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Infants are vulnerable consumers and highly depend on dietary proteins for growth and development during their first months of life. Infant formula (IF) and follow-on formula (FOF) have been developed to meet these requirements, although few protein sources are currently allowed to be used. At the same time, allergies to these available protein sources are becoming more frequent. There is thus a need to explore alternative protein sources for infant nutrition. One alternative could be quinoa, which is a pseudocereal that is naturally free from gluten and has a high protein content and quality. This review assessed the composition, nutritional properties, and applicability of quinoa proteins for IF and FOF as well as the legal framework for their use in the European Union (EU). The protein quality of isolated quinoa proteins (IQPs) is relatively high compared with other plant-based proteins like rice. Besides, during the protein isolation process, unfavorable compounds are mostly removed, ensuring that the final product can comply with the maximum residue concentrations allowed. Overall, IF and FOF are strictly regulated under the Foods for Specific Groups (FSG) Regulation (EU) No 609/2013 and more research is needed before the introduction of IQP in such products is considered, but this review shows it has several promising features that warrant further investigation., Statement of Significance: Quinoa is increasingly recognized as an excellent gluten-free protein source for a wide range of consumers, including infants, and isolated quinoa proteins are therefore a promising source of proteins for IF and FOF. This perspective provides new insights, using a multidisciplinary approach, on the composition, nutritional properties, and applicability of quinoa proteins, as well as the legal framework of IF and FOF in the EU.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on bovine milk osteopontin (bmOPN) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF concerns OPN derived from bovine whey. The NF is intended to be used at a maximum use level of 151 mg/L, in infant formula (IF), follow-on formula (FoF) and ready-to-eat dairy-based meals for children up to 35 months of age. As compared to the concentrations naturally present in cow's milk and concentrations found in IF on the market reported in the literature, the proposed use level of the NF represents an about 10-fold higher concentration of bmOPN. The intended use levels of the NF would provide bmOPN at a concentration within the range of human milk (hm) OPN. In a 6-month study, 14, 72 and 140 mg bmOPN/L in reconstituted (as consumed) IF were given to 279 infants in order to study possible effects on frequency and severity of adverse events, and growth, formula intake and stool consistency. Despite that a number of inconsistencies and limitations were noted in the study report, the Panel considers that the results obtained from this study do not raise safety concerns. Considering the source of the NF, that neither the toxicological studies nor the provided infant study do raise safety concerns, and the low bmOPN plasma levels in infants resulting from the consumption of the NF, the Panel considers that the margin of exposure (i.e. 36) between the NOAEL of the subchronic toxicity study (1,200 mg/kg bw per day) and the highest P95 estimate for infants (33.4 mg/kg bw per day) is sufficient. The Panel concludes that the NF is safe under the proposed conditions of use.

The inappropriate concentration of copper (Cu) and zinc (Zn) in formulae for infants can lead to abnormal micronutrient intake and adverse health outcomes. This study aimed to determine the concentration of Cu and Zn in different formulae and evaluate the Cu/Zn ratio. Besides, the daily intake (DI) of both micronutrients was estimated. Cu and Zn concentration in 103 formulae for infants, available in the Polish market, were assessed using atomic absorption spectrometry. The estimated DI was calculated from the average energy requirements for the 0–6 months aged infants. The microelement content of formulae was mostly in good agreement with that declared by the manufacturer (5–10% variations compared to the labeled values). The Cu/Zn ratio ranged from 1:8 to 1:25. The estimated DI of Cu was in the range of 0.14–1.11 mg/day. Six (6.7%) of the formulae did not meet the recommended range of Cu intake, especially during the first month of life and in the case of formulae for special medical purposes. The estimated DI of Zn varied from 2.27–11.25 mg/day. In most cases, the concentration of Cu and Zn in infant formulae was within the recommended range. It would be advisable to consider monitoring the DI of Cu and reconsider the Cu content in formulae for infants in proportion to its expected consumption.

International audience; No abstract available

A healthy child passes through a process of growth and harmonious development, his environment and food quality representing determining premises of his health, especially during the first two years. When breastfeeding is impossible due to the absence of milk secretion installation or to an insufficient amount of maternal milk, the alternative sources of feeding consist either in the administration of milk formulas or, under precarious social-economical conditions, in cow milk. As each infant has its individual needs, there is a variety of milk formulas, such that to provide the infant an adequate quantitative and qualitative nutrition, optimum for a harmonious development. There are several categories of formulas, based on proteins from milk or soy, hydrolyzed proteins and amino acids, as well as differences between the products from each category.

Young child formulae (YCF) are milk-based drinks or plant protein-based formulae intended to partially satisfy the nutritional requirements of young children ages 1 to 3 years. Although widely available on the market, their composition is, however, not strictly regulated and health effects have not been systematically studied. Therefore, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition (CoN) performed a systematic review of the literature to review the composition of YCF and consider their role in the diet of young children. The review revealed limited data but identified that YCF have a highly variable composition, which is in some cases inappropriate with very high protein and carbohydrate content and even high amounts of added sugars. Based on the evidence, ESPGHAN CoN suggests that the nutrient composition of YCF should be similar to that of follow-on formulae with regards to energy and nutrients that may be deficient in the diets of European young children such as iron, vitamin D, and polyunsaturated fatty acids (n-3 PUFAs), whereas the protein content should aim toward the lower end of the permitted range of follow-on formulae if animal protein is used. There are data to show that YCF increase intakes of vitamin D, iron, and n-3 PUFAs. However, these nutrients can also be provided via regular and/or fortified foods or supplements. Therefore, ESPGHAN CoN suggests that based on available evidence there is no necessity for the routine use of YCF in children from 1 to 3 years of life, but they can be used as part of a strategy to increase the intake of iron, vitamin D, and n-3 PUFA and decrease the intake of protein compared with unfortified cow's milk. Follow-on formulae can be used for the same purpose. Other strategies for optimizing nutritional intake include promotion of a healthy varied diet, use of fortified foods, and use of supplements.

Humano mlijeko je po svom sastavu idealna hrana za prehranu dojenčadi. Iznimno, kada je dojenje iz opravdanih razloga onemogućeno, jedina adekvatna zamjena za prehranu dojenčadi su adaptirana mlijeka odnosno prema Pravilniku o početnoj i prijelaznoj hrani za dojenčad (NN 39/13), početna i prijelazna hrana za dojenčad. S obzirom da su dojenčad izrazito osjetljiva dobna skupina, nužne su redovite kontrole sastava, kvalitete i zdravstvene ispravnosti početne i prijelazne hrane za dojenčad. Proteini su od iznimne važnosti za njihov pravilan rast i razvoj, stoga je cilj ovoga rada bio odrediti udio proteina u uzorcima prijelazne hrane za dojenčad, usporediti ih s deklaracijama proizvoda i utvrditi jesu li analizirane vrijednosti u skladu s Pravilnikom o početnoj i prijelaznoj hrani za dojenčad (NN 39/13). Proteini su određeni metodom po Kjeldahlu direktno iz udjela dušika upotrebom Kjeltec uređaja. Udio proteina određen u svim ispitivanim uzorcima je u granicama propisanim pravilnikom, a utvrđena odstupanja od podataka na deklaracijama su u dozvoljenim granicama prihvatljivosti. Human milk is the optimal food for infants. Exceptionally, when breastfeeding is for certain medical reasons prevented, adequate replacement for human milk is adapted milk produced under the regulations and called the infant and follow-on formula. Since infants and toddlers are particularly sensitive population group, regular monitoring of composition, quality control and foos safety are necessary. Proteins are extremely important for their growth and development, so the goal of this study was to determine the final protein content in samples of follow-on formulas and compare them with product labels and determine whether obtained results are in accordance with the regulations (NN 39/13). Proteins were determined by Kjeldahl method directly from nitrogen content using Kjeltec devices. Protein content of all analized samples is within the limits prescribed by the regulations and minimum deviation of the data are obtained in the declarations.

Background: In most European countries advertisements of infant formula are forbidden, while those of follow-on formula are allowed. Recent researches carried out in Australia and Great Britain have suggested that advertisement of toddler formula is used by the producing industry as a line extension to promote infant and follow-on formulas. Objectives: The objective of the study is to assess how advertisements of follow-on formulas are perceived by pregnant women and mothers in Italy. Materials and Methods: The study was carried out in 8 cities of the North, Centre and South of Italy and had two components: 1) a quantitative analysis of 562 self-administered questionnaires for mothers of children under 3 years of age, to explore their exposure to and perception of formula advertisements; 2) a qualitative analysis of 80 in-depth semi-structured interviews to 80 pregnant women, in their 32-36 weeks of gestation with no other children, on their understanding and perception of two advertisements for follow-on formulas. Results: Asked in the self-administered questionnaires whether they had ever come across advertisements of infant formulas, 81% of mothers reported that they had, despite the fact that such advertisements are prohibited by law. The qualitative interviews to pregnant women showed their inability to identify the advertised products at first glance due to the ambiguity of the numeral 2 and the presumed age of the portrayed babies; this confusion did not disappear after careful observation of the advertisements and reading of the text. Conclusions: Advertisements of follow-on formulas are perceived by many pregnant women and mothers as promoting infant formulas.

The primary objective of this study was to determine the bifidogenic effect of galacto-oligosaccharides (GOS) in a follow-on formula and the effects on other intestinal bacteria. Secondary objectives were the effects on stool characteristics, growth, and general well-being.In a multicenter, double-blind study, 159 healthy infants, formula-fed at enrollment (at 4-6 months), were randomized to an experimental follow-on formula supplemented with 5 g/L (GOS) (77 infants), or to a standard follow-on formula (control, 82 infants). Infants were evaluated at enrollment (study day 1 = sd1), after 6 weeks (study day 2 = sd2), and after an additional 12 weeks (study day 3 = sd3). At each study day, a fresh stool sample for the bacterial counts was collected, and the growth parameters were measured. At sd2, urinary specimens were collected for the evaluation of urinary osmolarity.At sd2 and sd3, the GOS group had a higher median number (colony-forming units per gram of stool) of bifidobacteria than did the control group (sd2 GOS 9.2 x 10(9) vs control 4.4 x 10(9), P = 0.012); (sd3 GOS 7.2 x 10(9) vs control 2.4 x 10(9), P = 0.027). Other bacteria did not show any significant differences between the 2 groups at all study days. The GOS produced softer stools but had no effect on stool frequency. The urinary osmolarity (mOsm/L) at sd2 was comparable in both groups. Supplementation had no influence on the incidence of gastrointestinal side effects or on the growth of the infants.These data indicate that the addition of GOS (5 g/L) to a follow-on formula positively influences the bifidobacteria flora and the stool consistency in infants during the supplementation period at weaning. No local or systemic side effects were recorded.

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the essential composition of infant and follow-on formula. This opinion reviews the opinion provided by the Scientific Committee on Food in 2003 on the essential requirements of infant and follow-on formulae in light of more recent evidence and by considering the Panel’s opinion of October 2013 on nutrient requirements and dietary intakes of infants and young children in the European Union. The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first six months of life in its previous opinion and an average amount of formula consumed during this period. From a nutritional point of view, the minimum contents of nutrients in infant and follow-on formula proposed by the Panel cover the nutritional needs of virtually all healthy infants born at term and there is no need to exceed these amounts in formulae, as nutrients which are not used or stored have to be excreted and this may put a burden on the infant’s metabolism. Therefore, the Panel emphasises that maximum amounts should be interpreted not as target values but rather as upper limits of a range which should not be exceeded.

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the essential composition of infant and follow-on formula. This opinion reviews the opinion provided by the Scientific Committee on Food in 2003 on the essential requirements of infant and follow-on formulae in light of more recent evidence and by considering the Panel’s opinion of October 2013 on nutrient requirements and dietary intakes of infants and young children in the European Union. The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first six months of life in its previous opinion and an average amount of formula consumed during this period. From a nutritional point of view, the minimum contents of nutrients in infant and follow-on formula proposed by the Panel cover the nutritional needs of virtually all healthy infants born at term and there is no need to exceed these amounts in formulae, as nutrients which are not used or stored have to be excreted and this may put a burden on the infant’s metabolism. Therefore, the Panel emphasises that maximum amounts should be interpreted not as target values but rather as upper limits of a range which should not be exceeded.

On request from the European Commission following an application by Dairy Goat Co‐operative (NZ) Ltd, the Panel on Dietetic Products, Nutrition and Allergies was asked to provide a scientific opinion on the suitability of goat milk protein as a source of protein in infant and follow‐on formulae. The Panel considered compositional data of an infant and a follow‐on formula made from whole goat milk that retained the natural whey‐to‐casein ratio of goat milk, data from a double‐blind, randomised, controlled, three‐centre trial, and a re‐analysis of the data of the trial which formed the basis of a previous evaluation of the Panel. A study in 200 Australian infants, randomised to receive an infant formula with unmodified goat milk protein or a cow milk formula exclusively for at least four months and thereafter in addition to complementary food until 12 months did not show statistically significant or clinically relevant differences in weight, length or head circumference development. The growth pattern of formula‐fed infants differed, as expected, from that of the WHO growth standard in particular with respect to weight‐for‐length. The results of this study were supported by the results of the trial considered in the Panel's earlier assessment, in which, however, the sample size was insufficient to draw conclusions. The Panel concludes that protein from goat milk can be suitable as a protein source for infant and follow‐on formulae, provided the final product complies with the compositional criteria laid down in Directive 2006/141/EC.

Texto completo: acesso restrito. p. 288–290 Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2014-08-26T12:35:44Z No. of bitstreams: 1 Tereza C. M. Ribeiro.pdf: 141152 bytes, checksum: d5b0268224afef15d175185ab448dbfe (MD5) Rejected by Delba Rosa (delba@ufba.br), reason: Por gentileza, certifique-se do endereço eletrônico: http://dx.doi.org/ 10.1097/MPG.0b013e31823a8a4c on 2014-09-15T16:12:40Z (GMT) Submitted by Edileide Reis (leyde-landy@hotmail.com) on 2014-09-17T12:02:27Z No. of bitstreams: 1 Tereza C. M. Ribeiro.pdf: 141152 bytes, checksum: d5b0268224afef15d175185ab448dbfe (MD5) Approved for entry into archive by Delba Rosa (delba@ufba.br) on 2014-09-26T14:58:04Z (GMT) No. of bitstreams: 1 Tereza C. M. Ribeiro.pdf: 141152 bytes, checksum: d5b0268224afef15d175185ab448dbfe (MD5) Made available in DSpace on 2014-09-26T14:58:04Z (GMT). No. of bitstreams: 1 Tereza C. M. Ribeiro.pdf: 141152 bytes, checksum: d5b0268224afef15d175185ab448dbfe (MD5) Previous issue date: 2012-02 Healthy 9- to 48-month-old children (n = 133) were randomized to receive a cow's-milk–based follow-on formula (control) or the same formula with polydextrose and galactooligosaccharides (PDX/GOS) for 108 days. Pediatricians assessed diarrheal disease, stool pattern, acute respiratory infection, systemic antibiotic use, and growth. The 2 groups had similar weight-for-length/height z score and similar odds of having diarrheal disease, acute respiratory infection, and systemic antibiotic use; however, PDX/GOS had greater odds of increased defecation than control (P

Objective: Intestinal microbiota plays an important role in the prevention of certain diseases during the pediatric years. Thus, there is an increasing interest in the addition of probiotics to infant formulas. The aim of this study was to evaluate the safety of a follow-on formula with Lactobacillus salivarius CECT5713 in 6-mo-old children. Methods: The antibiotic susceptibility of L salivarius CECT5713 was analyzed by a dilution method. A double-blinded, randomized, placebo controlled study was performed. Children (n = 80) were distributed in two groups and consumed the formula supplemented or not with probiotics (2 x 10(6) colony-forming units letting) during 6 mo. Fecal samples were collected at enrollment, at 3 mo, and at the end of trial. Clinical and anthropometric evaluations were performed. Depending on the variable, one-way or two-way repeated measures analysis of variance were used for the statistical analysis. Results: The antibiotic susceptibility profile of the strain resulted as safe. No adverse effects associated with the consumption of the probiotic formula were reported. In addition, clinical parameters did not differ between groups. Consumption of the probiotic supplemented formula led to an increase in the fecal lactobacilli content (7.6 +/- 0.2 versus 7.9 +/- 0.1 log cfu/g, P < 0.05). Lactobacillus salivarius CECT5713 was detected in the feces of volunteers from the probiotic group. Probiotic consumption induced a significant increase in the fecal concentration of butyric acid at 6 mo. Conclusion: Thus, a follow-on formula with L salivarius CECT5713 is safe and well tolerated in 6-mo-old infants. (C) 2010 Elsevier Inc. All rights reserved.

Furrd~rmenro: Los sustitutos de la leche materna han sido comercializados con gran trascendencia económica, a veces sin tener en cuenta los aspectos sanitarios y nutricionales para el consumidor. Las autoridades sanitarias se han visto implicadas en este tema, tanto a nivel Internacional como Europeo, dictando normas o directrices a seguir en la comercialización de los sustitutos de la leche materna, que han sido adoptadas por la legislación Española. El objetivo del trabajo es comentar las normas que reglamentan los preparados alimenticios de lactantes y niños de corta edad. hf~IfJd0.S: Se analizan y comentan los contenidos de las normas. tanto internacionales, como europeas y nacionales, de preparados pnm lactantes y de continuación. Rrsuit~r&s: Las normas sobre preparados pam lactantes y de continuación prohiben el término de “leches matemizadas” e insisten en la locroncirr mrrtrrna que ~610 deberd ser sustituida por indicación de personal sanitario. Esta legislación regula, ademas, su composición química, cualitativa y cuantitativa; establece normas para el correcto etiquetado, que deberá contener una información adecuada sin idealizar el producto, pero sí se admiten gmficas o dibujos que ilustren una correcta preparación; contempla la distribución, venta y adecuada publicidad. que deber5 ser controlada, prohibiendo las muestras gratuitas o cualquier donación tanto a particulares como a centros sanitarios. Cnnclusionus: Con la situación actual sobre “preparados para lactantes y de continuación”, las autoridades sanitarias intentan que el cumplimiento de las normas legislativas beneficien la adecuada alimentación del lactante y nifío de corta edad, siendo responsabilidad de todos la protección de este tipo de consumidor. Bockground: The comercialization of breast milk substitutes has had great economic transcendente, sometimes without considering the sanitary and nutritional consequences for the customer. The sanitary authorities have been implied in this matter both in the Intemational and European tields, issuing standards and regulations for the commercialization of breats milk substitutes which have been adopted by the Spanish Regulation. The aim of mis paper is comment the tegulations that affect foods for breas&feeding and short age children. Merliorls: This report analyzes and comments on the contets of intemational, european and national regulation on infant and follow-on formula. Rtwlts: The regulations about Infant formula and Followon formula. banning the term of “humanized milk” and remarking the preferente for breast feeding, which could only be substituted by sanitary professionals. This regulation deals with the appropiate chemical composition of these products, qualitative and quantitative. It includes standards for correct labeling, which should contain the approiate information without idealizing the product. Drawings and pictures showing the correct preparation are allowed. lt provides for distribution and sales. as well as for correct advertising, which should be under control. This regulation also bans free samples and any other donation to particular customers oí sanitary institutions. Conclusions: The present regulation on “lnfant and Follow- on formulas” pursues the adequate nutrition of breast-feeding and short age children, beinf the protection of chis kind of customers everyone’s responsability.

Objectives Few studies have assessed efficacy and safety of prebiotics in infants at the time of diversification. We investigated the beneficial effects of a follow-on milk formula supplemented with short-chain fructo-oligosaccharides (scFOS) in healthy infants after 4 months of age. Subjects/methods 75 formula-fed healthy infants were included at the age of 4 months in a randomized, controlled, double blind study and received either a placebo or scFOS supplemented formula for six months. Faecal poliovirus sIgA after vaccination and bifidobacteria concentration, height, weight and digestive tolerance were monitored. Results After 1 and 2 months of supplementation, no significant difference was observed between the groups for the evolution of poliovirus sIgA concentration compared to baseline. A significant increase in bifidobacteria count was observed after 1 month of ScFOS supplementation, but this difference was no longer significant after 2 months. Breastfeeding history of infants was shown to have an impact on faecal bifidobacteria evolution. Tolerance and growth parameters were similar in the 2 groups. Conclusions A follow-on milk formula supplemented with scFOS modulates intestinal microbiota via an increase of faecal bifidobacteria concentration, while no effect on sIgA concentrations could be demonstrated. scFOS addition elicited normal digestive tolerance and normal growth suggesting it can be used safely at 5 g/L in infants after 4 months of age.