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Moreira DH, Gregory SB, Younge NE. Human milk fortification and use of infant formulas to support growth in the neonatal intensive care unit. Nutr Clin Pract 2023; 38 Suppl 2:S56-S65. [PMID: 37721458 PMCID: PMC10662944 DOI: 10.1002/ncp.11038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/03/2023] [Accepted: 06/10/2023] [Indexed: 09/19/2023] Open
Abstract
Newborn infants require adequate nutrition to achieve full potential growth and development. Early life nutrition and health impacts long-term outcomes through adulthood. Human milk is the optimal source of nutrition during the first 6 months of life. However, infants admitted to the neonatal intensive care unit (NICU) often have comorbidities that create more or different nutrition demands than healthy newborns. There are different strategies to meet the nutrition needs of sick newborns, including use of parenteral nutrition, human milk fortifiers (HMFs), and infant formulas. Multinutrient HMFs are frequently used to achieve the higher nutrition demands of preterm infants. They are available in various presentations, such as human milk- or cow milk-derived, liquid or powder, and acidified or nonacidified, each of which has different risks and benefits associated with its use. Infant formulas are available to meet a demand when mother's own milk or donor breast milk is not available or sufficient, and there are also specialty formulas for infants with certain diseases that present unique nutrition needs. This review is focused on the use of HMFs to support the unique nutrition requirements of preterm infants for healthy growth, as well as the indications for the use of formulas among infants in the NICU.
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Affiliation(s)
- Denise H Moreira
- Department of Pediatrics, Division of Neonatology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sarah B Gregory
- Department of Pediatrics, Division of Neonatology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Noelle E Younge
- Department of Pediatrics, Division of Neonatology, Duke University School of Medicine, Durham, North Carolina, USA
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Decker JE, Delahanty MT, Davey A, Robson SM, Trabulsi JC. Human Milk, Infant Formula, and Other Milks Fed to Infants and Toddlers in the United States, NHANES 2007-2018. J Acad Nutr Diet 2023; 123:1320-1328.e3. [PMID: 36332789 DOI: 10.1016/j.jand.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND For the first time, the 2020-2025 Dietary Guidelines for Americans provide specific guidance regarding the types of foods and beverages that should be offered in the first 2 years of life. Milk, in various forms (eg, human milk, infant formula, and cow's milk) contributes a large proportion of key nutrients to the diets of infants and toddlers in the United States. OBJECTIVE The aim of this study was to determine the types of milk (human milk, infant formula, and other milk) fed to US infants and toddlers in the past 12 years and to describe trends over time. DESIGN This was a cross-sectional analysis of 2-day, 24-hour dietary recalls. PARTICIPANTS/SETTING Data from the 2007-2018 National Health and Nutrition Examination Survey were used for these analyses. Infants and toddlers aged 0 through 23.9 months with 2 days of dietary recall data (n = 3,079) were included. MAIN OUTCOME MEASURES The main outcome was proportion of infants and toddlers fed different milk types. STATISTICAL ANALYSES PERFORMED Survey-adjusted weighted percentages were used to report sociodemographic characteristics and the proportion of subjects fed each milk type category by age group and survey cycles. Binary and multinomial logistic regressions were used to assess differences in subject characteristics by age groups. RESULTS Sociodemographic characteristics did not differ by age group. The proportion of infants aged 0 to <6 months fed infant formula only was 60.2% in 2007-2012 and 44.8% in 2013-2018. The proportion of infants aged 6 to <12 months fed partially hydrolyzed infant formula only was 7.3% in 2007-2012 and 13.1% in 2013-2018. In toddlers (>12 months old), cow's milk was the predominant milk type in both 2007-2012 and 2013-2018. CONCLUSIONS The percentage of infants fed any human milk increased over the past decade. Unsweetened cow's milk was the most predominate milk type consumed among toddlers.
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Affiliation(s)
- Jessica E Decker
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Michelle T Delahanty
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Adam Davey
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Jillian C Trabulsi
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware.
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Boutsikou T, Sekkidou M, Karaglani E, Krepi A, Moschonis G, Nicolaou N, Iacovidou N, Pancheva R, Marinova-Achkar M, Popova S, Kapetanaki A, Iliodromiti Z, Papaevangelou V, Sardeli O, Papathoma E, Schaafsma A, Bos R, Manios Y, Xepapadaki P. The Impact of Infant Feeding Regimen on Cow's Milk Protein Allergy, Atopic Dermatitis and Growth in High-Risk Infants during the First 6 Months of Life: The Allergy Reduction Trial. Nutrients 2023; 15:nu15112622. [PMID: 37299585 DOI: 10.3390/nu15112622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The development of early-onset cow's milk protein allergy and atopic dermatitis during the first months of life is multifactorial, including both genetic and nutritional aspects. This study aims to assess the impact of different feeding patterns on the incidence of cow's milk protein allergy, atopic dermatitis, and growth among infants with a family history of allergy. A total of 551 high-risk infants were randomly recruited from 3 European countries in three feeding regimens: exclusive breastfeeding, partially hydrolyzed formula, or standard formula with intact protein either exclusively or supplementary to breastfeeding. During the first 6 months of intervention, amongst infants with a family history of atopic dermatitis, 6.5% of partially hydrolyzed formula-fed infants and 22.7% of exclusively breastfed infants (p = 0.007) presented with atopic dermatitis respectively. Growth as assessed by weight increase did not differ between the aforementioned groups. Although cow's milk protein allergy was not related to the different milk feeding regimens in the whole cohort, when adjusting for high breast milk intake, the respective incident was significantly lower in the infants consuming partially hydrolyzed formula (p < 0.001). This data indicates that a specific partially hydrolyzed formula could serve as a more appropriate complement to breast milk compared to a standard intact protein formula in high-risk infants, to reduce the incidence of atopic dermatitis.
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Affiliation(s)
- Theodora Boutsikou
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - Mikaela Sekkidou
- Asthma and Allergy Center, 3025 Limassol, Cyprus
- University of Nicosia Medical School, 2408 Nicosia, Cyprus
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 17671 Athens, Greece
| | - Adamantia Krepi
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - George Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
| | - Nicolaos Nicolaou
- Asthma and Allergy Center, 3025 Limassol, Cyprus
- University of Nicosia Medical School, 2408 Nicosia, Cyprus
| | - Nicoletta Iacovidou
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - Rouzha Pancheva
- Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, 9000 Varna, Bulgaria
| | - Miglena Marinova-Achkar
- Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, 9000 Varna, Bulgaria
| | - Simoneta Popova
- Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, 9000 Varna, Bulgaria
| | - Anastasia Kapetanaki
- Neonatal Intensive Care Unit, General and Maternity Hospital Elena Venizelou, 11521 Athens, Greece
| | - Zoi Iliodromiti
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - Vassiliki Papaevangelou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, ATTIKON General University Hospital, 12462 Athens, Greece
| | - Olympia Sardeli
- Third Department of Pediatrics, National and Kapodistrian University of Athens, ATTIKON General University Hospital, 12462 Athens, Greece
| | - Evangelia Papathoma
- Neonatal Intensive Care Unit, Alexandra General Hospital, 11528 Athens, Greece
| | | | - Rolf Bos
- FrieslandCampina, 3818 LE Amersfoort, The Netherlands
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 17671 Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15771 Athens, Greece
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Otten L, Schelker E, Petersen H, Nomayo A, Fleddermann M, Arendt BM, Britzl T, Haberl EM, Jochum F. Safety and Suitability of an Infant Formula Manufactured from Extensively Hydrolysed Protein in Healthy Term Infants. Nutrients 2023; 15:1901. [PMID: 37111119 PMCID: PMC10146495 DOI: 10.3390/nu15081901] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
We aimed to demonstrate that healthy term infants experience noninferior growth with infant formula manufactured from extensively hydrolysed whey protein (eHF) compared to intact cow's milk protein (control formula, CF). This prospective, randomised, double-blind, parallel-group, controlled, multicentre trial included healthy term infants who were exclusively formula-fed. Infants ≤ 25 days of age received eHF or CF for at least three months up to 120 days of age, with a follow-up until 180 days of age. A reference group included exclusively breastfed infants (BF). Of 318 infants randomised, 297 (148 CF, 149 eHF) completed the study per protocol. Weight gain up to 120 days of age was noninferior (margin -3.0 g/day) in eHF (28.95 (95% CI: 27.21; 30.68) g/day) compared to CF (28.85 (95% CI: 27.10; 30.61) g/day) with a difference in means of 0.09 g/day and a lower limit of the one-sided 97.5% CI of -0.86 g/day (p < 0.0001 for noninferiority testing). Weight gain remained comparable during follow-up. Further anthropometric parameters did not differ between the infant formula groups throughout the study. Growth was comparable in BF. No relevant safety issues were observed. To conclude, eHF meets infant requirements for adequate growth during the first six months of life and can be considered safe and suitable.
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Affiliation(s)
- Lindsey Otten
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Elisabeth Schelker
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Hanna Petersen
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Antonia Nomayo
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Manja Fleddermann
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Bianca M. Arendt
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Theresa Britzl
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Elisabeth M. Haberl
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Frank Jochum
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
- Brandenburg Medical School Theodor Fontane (MHB), Fehrbelliner Str. 38, 16816 Neuruppin, Germany
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Li M, Fang Y, Lian Y, Lu X, Qiu M, He Y. Effect of hydrolyzed formulas on gastrointestinal tolerance in preterm infants: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2022; 35:10173-10180. [DOI: 10.1080/14767058.2022.2122794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Mengyuan Li
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Yuehui Fang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Yiyao Lian
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Xiaodi Lu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Meijuan Qiu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Yuna He
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
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Qin A, Li X, Yang F, Yang J, Li H, Li H, Yu J. Extensively hydrolysed sodium caseinate. Part I: selection of enzymes, molecular mass distribution, and allergy site analysis by liquid chromatography-mass spectrometry. Int Dairy J 2022. [DOI: 10.1016/j.idairyj.2022.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hydrolysierte Säuglingsnahrung für die Allergieprävention – wissenschaftliche Evidenz und Empfehlungen für die Praxis. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Zusammenfassung
Hintergrund
Laut S3-Leitlinie „Allergieprävention“ (Update 2021) soll bei nicht (voll) gestillten Säuglingen mit erhöhtem Allergierisiko geprüft werden, ob eine Säuglingsnahrung mit nachgewiesener allergiepräventiver Wirksamkeit verfügbar ist. Einige Hersteller bewerben ihre Produkte entsprechend.
Ziel der Arbeit
Der Artikel gibt einen Überblick über die wissenschaftliche Evidenz und internationale Empfehlungen zum Einsatz von hydrolysierter Säuglingsnahrung (sog. hypoallergene [HA-]Nahrung) zur Prävention von atopischen Erkrankungen.
Materialien und Methoden
In medizinischen Datenbanken wurde eine Literaturrecherche (Zeitraum: 2016–2021) zum Nutzen von hydrolysierten Säuglingsnahrungen für die Allergieprävention bei Risikokindern und zu entsprechenden internationalen Leitlinien durchgeführt. Auf dieser Basis wurden die aktuelle Empfehlung der deutschen S3-Leitlinie sowie die Produkte auf dem deutschen Markt eingeordnet.
Ergebnisse
Es gibt keine hinreichenden Belege für einen generellen allergiepräventiven Nutzen von Säuglingsnahrungen mit Proteinhydrolysat bei Säuglingen mit erhöhtem Allergierisiko. Die GINI-Interventionsstudie deutet darauf hin, dass eine der eingesetzten Hydrolysatnahrungen zur Prävention atopischer Dermatitis bei Risikokindern wirksam gewesen sein könnte. Die Ergebnisse können aber, auch angesichts methodischer Schwächen, nicht als alleinige Basis für eine allgemeine Empfehlung zur Verwendung von HA-Nahrung herangezogen werden. Internationale Fachgesellschaften sprechen sich seit einigen Jahren eher gegen eine solche Empfehlung aus.
Diskussion
Für die derzeit in Deutschland vermarkteten Säuglingsnahrungen auf Basis von partiell hydrolysiertem Protein fehlen Wirksamkeitsbelege. Sie können daher nicht zur Allergieprävention empfohlen werden.
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Yang J, Yang SI, Jeong K, Kim KW, Kim YH, Min TK, Pyun BY, Lee J, Jung JA, Kim JH, Lee S. A partially hydrolyzed whey formula provides adequate nutrition in high-risk infants for allergy. Nutr Res Pract 2022; 16:344-353. [PMID: 35663446 PMCID: PMC9149326 DOI: 10.4162/nrp.2022.16.3.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/22/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES Hydrolyzed formula is often fed to infants with gastrointestinal or immune issues, such as malabsorption or cow's milk allergy, because enzymatic treatment has rendered it more digestible and less allergenic than standard cow's milk formula (SF). Partially hydrolyzed formula (PHF) should be considered for those infants who are intolerant to extensively hydrolyzed formula. However, there are concerns about the nutritional insufficiencies of PHF. We aimed to evaluate the effects of PHF on the growth and health indicators in infants who were at high-risk of allergic disease and potential candidates for consuming PHF. SUBJECTS/METHODS A total of 83 infants aged 0–2 mon with a family history of allergies were assigned to consume either PHF or SF until 24 weeks of age. Anthropometric measures were obtained at baseline, 12 weeks, and 24 weeks; blood samples were drawn and evaluated at the end of the study. RESULTS No significant differences were observed in weight, height, and weight-for-height at any time point in each sex between the PHF and SF groups. At 24 weeks of age, the weight-for-age and height-for-age z-scores of the SF group were higher than those of the PHF group, but there was no significant difference in the weight-for-height z-score. There were no significant differences in levels of white blood cells, hemoglobin, ferritin, protein, albumin, aspartate aminotransferase, alanine aminotransferase, eosinophil cationic protein, and immunoglobulin E. CONCLUSIONS In this study, there were no differences in growth and blood panels between the infants consuming PHF or SF. Therefore, infants who are unable to tolerate SF can be fed PHF without nutritional concerns about growth.
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Affiliation(s)
- Jiyeon Yang
- Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Korea
- Maeil Innovation Center, Maeil Dairies Co., Ltd., Pyeongtaek 17714, Korea
| | - Song I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea
| | - Kyunguk Jeong
- Department of Pediatrics, Ajou University School of Medicine, Suwon 16499, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Yoon Hee Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Taek Ki Min
- Department of Pediatrics, Soonchunhyang University Hospital, Seoul 04401, Korea
| | - Bok Yang Pyun
- Department of Pediatrics, Soonchunhyang University Hospital, Seoul 04401, Korea
| | - Jeongmin Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon 16499, Korea
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
| | - Ji A Jung
- Maeil Innovation Center, Maeil Dairies Co., Ltd., Pyeongtaek 17714, Korea
| | - Jeong Hee Kim
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Korea
| | - Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon 16499, Korea
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Wang Y, Li Z, Wu JL, Zhang L, Liu M, Tan M, Botma A, Liu M, Mulder KA, Abrahamse-Berkeveld M, Cai W. A partially hydrolyzed formula with synbiotics supports adequate growth and is well tolerated in healthy, Chinese term infants: A double-blind, randomized controlled trial. Nutrition 2021; 91-92:111472. [PMID: 34626956 DOI: 10.1016/j.nut.2021.111472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate growth and gastrointestinal tolerance in infants fed a partially hydrolyzed protein formula (pHF) with a synbiotic mixture of short-chain galacto-oligosaccharides and long-chain fructooligosaccharides (scGOS/lcFOS; 9:1) and Bifidobacterium breve M-16V (test formula) compared with an intact protein infant formula (IF) with scGOS/lcFOS (control formula). METHODS This randomized, double-blind, controlled, multicenter trial enrolled healthy, fully formula-fed Chinese infants (≤44 d) who received either the test (n = 112) or control formula (n = 112) until 17 wk of age. Fully breastfed infants served as a reference (n = 60). Anthropometrics, gastrointestinal symptoms, and adverse events were assessed monthly. Primary outcome was weight gain in grams per day from baseline to 17 wk of age. RESULTS Equivalence in daily weight gain (primary outcome) was demonstrated between the test and control groups (estimated mean difference [SE]: -0.36 [0.93] g/d, 90% confidence interval [CI], -1.90 to 1.18) as well as between each IF group and the breastfed reference group (test: 0.02 [1.05] g/d, 90% CI, -1.71 to 1.75; control: 0.36 [1.04] g/d, 90% CI, -1.35 to 2.08). There were no clinically relevant differences in gastrointestinal tolerance or adverse events between the formula groups. CONCLUSION A pHF with synbiotics supports adequate growth and is well tolerated in healthy, term-born Chinese infants. Additionally, infant growth and gastrointestinal tolerance measures of both IF groups were comparable to the breastfed group and can be considered suitable and well tolerated for use.
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Affiliation(s)
- Ying Wang
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Zailing Li
- Peking University Third Hospital, Department of Pediatrics, Peking, China
| | - Jie-Ling Wu
- Guangdong Women and Children Hospital, Department of Children Health Care, Guangzhou, China
| | - Lili Zhang
- Wuxi Children's Hospital, Department of Children Health Care, Wuxi, China
| | - Min Liu
- Shanghai Public Health Clinical Center, Obstetrics Department, Shanghai, China
| | - Meizhen Tan
- Guangzhou Women and Children's Medical Centre, Obstetrics Department, Guangzhou, China
| | - Akke Botma
- Danone Nutricia Research, Utrecht, The Netherlands
| | - Mengjin Liu
- Danone Open Science Research Centre, Shanghai, China
| | | | | | - Wei Cai
- Division of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Elgersma KM, Sommerness SA. What Does It Mean to Be Breastfed? A Concept Analysis in the Context of Healthcare Research, Clinical Practice, and the Parent Perspective. J Perinat Neonatal Nurs 2021; 35:305-312. [PMID: 34570045 DOI: 10.1097/jpn.0000000000000572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Over the past 3 decades, there have been attempts to define breastfeeding for scientific research. However, a lack of clarity remains, with concurrent ambiguity in clinical practice and insufficient inclusion of the parent perspective. Furthermore, previous concept analyses of "breastfeeding" may not fully represent what it means for an infant to be breastfed. Therefore, this concept analysis sought to define "breastfed" in the context of Western healthcare research, clinical practice, and the parent perspective. Informed by Rodgers' evolutionary method, a literature search resulted in 16 representative articles, with related terms, attributes, antecedents, and consequences identified. Analysis of the literature resulted in a theoretical definition of breastfed as a valuable process, experience, or characteristic that involves human milk consumption by an infant through a variety of delivery methods. To be breastfed relies on the existence of lactation, whether from a parent or another source, and depends upon the intentional decision of a birthing person, caregiver, or provider. It is recommended that healthcare providers and institutions adopt this inclusive definition, committing to a linguistic and conceptual distinction between a breastfed infant and direct breastfeeding. Increased clarity may improve comparability between studies, reporting to government agencies, provider communication, and supportive, family-centered care.
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11
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Huang Y, Zhou Y, Li H, Chen Y, Mu Y, Yuan A, Yang Y, Liu J. The Effects of a Partially Hydrolyzed Formula with Low Lactose and Probiotics on Mild Gastrointestinal Disorders of Infants: A Single-Armed Clinical Trial. Nutrients 2021; 13:3371. [PMID: 34684372 PMCID: PMC8540403 DOI: 10.3390/nu13103371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022] Open
Abstract
Partially hydrolyzed formula (pHF) containing low lactose and probiotics may benefit the gastrointestinal health of infants. We aimed to assess the effects of pHF on mild gastrointestinal disorders (MGDs) of infants. In this single-armed trial, 80 full-term infants with MGDs were enrolled and fed a pHF for 14 consecutive days. The primary outcome resulted from the scores of gastrointestinal symptoms reported by parents using a validated Infant Gastrointestinal Symptom Questionnaire (IGSQ) at Day 0 (baseline), Day 7, and Day 14. The total IGSQ scores ranged from 13 to 65. Higher scores indicated worse gastrointestinal symptoms. The IGSQ scores (mean ± SD) decreased from Day 0 (36.0 ± 5.7) to Day 7 (28.7 ± 7.4) and Day 14 (26.5 ± 8.1 (p < 0.001), with corresponding digestive distress prevalence (IGSQ score > 30) decreasing from 87.5% to 35.0% and 28.8% (p < 0.001). In the first three days, vomiting and flatulence scores decreased at Day 1 versus Day 0, and the crying score decreased at Day 2, but no significant changes were observed for fussy and stool characteristics. All growth parameters increased and no parents reported adverse events. In conclusion, feeding with a pHF containing low lactose and probiotics may comfort infants with MGDs, and the comforting effect likely manifests early in the first three days of the feeding interventions. Trial registration: ClinicalTrials.gov NCT04112056.
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Affiliation(s)
- Yongying Huang
- The Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (Y.H.); (Y.Z.); (H.L.)
| | - Yubo Zhou
- The Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (Y.H.); (Y.Z.); (H.L.)
| | - Hongtian Li
- The Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (Y.H.); (Y.Z.); (H.L.)
| | - Yipu Chen
- Nestlé Product Technology Center-Nutrition, 1800 Vevey, Switzerland;
| | - Yingchao Mu
- Huantai Maternal and Child Health Care Hospital, Zibo 256400, China;
| | - Anan Yuan
- Nestlé (China) Ltd., Beijing 100102, China; (A.Y.); (Y.Y.)
| | - Yantao Yang
- Nestlé (China) Ltd., Beijing 100102, China; (A.Y.); (Y.Y.)
| | - Jianmeng Liu
- The Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China; (Y.H.); (Y.Z.); (H.L.)
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100191, China
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12
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Comparison of the acute metabolic effect of different infant formulas and human milk in healthy adults: a randomized trial. Nutr Diabetes 2021; 11:13. [PMID: 33859173 PMCID: PMC8050262 DOI: 10.1038/s41387-021-00154-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/15/2021] [Accepted: 03/29/2021] [Indexed: 12/25/2022] Open
Abstract
Background/Objectives Different infant formulas, varying in protein type and quantity, are available for infants who are not breastfed or are partially breastfed. Postprandial insulinemic and glycemic responses to intact vs partially hydrolyzed protein in infant formula are unclear. To compare the effect of different forms (partially hydrolyzed vs non-hydrolyzed) and levels of protein in infant formula compared with a human milk reference subgroup on insulin response in adults. Subjects/Methods In a randomized, double-blinded, cross-over study, 35 healthy adults consumed 600 ml of three different infant formulas: Intact protein-based formula (INTACT) (1.87 g protein/100 kcal; whey/casein ratio of 70/30; 63 kcal/100 ml), partially hydrolyzed whey-based formula (PHw) (1.96 g protein/100 kcal; 100% whey; 63 kcal/100 ml), a high-protein partially hydrolyzed whey-based formula (HPPHw) (2.79 g protein/100 kcal; 100%whey; 73 kcal/100 ml) and a subgroup also consumed human milk (HM) (n = 11). Lipid and carbohydrate (lactose) contents were similar (5.1–5.5 and 10.5–11.6 g/100 kcal, respectively). Venous blood samples were taken after overnight fasting and at different intervals for 180 min post-drink for insulin, glucose, blood lipids, GLP-1, glucagon, and C-peptide. Results Twenty-nine subjects (eight consuming HM) adhered to the protocol. INTACT and PHw groups had similar postprandial insulinemia and glycaemia (Cmax and iAUC) that were not different from those of the HM subgroup. HPPHw resulted in higher postprandial insulin responses (iAUC) relative to all other groups (p < 0.001, p < 0.001, p = 0.002 for the comparison with INTACT, PHw, HM, respectively). HPPHw resulted in a higher glucose response compared to INTACT and PHw (iAUC: p = 0.003, p = 0.001, respectively), but was not different from HM (p = 0.41). Conclusion This study in adults demonstrates similar postprandial insulinemia and glycaemia between INTACT and PHw, close to that of HM, but lower than HPPHw, which had a higher protein content compared to the other test milks. The findings remain to be confirmed in infants. Clinical trial registration This study is registered at clinicaltrials.gov, identifier NCT04332510.
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Van den Abbeele P, Sprenger N, Ghyselinck J, Marsaux B, Marzorati M, Rochat F. A Comparison of the In Vitro Effects of 2'Fucosyllactose and Lactose on the Composition and Activity of Gut Microbiota from Infants and Toddlers. Nutrients 2021; 13:726. [PMID: 33668823 PMCID: PMC7996240 DOI: 10.3390/nu13030726] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 12/15/2022] Open
Abstract
Because of the recognized health benefits of breast milk, it is recommended as the sole nutrition source during the first 6 months of life. Among the bioactive components are human milk oligosaccharides (HMOs) that exert part of their activity via the gut microbiota. Here, we investigated the gut microbiota fermentation of HMO 2'fucosyllactose (2'-FL), using two in vitro models (48 h fecal incubations and the long-term mucosal simulator of the human intestinal microbial ecosystem [M-SHIME®]) with fecal samples from 3-month-old breastfed (BF) infants as well as 2-3 year old toddlers. The short-term model allowed the screening of five donors for each group and provided supportive data for the M-SHIME® study. A key finding was the strong and immediate increase in the relative abundance of Bifidobacteriaceae following 2'-FL fermentation by both the BF infant and toddler microbiota in the M-SHIME®. At the metabolic level, while decreasing branched-chain fatty acids, 2'-FL strongly increased acetate production together with increases in the health-related propionate and butyrate whilst gas production only mildly increased. Notably, consistently lower gas production was observed with 2'-FL fermentation as compared to lactose, suggesting that reduced discomfort during the dynamic microbiome establishment in early life may be an advantage along with the bifidogenic effect observed.
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Affiliation(s)
| | - Norbert Sprenger
- Nestlé Institute of Health Sciences, Société des Produits Nestlé S.A., Vers-Chez-Les-Blanc, CH-1000 Lausanne, Switzerland;
| | - Jonas Ghyselinck
- ProDigest, Technologiepark 82, 9052 Zwijnaarde, Belgium; (P.V.d.A.); (J.G.); (B.M.)
| | - Benoît Marsaux
- ProDigest, Technologiepark 82, 9052 Zwijnaarde, Belgium; (P.V.d.A.); (J.G.); (B.M.)
- Center for Microbial Ecology and Technology (CMET), Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - Massimo Marzorati
- ProDigest, Technologiepark 82, 9052 Zwijnaarde, Belgium; (P.V.d.A.); (J.G.); (B.M.)
- Center for Microbial Ecology and Technology (CMET), Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - Florence Rochat
- Nestlé Institute of Health Sciences, Société des Produits Nestlé S.A., Vers-Chez-Les-Blanc, CH-1000 Lausanne, Switzerland;
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14
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Vandenplas Y, Meyer R, Chouraqui JP, Dupont C, Fiocchi A, Salvatore S, Shamir R, Szajewska H, Thapar N, Venter C, Verhasselt V. The role of milk feeds and other dietary supplementary interventions in preventing allergic disease in infants: Fact or fiction? Clin Nutr 2021; 40:358-371. [DOI: 10.1016/j.clnu.2020.10.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/06/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
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15
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Fleischer DM, Chan ES, Venter C, Spergel JM, Abrams EM, Stukus D, Groetch M, Shaker M, Greenhawt M. A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:22-43.e4. [PMID: 33250376 DOI: 10.1016/j.jaip.2020.11.002] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Recently published data from high-impact randomized controlled trials indicate the strong potential of strategies to prevent the development of food allergy in high-risk individuals, but guidance in the United States at present is limited to a policy for only the prevention of peanut allergy, despite other data being available and several other countries advocating early egg and peanut introduction. Eczema is considered the highest risk factor for developing IgE-mediated food allergy, but children without risk factors still develop food allergy. To prevent peanut and/or egg allergy, both peanut and egg should be introduced around 6 months of life, but not before 4 months. Screening before introduction is not required, but may be preferred by some families. Other allergens should be introduced around this time as well. Upon introducing complementary foods, infants should be fed a diverse diet, because this may help foster prevention of food allergy. There is no protective benefit from the use of hydrolyzed formula in the first year of life against food allergy or food sensitization. Maternal exclusion of common allergens during pregnancy and/or lactation as a means to prevent food allergy is not recommended. Although exclusive breast-feeding is universally recommended for all mothers, there is no specific association between exclusive breast-feeding and the primary prevention of any specific food allergy.
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Affiliation(s)
- David M Fleischer
- Section of Allergy & Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo
| | - Edmond S Chan
- Division of Allergy & Immunology, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada
| | - Carina Venter
- Section of Allergy & Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo
| | - Jonathan M Spergel
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pa
| | - Elissa M Abrams
- Section of Allergy and Clinical Immunology, Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada
| | - David Stukus
- Division of Allergy and Immunology, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio
| | - Marion Groetch
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Marcus Shaker
- Section of Allergy and Clinical Immunology, Children's Hospital at Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Matthew Greenhawt
- Section of Allergy & Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo.
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16
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Turco R, Russo M, Bruzzese D, Staiano A. Efficacy of a partially hydrolysed formula, with reduced lactose content and with Lactobacillus reuteri DSM 17938 in infant colic: A double blind, randomised clinical trial. Clin Nutr 2020; 40:412-419. [PMID: 32600858 DOI: 10.1016/j.clnu.2020.05.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/12/2020] [Accepted: 05/27/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS We aimed to compare the efficacy of a partially hydrolysed formula (pHF) with reduced lactose content and Lactobacillus reuteri DSM 17938 (L. reuteri) with a standard formula in infant colic (IC). METHODS We performed a double blind, parallel-group randomized active-controlled. Inclusion criteria were: exclusively formula fed, full term infants, aged <4 months, diagnosis of IC. All the enrolled infants were randomized to receive either pHF with reduced lactose content and L. reuteri (Group A) or standard formula (Group B). The treatment duration was 4 weeks and children were followed-up to 8 weeks. The primary outcome was the mean infant crying duration at 28 days. RESULTS Two-hundred-forty-one children were randomized to the treatments' group (Group A = 124; Group B = 117). Mean daily crying time at 28th day was significantly lower in Group B when compared to Group A [104.7 (87-122.4) versus 146.4 min (129.2-163.7), treatment effect -41.8 (95% C.I.: -66.5 to -17.1), p = 0.001]. No significant adverse event was reported in both groups. CONCLUSIONS Standard formula showed a lower overall crying time respect to the intervention formula (ClinicalTrials.govNCT02813772).
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Affiliation(s)
- Rossella Turco
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
| | - Marina Russo
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
| | - Dario Bruzzese
- Department of Public Health, University of Naples "Federico II", Naples, Italy.
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
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17
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Di Mauro A, Baldassarre ME, Brindisi G, Zicari AM, Tarantini M, Laera N, Capozza M, Panza R, Salvatore S, Pensabene L, Fanelli M, Laforgia N. Hydrolyzed Protein Formula for Allergy Prevention in Preterm Infants: Follow-Up Analysis of a Randomized, Triple-Blind, Placebo-Controlled Study. Front Pediatr 2020; 8:422. [PMID: 32903747 PMCID: PMC7438860 DOI: 10.3389/fped.2020.00422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Allergic diseases are a major public health burden worldwide. Evidence suggests that early nutrition might play a key role in the future development of allergies and the use of hydrolyzed protein formulas have been proposed to prevent allergic disease, mainly in term infants with risk factors. Aim: To evaluate the preventive effect of a hydrolyzed protein formula vs. an intact protein formula on allergy development in preterm infants with or without risk factors. Methods: We performed a 3-year follow-up study of a previous triple-blind, placebo-controlled randomized trial. Evidence of atopic dermatitis, asthma and IgE-mediated food allergies were evaluated according to a validated parental questionnaire (Comprehensive Early Childhood Allergy Questionnaire). Food sensitization was also investigated by skin prick test at 3 years of chronological age. Results: Of the 30 subjects in the intact protein formula group and 30 in the extensively hydrolyzed formula group, respectively 18 and 16 completed the 3-year follow-up and entered the final analysis. No group differences in the incidence of atopic dermatitis, asthma, IgE-mediated food allergies, and food sensitization were found. Conclusion: Despite the small number of cases, extensively hydrolyzed protein formula seems to be ineffective in allergic diseases prevention in preterm neonates. Further adequately powered, randomized controlled trials evaluating hydrolyzed protein formula administration to prevent allergic diseases in preterm neonates are needed.
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Affiliation(s)
- Antonio Di Mauro
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Maria Elisabetta Baldassarre
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Giulia Brindisi
- Pediatrics Department, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Anna Maria Zicari
- Pediatrics Department, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Martina Tarantini
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Nicla Laera
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Manuela Capozza
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Raffaella Panza
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Silvia Salvatore
- Department of Pediatric, Ospedale "F. Del Ponte", University of Insubria, Varese, Italy
| | - Licia Pensabene
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Margherita Fanelli
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - Nicola Laforgia
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
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18
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Davisse-Paturet C, Raherison C, Adel-Patient K, Divaret-Chauveau A, Dufourg MN, Lioret S, Charles MA, de Lauzon-Guillain B. Reply to J. Heinrich. Pediatr Allergy Immunol 2020; 31:108-109. [PMID: 31660638 DOI: 10.1111/pai.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Chantal Raherison
- Inserm, Bordeaux Population Health Research Center, Team EPICENE, Bordeaux University, Bordeaux, France
| | - Karine Adel-Patient
- UMR Service de Pharmacologie et Immunoanalyse, CEA, INRA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Amandine Divaret-Chauveau
- Unité d'allergologie pédiatrique, Hôpital d'enfants, CHRU de Nancy, Nancy, France.,EA3450, Université de Lorraine, Vandoeuvre les Nancy, France
| | | | | | - Marie-Aline Charles
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Ined, Inserm, Joint Unit Elfe, Paris, France
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Jensen L, Larsen J, Madsen C, Laursen R, Jacobsen L, Bøgh K. Preclinical Brown Norway Rat Models for the Assessment of Infant Formulas in the Prevention and Treatment of Cow’s Milk Allergy. Int Arch Allergy Immunol 2019; 178:307-314. [DOI: 10.1159/000495801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/27/2018] [Indexed: 11/19/2022] Open
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20
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Vandenplas Y, Munasir Z, Hegar B, Kumarawati D, Suryawan A, Kadim M, Djais JT, Basrowi RW, Krisnamurti D. A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants. KOREAN JOURNAL OF PEDIATRICS 2019; 62:149-154. [PMID: 30651423 PMCID: PMC6528056 DOI: 10.3345/kjp.2018.07276] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/12/2019] [Indexed: 12/25/2022]
Abstract
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow’s milk and processed to adjust for the nutritional needs of infants. However, cow’s milk is one of the most common causes of food allergy, affecting 2%–5% of all formula-fed infants during their first year of life. One strategy to prevent cow’s milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.
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Affiliation(s)
- Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - Zakiudin Munasir
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Badriul Hegar
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dewi Kumarawati
- Department of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Indonesia
| | - Ahmad Suryawan
- Department of Child Health, Medical School, Unviersity of Airlangga, Surabaya, Indonesia
| | - Muzal Kadim
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Julistio Tb Djais
- Department of Child Health, Medical School, University of Padjadjaran, Bandung, Indonesia
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