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Background/Objectives: Human milk is the optimal source of nutrition and protection against infection for infants. If breastfeeding is not possible, standard and hydrolyzed infant formulas (IF) are an alternative. Extensively hydrolyzed IFs (eHFs) contain bioactive peptides, but their activities have rarely been evaluated. The aim of this study was to characterize and compare the bioactive peptide profiles of different eHFs and standard IFs before and after in vitro digestion. Methods: Two forms, liquid and powder, of intact protein formula (iPF) and eHF were subjected to in vitro gastrointestinal digestion, mimicking a young infants gut (age 0-4 months) and an older infants gut (>6 months). Bioactive peptides of in vitro digested and undigested formulas were analysed with Liquid Chromatography-Mass Spectrometry (LC-MS). Results: In all samples, a variety of peptides with potential bioactive properties were found. Immuno-regulatory peptides, followed by antimicrobial and antioxidative peptides were most frequent, as were peptides promoting wound healing, increasing mucin secretion, regulating cholesterol metabolism, and preventing bacterial infection. Peptides typically found in yoghurt and colostrum were identified in some formula samples. Conclusions: The high amounts of bioactive peptides with various properties in eHFs and iPFs indicate a possible contribution to infection protection, healthy gut microbiomes, and immunological development of infants. eHFs showed similar compositions of bioactive peptides to iPFs, with intermittently increased peptide variety and quantity.

BACKGROUND: Infant formula in the United States contains abundant iron, raising health concerns about excess iron intake in early infancy. OBJECTIVES: Using a piglet model, we explored the impact of high iron fortification and prebiotic or synbiotic supplementation on iron homeostasis and trace mineral bioavailability. METHODS: Twenty-four piglets were stratified and randomly assigned to treatments on postnatal day 2. Piglets were individually housed and received an iron-adequate milk diet (AI), a high-iron milk diet (HI), HI supplemented with 5% inulin (HI with a prebiotic [HIP]), or HIP with an oral gavage of Ligilactobacillus agilis YZ050, an inulin-fermenting strain, every third day (HI with synbiotic [HIS]). Milk was provided in 14 meals daily, mimicking formula feeding in infants. Fecal consistency score and body weight were recorded daily or every other day. Blood and feces were sampled weekly, and tissues collected on postnatal day 29. Data were analyzed using mixed model analysis of variance with repeated measures whenever necessary. RESULTS: Diet did not affect growth. HI increased hemoglobin, hematocrit, and serum iron compared to AI. Despite marginal adequacy, AI upregulated iron transporter genes and maintained satisfactory iron status in most pigs. HI upregulated hepcidin gene expression in liver, caused pronounced tissue iron deposition, and markedly increased colonic and fecal iron. Inulin supplementation, regardless of L. agilis YZ050, not only attenuated hepatic iron overload but also decreased colonic and fecal iron without altering pH or the expression of iron regulatory genes. HI lowered zinc (Zn) and copper (Cu) in the duodenum and liver compared to AI, whereas HIP and HIS further decreased Zn and Cu in the liver and diminished colonic and fecal trace minerals. CONCLUSIONS: Early-infancy excessive iron fortification causes iron overload and compromises Zn and Cu absorption. Inulin decreases trace mineral absorption likely by enhancing gut peristalsis and stool frequency.

UNLABELLED: In May of 2022, millions of U.S. parents encountered uncertainty in safely feeding their infants due to the infant formula shortage. METHODS: An anonymous, electronic, cross-sectional, retrospective survey was used. RESULTS: U.S. parents (n = 178) whose infants were ~10 weeks old during the shortage completed the survey. Of parents, 81% switched formulas during the shortage, 87% switched because they could not find the formula they typically used, 34% switched 3-5 times, 29% of parents visited ≥4 stores/24 h and 26% of parents traveled >20 miles/24 h to purchase formula. Use of infant formula increased (p < 0.01); in infants requiring specialty formula, use of intact cows milk formula increased (p < 0.05) and use of premature infant formulas decreased (p < 0.05). Infants relying on specialty formulas experienced at least one undesirable outcome compared with non-specialty users. Parents used social media, relatives/friends and healthcare providers for support during the shortage, but their helpfulness scores were suboptimal. Parents reported the need for greater infant formula availability, free prenatal lactation education and postpartum lactation support. CONCLUSIONS: Government, regulatory and healthcare policy oversight are needed to protect the infant feeding system, including more commercially available products, access to banked donor milk and lactation support.

Toddler milk is an ultra-processed beverage consisting primarily of powdered milk, caloric sweeteners, and vegetable oil. Pediatric health authorities do not support the use of toddler milk, and emerging evidence suggests that toddler-milk marketing practices may mislead consumers. However, studies have not synthesized the extent of toddler-milk marketing practices or how these practices affect parents decisions about whether to serve toddler milk. We aimed to summarize the literature about toddler milk to identify what is known about: (1) parents toddler-milk purchasing and feeding behaviors, (2) toddler-milk marketing, and (3) how marketing practices influence parents beliefs and perceptions about toddler milk. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we systematically searched 8 databases (PubMed, APA PsycINFO, Scopus, Cochrane Central, Embase, CINAHL, Communication & Mass Media Complete, and Business Source Premier). We identified 45 articles about toddler milk. Studies were conducted in 25 countries across 6 continents. Five types of findings emerged: (1) consumption and feeding behaviors, (2) demographic correlates of toddler-milk purchasing and consumption, (3) misperceptions and beliefs, (4) increased sales, and (5) increased marketing and responses to marketing. The included articles suggested that toddler-milk sales are growing rapidly worldwide. Findings also revealed that toddler-milk packages (eg, labels, branding) resemble infant formula packages and that toddler-milk marketing practices may indirectly advertise infant formula. Purchasing, serving, and consumption of toddler milk were higher in Black and Hispanic populations than in non-Hispanic White populations, and parents with higher educational attainment and income were more likely to offer toddler milk to their children. Findings suggest a need for policies to prevent cross-marketing of toddler milk and infant formula, reduce provision of toddler milk to infants and toddlers, and prevent caregivers from being misled about toddler-milk healthfulness.

Objective: To assess common gastrointestinal symptoms in healthy Brazilian infants receiving goat milk-based formula (GMF) compared to cow's milk-based formula (CMF). Methods: We performed a 24-weeks double-blind, randomized, controlled study in Brazil, enrolling healthy infants from 3 to 12 months of age. Primary outcome were the gastrointestinal (GI) symptoms stool consistency, regurgitation frequency and crying duration. Secondary outcomes were growth trajectories and hemoglobin levels. Repeated mixed models were used to compare outcomes variables between GMF and CMF groups, while adjusting for age at baseline. Results: Fifty-six infants were recruited and randomly allocated in the GMF (n = 26) and the CMF (n = 30) group. Scores on all measured GI symptoms were low and similar among the groups throughout intervention period and improved over time. Average age- and sex-adjusted WHO z-scores of weight, length, head circumference, and weight-for-length were all within +/-1 SD and similar between groups, indicating adequate growth. Serum hemoglobin was 11.1 (SD 0.7) g/dL in infants fed GMF and 11.0 (SD 0.8) g/dL in infants fed CMF after the intervention and was similar between groups. Conclusion: GMF was well tolerated, safe and supported adequate growth in infants. This was shown by the low occurrence of GI symptoms, adequate blood hemoglobin levels and adequate growth within WHO standards. Trial registration: The clinical trial was approved by the ethics committee of the Federal University of Bahia under number CAAE06923319.5.0000.5577. The study was retrospectively registered in clinicaltrials.gov on 02/05/2024 under identifier NCT06395571. [ABSTRACT FROM AUTHOR]

Objectives: Beginning in February 2022, the United States faced an infant formula shortage that severely impacted access and affordability. Little is known about how this shortage impacted infant feeding intentions among expectant mothers. Our study sought to determine the impact of the formula shortage on prenatal feeding intentions and to understand expectant mothers' feelings and perceived stress related to the shortage. Methods: This cross-sectional, exploratory, observational study of pregnant women (n = 57) residing in New York City utilized a self-administered online survey in May–July 2022. Results: The results indicate that ten (17.5%) respondents changed their feeding intentions during the infant formula shortage for months 0–3 or 3–6 of infancy to include more breastfeeding than originally intended. These mothers also reported significantly higher stress levels related to the shortage than their non-changing peers. Conclusions for practice: Our results suggest that the formula shortage influenced feeding intentions among a subset of surveyed expectant mothers. The stress associated with the shortage influenced prenatal feeding intentions to include more breastfeeding than intended prior to the shortage. Prenatal healthcare providers should consider the availability of infant formula as one of myriad factors that influence infant feeding intentions, and that the stress associated with whether infant formula is readily available may influence these intentions as well. Significance: Numerous factors, including social, cultural, and economic influences, can shape prenatal infant feeding intentions. Our results suggest that availability of infant formula may be an additional element in this decision-making process. Our study found that the 2022 infant formula shortage influenced expectant mothers to include more breastfeeding in their feeding plans than they had originally intended as a result of the shortage. To our knowledge, there has been no research published that examines the effect of an infant formula shortage on the feeding intentions of expectant mothers. [ABSTRACT FROM AUTHOR]

3-Monochloropropanediol fatty acid esters (3-MCPDE) and glycidyl esters (GE) are well-identified processing-induced chemical toxicants detected in infant formula and baby foods worldwide. We analysed the levels of 3-MCPDE and GE in infant formula and baby food products available in Saudi Arabia, followed by a dietary risk assessment for exposure to these contaminants in infants and young children from birth to 3 years. Eighty-five commercial infant formulas (n = 35) and baby foods (n = 50) available for consumption by infants and babies purchased from the Saudi market during 2022 were analysed for these contaminants using gas chromatography-tandem mass spectrometry. 3-MCPDE and GE were detected in 100 and 80% of the samples, with a mean concentration of 57 µg/kg (range: 2–285 µg/kg) and 30 µg/kg (range: not detected–217 µg/kg), respectively. The highest concentration was found in milk-based formula for infants 0–6 months (285 µg/kg) and the lowest was found in fruit purees (2 µg/kg). Preliminary exposure and risk assessment showed increased exposure to 3-MCPDE for infants exclusively fed infant formula with exposure declining with age due to the introduction of solid foods. GE exposure levels reached 0.8 µg/kg body weight per day, which declined over time with margin of exposure values below 25,000. These results indicate that the levels of 3-MCPDE and GE in infant formula may pose potential risks to infants exclusively fed formula; therefore, adopting EU regulations should reduce the presence of these processing contaminants in essential infant foods. [ABSTRACT FROM AUTHOR]

This review critically evaluates current in vitro gastrointestinal models for assessing infant formulas from a perspective focusing on a process along digestion, absorption and microbial fermentation. Despite their potential, none of the current in vitro gastrointestinal models fully considers the dynamics and continuous upstream‐downstream process of the human digestive tract. Considering the substantial differences between infants and adults, there is a pressing need for whole‐process gastrointestinal models tailored to infants. Developing such models is crucial for accurately assessing infant formula nutritional value and physiological function, enhancing the formulation of infant formulas to better meet the needs of infants. [ABSTRACT FROM AUTHOR]

BACKGROUND: The nutritional intake of formula‐fed newborns is often limited to a single source, so it must be supplemented with essential nutrients for the growth and proper development of infants. Taurine, l‐carnitine, and choline are considered conditionally essential nutrients especially in newborns and infants. RESULTS: In this work, a simple routine hydrophilic interaction liquid chromatography‐electrospray ionization‐tandem mass spectrometry (HILIC‐ESI‐MS/MS) method was developed and validated for the simultaneous determination of these semi‐essential nutrients in infant and adult/pediatric milk formulas. The extraction recoveries were between 90% and 114%. Precision of the method offered relative standard deviation below 5% and 7% for intra‐day and inter‐day precision, respectively. The proposed method was successfully applied to quantification of taurine, l‐carnitine, and choline in milk formula. The contents found were in good agreement with those provided on the product label for almost all samples. CONCLUSION: In view of these results, it can be concluded that the developed method can be a useful approach for the simultaneous determination of taurine, l‐carnitine and choline in powdered milk samples, so it can be useful in the routine quality control of this kind of samples. © 2024 The Author(s). Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

The lipid profile including total fatty acid (FA), sn‐2 positional distribution on triacylglycerol, and phospholipid (PL) FA in human milk, infant formulas, and animal milk (cow, goat, camel, donkey, and yak milk) were analyzed. Animal milk contained higher saturated fatty acids (45.08%–66.29%) than human milk (37.44%) and infant formula (33.46%). In the perspective of FA, human milk and the commercial formulas showed a better similarity. Human milk contained significantly (p < 0.05) higher 16:0 at the sn‐2 position (50.88%) than infant formulas (23.09%) and animal milk (28.95%–46.72%). As to PL‐FA, human milk contained significantly (p < 0.05) higher 16:0 and 18:0 but lower 18:1 n‐9 than other milk. The relative contents of arachidonic acid (AA), docosahexaenoic acid (DHA), and nervonic acid (NA) in human milk were higher in PL‐FA than that in total FA. Noteworthy, the contents of AA, DHA, and NA in both total FA and PL‐FA were higher in human milk than other milk. These results indicated that the fortification of 16:0 at the sn‐2 position, and AA, DHA, and NA in both total FA and PL‐FA could improve the quality of infant formulas. [ABSTRACT FROM AUTHOR]

Staphylococcal food poisoning is a significant foodborne illness caused by staphylococcal enterotoxins (SEs). Immunoassays have become the primary method for rapidly detecting harmful bacteria and toxins because of their excellent sensitivity and specificity. However, these assays have limitations in that they cannot differentiate between types of SEs and do not provide rapid, on-site, quantitative testing. In this study, a time-resolved fluorescence immunochromatography assay (TRFICA) was developed specifically for detecting staphylococcal enterotoxin E (SEE), which is commonly found in dairy products. Compared with a double antibody sandwich enzyme-linked immunosorbent assay, which had a detection limit of 0.028 ng/mL, TRFICA demonstrated comparable sensitivity, enabling SEE quantification with a detection limit as low as 0.081 ng/mL in infant formula. Validation by spiking infant formula samples confirmed no cross-reactivity with analogs (recoveries ranged from 93.17% to 128.77%). Furthermore, with an 8-min reaction time and interpretation delivered by a portable TRFICA strip reader, our method demonstrates potential for use in mobile and on-site detection. This study describes a rapid, easy, and reliable method for detecting trace levels of SEE in infant formula, which could serve as an early screening tool toward preventing food poisoning in infants and children. [ABSTRACT FROM AUTHOR]

The Chilean Technical Manual for Milk Dietary Service (SEDILE) was evaluated to determine its effectiveness in ensuring the microbiological safety and vitamin D adequacy of a commercially available powdered infant formula (PIF) used in SEDILE. The evaluation focused on whether adherence to the manual's guidelines positively influenced these factors. Both the PIF and the reconstituted PIF (RIF) were found to be free from Cronobacter sakazakii and Salmonella enterica contamination, with levels of total coliforms and Escherichia coli within acceptable limits. Moreover, the vitamin D content in the formula was within the expected range. These findings suggest that following the Chilean Technical Manual for SEDILE contributes to the microbiological safety and nutritional adequacy of RIF in dietary services. [ABSTRACT FROM AUTHOR]

Following an outbreak of Cronobacter sakazakii infection in infant formula, the US Food and Drug Administration commissioned a series of reports and then undertook a major reorganization of its food program. This article describes the changes that went into effect on 1 October 2024, why those changes are likely to improve the new Human Foods Program, and additional work that must be undertaken to enhance the agency's impact upon public health. [ABSTRACT FROM AUTHOR]

The evidence regarding the association between infant formula (IF) composition and the prevention of allergy and respiratory diseases remains sparse and inconclusive. This study aimed to evaluate whether some IF characteristics were associated with the risk of allergy or respiratory diseases in childhood. Among 1243 formula‐fed children from the EDEN mother–child cohort, IF characteristics concerning long‐chain polyunsaturated fatty acids (LCPUFAs) enrichment, prebiotic/probiotic enrichment, and hydrolysis of proteins were identified from the ingredients list. Eczema, wheezing, food allergy, asthma, and allergic rhinitis up to age 8 years were prospectively collected and summarized into four allergic and respiratory multimorbidity clusters. Associations between 4‐month IF characteristics and risk of allergy or respiratory diseases were tested using logistic regressions adjusted on main confounders. The consumption of LCPUFA‐enriched formula was not linked to allergic and respiratory multimorbidity clusters, but to a lower risk of any allergy, eczema, and wheezing. Probiotic‐enriched formula consumption was associated with a lower risk of belonging to the 'Allergy without asthma' cluster (odds ratio [OR] [95% confidence interval, CI] = 0.63 [0.40–0.99]), and consumption of a formula enriched in Bifidobacterium lactis was associated with a lower risk of any allergy (OR [95% CI] = 0.59 [0.41–0.85]). Partially hydrolysed formula (pHF) consumption was associated with a higher risk of belonging to the 'Allergy without asthma' cluster (OR [95% CI] = 2.73 [1.65–4.51]). This study confirms the positive association between pHF consumption and the risk of allergy found in previous observational studies and suggests that consumption of LCPUFA‐enriched or probiotic‐enriched formula was associated with a lower risk of allergy. Key messages: The study aimed to explore, among formula‐fed infants, the association between infant formula characteristics and allergic or respiratory multimorbidity clusters in early childhood.Probiotic‐enriched formula consumption was associated with a lower risk of belonging to the 'Allergy without asthma' cluster.Partially hydrolysed formula consumption was associated with a higher risk of belonging to the 'Allergy without asthma' cluster, even after exclusion of cases reported at 1 year. [ABSTRACT FROM AUTHOR]

Aim: To examine how reduced iron content and added bovine lactoferrin in infant formula affect the antibody response following routine immunisation. Methods: In this randomised controlled trial, 180 Swedish formula‐fed infants received, from 6 weeks to 6 months of age, a 2 mg/L iron formula with (n = 72) or without (n = 72) bovine lactoferrin, or a control formula with 8 mg/L iron and no lactoferrin (n = 36). Another 72 infants were recruited as a breastfed reference. Serum immunoglobulin G (IgG) levels against Haemophilus influenzae type b (Hib), diphtheria and tetanus were assessed at four, six and 12 months of age. Results: With an equal gender distribution, 180 + 72 term infants were included with a mean age of 7.0 ± 0.7 weeks. At 12 months, infants fed low iron formula showed a significantly higher geometric mean Hib IgG (1.40 μg/mL [1.07–1.83]) compared to the control formula infants (0.67 μg/mL [0.42–1.07]). For all three vaccines, breastfed infants had significantly lower IgG levels at six and 12 months of age. Conclusion: Except for higher Hib IgG levels at 12 months in infants fed low iron formula, the interventions did not affect vaccine IgG response. Unexpectedly, breastfed infants had significantly lower vaccine IgG levels compared to formula‐fed infants. [ABSTRACT FROM AUTHOR]

Background: The gut microbiota of breast-fed infants is dominated by infant-type human-residential bifidobacteria (HRB) that contribute to infant health; thus, it is crucial to develop infant formulas that promote the establishment of a gut microbiota enriched with infant-type HRB, closely resembling that of breastfed infants. Methods: We compared various non-digestible prebiotic oligosaccharides and their combinations using a fecal culture system to explore which candidates could promote the growth of all infant-type HRB and rarely yield non-responders. The analysis included lactulose (LAC), raffinose (RAF), galactooligosaccharides (GOS), and short- and long-chain fructooligosaccharides. Fecal samples were collected from seven infants aged 1.5–10.2 months and cultured with each oligosaccharide individually or their combinations. Results: No single oligosaccharide effectively promoted the growth of all infant-type HRB, although GOS promoted the growth of HRB other than Bifidobacterium longum subsp. longum. Only the LAC/RAF/GOS group evenly and effectively promoted the growth of all infant-type HRB. Accordingly, acetate production was higher in fecal cultures supplemented with GOS or LAC/RAF/GOS than in the other cultures, suggesting that it is a superior combination for all infant-type HRB and rarely yields non-responders. Conclusions: This study can aid in developing infant formulas that help align the gut microbiota of formula-fed infants with that of breastfed infants. [ABSTRACT FROM AUTHOR]

Background: The International Code of Marketing of Breast-milk Substitutes, or 'the Code,' sets standards to regulate marketing of commercial milk formula (CMF) to protect breastfeeding. World Health Organization member states are advised to legislate the Code into national law, but understanding of its implementation outcomes is limited. This systematic review aimed to examine implementation outcomes in countries implementing the Code as national law. Methods: We systematically searched five academic databases in September 2022 for articles published in English from 1982 to 2022. We double-screened titles/abstracts and then full texts for eligible articles reporting implementation outcomes of the Code in 144 eligible countries. We used the Mixed Methods Appraisal Tool for quality assessment and synthesized data thematically. We applied the Proctor et al. framework to guide synthesis of implementation outcomes, organizing our findings according to its taxonomy. Results: We included 60 eligible articles of the 12,075 screened, spanning 28 countries. Fifty-seven articles focused on legal compliance, 5 on acceptability, and 1 on feasibility. Compliance was assessed across multiple sources, including mothers, health workers, media, points of sale, and product labels. Maternal exposure to CMF promotion remained widespread, with reports of mothers receiving free samples and coupons, and encountering media advertisements. Compliance of health workers varied across countries, with many reporting contact with CMF companies despite legal prohibitions. Public hospitals generally showed better adherence to the national law than private ones. While implementing the Code as national law effectively regulated the promotion of CMF for infants aged 0–12 months in public settings and in the media, it remains insufficient in addressing the promotion of unregulated products like growing-up milk, which are often marketed through emerging strategies such as cross-promotion and digital advertising. Point-of-sales compliance was inconsistent, with many countries reporting non-compliant price-related promotions. Conclusion: To enhance legal compliance, robust monitoring and reporting systems are necessary. Utilizing technology-assisted solutions for monitoring compliance can be an option for countries with limited human resources. Adequate training for health workers and communication strategies targeting shop managers about national law are also essential in enhancing their acceptability and compliance. [ABSTRACT FROM AUTHOR]

This study examines which factors influence the preferences of mothers seeking advice on the use of infant formula in feeding practices. The effects of their close social circle, medical professionals and social network forums on feeding choices were evaluated. Data were collected from 638 questionnaires from mothers and were statistically analyzed. Our findings suggest that age may influence the preference to seek advice from a close social circle over consulting with medical professionals (p-value = 0.019 < 0.05). The educational level and the number of children impact the preferences of using infant formula over combining it with breastfeeding (p-value = 0.000 < 0.05 and p-value = 0.004 < 0.05, respectively). The research contributes to the understanding of the complex interplay between various demographic and socioeconomic factors and the decision-making process of mothers based on multiple social and digital sources of influence. The research presents valuable insights for healthcare policymakers and professionals in supporting mothers and providing them with up-to-date information. Feeding information can be distributed through all the communication channels that were examined in this study to benefit different socio-economic groups and to contribute to the well-being of infants in the long-run. [ABSTRACT FROM AUTHOR]

Human breast milk (HBM) is the "gold standard" for infant nutrition. When breast milk is insufficient or unavailable, infant milk formula (IMF) can provide a safe and nutritious alternative. However, IMFs differ considerably from HBM in composition and health function. We compared the digestibility and potential health functions of IMF containing low cream (LC-) or high cream (HC-) with pooled HBM. After simulated infant digestion of these samples, the bioavailability of key nutrients and immunomodulatory activities were determined via cell-based in vitro assays. A Caenorhabditis elegans leaky gut model was established to investigate cream effects on gut health. Distinct differences were observed in peptide diversity and sequences released from HC-IMF compared with LC-IMF during simulated digestion (p < 0.05). Higher levels of free fatty acids were absorbed through 21-day differentiated Caco-2/HT-29MTX monolayers from HC-IMF, compared with LC-IMF and HBM (p < 0.05). Furthermore, the immune-modulating properties of HC-IMF appeared to be more similar to HBM than LC-IMF, as observed by comparable secretion of cytokines IL-10 and IL-1β from THP-1 macrophages (p > 0.05). HC-IMF also supported intestinal recovery in C. elegans following distortion versus LC-IMF (p < 0.05). These observations suggest that cream as a lipid source in IMF may provide added nutritional and functional benefits more aligned with HBM. [ABSTRACT FROM AUTHOR]

The modular nutrients are mixtures or isolated macronutrients that can be enriched with micronutrients. Modules are generally added in pediatrics, to the formula or to enteral preparations, to increase the energy intake or some specific nutrient. The existing carbohydrate modules are: maltodextrins, cereals, corn starch. The protein modules comprise; the formula concentration as well as the addition of fortifiers and finally, the lipid modules are made up of vegetable oil, medium chain triglycerides and mixed mixtures. The osmolarity must be considered depending on the type of formula and module to be used, carbohydrate modules are generally the ones that increase osmolarity the most. The usefulness of adding nutritional modules in current pediatrics persists and is a beneficial tool in various pathologies and nutritional status. [ABSTRACT FROM AUTHOR]

Cow's milk protein allergy (CMPA) is a reproducible immune reaction to exposure to cow's milk proteins. The diagnosis of CMPA is based on an oral food challenge (OFC) after an elimination diet, and other complementary tests such as skin prick test (SPT) and serum IgE measurement (sIgE) are described. This article provides a comprehensive and up-to-date overview of CMPA; its pathophysiology, treatment and diagnosis. With emphasis on diagnostic methods and clinical considerations to avoid underdiagnosis or supradiagnosis of this pathology. The importance of intestinal microbiota in CMPA is also emphasized, and some specific non-IgE-mediated syndromes such as PLV-induced proctitis or proctocolitis and PLV-induced enterocolitis (FPIES) are mentioned. In summary. [ABSTRACT FROM AUTHOR]

Summary: Cow milk protein allergy (CMPA) is one of the most common food allergies in the pediatric age worldwide. Prevalence, persistence, and severity of this condition are on the rise, with a negative impact on the health‐related quality of life of the patients and families and on the costs related to its management. Another relevant issue is that CMPA in early life may be the first stage of the "allergic march," leading to the occurrence of other atopic manifestations later in life, especially asthma, atopic eczema, urticaria, and rhinoconjunctivitis. Thus, "disease modification" options that are able to modulate the disease course of pediatric patients affected by CMPA would be very welcomed by affected families and healthcare systems. In this review, we report the most relevant progress on this topic. [ABSTRACT FROM AUTHOR]

Objective: Many parents experience lack of support and access to resources on how to prepare, handle, and provide formula milk to their infants. The purpose of this scoping review was to map and describe key information in existing research about how healthcare professionals receive information and how they inform and counsel parents about formula milk. Design: A scoping review fulfilling the PRISMA‐ScR checklist criteria used systematic searches targeting the study objective in the databases Embase, MEDLINE, and CINAHL on February 8th and 9th, 2022. Results: Six studies with 959 participants in total were included. The research designs were focus group studies with and without combining individual interviews, an individual interview study, a study consisting of individual interviews and ethnographic observations, a survey, and a two‐phase study consisting of a qualitative interview and a quantitative survey. Findings indicate lack of evidence‐based information provided about infant formula by health care professionals when they counsel parents on formula feeding. Conclusions: Few studies focus on how healthcare professionals inform and counsel parents about formula milk. Health authorities should provide more evidence‐based information to make formula feeding more feasible. Due to conflicting and omitted information, mothers often receive poor counselling on formula feeding. [ABSTRACT FROM AUTHOR]

This study reviews global levels of ochratoxin A (OTA) in infant formula and cereal-based foods, using Monte Carlo simulation to assess risks. The review found 24 studies on global OTA levels in infant food and cereal-based products, using databases including PubMed, Scopus, Web of Science and Embase until March 2024. We estimated OTA exposure in infant food based on concentration, intake and body weight. The exposure and hazard quotient margin were calculated using BMDL10 and TDI values. Monte Carlo simulation evaluated human health risks from OTA in infant formula and cereal-based foods. A global study from 14 countries shows varying levels, surpassing EU limits in Tunisia, Ecuador, the USA, and generally in Africa, notably in infant cereals, which had higher levels than formula. Globally, OTA was present in 29.3% of the 3348 samples analyzed, with Lebanon at 95.2% and Brazil at 0%. Analysis indicates only non-carcinogenic risk for infants. While health risks for infants are mostly low, ongoing research and monitoring are vital to minimize OTA exposure in infant food. [ABSTRACT FROM AUTHOR]

The sensory quality of infant formula (IF) has a significant impact on the preferences and purchasing behavior of maternal consumers. Consumer-based rapid descriptive methods have become popular and are widely preferred over classical methods, but the application of Pivot Profile (PP) in IF is still little explored. In this study, both Pivot Profile (PP) and Quantitative Descriptive Analysis (QDA) were applied to characterize the sensory profile of 12 batches of one-stage and three-stage IF with different storage periods, respectively, along with consumer preference data to determine the flavors contributing to liking. The results of PP and QDA aligned moderately well, with the most perceptible differences identified as "fishy", "milky", and "T-sweet" attributes. IFs with shorter storage times were highly associated with "milky" aromas and "T-sweet" tastes, whereas IFs with longer storage times exhibited a strong correlation with "fishy" and "oxidation" aromas. External preference analysis highlighted that the occurrence of "fishy" and "oxidation" aromas during prolonged storage periods significantly reduced the consumer preference for IFs. Conversely, the perception of "milky" and "creamy" aromas and "T-sweet" tastes may be critical positive factors influencing consumer preference. This study provided valuable insights and guidance for enhancing the sensory quality and consumer preference of IF. [ABSTRACT FROM AUTHOR]

Polyunsaturated fatty acids (PUFAs), especially arachidonic acid (ARA) and docosahexaenoic acid (DHA), are extremely important fatty acids for brain development in the fetus and early childhood. Premature infants face challenges obtaining these two fatty acids from their mothers. It has been reported that supplementation with triacylglycerols (TAGs) with an ARA:DHA (w/w) ratio of 2:1 may be optimal for preterm infants, as presented in commercial formulas such as Formulaid™. This study explored methods to produce TAGs with a 2:1 ratio (ARA:DHA), particularly at the more bioavailable sn-2 position of the glycerol backbone. Blending and enzymatic acidolysis of microalgae oil (rich in DHA) and ARA-rich oil yielded products with the desired ARA:DHA ratio, enhancing sn-2 composition compared to Formulaid™ (1.6 for blending and 2.3 for acidolysis versus 0.9 in Formulaid™). Optimal acidolysis conditions were 45 °C, a 1:3 substrate molar ratio, 10% Candida antarctica lipase, and 4 h. The process was reproducible, and scalable, and the lipase could be reused. In vitro digestion showed that 75.5% of the final product mixture was bio-accessible, comprising 19.1% monoacylglycerols, ~50% free fatty acids, 14.6% TAGs, and 10.1% diacylglycerols, indicating better bio-accessibility than precursor oils. [ABSTRACT FROM AUTHOR]

Abstract Background The International Code of Marketing of Breast-milk Substitutes, or ‘the Code,’ sets standards to regulate marketing of commercial milk formula (CMF) to protect breastfeeding. World Health Organization member states are advised to legislate the Code into national law, but understanding of its implementation outcomes is limited. This systematic review aimed to examine implementation outcomes in countries implementing the Code as national law. Methods We systematically searched five academic databases in September 2022 for articles published in English from 1982 to 2022. We double-screened titles/abstracts and then full texts for eligible articles reporting implementation outcomes of the Code in 144 eligible countries. We used the Mixed Methods Appraisal Tool for quality assessment and synthesized data thematically. We applied the Proctor et al. framework to guide synthesis of implementation outcomes, organizing our findings according to its taxonomy. Results We included 60 eligible articles of the 12,075 screened, spanning 28 countries. Fifty-seven articles focused on legal compliance, 5 on acceptability, and 1 on feasibility. Compliance was assessed across multiple sources, including mothers, health workers, media, points of sale, and product labels. Maternal exposure to CMF promotion remained widespread, with reports of mothers receiving free samples and coupons, and encountering media advertisements. Compliance of health workers varied across countries, with many reporting contact with CMF companies despite legal prohibitions. Public hospitals generally showed better adherence to the national law than private ones. While implementing the Code as national law effectively regulated the promotion of CMF for infants aged 0–12 months in public settings and in the media, it remains insufficient in addressing the promotion of unregulated products like growing-up milk, which are often marketed through emerging strategies such as cross-promotion and digital advertising. Point-of-sales compliance was inconsistent, with many countries reporting non-compliant price-related promotions. Conclusion To enhance legal compliance, robust monitoring and reporting systems are necessary. Utilizing technology-assisted solutions for monitoring compliance can be an option for countries with limited human resources. Adequate training for health workers and communication strategies targeting shop managers about national law are also essential in enhancing their acceptability and compliance.

Purpose: Necrotizing enterocolitis (NEC) is the most severe gastrointestinal disease in preterm infants caused by an exaggerated intestinal epithelial immune activation. Several studies show that modulation of toll-like receptor 9 (TLR9) activity may have positive effects on preventing intestinal inflammatory mechanisms ultimately resulting in NEC development. In this study, the effect of various infant formulas (IF) and the probiotic strain Limosilactobacillus fermentum CECT5716 on TLR9 activation were analyzed in vitro. Methods: First, TLR4 and TLR9 expression was analyzed on human primary intestinal epithelial cells (P-IECs) by qPCR and Western blot analysis. Then genetically designed HEK-Dual™ hTLR9 (NF/IL8) reporter cells (HEK-Dual) were treated with different IFs, L. fermentum CECT5716, and different functional components to measure TLR9 activation via luminescence. Finally, the IFs were investigated in P-IECs to analyze TLR downstream signaling by Western blot analysis. Results: IFs containing intact protein and L. fermentum CECT5716 activated TLR9 in HEK-Dual cells, but the functional components lactoferrin, L-5-methyltetrahydrofolate, and hydrolyzed whey proteins failed to activate TLR9. In P-IECs, the IFs induced increased phosphorylation of MAPK8/9 of the TLR signaling pathway and significantly reduced IL6 levels. Consistently, IL6 levels were increased in P-IECs when TLR9-signaling was inhibited. Interestingly, L. fermentum CECT5716 enhanced TLR9-signaling and increased NF-kappa-B inhibitor alpha-phosphorylation. Conclusion: We found out that the used control formula, prebiotic formula, prebiotic formula with hydrolyzed-protein, and L. fermentum CECT5716 reduce IL6 levels in human P-IECs through TLR9 activation. L. fermentum CECT5716 and the here tested IFs could be a promising approach for modulation of gut health in infants. [ABSTRACT FROM AUTHOR]

Abstract Melamine is a recognized food contaminant that can arise incidentally or intentionally in specific categories of food. This study aimed to validate the melamine detection and quantification in infant formula and milk powders and also analyzed 40 samples consist of infant formula and milk powders from commercially available food products, from different geographic regions of Iran. The approximate content of melamine in samples was measured by High-performance liquid chromatography-ultra violet (HPLC–UV) system. A calibration curve (R2 = 0.9925) was established for detection of melamine in the range of 0.1–1.2 μg mL−1. Limit of quantification and limit of detection were 1 μg mL−1 and 3 μg mL−1, respectively. The presence of melamine in infant formula and milk powdered was investigated and it was observed that the amount of melamine in samples of infant formulas and milk powders was 0.001–0.095 mg kg−1 and 0.001–0.004 mg kg−1, respectively. These values were found to be within the prescribed limits by the European Union and Codex Alimentarius Commission legislation. It is important to note that the consumption of these dairy products, which contain low content of melamine, does not pose any significant threat to consumer health. Furthermore, the results of the risk assessment confirmed this issue.

Melamine is a recognized food contaminant that can arise incidentally or intentionally in specific categories of food. This study aimed to validate the melamine detection and quantification in infant formula and milk powders and also analyzed 40 samples consist of infant formula and milk powders from commercially available food products, from different geographic regions of Iran. The approximate content of melamine in samples was measured by High-performance liquid chromatography-ultra violet (HPLC–UV) system. A calibration curve (R2 = 0.9925) was established for detection of melamine in the range of 0.1–1.2 μg mL−1. Limit of quantification and limit of detection were 1 μg mL−1 and 3 μg mL−1, respectively. The presence of melamine in infant formula and milk powdered was investigated and it was observed that the amount of melamine in samples of infant formulas and milk powders was 0.001–0.095 mg kg−1 and 0.001–0.004 mg kg−1, respectively. These values were found to be within the prescribed limits by the European Union and Codex Alimentarius Commission legislation. It is important to note that the consumption of these dairy products, which contain low content of melamine, does not pose any significant threat to consumer health. Furthermore, the results of the risk assessment confirmed this issue. [ABSTRACT FROM AUTHOR]

Supplementing infant formulas (IFs) with oligosaccharides has gathered much attention over the years because of their purported disease-protecting and health-promoting properties. Despite various clinical trials evaluating the health efficacy of such formulas, many lacked rigor, producing conflicting results. This systematic review focuses on human intervention trials that have examined the purported effects of oligosaccharide-supplemented IFs on the gastrointestinal health in formula-fed infants There is strong evidence showing that supplementing IFs with fructooligosaccharides (FOS) or galactooligosaccharides (GOS) at 7–8 g/L, or other naturally-occurring oligosaccharides or synthetic human-milk oligosaccharides (HMOs) at up to 5.8 g/L, as per industry standards, is well-tolerated by infants, effective in increasing stool frequency and softening of stools, promoting the growth of Bifidobacterium spp. and moderate evidence for reducing the risk of enteric infections. However, the evidence related to the effectiveness of oligosaccharide supplementation in enhancing short-chain fatty acid production, improving gut barrier function, modulating immune function, and reducing the severity and incidence of allergic diseases remains weak and inconclusive and requires further investigation. Supplementation of IFs with oligosaccharides had no demonstrable effect on the growth rate of infants. Thus, further well-designed, randomized, placebo-controlled studies are needed to unequivocally demonstrate other health benefits of oligosaccharide-supplemented IFs. [ABSTRACT FROM AUTHOR]

Many improvements have been made to bring infant formula (IF) closer to human milk (HM) regarding its nutritional and biological properties. Nevertheless, the protein components of HM and IF are still different, which may affect their digestibility. This study aimed to evaluate and compare the protein digestibility of HM and IF using the infant INFOGEST digestion method. Pooled HM and a commercial IF were subjected to the infant INFOGEST method, which simulates the physiological digestion conditions of infants, with multiple directions, i.e. the curd state, gel images of SDS-PAGE, molecular weight distribution, free amino acid concentrations and in vitro protein digestion rate. HM underwent proteolysis before digestion and tended to have a higher protein digestion rate with finer curds during gastric digestion, than the IF. However, multifaceted analyses showed that the protein digestibility of HM and IF was not significantly different after gastrointestinal digestion. In conclusion, the infant INFOGEST method showed that the digestibility of HM and IF proteins differed to some extent before digestion and after gastric digestion, but not at the end of gastrointestinal digestion. The findings of this study will contribute to the refinement of IF with better protein digestibility in infant stomach. [ABSTRACT FROM AUTHOR]

In many parts of the world, goat milk has been part of the human diet for millennia. Allergy to goat's milk, not associated with allergy to cow's milk, is a rare disorder, although some cases have been described. Goat milk proteins have substantial homology with cow's milk proteins and even show cross-reactivity; therefore, they are not advised as an alternative to cow's milk for infants with IgE-mediated cow's milk allergies. However, there are indications that, due to the composition of the goat milk proteins, goat milk proteins show lower allergenicity than cow's milk due to a lower αS1-casein content. For this reason, goat milk might be a better choice over cow's milk as a first source of protein when breastfeeding is not possible or after the breastfeeding period. Additionally, some studies show that goat milk could play a role in specific types of non-IgE-mediated cow milk allergy or even in the prevention of sensitization to cow's milk proteins. This review discusses a possible role of goat milk in non-IgE mediated allergy and the prevention or oral tolerance induction of milk allergy. [ABSTRACT FROM AUTHOR]

Infant formulas and their quality are an extremely important factor for proper growth and development and their composition and nutritional quality are extremely important. Fast, green, and cheap quality analysis methods are definitely desirable. Therefore, the aim of this work was to examine the potential of applying near-infrared (NIR) spectroscopy using two devices: a (i) laboratory NIR analyzer and (ii) portable NIR device. Both devices record the vibrations of molecules in the NIR region of 900–1699 nm. Infant formulas intended for children up to 6 months (n = 6) and for infants with a sensitive digestive system or confirmed allergy to cow's milk proteins (n = 5) were tested. Each infant formula was recorded in the form of powder and in the form of prepared samples corresponding to different ages, according to the instructions on the product declaration. The parameters of color, conductivity, and total dissolved solids (TDS) were also measured. The measured parameters and the chemical composition of infant formulas were associated with NIR spectra and with the application of chemometric tools (principal component analysis (PCA) and partial least squares regression (PLSR)), the similarity and/or difference between the samples was determined and the qualitative/quantitative potential was determined through applications of both devices. Characteristic peaks at certain wavelengths indicate the presence of carbohydrates, proteins, and water were identified and are specific for regular and specific purpose infant formulas. It is precisely these specificities in the composition, which are visible in the NIR spectrum, that make it possible to distinguish samples on a qualitative level. The connection of NIR spectra as input variables and 22 parameters (color, TDS, conductivity, and energy–nutrient composition) as output variables, using PLSR, gave an insight into the quantitative potential, i.e., the possibility of predicting the observed parameters on the basis of NIR spectra (recorded using two devices). The quantitative potential was confirmed on the basis of model parameters that resulted in acceptable values for both NIR devices: the coefficient of determination for the calibration, Rc2 > 0.9, and Range Error Ratio, RER > 6. [ABSTRACT FROM AUTHOR]

In the melamine scandals of the early 2000s, different companies of the dairy industry cheated their products by applying chemical substances to feign a higher content of nitrogen. However, this had a severe toxic impact on the kidney health of consumers. As a result, tremendous effort was put into the prevention of further harm to the public. In the present study, a fast–screening method for the determination of melamine and cyanuric acid in infant formula was developed. While a 1D–LC approach is faster and easier to set up, a 2D–LC approach allows for a more accurate result with better selectivity and sensitivity. For both instrumental approaches, the signal ratio of the isotopologues was crucial and had a dominant effect on the results and the measurement uncertainty. For this reason, the different contributions to the measurement uncertainty were determined experimentally using Matched Standard Addition–IDMS and compared to the Exact Matching Double IDMS. [ABSTRACT FROM AUTHOR]

Given the limited evidence, there is no conclusive proof of the neurocognitive benefits of bovine milk fat globule membrane supplementation in infant formula. This study evaluates the neurocognitive benefits of bovine milk fat globule membrane supplementation in formula, comparing it to standard formula and assessing its noninferiority to breast milk. Data were sourced from studies published between January 2000 and March 2024 from PubMed, Cochrane Library, Web of Science, and Embase. Eight randomized controlled trials involving 1352 healthy term neonates, infants, and children up to 2 years old were included. Bovine milk fat globule membrane supplementation was significantly associated with improved cognitive development (mean difference: 3.29, 95% CI: 1.65 to 4.93, p < 0.001) and demonstrated minimal heterogeneity (I2 = 0%, p = 0.564). It showed significant improvement in executive function but not in language, motor, or social-emotional development. In non-inferiority analysis, there was no significant difference compared to breast milk regarding cognitive development. These findings support bovine milk fat globule membrane as a valuable addition to infant formula for cognitive benefits. [ABSTRACT FROM AUTHOR]

The potential of focused beam reflectance measurement (FBRM) and electrical resistance tomography (ERT) was evaluated as on‐line process analytical technologies (PAT) for monitoring powder rehydration. Skim milk powder (SMP) and stage one infant formulas were evaluated. Among all samples, SMP had the greatest conductivity by ERT (P < 0.05), this was confirmed by off‐line methods, that is, SMP had a higher solubility, whereas infant formulas had lower solubility. Particle counts for fines of all samples reached peak values ~450 s. Results demonstrated PAT tools offer capability for rehydration characterisation of dairy and non‐dairy powders. [ABSTRACT FROM AUTHOR]

Bottles and teats are ubiquitously used for feeding infants and young children. Yet there are limited empirical studies on the scope of infant feeding bottles, their attributes, or their marketing claims. We report the first comprehensive survey on infant feeding bottles and teats in Germany. We aimed to explore the extent of bottles and teats available in Germany, describe their physical attributes and analyze their marketing claims. A cross‐sectional survey of German bottle and teat manufacturer websites was conducted between June and November 2022. Product attributes are presented with descriptive statistics and photographs. Marketing claims are summarized in a descriptive content analysis. We identified 41 brands encompassing 447 unique products (226 bottles, 221 teats). The majority of bottles were plastic (147, 65%) or glass (64, 28%), and the majority of teats were silicone (188, 85%). Most brands (38, 93%) promoted products using one or more inappropriate marketing claims, including equivalency to breastfeeding (29, 73%), idealization through technical or medical descriptions (23, 58%), claims on disease prevention (31, 78%), references to naturalness (29, 73%), infant autonomy (10, 25%), and endorsements from parents (10, 25%) or health professionals (11, 28%). The majority of bottles and teats available in Germany appear to be marketed inappropriately and hold the potential to undermine public health recommendations on infant and young child feeding. Therefore, we recommend Germany strengthens legislation on the marketing of bottles and teats in accordance with the International Code of Marketing of Breastmilk Substitutes. Key messages: There is limited research on infant feeding bottles and teats or their marketing claims.Most infant feeding bottle brands identified (38, 93%) promoted products using one or more inappropriate marketing claims.No national legislation currently exists to restrict misleading marketing claims on infant feeding bottles and teats.Large bottle volumes, teats designed for feeding complementary foods and nonstandardized language for teat flow rates may promote overfeeding, overweight and obesity.Bottles and teats should be made of safe materials, be designed for easy cleaning, meet specified European standards and reference the European safety standard. [ABSTRACT FROM AUTHOR]

Cronobacter species are opportunistic pathogens that are capable of causing morbidity and mortality, particularly in infants. Although the transmission dynamics involved in Cronobacter infections remain largely unknown, contaminated powdered infant formula (PIF) has been linked to 30% of Cronobacter sakazakii cases involving invasive illness in infants. As several lines of evidence have implicated the domestic environment in PIF contamination, we undertook a microbiological survey of homes (N = 263) across the US. Cronobacter spp. and C. sakazakii were isolated from 36.1% and 24.7% of US homes, respectively, with higher recovery rates observed for floor and kitchen surfaces. Multi-locus sequence typing indicated that the dominant strain was C. sakazakii ST4, the sequence type most commonly associated with neonatal meningitis. For comparison purposes, retail foods (N = 4,009) were also surveyed, with the highest contamination frequencies (10.1%-26.3%) seen for nut products, seeds, and grains/baked goods/flours. The sequence type profile of isolates recovered from homes mirrored that of isolates recovered from retail foods, with increased representation of ST1, ST4, ST13, ST17, and ST40. Analysis of 386 whole genomic sequences revealed significant diversity. Redundancies were only observed for isolates recovered from within the same domicile, and there were no identical matches with sequences archived at the NCBI pathogen database. Genes coding for putative virulence and antibiotic resistance factors did not segregate with clinically significant sequence types. Collectively, these findings support the possibility that contamination events occurring within the home should not be overlooked as a contributor to community-onset Cronobacter infections. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Human milk is universally regarded as the gold standard to fulfill nutrition needs of infants. Lactoferrin (LF) is a major multiple bioactive glycoprotein in human milk but little is presented in infant formula. LF can resist digestion in the infant gastrointestinal tract and is absorbed into the bloodstream in an intact form to perform physiological functions. Evidence suggest that LF prevents pathogen infection, promotes immune system development, intestinal development, brain development and bone health, as well as ameliorates iron deficiency anemia. However, more clinical studies of LF need to be further elucidated to determine an appropriate dosage for application in infant formula. LF is sensitive to denaturation induced by processing of infant formula such as heat treatments and spay drying. Thus, further studies should be focus on maximizing the retention of LF activity in the infant formula process. This review summarizes the structural features of LF. Then the digestion, absorption and metabolism of LF in infants are discussed, followed by the function of LF for infants. Further, we summarize LF in infant formula and effects of processing of infant formula on bioactivities of LF, as well as future perspectives of LF research. [ABSTRACT FROM AUTHOR]

Quantify and compare reported breastfeeding support practices in the Baby-Friendly Hospital Initiative (BFHI) and non-BFHI facilities. Cross-sectional survey. Regions across the US. Two hundred and eighty-six facilities (110 BFHI and 176 non-BFHI) selected by a stratified (by hospital size) random sample of 50% BFHI and 50% non-BFHI facilities. Emailed survey Fall 2019 through Spring 2020. Reported adherence to the 10 Steps to Successful Breastfeeding. Wilcoxon rank sum test with continuity correction, Pearson chi-square test of independence, and Fisher's exact test. Baby-Friendly Hospital Initiative facilities were more likely to report adherence to the 10 Steps to Successful Breastfeeding. Only 2 of the reported steps were not significantly different: immediate postnatal care and responsive feeding. This research supports breastfeeding support interventions within hospitals as both BFHI and non-BFHI facilities have room for improvement. Interventions targeting non-BFHI facilities are an opportunity to close the disparity in breastfeeding care. [ABSTRACT FROM AUTHOR]

Milk bioactivity refers to the specific health effects of milk components beyond nutrition. The science of milk bioactivity involves the systematic study of these components and their health effects, as verified by empirical data, controlled experiments, and logical arguments. Conversely, 'faith in milk bioactivity' can be defined as personal opinion, meaning, value, trust, and hope for health effects that are beyond investigation by natural, social, or human sciences. Faith can be strictly secular, but also influenced by spirituality or religion. The aim of this paper is to show that scientific knowledge is frequently supplemented with faith convictions to establish personal and public understanding of milk bioactivity. Mammalian milk is an immensely complex fluid containing myriad proteins, carbohydrates, lipids, and micronutrients with multiple functions across species, genetics, ages, environments, and cultures. Human health includes not only physical health, but also social, mental, and spiritual health, requiring widely different fields of science to prove the relevance, safety, and efficacy of milk interventions. These complex relationships between milk feeding and health outcomes prevent firm conclusions based on science and logic alone. Current beliefs in and understanding of the value of breast milk, colostrum, infant formula, or isolated milk proteins (e.g., immunoglobulins, α-lactalbumin, lactoferrin, and growth factors) show that both science and faith contribute to understand, stimulate, or restrict the use of milk bioactivity. The benefits of breastfeeding for infants are beyond doubt, but the strong beliefs in its health effects rely not only on science, and mechanisms are unclear. Likewise, fear of, or trust in, infant formula may rely on both science and faith. Knowledge from science safeguards individuals and society against 'milk bioactivity superstition'. Conversely, wisdom from faith-based convictions may protect science from unrealistic 'milk bioactivity scientism'. Honesty and transparency about the potentials and limitations of both scientific knowledge and faith convictions are important when informing individuals and society about the nutritious and bioactive qualities of milk. [ABSTRACT FROM AUTHOR]

The binding ratio of palmitic acid (PA) at the sn-2 position of triacylglycerols in infant formulas is lower than that in breast milk, resulting in higher levels of fecal PA. Even if the ratio is increased to 40–50%, fecal PA levels in formula-fed infants remain higher than those in breast–fed infants. In Japan, infant formulas with 50% or more of PA bound to sn-2 (high sn-2 PA milk) are commercially available; however, their effects on PA excretion have not been investigated. Therefore, this observational study aimed to preliminarily evaluate whether the feeding volume of high sn-2 PA milk is significantly associated with fecal total/soaped PA levels in newborns. Infant formulas were classified as high (≥50% of PA bound to sn-2) or low sn-2 (<50%) PA milk. Associations between feeding volume of high or low sn-2 PA milk and fecal PA levels were evaluated using multiple regression analysis models. The results showed that the feeding volume of low sn-2 PA milk was positively associated with fecal total/soaped PA levels, while there was no significant association between those of high sn-2 PA milk and fecal total/soaped PA levels. Our preliminary study suggests that high sn-2 PA milk may reduce increased fecal PA levels in formula-fed newborns. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The coronavirus disease 2019 (COVID-19) pandemic increased food insecurity among US households, however, little is known about how infants, who rely primarily on human milk and/or infant formula, were impacted. We conducted an online survey with US caregivers of infants under 2 years of age (N = 319) to assess how the COVID-19 pandemic impacted breastfeeding, formula-feeding and household ability to obtain infant-feeding supplies and lactation support (68% mothers; 66% White; 8% living in poverty). We found that 31% of families who used infant formula indicated that they experienced various challenges in obtaining infant formula, citing the following top three reasons: the formula was sold out (20%), they had to travel to multiple stores (21%) or formula was too expensive (8%). In response, 33% of families who used formula reported resorting to deleterious formula-feeding practices such as diluting formula with extra water (11%) or cereal (10%), preparing smaller bottles (8%) or saving leftover mixed bottles for later (11%). Of the families who fed infants human milk, 53% reported feeding changes directly as a result of the pandemic, for example, 46% increased their provisioning of human milk due to perceived benefits for the infant's immune system (37%), ability to work remotely/stay home (31%), concerns about money (9%) or formula shortages (8%). Fifteen percent of families who fed human milk reported that they did not receive the lactation support they needed and 4.8% stopped breastfeeding. To protect infant food and nutrition security, our results underscore the need for policies to support breastfeeding and ensure equitable and reliable access to infant formula.

BackgroundIn May of 2022, parents living in the United States experienced a dramatic infant formula shortage caused by supply chain issues and the recall of several infant formula products over contamination concerns.MethodsAn anonymous, electronic, cross-sectional survey was designed to understand infant feeding practices, parental experience and perceived support during the crisis.ResultsNinety-nine parents that lived in the U.S. and fulfilled study criteria completed the survey. 66% of respondents were female, and 75% of respondents were recipients of the Special Supplemental Nutrition Program for Women Infant Children (WIC). Parental mean age was 30.0 years, and the mean infant age was 26.8 weeks. The number of individuals that used at least one unsafe infant feeding practice increased from 8% before the infant formula shortage to 48.5% during the shortage (p

Background: Early formula supplementation (EFS, formula on birthdate or day after) is associated with maternal obesity and reduced breastfeeding, but the effect of prenatal breastfeeding intention on these relationships is understudied. Objectives: We evaluated how EFS affected breastfeeding outcomes after controlling for obesity, sociodemographic and health factors. Methods: Multivariable regression modeling, stratified by prenatal breastfeeding intention. Conclusions: Our findings suggest that EFS may be less disruptive to breastfeeding in mothers with strong intention to meet breastfeeding recommendations, regardless of maternal BMI.

Abstract The evidence regarding the association between infant formula (IF) composition and the prevention of allergy and respiratory diseases remains sparse and inconclusive. This study aimed to evaluate whether some IF characteristics were associated with the risk of allergy or respiratory diseases in childhood. Among 1243 formula‐fed children from the EDEN mother–child cohort, IF characteristics concerning long‐chain polyunsaturated fatty acids (LCPUFAs) enrichment, prebiotic/probiotic enrichment, and hydrolysis of proteins were identified from the ingredients list. Eczema, wheezing, food allergy, asthma, and allergic rhinitis up to age 8 years were prospectively collected and summarized into four allergic and respiratory multimorbidity clusters. Associations between 4‐month IF characteristics and risk of allergy or respiratory diseases were tested using logistic regressions adjusted on main confounders. The consumption of LCPUFA‐enriched formula was not linked to allergic and respiratory multimorbidity clusters, but to a lower risk of any allergy, eczema, and wheezing. Probiotic‐enriched formula consumption was associated with a lower risk of belonging to the ‘Allergy without asthma’ cluster (odds ratio [OR] [95% confidence interval, CI] = 0.63 [0.40–0.99]), and consumption of a formula enriched in Bifidobacterium lactis was associated with a lower risk of any allergy (OR [95% CI] = 0.59 [0.41–0.85]). Partially hydrolysed formula (pHF) consumption was associated with a higher risk of belonging to the ‘Allergy without asthma’ cluster (OR [95% CI] = 2.73 [1.65–4.51]). This study confirms the positive association between pHF consumption and the risk of allergy found in previous observational studies and suggests that consumption of LCPUFA‐enriched or probiotic‐enriched formula was associated with a lower risk of allergy.