of infants in CG weight, 8723 ± 245 g versus 8558 ± 214g; WAZ, 1.02 ± 0.31 versus 0.44 ± 0.18; WHZ, 0.98 ± 0.31 versus 0.41 ± 0.12; Hb, 125.5 ± 15.4 g/L versus 116.9 ± 13.1 g/L; SF, 44.7 ± 17.2 μg/L versus 31.6 ± 18.4 μg/L; TFR-F index, 1.88 ± 0.41 versus 1.26 ± 0.39; TBIC, 6.12 ± 0.78 mg/kg versus 5.26 ± 0.55 mg/kg for FG and CG; P < 0.05), but significantly lower (P < 0.05) for the prevalence of anemia (4.1% versus 7.5%), iron deficiency (13.9% versus 24.4%), and iron-deficient anemia (1.7% versus 6.1%). ConclusionWhen infants who were exclusively breastfed were supplemented with lactoferrin-fortified milk, significant increases in TBIC and iron absorption in the intestine were seen.

Maternal active or passive smoking causes oxidative stress in placental tissue

The aim of this study was to assess the influence of active and passive maternal smoking on placenta total oxidant/antioxidant status in term infants. The levels of cord blood total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were measured in samples of fetal placental tissue, cord blood, and the maternal peripheral blood serum and from 19 mothers who were active smokers, 19 who were passive smokers, and 22 who were nonsmokers (not exposed to active or passive smoking). The pregnancies were between 37 and 40 weeks' gestation, were uncomplicated, and the infants were delivered vaginally. Birth weight and head circumference in the active smokers were significantly (P < 0.001) lower than those in the controls. Placenta, cord blood, and the maternal peripheral TAC levels were significantly lower in the active smokers compared with the controls (P < 0.001), while TOS and OSI levels were significantly higher in the active and passive smokers than in the controls (P < 0.001). A positive significant correlation was found between active maternal smoking and placenta TOS and OSI levels (P < 0.016), and a significant negative correlation was found between number of cigarettes exposed to and birthweight and head circumference (P < 0.05). In conclusion, active or passive maternal smoking is associated with important alterations in oxidant and antioxidant balance in fetal placental tissue and causes potent oxidative stress.

Intrapartum stress and lipid status of term infants: relation to fetal adrenal production of dehydroepiandrosterone sulphate

Objective. Evaluate the effect of acute intrapartum stress on umbilical cord plasma levels of cholesterol, triglyceride and dehydroepiandrosterone sulphate (DS) in term infants.Methods. Umbilical cord plasma levels of cholesterol, triglyceride and DS were measured in 176 infants that delivered ≥37 weeks' gestation. Eighty-eight infants experienced acute intrapartum stress while the remaining infants were non-stressed controls who were case-matched by gestational age and delivery method.Results. The umbilical cord plasma levels of cholesterol in the stressed infants (71.7 ± 16.1 mg/dL, mean ± SD) were similar to those of the control infants (70.9 ± 16.0 mg/dL). Triglyceride levels in stressed infants were significantly higher (p = 0.003) than those of control infants. Both stressed and control infants with increased triglyceride levels had normal DS levels; however, those with increased cholesterol levels had reduced umbilical cord plasma levels of DS. Stressed infants with increased cholesterol levels had significantly lower DS levels than control infants (p = 0.008).Conclusions. Intrapartum stress leads to increased fetal plasma levels of triglycerides; yet, cholesterol levels are usually unaffected. Infants with increased cholesterol levels also have reduced DS levels, suggesting that the rise in cholesterol was due to a reduction in fetal adrenal utilisation of plasma cholesterol as substrate for steroid formation.

Growth and Safety in Term Infants Fed Reduced‐Protein Formula with Added Bovine Alpha‐Lactalbumin

ABSTRACTObjectiveTo assess growth, tolerance, and biochemical measures of protein status in term infants fed an experimental formula with reduced total protein concentration and enriched in bovine alpha‐lactalbumin prepared from an alpha‐lactalbumin dominant bovine whey.MethodsHealthy, term, exclusively formula‐fed infants ≤14 days postnatal age, between 10th and 90th percentiles in weight and length for age were studied in this randomized, masked, multicenter study. Infants received ad libitum feedings of either experimental or control formula for 12 weeks. Adverse events and acceptability of formulas were assessed every 2 weeks. Weight, length, and head circumference were measured at baseline and every 4 weeks. Serum creatinine, albumin, and blood urea nitrogen were assessed at baseline and study completion. Anthropometric measures were compared to Centers for Disease Control reference ranges using Z scores.ResultsOne hundred ninety‐three infants were enrolled. One hundred thirty‐four completed the protocol. Seventy‐two received experimental formula, and 62 received control formula. The mean baseline body weight was higher in infants fed experimental formula (P = 0.042), so baseline weight was used as a covariate in statistical analyses. There were no differences between groups in gains in weight, length, or head circumference during the study. Mean serum albumin and blood urea nitrogen (BUN) levels were similar at study initiation. At study completion, serum albumin levels were the same in both groups, whereas BUN was significantly higher in infants fed control formula (P = 0.0016). More infants fed control (n = 20) than experimental (n = 15) formula discontinued the study because of adverse events. There were no differences in the adverse event profiles of the groups completing the study. Most of the adverse events were mild and resolved without treatment or sequelae. Acceptability and tolerance of the experimental formula was greater than the control formula, except at 2 weeks. Unacceptable ratings ranged from 0% to 10% (mean, 4.1%) in the experimental formula group and from 1.6% to 14.1% (mean, 7.0%) in the control formula group.ConclusionsGrowth and serum albumin were comparable in infants fed experimental and control formulas for the first 12 weeks of life, suggesting adequate protein nutrition from the alpha‐lactalbumin–rich formula, despite its lower total protein content. Growth and adverse events data support the safety of the experimental formula. Fewer discontinuations and unsatisfactory ratings among infants fed the experimental formula suggest that it is better tolerated than control formula.

Effect of early complementary feeding on nutritional status in term infants in rural Nigeria.

Breastfeeding is common in developing countries, but exclusive breastfeeding is rare, and complementary foods are introduced at an early age. The objective of the present study is to determine the effect of early complementary feeding on the nutritional status of infants. Weight-for-age (WA) indices have been determined for 82 infants 3 to 4 months old participating in a breastfeeding study. They included 42 that started complementary feeding early (before 2 months) and 40 that started later. Weight-for-age indices were significantly lower for the early group than for the later group (t = 3.00, p = 0.004). The prevalence of underweight (WA SD scores below -2.0) was 7.5% in the later complementary feeding group and 28.6% in the early group (chi(2) = 4.76, p = 0.0292). Severe underweight (WA SD scores below -3.0) prevalences were 0% and 14.3% respectively (p = 0.0259). Thus, poorer nutritional status was significantly associated with earlier complementary feeding. The results suggest that exclusive breastfeeding, (together with promotion of weaning education and growth monitoring) should be vigorously promoted in these rural communities.

Selenium status in term infants fed human milk or infant formula with or without added selenium

Selenium (Se) is an essential element for human nutrition. To date, infant formulas manufactured in the United States are not fortified with Se, but provide Se as an intrinsic part of the ingredients. Two studies were conducted to assess the plasma and RBC levels of Se and glutathione peroxidase activity (GSH-Px) in term infants. In Study 1, infants were fed either human milk, 0.29 μmol Se/L (23 μg Se/L), or one of two whey-predominant formulas containing only intrinsic Se, 0.16 μmol Se/L (13 μg Se/L), or intrinsic Se plus sodium selenite, with a total of 0.43 μmol Se/L (34 μg Se/L), from birth to 2 months of age. In Study 2, infants were fed either human milk, 0.32 μmol Se/L (25 μg Se/L), or one of two soy-based formulas containing only intrinsic Se, 0.19 μmol Se/L (15 μg Se/L), or intrinsic Se plus sodium selenite, with a total of 0.24 μmol Se/L (19 μg Se/L), from birth to 6 months of age. The results of the two studies showed that in infants with adequate selenium status at birth, wheypredominant formulas with or without added Se containing at least 0.16 μmol Se/L (13 μg Se/L) and soy-based formulas with or without added Se containing at least 0.19 μmol Se/L (15 μg Se/L) maintained Se status comparable to that observed in human milk fed infants.