Metabolic Impact of Infant Formulas in Young Infants. An Outlook From the Urine Metabolome

Abstract Although breast milk is the ideal food source for newborns during the first six months of life, a high percentage of children receive infant formulas. There is evidence that specific diet habits may influence individual metabolic profile. Therefore, in newborns, such profile can be influenced by the use of infantile formulas given the composition differences that display compared to human milk. Up to now there are no reports in the literature that address this issue. Thus, this work aims to compare the metabolic profile of full-term newborns that were feed with either breast milk (n=32) or infantile formulas (n=21). Metabolic profile was established based on urine analysis through gas chromatography-mass spectrometry (GC-MS) and nuclear magnetic resonance (H-NMR). Results evidenced a more gluconeogenic profile in breast fed infants. In addition, infant formula fed infants presented urinary excretion of metabolites derived from specific compounds present in this type of diet that were not observed in breast fed infants. Finally, it was observed that in infant formula fed infants there was excretion of basal levels of metabolites of clinical relevance. This results show the importance of understanding the metabolic impact of diet in newborn population in normal and pathological contexts.

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Impact of an Infant Formula Containing a Novel Fat Blend (Cow’s Milk Fat, Fish and Vegetable Oil) and Prebiotics on Stool Fatty Acid Soaps and Erythrocyte Fatty Acid Profiles in Full-Term Healthy Newborns

Annals of Nutrition and Metabolism ◽

10.1159/000515705 ◽

2021 ◽

pp. 1-8

Author(s):

Maroula Lambidou ◽

Birgit Alteheld ◽

Rolf Fimmers ◽

Frank Jochum ◽

Antonia Nomayo ◽

...

Keyword(s):

Body Weight ◽

Fatty Acid ◽

Infant Formula ◽

Milk Fat ◽

Control Group ◽

Human Breast Milk ◽

Infant Formulas ◽

Fa Composition ◽

And Control ◽

Breast Fed

Introduction: Recently, new commercial infant formulas have been composed considering novel fat blends and oligosaccharides to better resemble the fatty acid (FA) composition and stereospecific distribution (e.g., increased amount of ß-palmitate) as well as probiotics content of human breast milk. We hypothesized that these newly composed infant formulas may decrease fecal FA soap excretion and may positively affect erythrocyte FA profiles compared with regular formulas. Methods: Healthy infants were randomly assigned to receive a high-sn-2-palmitate formula (>25% of the PA is esterified to the sn-2 position of the glycerol backbone, verum: n = 30) or a “standard” formula containing <10% of PA in sn-2 position and no oligosaccharides (control: n = 27); a non-randomized group of breast-fed infants served as control. Anthropometric data of the infants (body weight, recumbent length, and head circumference) were recorded at inclusion (visit 1) and 6 and 12 weeks after onset of intervention (visits 2 and 3). Blood samples for erythrocyte FA analysis (gas chromatography) were taken at visits 1 and 2; stool samples were collected at visit 2. Results: Quantitative formula intake (mL/kg body weight × day) at visit 2 (verum: 155 ± 30, control: 164 ± 30) and visit 3 (verum: 134 ± 26, control: 134 ± 21) was comparable. Six weeks after onset of intervention, stool total FA soaps, palmitate soaps, and total FAs were similar in both formula-fed groups but significantly higher than in breast-fed infants. During the 6-week intervention, erythrocyte palmitate decreased significantly from baseline in all 3 groups with no group differences (verum: 29.20 ± 1.17 to 27.12 ± 0.66, control: 29.88 ± 2.00 to 27.01 ± 0.94, breast-fed: 30.20 ± 0.86 to 26.84 ± 0.98). For selected FAs, significant changes over time in verum and control group were obvious but without formula effects. Some variations in the FA profile of breast-fed infants compared to both verum and control groups were observed. Conclusions: In contrast to our hypothesis, feeding a newly composed infant formula based on a fat blend with 25% of PA in the sn-2 position of triacylglycerols and supplemented with a prebiotic could not decrease insoluble FA soap excretion compared with a standard product; in this respect, breastfeeding is obviously the best choice. Surprisingly, erythrocyte FA profiles were comparable in formula-fed and breast-fed infants; obvious alterations in FA composition of the respective fat sources and structure did not affect FA incorporation into membranes. Caution should be, however, exercised in drawing robust conclusions in the absence of larger, adequately powered intervention studies.

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Amine variations in faecal content in the first weeks of life of newborns in relation to breast-feeding or infant formulas

British Journal Of Nutrition ◽

10.1017/s0007114519001879 ◽

2019 ◽

Vol 122 (10) ◽

pp. 1130-1141

Author(s):

Lorena Suárez ◽

María Moreno-Luque ◽

Irene Martínez-Ardines ◽

Nereida González ◽

Patricia Campo ◽

...

Keyword(s):

Breast Milk ◽

Infant Formula ◽

Breast Feeding ◽

Intervention Studies ◽

Caucasian Woman ◽

Infant Formulas ◽

Individual Variations ◽

Feeding Type ◽

Polyamine Content ◽

The Ideal

AbstractBreast-feeding is the ideal nutrition for a newborn’s integral necessities. It seems crucial therefore to know its composition in order to provide suitable infant formula when required. Of these, polyamines (with lactation and the microbiota being its intestinal source) are involved in the development of gut epithelium and immunity. Safety concerns limit human intervention studies. Therefore, we studied the amounts of polyamines supplied by breast milk (varying among mothers) or infant formula feeding, up to day 30 postpartum, in the faeces of newborns. Independent samples (68) of breast milk from fifty-nine healthy Caucasian woman (day 0, 1, 3, 5, 7, 15 and 30 postpartum) who had natural deliveries after week 38, same-day faeces of newborns when available (eighty-one from breast milk and fifty-five from infant formula fed) and six infant formulas were collected and the polyamine content was determined by HPLC. In breast milk, polyamines and isoamylamine (a primary amine), with inter-individual variations, increased over time (with a higher content of spermidine; no other amines were present). Overall, they were much higher than in infant formula. By the 2nd week after birth, polyamines, cadaverine and tyramine, but not isoamylamine, were higher in the faeces of those fed infant formula compared with those fed breast milk. Cadaverine and tyramine could be used to predict the feeding type used for newborns. The differences in the content may be related to distinct colonisation of amine-producing bacteria, which can be established by polyamines. Further studies are required to determine the clinical utility of these findings.

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Current Methods for the Analysis of Selected Novel Nutrients in Infant Formulas and Adult Nutritionals

Journal of AOAC International ◽

10.5740/jaoacint.15-0247 ◽

2016 ◽

Vol 99 (1) ◽

pp. 30-41 ◽

Cited By ~ 7

Author(s):

Brendon D Gill ◽

Harvey E Indyk ◽

David C Woollard

Keyword(s):

Sialic Acid ◽

Breast Milk ◽

Infant Formula ◽

Analytical Methods ◽

Infant Nutrition ◽

Sole Source ◽

Human Infant ◽

Infant Formulas ◽

Representative Selection

Abstract Infant formula is designed to provide the human infant with a sole source of nutrition and it is intended to imitate breast milk. In recent years, advances in the science of infant nutrition have led to an increasing number of novel ingredients that are supplemented into infant formula. As the list of these nutritionally important nutrients is lengthy, this review summarizes contemporary analytical methods that have been applied to a representative selection (lutein, carnitine, choline, nucleotides, inositol, taurine, sialic acid, gangliosides, triacylglycerides, oligosaccharides, α-lactalbumin, and lactoferrin).

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Oligosaccharides in infant formula: more evidence to validate the role of prebiotics

British Journal Of Nutrition ◽

10.1017/s0007114515000823 ◽

2015 ◽

Vol 113 (9) ◽

pp. 1339-1344 ◽

Cited By ~ 78

Author(s):

Yvan Vandenplas ◽

Irina Zakharova ◽

Yulia Dmitrieva

Keyword(s):

Breast Milk ◽

Human Milk ◽

Infant Formula ◽

Formula One ◽

Beneficial Effects ◽

Golden Standard ◽

Defecation Frequency ◽

One Step ◽

Prebiotic Oligosaccharides ◽

Breast Fed

The gastrointestinal (GI) microbiota differs between breast-fed and classic infant formula-fed infants. Breast milk is rich in prebiotic oligosaccharides (OS) and may also contain some probiotics, but scientific societies do not recommend the addition of prebiotic OS or probiotics to standard infant formula. Nevertheless, many infant formula companies often add one or the other or both. Different types of prebiotic OS are used in infant formula, including galacto-oligosaccharide, fructo-oligosaccharide, polydextrose and mixtures of these OS, but none adds human milk OS. There is evidence that the addition of prebiotics to infant formula brings the GI microbiota of formula-fed infants closer to that of breast-fed infants. Prebiotics change gut metabolic activity (by decreasing stool pH and increasing SCFA), have a bifidogenic effect and bring stool consistency and defecation frequency closer to those of breast-fed infants. Although there is only limited evidence that these changes in GI microbiota induce a significant clinical benefit for the immune system, interesting positive trends have been observed in some markers. Additionally, adverse effects are extremely seldom. Prebiotics are added to infant formula because breast milk contains human milk OS. Because most studies suggest a trend of beneficial effects and because these ingredients are very safe, prebiotics bring infant formula one step closer to the golden standard of breast milk.

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Effect of Infant Formula on Stool Characteristics of Young Infants

PEDIATRICS ◽

10.1542/peds.95.1.50 ◽

1995 ◽

Vol 95 (1) ◽

pp. 50-54 ◽

Cited By ~ 4

Author(s):

Jeffrey S. Hyams ◽

William R. Treem ◽

Nancy L. Etienne ◽

Harry Weinerman ◽

Douglas MacGilpin ◽

...

Keyword(s):

Breast Milk ◽

Parental Education ◽

Gastrointestinal Disease ◽

Gastrointestinal Symptoms ◽

Young Infants ◽

The Common ◽

Double Blinded ◽

The Relationship ◽

Formula Type ◽

Breast Fed

Background. Many infants are switched between multiple formula preparations early in life because of perceived abnormalities in stooling pattern as well as gastrointestinal symptoms. Objective. To investigate the relationship between the type of formula consumed and the stooling characteristics and gastrointestinal symptoms of young infants. Methods. Healthy 1-month-old infants were fed one of four commercial formula preparations (Enfamil, Enfamil with Iron, ProSobee, and Nutramigen) for 12 to 14 days in a prospective double-blinded (parent/physician) fashion. Parents completed a daily diary of stool characteristics as well as severity of spitting, gas, and crying for the last 7 days of the study period. A breast-fed infant group was studied as well. Results. Two hundred eighty five infants were enrolled and 238 completed the study. Infants receiving breast milk or Nutramigen had twice as many stools as other formula groups (P < .001). Infants receiving ProSobee had hard/firm stools more often than breast-fed or other formula-fed groups (P < .00001). Watery stools were more common in infants fed Nutramigen than other formula groups (P < .04). Green stools were more common in 12 mg/L iron preparations (Enfamil with iron, ProSobee, Nutramigen) than in those with 1 mg/L (Enfamil, breast milk) (P < .00001). Spitting, gassiness, and crying were of equal severity in all formula groups. Conclusions. The interpretation of stool frequency, color, and consistency must take into account the infant's formula type as significant variations in normal infants occur. Parental education on the range of infant stooling characteristics as well as the common occurrence of spitting, gas, and crying may alleviate concern for formula intolerance and underlying gastrointestinal disease.

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Human milk and infant formula modulate intestinal microbiota and immune system of human microbiota-associated mice

Food & Function ◽

10.1039/d0fo03004j ◽

2021 ◽

Author(s):

Na Li ◽

Qing gang Xie ◽

Lina Zhao ◽

Jialu Shi ◽

Evivie Etareri Smith ◽

...

Keyword(s):

Immune System ◽

Breast Milk ◽

Human Milk ◽

Infant Formula ◽

Intestinal Microbiota ◽

Exclusive Breastfeeding ◽

Infant Formulas ◽

Human Microbiota

Many infants on exclusive breastfeeding regimen are often fed inadequate amounts, and this creates an imbalance between the overall effects of breast milk and commercial infant formulas. We comparatively analyzed...

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Resembling breast milk: influence of polyamine-supplemented formula on neonatal BALB/cOlaHsd mouse microbiota

British Journal Of Nutrition ◽

10.1017/s0007114513003565 ◽

2013 ◽

Vol 111 (6) ◽

pp. 1050-1058 ◽

Cited By ~ 16

Author(s):

Carlos Gómez-Gallego ◽

M. Carmen Collado ◽

Gaspar Pérez ◽

Toni Ilo ◽

Ulla-Marjut Jaakkola ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Breast Milk ◽

Infant Formula ◽

Delivery Mode ◽

Immune Functions ◽

Microbial Composition ◽

Human Infants ◽

Bioactive Substances ◽

Immune System Development ◽

Breast Fed

Infant microbiota is influenced by numerous factors, such as delivery mode, environment, prematurity and diet (breast milk or formula). In addition to its nutritional value, breast milk contains bioactive substances that drive microbial colonisation and support immune system development, which are usually not present in infant formulas. Among these substances, polyamines have been described to be essential for intestinal and immune functions in newborns. However, their effect on the establishment of microbiota remains unclear. Therefore, the aim of the present study was to ascertain whether an infant formula supplemented with polyamines has an impact on microbial colonisation by modifying it to resemble that in breast-fed neonatal BALB/c mice. In a 4 d intervention, a total of sixty pups (14 d old) were randomly assigned to the following groups: (1) breast-fed group; (2) non-enriched infant formula-fed group; (3) three different groups fed an infant formula enriched with increasing concentrations of polyamines (mixture of putrescine, spermidine and spermine), following the proportions found in human milk. Microbial composition in the contents of the oral cavity, stomach and small and large intestines was analysed by quantitative PCR targeted at fourteen bacterial genera and species. Significantly different (P< 0·05) microbial colonisation patterns were observed in the entire gastrointestinal tract of the breast-fed and formula-fed mice. In addition, our findings demonstrate that supplementation of polyamines regulates the amounts of total bacteria,Akkermansia muciniphila,Lactobacillus,Bifidobacterium,Bacteroides–PrevotellaandClostridiumgroups to levels found in the breast-fed group. Such an effect requires further investigation in human infants, as supplementation of an infant formula with polyamines might contribute to healthy gastrointestinal tract development.

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Arias icterus: Prolonged unconjugated hyperbilirubinemia caused by breast milk

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0712655m ◽

2007 ◽

Vol 135 (11-12) ◽

pp. 655-658

Author(s):

Marija Mladenovic ◽

Nedeljko Radlovic ◽

Dragana Ristic ◽

Zoran Lekovic ◽

Petar Radlovic ◽

...

Keyword(s):

Breast Milk ◽

Breast Feeding ◽

Bilirubin Level ◽

Serum Bilirubin ◽

Unconjugated Bilirubin ◽

Negative Consequences ◽

Unconjugated Hyperbilirubinemia ◽

Young Infants ◽

Breast Milk Jaundice ◽

Breast Fed

Introduction Breast milk jaundice occurs in 1-2% of healthy breast-fed newborns and young infants. It develops as the result of liver immaturity and the inhibitory effect of mother?s milk to the clearance of unconjugated bilirubin. Objective The paper analyzes variations in the level and length of unconjugated hyperbilirubinemia in breast-fed infants. Method The study was conducted on a sample of 29 young infants (19 male) with breast milk jaundice. All infants were born on time, by natural delivery and without complications. All were on breast-feeding only and developed optimally. None of the infants had either haemolysis or any other disease associated with unconjugated hyperbilirubinemia. Results All infants had physiological jaundice in the first week after birth, with unconjugated bilirubin level of 166-260 ?mol (201.50?36.37 ?mol). In the postneonatal period the highest bilirubin level was recorded in the fifth week of life and was 87-273 ?mol (166.82?45.06 ?mol), which then spontaneously, without interruption of breast-feeding, gradually declined. The decrease of the unconjugated fraction of serum bilirubin between the fourth and fifth week was significant, and after that highly significant. The normalization of serum bilirubin occurred in the seventh and thirteenth week (10.41?1.68 ?mol). Negative consequences of hyperbilirubinemia were not noted in any of the infants. Conclusion Breast milk jaundice presents a harmless and transitory disorder of bilirubin metabolism. It occurs in healthy breast-fed neonates and young infants. Jaundice is most marked in early neonatal period, and then it gradually declines and disappears between the seventh and thirteenth week.

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Infant Rhesus Macaque Brain α-Tocopherol Stereoisomer Profile Is Differentially Impacted by the Source of α-Tocopherol in Infant Formula

Journal of Nutrition ◽

10.1093/jn/nxaa174 ◽

2020 ◽

Vol 150 (9) ◽

pp. 2305-2313 ◽

Cited By ~ 1

Author(s):

Matthew J Kuchan ◽

Katherine M Ranard ◽

Priyankar Dey ◽

Sookyoung Jeon ◽

Geoff Y Sasaki ◽

...

Keyword(s):

Breast Milk ◽

Infant Formula ◽

Reference Group ◽

Rhesus Macaques ◽

Maternal Diet ◽

Brain Regions ◽

Infant Formulas ◽

Natural Form ◽

Post Hoc ◽

Infant Rhesus

ABSTRACT Background α-Tocopherol (αT) in its natural form [2′R, 4′R, 8′R αT (RRR-αT)] is more bioactive than synthetic α-tocopherol (all rac-αT). All rac-αT is widely used in infant formulas, but its accretion in formula-fed infant brain is unknown. Objective We sought to compare αT and stereoisomer status in infant rhesus macaques (Macaca mulatta) fed infant formula (RRR-αT or all rac-αT) with a reference group fed a mixed diet of breast milk and maternal diet. Methods From 1 d after birth until 6 mo of age, infants (n = 23) were either nursery reared and exclusively fed 1 of 2 formulas by staff personnel or were community housed with their mothers and consumed a mixed reference diet of breast milk (69 mL/d at 6 mo) transitioning to monkey diet at ∼2 mo (MF; n = 8). Formulas contained either 21 μmol RRR-αT/L (NAT-F; n = 8) or 30 μmol all rac-αT/L (SYN-F; n = 7). Total αT and αT stereoisomers were analyzed in breast milk at 2, 4, and 6 mo and in monkey plasma and liver and 6 brain regions at 6 mo of age. α-Tocopherol transfer protein (α-TTP), lipoprotein αT, and urinary α-carboxyethyl-hydroxychroman (α-CEHC) were measured. One-way ANOVA with Tukey's post-hoc test was used for analysis. Results At study termination, plasma, liver, lipoprotein, and brain total αT did not differ between groups. However, the NAT-F–fed group had higher RRR-αT than the SYN-F–fed group (P < 0.01) and the MF group (P < 0.0001) in plasma (1.7- and 2.7-fold) and brain (1.5- and 2.5-fold). Synthetic αT 2R stereoisomers (SYNTH-2R) were generally 3- and 7-fold lower in brain regions of the NAT-F group compared with those of the SYN-F and MF groups (P < 0.05). SYNTH-2R stereoisomers were 2-fold higher in MF than SYN-F (P < 0.0001). The plasma percentage of SYNTH-2R was negatively correlated with the brain percentage of RRR-αT (r = −0.99, P < 0.0001). Brain αT profiles were not explained by α-TTP mRNA or protein expression. Urine α-CEHC was 3 times higher in the NAT-F than in the MF group (P < 0.01). Conclusions Consumption of infant formulas with natural (NAT-F) compared with synthetic (SYN-F) αT differentially impacted brain αT stereoisomer profiles in infant rhesus macaques. Future studies should assess the functional implications of αT stereoisomer profiles on brain health.

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Feeding patterns in the first two years of life in Basra, Iraq

Eastern Mediterranean Health Journal ◽

10.26719/1998.4.3.448 ◽

1998 ◽

Vol 4 (3) ◽

pp. 448-451

Author(s):

Y. S. Benyamen ◽

M. K. Hassan

Keyword(s):

Breast Milk ◽

Infant Formula ◽

Breast Feeding ◽

Common Reason ◽

Feeding Patterns ◽

Solid Foods ◽

Supplementary Foods ◽

Breast Fed

The feeding patterns of 694 children ranging from 12 to 24 months of age were studied. Approximately 91% were exclusively breast-fed at 1 week of age with a further 4% receiving supplementary foods at this stage. At 1 year of age, 52% were receiving breast milk as the only source of milk and 13% were receiving infant formula in addition to breast milk. Inadequate breast milk was the most common reason reported by mothers for discontinuing breast-feeding. Of children receiving formula, 42.9% were receiving diluted formula.70.9% of mothers introduced solid foods at 4 to 6 months of age while 5.8% did not introduce solid foods until after the age of 8 months

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