Commentary on Breast-Feeding and Infant Formulas, Including Proposed Standards for Formulas

This statement proposes recommendations toward increasing the practice of breast feeding. Specific recommendations made for standards of infant formulas as to calorie, protein, fat, vitamin, and mineral levels apply to both milk-based and milk-substitute infant formulas. Such formulas, when used in place of breast-feeding, must supply most or all of the nutrients infants require during the first weeks or months of life. The minimum levels of nutrients per 100 kcal recommended for formulas provide good growth and development in healthy, full-term infants; distinct hazards may be encountered at levels below these. However, no significant advantage is to be gained by providing levels in excess of these minima in normal infants. Recommendations for maximum levels are made only where quantities in excess lead to toxicity; generally, levels near the minima recommended are most desirable because they are the most likely to reflect the composition of human milk, and the least likely to result in any undesirable nutrient to nutrient interaction. The recommendations also can be used as reference standards for formulas for special dietary uses of "medical" formulas. The Committee recommends that "medical" formulas be classified by FDA into a special group under the paragraph dealing with infant formulas.

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Soy-Protein Formulas: Recommendations for Use in Infant Feeding

PEDIATRICS ◽

10.1542/peds.72.3.359 ◽

1983 ◽

Vol 72 (3) ◽

pp. 359-363

Author(s):

Keyword(s):

Soy Protein ◽

Cow’S Milk ◽

Infant Formulas ◽

Human Infants ◽

Term Infants ◽

Cow's Milk ◽

Clear Cut ◽

Critical Issues ◽

Milk Substitute

Many infant formulas are available as alternatives to breast-feeding. These formulas are necessary and valuable resources in the nutriture of infants, but it is important to evaluate their use and efficacy periodically. Soybean preparations were suggested as a milk substitute by Hill and Stuart1 in 1929. Since then, the use of these products has expanded appreciably, and they are used for an estimated 10% to 15% of all formula-fed infants. This increase in use has prompted examination of the following critical issues about the indications for use of soy-protein formulas in infants. (1) Are soy-protein formulas an adequate nutritional substitute for cow's milk-based formulas in full-term infants? (2) Is it appropriate to recommend soy-protein formulas to provide a lactose-free formula, or are there better alternatives? (3) Are soy-protein formulas ever indicated for use in premature infants? (4) What is the evidence for and against the use of soy-protein formulas in the management of cow's milkprotein allergy? (5) What is the role of soy-protein formulas in prophylaxis of allergic disease? (6) What is the evidence for and against the use of soy-protein formulas in the management of "colic"? Examination of these issues will hopefully, provide a more clear-cut basis for decisions regarding the use of soy-protein formulas and updated recommendations for the role of soy-protein formulas in feeding human infants. COMPOSITION OF SOY-PROTEIN FORMULAS Soy-protein formulas, although different in carbohydrate and protein source, are similar in composition to cow's milk-protein formulas following the American Academy of Pediatrics, Committee on Nutrition, 1976 recommendations for nutrient levels in infant formulas.2

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From Mum to Bum: An Observational Study Protocol to Follow Digestion of Human Milk Oligosaccharides and Glycoproteins from Mother to Preterm Infant

Nutrients ◽

10.3390/nu13103430 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3430

Author(s):

Jannie G. E. Henderickx ◽

Esther J. d’Haens ◽

Marieke A. C. Hemels ◽

Mariëtte E. Schoorlemmer ◽

Astrid Giezen ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Human Milk ◽

Preterm Infants ◽

Growth And Development ◽

Neonatal Intensive Care ◽

Neonatal Care ◽

Infant Growth ◽

Full Term ◽

Term Infants ◽

Fecal Samples

The nutritional requirements of preterm infants are challenging to meet in neonatal care, yet crucial for their growth, development and health. Aberrant maturation of the gastrointestinal tract and the microbiota could affect the digestion of human milk and its nutritional value considerably. Therefore, the main objective of the proposed research is to investigate how the intestinal microbiota of preterm and full-term infants differ in their ability to extract energy and nutrients from oligosaccharides and glycoproteins in human milk. This pilot study will be an observational, single-center study performed at the Neonatal Intensive Care Unit at Isala Women and Children’s Hospital (Zwolle, The Netherlands). A cohort of thirty mother–infant pairs (preterm ≤30 weeks of gestation, n = 15; full-term 37–42 weeks of gestation, n = 15) will be followed during the first six postnatal weeks with follow-up at three- and six-months postnatal age. We will collect human milk of all mothers, gastric aspirates of preterm infants and fecal samples of all infants. A combination of 16S rRNA amplicon sequencing, proteomics, peptidomics, carbohydrate analysis and calorimetric measurements will be performed. The role of the microbiota in infant growth and development is often overlooked yet offers opportunities to advance neonatal care. The ‘From Mum to Bum’ study is the first study in which the effect of a preterm gut microbiota composition on its metabolic capacity and subsequent infant growth and development is investigated. By collecting human milk of all mothers, gastric aspirates of preterm infants and fecal samples of all infants at each timepoint, we can follow digestion of human milk from the breast of the mother throughout the gastrointestinal tract of the infant, or ‘From Mum to Bum’.

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BREAST FEEDING; A BOON FOR INFANTS AS WELL AS FOR MOTHER -A REVIEW

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v4.i8.2016.2577 ◽

2016 ◽

Vol 4 (8) ◽

pp. 176-180

Author(s):

Nirmal Kaur ◽

Neha Qumar ◽

Mahima Agarwal

Keyword(s):

Child Health ◽

Human Milk ◽

Breast Feeding ◽

Reproductive Cycle ◽

Growth And Development ◽

Maternal Body

Lactation is the process of synthesizing and secreting milk from the breasts to feed young ones. It is an integral part in the physiologic completion of the reproductive cycle of mammals including humans. Human milk ensures the infants‘systemic protection, growth and development; therefore breastfeeding is one of the most effective ways to ensure excellent child health and survival. Lactation is the result of well-coordinated effort of the hormones. Throughout pregnancy the placenta produces oestrogen and progesterone. In addition to performing various functions, these hormones prepare breasts physically for lactation and suppress prolactin during pregnancy. Towards the end of pregnancy, prolactin increases, ready for milk synthesis. The removal of the placenta at birth triggers the breast to respond to suckling by making milk. The maternal body prepares for lactation not only by developing the breast to produce milk but also by storing additional nutrients and energy.

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Special Infant Formulas

Pediatrics in Review ◽

10.1542/pir.12.2.55 ◽

1990 ◽

Vol 12 (2) ◽

pp. 55-62

Author(s):

William J. Klish

Keyword(s):

Human Milk ◽

The United States ◽

Term Infant ◽

Early Research ◽

Infant Formulas ◽

Living Tissue ◽

Nutritional Content ◽

Milk Substitute ◽

Optimal Mode ◽

Immunologic Properties

Breast-feeding is still the optimal mode of feeding for the normal full-term infant. At the present time, no infant formula has been developed that can reproduce the immunologic properties, digestibility, and trophic effects of human milk. The nutritional content of infant formulas has come a long way since 1849 when Baron Justus van Liebig stated that all living tissue, including food, was composed of different proportions of carbohydrate, fat, and protein. This resulted in the first commercially available human milk substitute, Baron von Liebig's Soluble Food, which was available in the United States by 1869.1 In 1884 Dr A.V. Meigs of Philadelphia published the chemical analysis of human and cow's milk that has served as the basis for modern infant formulas.2 The stimulus for this early research for a substitute for human milk was based upon the recognition that not all infants have access to human milk. Infants fed with substitute foods did not thrive well, so attention was turned to the nutritional content of infant feeding mixtures. This emphasis remains to the present time, even though technology has developed in this past decade so that investigators are beginning to understand the importance to the growing infant of other factors such as the immunologic and trophic components of milk.

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Does the contribution of human milk oligosaccharides to the beneficial effects of breast milk allow us to hope for an improvement in infant formulas?

Critical Reviews in Food Science and Nutrition ◽

10.1080/10408398.2020.1761772 ◽

2020 ◽

pp. 1-12

Author(s):

Jean-Pierre Chouraqui

Keyword(s):

Breast Milk ◽

Human Milk ◽

Infant Formulas ◽

Human Milk Oligosaccharides ◽

Milk Oligosaccharides ◽

Beneficial Effects

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Study of the phenolic compound profile and antioxidant activity of human milk from Spanish women at different stages of lactation: A comparison with infant formulas

Food Research International ◽

10.1016/j.foodres.2021.110149 ◽

2021 ◽

Vol 141 ◽

pp. 110149

Author(s):

Silvia Sánchez-Hernández ◽

Adelaida Esteban-Muñoz ◽

Cristina Samaniego-Sánchez ◽

Rafael Giménez-Martínez ◽

Beatriz Miralles ◽

...

Keyword(s):

Antioxidant Activity ◽

Human Milk ◽

Phenolic Compound ◽

Infant Formulas ◽

Spanish Women

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Longitudinal Changes in the Concentration of Major Human Milk Proteins in the First Six Months of Lactation and Their Effects on Infant Growth

Nutrients ◽

10.3390/nu13051476 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1476

Author(s):

Jian Zhang ◽

Ai Zhao ◽

Shiyun Lai ◽

Qingbin Yuan ◽

Xiaojiang Jia ◽

...

Keyword(s):

Human Milk ◽

Maternal Education ◽

Mode Of Delivery ◽

Milk Proteins ◽

Protein Composition ◽

Infant Growth ◽

Term Infants ◽

Longitudinal Changes ◽

Milk Samples ◽

The Impact

Our knowledge related to human milk proteins is still limited. The present study determined the changes in multiple human milk proteins during the first six months of lactation, investigated the influencing factors of milk proteins, and explored the impact of milk proteins on infant growth. A total of 105 lactating women and their full-term infants from China were prospectively surveyed in this research. Milk samples were collected at 1–5 days, 8–14 days, 1 month, and 6 months postpartum. Concentrations of total protein and α-lactalbumin were measured in all milk samples, and concentrations of lactoferrin, osteopontin, total casein, β-casein, αs−1 casein, and κ-casein were measured in milk from 51 individuals using ultra performance liquid chromatography coupled with mass spectrometry. The concentration of measured proteins in the milk decreased during the first six months of postpartum (p-trend < 0.001). Maternal age, mode of delivery, maternal education, and income impacted the longitudinal changes in milk proteins (p-interaction < 0.05). Concentrations of αs−1 casein in milk were inversely associated with the weight-for-age Z-scores of the infants (1 m: r −0.29, p 0.038; 6 m: r −0.33, p 0.020). In conclusion, the concentration of proteins in milk decreased over the first six months postpartum, potentially influenced by maternal demographic and delivery factors. Milk protein composition may influence infant weights.

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