Infant Weaning Research Articles

Formulation of Infant Weaning Foods from Vegetable Proteins and Cereal

Formulation of Infant Weaning Foods from Vegetable Proteins and Cereal

Breastfeeding: the hidden barrier in Côte d'Ivoire's quest to eliminate mother-to-child transmission of HIV.

IntroductionCôte d'Ivoire has one of the worst HIV/AIDS epidemics in West Africa. This study sought to understand how HIV-positive women's life circumstances and interactions with the public health care system in Bouaké, Côte d'Ivoire, influence their self-reported ability to adhere to antiretroviral prophylaxis during pregnancy.MethodsSemistructured interviews were conducted with 24 HIV-positive women not eligible for antiretroviral therapy and five health care workers recruited from four public clinics in which prevention of mother-to-child transmission services had been integrated into routine antenatal care.ResultsSelf-reported adherence to prophylaxis is high, but women struggle to observe (outdated) guidelines for rapid infant weaning. Women's positive interactions with health providers, their motivation to protect their infants and the availability of free antiretrovirals seem to override most potential barriers to prophylaxis adherence.ConclusionsThis study reveals the importance of considering the full continuum of prevention of mother-to-child transmission interventions, including infant feeding, instead of focussing primarily on prophylaxis for the mother and newborn.

The effects of weaning with either fruits or vegetables at the age of 4–6 months on vegetable and fruit acceptance at 12 and 23 months

The low vegetable intake in children is probably due to the notion that vegetables are disliked. Because most taste preferences are formed during the first year of life, we started an intervention among weaning infants ( n = 101) to increase the liking for vegetables. We expected that starting weaning with exclusively vegetable purees, would increase the infants’ preferences for vegetables. At 4–6 months of age, one group was weaned with only vegetables, the other group with only fruit for 18 consecutive days. On day 19, the vegetable group received their first fruit (apple) and the fruit group their first vegetable (green beans). At 12 ( n = 86) and 23 ( n = 81) months of age the children’s consumption was measured in our laboratory and reported by their parents using a 3-day food diary for home intake. After the 19-day intervention, green beans intake was significantly higher in the vegetable group than in the fruit group. At 12 and 23 months of age apple and green beans intake did not differ significantly between the groups in the lab. However, home intake of vegetables at 12 months of age was significantly higher in the vegetable group than in the fruit group, but not at 23 months of age. These findings suggest that starting weaning with vegetables results in a higher vegetable consumption to at least 12 months of age.

Weight at Weaning of Preterm Infants from Incubator to Bassinet: A Randomized Clinical Trial

To evaluate thermal responses, weight gain, and resting energy expenditure (REE) in preterm infants weaned from an infant incubator to a warming bassinet after reaching a body weight of either 1,500 or 1,600 g, respectively. Preterm infants weighing ≤ 1,500 g were randomly allocated for weaning from a convective incubator after reaching 1,500 g body weight (study group) or 1,600 g (controls). Postweaning body temperature was recorded at short intervals. REE was measured before and after weaning, while the weight gain was calculated daily. All 21 enrolled infants were weaned successfully to a bassinet (room temperature). REE inside the incubator and in the warming bassinette was similar between infants weaned at 1,500 g and at 1,600 g (2.9 ± 6.8 vs. 1.1 ± 4.8 kcal/kg/d, respectively (p = 0.7). REE increased slightly after weaning in both groups. Weight gain and days from randomization to discharge did not differ between groups. Weaning very low birth weight infants from an incubator to a warming bassinet at a body weight of 1,500 g is feasible and has no significant deleterious effects on weight gain and REE. The many benefits provided by such greater accessibility to premature infants are discussed.

Practical advice and support for the infant weaning process

NUTRITION There is still controversy surrounding the age at which babies should move onto solid food, says Suneeta Kochhar

Practical advice and support for the infant weaning process

There is still controversy surrounding the age at which babies should move onto solid food.

Sildenafil Weaning After Discharge in Infants With Congenital Diaphragmatic Hernia

Sildenafil is used to treat pulmonary hypertension (PAH) in infants with congenital diaphragmatic hernia (CDH). However, data to guide sildenafil dosing and weaning are limited. This is concerning in light of a recent report describing increased risk associated with high-dose sildenafil regimens in non-CDH PAH. A retrospective cohort study of sildenafil usage, dosing, and weaning in infants with CDH was conducted at the authors' institution. The findings show that 17 % (19/122) of infants were discharged receiving sildenafil at a median dose of 8 mg/kg/day (range 2.91-5.78 mg/kg/day). The weaning rate was 0.1 mg/kg/week (range 0.01-0.5 mg/kg/week). The infants ceased therapy after a median of 343 days. At the age of 1 year, 29 % were receiving sildenafil at a dose higher than 1.5 mg/kg/day. One infant died of severe PAH. Sildenafil therapy at discharge is common in severe CDH. Variation in dosing and weaning rates highlights the need for standardized assessment and treatment of PAH after discharge to optimize the benefits and minimize the adverse effects of sildenafil.

Dietary supplementation with Bifidobacterium lactis NCC2818 from weaning reduces local immunoglobulin production in lymphoid-associated tissues but increases systemic antibodies in healthy neonates

Weaning is associated with a major shift in the microbial community of the intestine, and this instability may make it more acquiescent than the adult microbiota to long-term changes. Modulation achieved through dietary interventions may have potentially beneficial effects on the developing immune system, which is driven primarily by the microbiota. The specific aim of the present study was to determine whether immune development could be modified by dietary supplementation with the human probiotic Bifidobacterium lactis NCC2818 in a tractable model of weaning in infants. Piglets were reared by their mothers before being weaned onto a solid diet supplemented with B. lactis NCC2818, while sibling controls did not receive supplementation. Probiotic supplementation resulted in a reduction in IgA (P<0·0005) and IgM (P<0·009) production by mucosal tissues but had no effect on IgG production (P>0·05). Probiotic-supplemented pigs had more mast cells than unsupplemented littermates (P<0·0001), although numbers in both groups were low. In addition, the supplemented piglets made stronger serum IgG responses to fed and injected antigens (P<0·05). The present findings are consistent with B. lactis NCC2818 reducing intestinal permeability induced by weaning, and suggest that the piglet is a valuable intermediate between rodent models and human infants. The results also strongly suggest that measures of the effect of probiotic supplementation on the immune system need to be interpreted carefully as proxy measures of health benefit. However, they are useful in developing an understanding of the mechanism of action of probiotic strains, an important factor in predicting favourable health outcomes of nutritional intervention.

Challenges in Infant Weaning : Starting Complementary Feeding at Completed 4th versus 6th Month

Challenges in Infant Weaning : Starting Complementary Feeding at Completed 4th versus 6th Month

Effects of chronic stress during pregnancy on maternal performance in the guinea pig (Cavia aperea f. porcellus)

Stress experienced during pregnancy can have persistent impact on the female's physiology and behaviour not only during but even beyond pregnancy. The present study aimed to evaluate such long-term effects of stress in terms of repeated strobe light exposure during early to mid gestation on behavioural aspects of mothering activities and lactational effort in lactating guinea pigs. We found that maternal behaviour was negatively affected by stress experience during pregnancy with treatment females developing a higher level of offspring-directed aggression than controls. In addition, our measure of lactational performances showed tendencies of lowered milk supply and longer pup suckling durations in stressed females. We suggest that this may represent a strategy to advance infant weaning following demanding conditions caused by chronic stress experience during pregnancy.

Nutritional Zinc Status in Weaning Infants: Association with Iron Deficiency, Age, and Growth Profile

In the present study, we evaluated the correlation between iron deficiency (ID) and zinc deficiency (ZD) and explored the demographic, anthropometric, and feeding-related factors associated with hypozincemia and hair zinc content in weaning infants. Infants aged 6-24months were recruited, their feeding history was recorded, and their heights and weights were measured. Hemoglobin content, serum iron/total iron-binding capacity, and ferritin and zinc concentrations of serum and hair (using inductively coupled plasma-mass spectroscopy) were assessed. Among 101 infants, 64 (63.4%) infants exhibited ID. The median serum zinc concentration in iron-deficient infants was lower than that in non-iron-deficient infants, respectively, 73.5μg/dL (interquartile range [IQR], 65.0-83.8) vs. 87.0μg/dL (IQR, 77.5-97.0; p = 0.001). The frequency of hypozincemia was also significantly higher in the iron-deficient group than in the non-iron-deficient group (21 out of 64 [32.8%] vs. 4 out of 37 [10.8%], respectively; p = 0.014). In multiple regression analysis, the risk of hypozincemia was significantly increased in infants with ID (p = 0.026), mildly underweight infants (weight-for-age Z score < -1; p = 0.034), and infants with mild wasting (weight-for-height Z score < -1; p = 0.028). Hair zinc concentrations (n = 81) were not significantly associated with ID status (p > 0.1); however, there was an inverse relationship between hair zinc concentrations and age of infants (r = -0.250; p = 0.024). In weaning infants, ID is a risk factor for hypozincemia. Hair zinc concentrations appeared to decrease as the age of infants increased during late infancy. Further large-scale studies are needed to validate the relationship between hypozincemia and mild degrees of weight gain impairment in this age group.

Effect of repeated exposure to either fruits or vegetables during the first 18 days of weaning on fruit and vegetable intake of infants at 12 months

The low vegetable intake in children is probably due to the notion that vegetables are disliked. Because most taste preferences are formed during the first year of life, we started an intervention among weaning infants (n = 101) to increase the liking for vegetables. We expected that starting weaning with exclusively vegetable purees, would increase the infants’ preferences for vegetables and this effect would still be present 7 months after weaning. Half of the infants received exclusively vegetable purees during the first 18 days of weaning (vegetable group), and the other half received exclusively fruit purees (fruit group). At 12 ± 1.4 (mean ± SD) months of age, 82 of the infants participated in a follow-up measurement. Their parents completed a 3-day food diary (n = 71) in which they reported everything their infant consumed during three days. At two separate days in the laboratory we measured ad libitum intake of apples and green beans. The mean vegetable intake at home was significantly higher in the vegetable group than in the fruit group. Also the fruit consumption in the vegetable group was higher, although not significant. The fruit and vegetable groups have similar intakes of apples and green beans. These results show that starting weaning with vegetables has a positive influence on the reported vegetable intake at 12 months.

Study on the relationship between iodine status and growth in infants at the key period of brain development

To investigate the relationship between iodine nutrition and growth/development in infants at the key period of brain development. All women from pregnancy to the end of lactation and the weaning infants within 3 years in the Linxia Hui Autonomous Prefecture (Linxia Prefecture) were added iodized oil in 2006 - 2010. In 2006, 2010 one town was randomly selected from each of the five directions (east, south, west, north, central) of each county in Linxia Prefecture. One village was chosen from every town and 20 infants, 20 pregnant women and 20 lactating women were randomly selected in each town. Urinary iodine (UI) of the infants, pregnant and lactating women were determined. DQ value, height and weight of part of infants were measured. According to the above sampling plan, UI of pregnant women, lactating women and infants had been monitored every year after intervention. 0-3 infants were choosing to be control before intervention. UI of 1056 and 2989 0-3 infants were investigated before and after the iodine oil intervention. After the 'iodine oil' intervention, the median UI of infants increased from 107.3 µg/L to 139.6 - 190.7 µg/L, the percentage of UI level that lower than 50 µg/L, decreased from 23.9% to 6.7% - 12.9%. DQ value increased from 92.8 to 104.3, the percentage of normal height and above increased from 65.0% to 82.1% and the percentage of the normal weight and above, increased from 59.3% to 81.4%. The outcomes of DQ value, height and weight showed statistically significant differences, compared to the pre-intervention outcomes (P < 0.05). The median UI of pregnant and lactating women increased from 89.3 µg/L to 118.2 - 187.8 µg/L and from 84.9 µg/L to 135.2 - 187.5 µg/L respectively. Infant's growth and development were retarded when iodine deficiency existed at the key period of brain development. Intake of oral iodine oil at key period of brain development could provide adequate nutrition thus improve growth and development on infants.

Japan–France–US comparison of infant weaning from mother’s viewpoint

Background: Breastfeeding and weaning are strongly connected with infant–mother mutual autonomy, and hence are good touchstones to examine the characteristics of the mother–child relationship. Comparison of the weaning practice gives a framework to understand characteristics of the mother–infant relationship. Objective: The purpose of this study was to compare three industrialised countries concerning the relationship between feeding and weaning practices and its reasons, mother’s perception of child care, and of breast milk and formula. Methods: A questionnaire study on weaning practice was conducted for 310 Japanese, 756 French, and 222 American mothers with 4- to 20-month-old infants. Results: French mothers expected and had accomplished weaning at an earlier age of the infant, compared to Japanese and American mothers. Perceived insufficiency of breast milk was the leading reason for the termination of breastfeeding for Japanese mothers at the earlier stages, whereas back to work was the more important reason for French mothers. Japanese mothers were more negative in their image of themselves as mothers, whereas French mothers felt more burdened by child-care. Japanese mothers who terminated breastfeeding because of perceived breast milk insufficiency were also those who were less motivated to breastfeed. Conclusion: Weaning is a significant framework to interpret cultural differences in mother–infant relationship. The perceived insufficiency is interpreted as a solution of conflict between the social pressure to breastfeed and its burden.

Are weaning infants at risk of iodine deficiency even in countries with established iodized salt programs?.

Because iodine deficiency (ID) during infancy can irreversibly impair neurodevelopment and increase mortality, it is critical that dietary iodine is adequate in this vulnerable group. Lactating mothers consuming iodized salt can transfer adequate iodine to the infant via breast milk, but during the weaning period, infants are at risk for ID for several reasons: (1) requirements per kg bodyweight for iodine and thyroid hormone during infancy are higher than at any other time in the life cycle; (2) experts recommend no extra salt (iodized or not) be given to infants during the first year; (3) cow's milk (a major source of dietary iodine in many countries) is also not recommended for infants during the first year; and (4) iron deficiency, a common disorder during infancy, can impair iodine metabolism and reduce thyroid hormone production. For many weaning infants in industrialized countries, iodine fortified into commercial infant foods becomes important. This has recently been demonstrated in Switzerland, where a long-standing iodized salt program provides adequate iodine to pregnant women and school-age children, but new national data suggest weaning infants not receiving iodine-containing commercial baby foods have inadequate iodine intakes. Thus, even in countries with effective iodized salt programs, infants may be at risk of ID during weaning and may need additional dietary and/or supplemental sources of iodine.

Early feeding and weaning in Irish infants in the Cork baseline birth cohort study

Increased risk for eczema and nutritional deficiencies are associated with early and late weaning, respectively (1) . Prospective data on infant feeding and weaning practices were collected as part of the Cork BASELINE birth cohort study. Primigravidae were recruited antenatally at 20 weeks gestation and their infants were examined at day 2 and at 2, 6 and 12 months. Questionnaires at each assessment captured early feeding and parents completed weaning diaries to document the first 6 weeks of transition to solid food. Data collected include body composition at 2 days and 2 months using air displacement plethysmography (PEAPOD), anthropometry, socio-demographic information, maternal and paternal allergies, home environment, pets, skin care, hygiene, illnesses and medication. Data extracted from weaning diaries include timing of first introduction to solid foods, description of food including ingredients; quantities consumed and gap between each new food. The major allergenic foods/ingredients (cow’s milk, wheat, eggs, shell-fish, fish, peanuts, tree nuts and soya (2) ) were of particular interest. Of the 1,537 maternal-infant dyads recruited at birth, weaning diaries were completed for 817 infants, of which 53 % are boys. Mean (SD) maternal age was 31 (3.8) years; 57 % of mothers worked in a professional or technical career and 45 % had a university education. Mean (SD) gestational age of infants was 39 (1.5) weeks and birth weight was 3.5 (0.5) Kg. According to WHO definitions (3) , 34, 4 and 37 % were exclusively, fully, and partially breastfed at discharge, respectively, and 25 % were formula-fed. At 2 months, 52, 30 and 18 % of infants were formula, breast and combination-fed, respectively. Of those receiving formula at 2 months, the median age in days they had last received breast-milk was 14 (IQR, 3-30). By 6 months, 14 % of babies were still receiving breast milk, in addition to solid food, formula or both. The median age of weaning to solids was 20 (IQR, 17-22) weeks and 81 % of infants were weaned between 17 and 26 weeks. 17 % of infants were weaned early ( < 17 weeks), with 28 and 45 % of those weaned at 15 and 16 weeks, respectively. Weaning beyond 26 weeks occurred in 20 (2%) infants. First weaning foods were baby rice (68%), infant breakfast cereals (14 %), carrots (4 %), apple (2 %) and other fruit/vegetables (10 %). The average gap between the first and second food was 7 days, with a mean of 15 (11.8) days between the first and fifth food. The mean number of different ingredients in the first 5 foods was 8 (4.1). At least one of the major allergenic foods/ ingredients was present in 65 % of weaning diaries; with cow’s milk (56 %), wheat (43%), soya (36%), egg (10 %) and fish (8 %) being identified. Weaning practices are broadly compliant with national recommendations with some significant deviations. Manufactured cereal products compared to home-prepared meals, were the primary source of exposure to the major allergenic foods and to more than one new food ingredients.

한방이유식에 대한 소고(小考) - 식료찬요(食療纂要)의 내용을 중심으로 -

Objectives: The purpose of this study is to suggest a way of weaning infant from the mother using an oriental medicine. Methods: Investigating the method of weaning infant from the mother using an oriental medicine, SikRyoChanYo. Results & Conclusions: There are two ways of weaning baby off from the mother using an oriental medicine. One way is a method of weaning ingredients analysis by oriental medicine. Another way is using an oriental medicinal. Weaning method using an oriental medicine can especially improve infant's health although we need more studies to prove this conclusion.

Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2011

This review highlights some of the research advances in anaphylaxis; hypersensitivity reactions to foods, drugs, and insects; and allergic skin diseases that were reported in the Journal in 2011. Food allergy appears to be increasing in prevalence and carries a strong economic burden. Risk factors can include dietary ones, such as deficiency of vitamin D and timing of complementary foods, and genetic factors, such as filaggrin loss-of-function mutations. Novel mechanisms underlying food allergy include the role of invariant natural killer T cells and influences of dietary components, such as isoflavones. Among numerous preclinical and clinical treatment studies, promising observations include the efficacy of sublingual and oral immunotherapy, a Chinese herbal remedy showing promising in vitro results, the potential immunotherapeutic effects of having children ingest foods with baked-in milk if they tolerate it, and the use of anti-IgE with or without concomitant immunotherapy. Studies of allergic skin diseases, anaphylaxis, and hypersensitivity to drugs and insect venom are elucidating cellular mechanisms, improved diagnostics, and potential targets for future treatment. The role of skin barrier abnormalities, as well as the modulatory effects of the innate and adaptive immune responses, are major areas of investigation.

Iodine Status of Pregnant and Postpartum Japanese Women: Effect of Iodine Intake on Maternal and Neonatal Thyroid Function in an Iodine-Sufficient Area

Iodine deficiency in pregnant and lactating women results in serious damage to their fetuses, newborns, and weaning infants. The effect of dietary iodine intake on maternal and infantile thyroid function has not been well studied in iodine-sufficient areas, and there are few data on appropriate gestational age-specific reference ranges for urinary iodine excretion during pregnancy and lactation. The aim of the study was to characterize the gestational change of urinary iodine excretion in Japanese women and to assess the effects of iodine status on thyroid function in mother and infant. A total of 934 Japanese women and their 722 newborn infants were enrolled in the study. Iodine and creatinine concentrations were determined in spot urine samples in the three trimesters of pregnancy and the postpartum period at 34.0 d after delivery. Serum thyroperoxidase antibody and thyroglobulin antibody, TSH, and free T(4) were measured in each trimester, and neonatal TSH was measured on postnatal d 4. The overall median urinary iodine concentration (UIC) during pregnancy was 219.0 μg/liter, higher than that in postpartum women (135.0 μg/liter). The prevalence of pregnant women with low UIC less than 100 μg/liter or high UIC greater than 500 μg/liter was 16.1 and 22.2%, respectively. Urinary iodine excretion decreased from 221.0 μg/liter in the first trimester to 208.0 μg/liter in the second trimester to 193.0 μg/liter in the third trimester, and then remained at 135.0 μg/liter postpartum. [corrected]. The maternal UIC correlated positively with serum TSH during pregnancy. There was no significant difference in UIC between subjects with positive thyroid autoantibodies and those with negative antibodies. Iodine intake assessed by UIC in Japanese pregnant women is regarded as sufficient and not excessive according to World Health Organization criteria. Although the data are local, our results provide additional information on the reference range for UIC throughout gestation in iodine-sufficient areas.

Feeding behavior and nutrient intake in spiny forest‐dwelling ring‐tailed lemurs (Lemur catta) during early gestation and early to mid‐lactation periods: Compensating in a harsh environment

Strong resource seasonality in Madagascar has led to the evolution of female feeding priority and weaning synchrony in most lemur species. For these taxa, pregnancy/early lactation periods coincide with low food availability, and weaning of infants is timed with increased resources at the onset of the rainy season. Reproductive females experience high metabolic requirements, which they must accommodate, particularly when food resources are scarce. Female ring-tailed lemurs (Lemur catta) residing in spiny forest habitat must deal with resource scarcity, high temperatures (∼36-40°C) and little shade in early to mid-lactation periods. Considered "income breeders," these females must use resources obtained from the environment instead of relying on fat stores; thus, we expected they would differ from same-sized males in time spent on feeding and in the intake of food and nutrients. We investigated these variables in two groups (N = 11 and 12) of Lemur catta residing in spiny forest habitat during early gestation and early to mid-lactation periods. Focal animal data and food plant samples were collected, and plants were analyzed for protein, kcal, and fiber. We found no sex differences for any feeding or nutrient intake variable for the top five food species consumed. Females in early gestation spent more time feeding compared with early/mid-lactation. Physiological compensation for spiny forest-dwelling females may be tied to greater time spent resting compared with gallery forest conspecifics, consuming foods high in protein, calories, and water, reduced home range defense in a sparsely populated habitat, and for Lemur catta females in general, production of relatively dilute milk compared with many strepsirrhines.