Food choices to meet nutritional needs of breast-fed infants and toddlers on mixed diets

Gut microbiome development and childhood undernutrition

Forty-five percent of deaths among children under 5 years of age are associated with undernutrition. Globally, almost 200 million children exhibit the two major forms of undernutrition-wasting (low weight-for-height) or stunting (low height-for-age), with many affected by both. Undernutrition is not due to food insecurity alone. Growing evidence indicates that perturbed postnatal gut microbiome development contributes to its pathogenesis. This perspective focuses on defining and repairing these defects in gut microbiome development. We describe an approach that involves the analysis of well-phenotyped human cohorts, followed by preclinical studies using gnotobiotic animals colonized with microbiota from these cohorts. Additionally, these models can be used to identify therapeutic targets and candidates that can then be tested clinically. Furthermore, introducing pretreatment microbiota from trial participants into gnotobiotic animals and re-enacting trial conditions allow mechanisms to be dissected. We highlight these recent advances as well as gaps in existing knowledge that present opportunities for future research.

Revised D-A-CH-reference values for the intake of zinc

BACKGROUND

The Nutrition Societies of Germany, Austria and Switzerland as the joint editors of the 'D-A-CH reference values for nutrient intake' have revised the reference values for zinc in July 2019.

METHODS

For infants aged 0 to under 4 months, an estimated value was set based on the zinc intake via breast feeding. For all other age groups, the reference values were calculated using the factorial method considering endogenous zinc losses via intestinal losses, urine, faeces, skin and sweat, semen in men and the additional zinc requirements to build up body weight in children and adolescents as well as in pregnant women. Due to the strong influence of phytate intake on zinc absorption, the recommendations for the intake of zinc for adults are derived depending on low (0.5 mmol/day, corresponding to 330 mg/day), moderate (1.0 mmol/day, corresponding to 660 mg/day) and high (1.5 mmol/day, corresponding to 990 mg/day) phytate intake. The reference values for lactating women take into account the zinc loss via breast milk.

RESULTS AND CONCLUSION

For adults, pregnant and lactating women, the recommended intake values for zinc range from 7 mg/day to 16 mg/day, depending on sex and dietary phytate intake.

Study protocol to assess the impact of an integrated nutrition intervention on the growth and development of children under two in rural Bangladesh

Background

The period from birth to two years is the “critical window” for achieving optimal growth and development. An inadequate quality and quantities of complementary foods, poor child-feeding practices and infection negatively impact the growth of under-twos. Approximately one-third of under-fives in developing countries are stunted; many are also micronutrient deficient. An estimated 6% of mortalities among under-fives can be prevented by ensuring optimal complementary feeding. The objective of the study was to assess the ability of a 12-month integrated nutrition intervention to improve the nutritional status (length-for-age Z-score) of 6 to 12-month-old children in rural Bangladesh.

Methods

In this community-based randomized controlled trial, the intervention group received a package of interventions that includes, food vouchers; to prepare egg-based nutritious snacks (suji firni for < 1-year-olds, suji halwa for > 1-year-olds), micronutrient powder to fortify children’s food at home, child feeding counselling and water, sanitation and hygiene (WASH), behaviour change communication. The control group received routine health messages provided by the government. Baseline and endline surveys were conducted; Data collection was performed monthly on children’s growth, food voucher utilization, child feeding and morbidity. In addition, we assessed the cognitive development of the children after 12 months of intervention.

Conclusion

This trial aims to explore whether an integrated nutrition intervention can mitigate childhood stunting during the critical window of opportunity in rural Bangladesh. The results may provide robust evidence to improve the linear growth of children in developing countries.

Trial registration

The study was retrospectively registered on August 17, 2018 and is available online at ClinicalTrials.gov (ID: NCT02768181).

Children living in the slums of Bangladesh face risks from unsafe food and water and stunted growth is common

AIM

This study investigated the microbial quality of food and water consumed by children in four slums in Dhaka, the capital of Bangladesh, together with the associated risk factors.

METHODS

This cross-sectional study took place from December 2015 to May 2016 and focused on 360 children under the age of five. We recorded household food security, namely adequate food for a healthy life, socio-economic and nutritional status, hygiene and feeding practices. Food and water samples were analysed.

RESULTS

We found that 63% of the children were malnourished and 58% were stunted. Yeast and moulds were detected in 86% of the food samples and coliforms in 73%. All the water samples were contaminated with faecal coliforms, yeasts and moulds and Staphylococcus. Food insecurity affected 83% of households. Children were twice as likely to be malnourished if they were born with a perceived low birthweight or their mothers did not wash their hands with soap after cleaning the child's bottom following defecation. Exclusively breastfed children were less likely to develop malnutrition.

CONCLUSION

Children from the Dhaka slums were frequently stunted and malnourished and contaminated food and water was common. Integrated efforts are essential to create public awareness about hygiene.

Optimization of red teff flour, malted soybean flour, and papaya fruit powder blending ratios for better nutritional quality and sensory acceptability of porridge

This study was carried out to optimize the compositions of red teff flour with malted soybean flour and papaya fruit powders for better nutritional quality and sensory acceptability of porridge. Total eleven formulations of the composite flours were determined using D-optimal mixture design with the help of Minitab Version 16 Statistical Software. The three ingredients were considered in the ranges of 55%-70%, 20%-30%, 5%-15% for red teff flour, malted soybean flour, and Papaya fruit powder, respectively. The prepared porridge samples from formulations were analyzed for nutritional composition, antinutritional factors, and sensory acceptability. Results of the study showed the significant difference (p < .05) in ash, fat, fiber, protein, carbohydrate, energy, iron, calcium, zinc, β-carotene, phytates, tannin, appearance, taste, mouthfeel, and overall acceptability as the composition of ingredients were changed. The overall optimum point was found in a range of red teff flour (60%-70%), malted soybean flour (20%-27.5%), and papaya fruit powder (10%-12.5%). In conclusion, the present approach can help in improve infants dietary quality of complementary foods by developing nutritionally enhanced red teff-based porridge used for intervention of malnutrition.

Age at introduction of solid foods and feeding difficulties in childhood: findings from the Southampton Women's Survey

This study aimed to determine whether age at introduction of solid foods was associated with feeding difficulties at 3 years of age. The present study was carried out using data from the Southampton Women's Survey (SWS). Women enrolled in the SWS who subsequently became pregnant were followed-up during pregnancy and postpartum, and the offspring have been studied through childhood. Maternal socio-demographic and anthropometric data and child anthropometric and feeding data were collected through interviews and self-administered questionnaires. When the children were 3 years of age, mothers/carers rated six potential child feeding difficulty questions on a four-point Likert scale, including one general question and five specific feeding difficulty questions. Age at introduction of solids as a predictor of feeding difficulties was examined in 2389 mother-child pairs, adjusting for child (age last breast fed, sex, gestation) and maternal characteristics (parity, pre-pregnancy BMI, age, education, employment, parenting difficulties, diet quality). The majority of mothers/carers (61 %) reported some feeding difficulties (general feeding difficulty question) at 3 years of age, specifically with their child eating enough food (61 %), eating the right food (66 %) and being choosy with food (74 %). Children who were introduced to solids ≥6 months had a lower risk of feeding difficulties (RR 0·73; 95 % CI 0·59, 0·91, P=0·004) than children who were introduced to solids between 4 and 6 months. No other significant associations were found. There were few associations between feeding difficulties in relation to age at introduction of solid foods. However, general feeding difficulties were less common among infants introduced to solid foods ≥6 months of age.

Infant nutrition and lifelong health: current perspectives and future challenges

Understanding the role and importance of nutrition in early postnatal life, as an influence on lifelong vulnerability to poor health, is an important part of current research. We need to be able to define optimal patterns of infant feeding, not just to support growth and development in infancy, but also as determinants of later health. To date, much of the focus on the long-term effects of infant nutrition has been on milk feeding, to compare breast and formula feeding and to evaluate the effects of exclusivity, timing and duration of feeding different types of milk in infancy; other aspects of infant feeding such as age at introduction of solid foods and type of weaning diet have received less attention, and relatively little is known about their links to later health. Contemporary data are needed to enable us to move beyond explanation of historical infant feeding data in order to understand and predict health outcomes in future generations. Ongoing and new population studies, that include infants from diverse settings, will be key to providing generalizable data that can be used to define optimal feeding practice. There are some methodological challenges ahead, although significant progress has already been made, and further progress is envisaged in the future. In particular, the opportunity to bring together epidemiological studies and new mechanistic insights that will help identify key aspects of infant nutrition and their causal effects offer great promise both in moving this field forward as well as the potential for health benefits for future generations.

Factors influencing first-time mothers' introduction of complementary foods: a qualitative exploration

BACKGROUND

Optimal infant nutrition comprises exclusive breastfeeding, with complementary foods introduced from six months of age. How parents make decisions regarding this is poorly studied. This study begins to address the dearth of research into the decision-making processes used by first-time mothers relating to the introduction of complementary foods.

METHODS

This qualitative explorative study was conducted using interviews (13) and focus groups (3). A semi-structured interview guide based on the Theory of Planned Behaviour (TPB). The TPB, a well-validated decision-making model, identifies the key determinants of a behaviour through behavioural beliefs, subjective norms, and perceived behavioural control over the behaviour. It is purported that these beliefs predict behavioural intention to perform the behaviour, and performing the behaviour. A purposive, convenience, sample of 21 metropolitan parents recruited through advertising at local playgroups and childcare centres, and electronically through the University community email list self-selected to participate. Data were analysed thematically within the theoretical constructs: behavioural beliefs, subjective norms and perceived behavioural control. Data relating to sources of information about the introduction of complementary foods were also collected.

RESULTS

Overall, first-time mothers found that waiting until six months was challenging despite knowledge of the WHO recommendations and an initial desire to comply with this guideline. Beliefs that complementary foods would assist the infants' weight gain, sleeping patterns and enjoyment at meal times were identified. Barriers preventing parents complying with the recommendations included subjective and group norms, peer influences, infant cues indicating early readiness and food labelling inconsistencies. The most valued information source was from peers who had recently introduced complementary foods.

CONCLUSIONS

First-time mothers in this study did not demonstrate a good understanding of the rationale behind the WHO recommendations, nor did they understand fully the signs of readiness of infants to commence solid foods. Factors that assisted waiting until six months were a trusting relationship with a health professional whose practice and advice was consistent with the recommendations and/or when their infant was developmentally ready for complementary foods at six months and accepted them with ease and enthusiasm. Barriers preventing parents complying with the recommendations included subjective and group norms, peer influences, infant cues indicating early readiness and food labelling inconsistencies.

Contextualising complementary feeding in a broader framework for stunting prevention

An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels.

The micronutrient status of children aged 24-60 months living in rural disaster areas one year after the Wenchuan Earthquake

Objective

In order to evaluate micronutrient status of children aged 24–60 months living in rural disaster areas after one year of the earthquake in Wenchuan.

Design

After one year of Wenchuan Earthquake, using PPS sampling methods, a total of 270 children from six-randomized townships near seismic center, in each township sample size consisted of 30 to 50 children, were sampled for evaluating Z-score of children's growth status, anemia prevalence, vitamin A, vitamin D, vitamin B₁₂, folic acid status. Final sample consisted of 152 boys and 118 girls, and blood samples were drawn from 206 children.

Results

The stunting (HAZ<2SD) and wasting (WHZ<2SD) were respectively 14.7% and 0.7%. Prevalence of anemia was 17.3% and percentage of iron deficiency was 45.7%. The prevalence of vitamin A deficiency and marginal deficiency was 15.4% and 30.3%, respectively. The sum of vitamin D deficiency and marginal deficiency was near 90%. Percentages of Zinc deficiency including marginal and deficiency were 65.5%. Percentages of vitamin B₁₂ marginal and deficiency were 8.6% and 10.6% and the prevalence of marginal deficiency was significantly higher in boys than in girls. Folic acid deficiency was not found in surveyed children using serum folic acid level <16.9 ng/ml.

Conclusion

In areas affected by Earthquake, preschool children had higher stunting prevalence and a relatively higher prevalence suffered from micronutrient deficiencies, including iron-deficiency anemia, and deficiencies of iron, zinc, vitamin A and vitamin B₁₂.

Prospective study on the effectiveness of complementary food supplements on improving status of elder infants and young children in the areas affected by Wenchuan earthquake

Objective

To prospectively evaluate the efficiency of daily providing complementary food supplements decreasing malnutrition and anemia prevalence in elder infants and young children living in areas affected by Wenchuan Earthquake.

Design

Using promotional probability sampling method, 250 to 300 children from six-randomized townships (30 to 50 children in each township) in Kang County affected by the Earthquake were randomly chosen for follow up to evaluate intervention effectiveness using anthropometric measurement and hemoglobin level at six, twelve and eighteen months after start of intervention.

Setting and Subjects

All children from 6 to 18 months of age in Kang County (in North Western China) were daily provided with complementary food supplements containing multiple vitamins and minerals for up to 24 months of age. The intervention period lasted for one and half year.

Results

At beginning of intervention, malnutrition prevalence, including underweight, stunting and wasting were respectively 4.5%, 8.9% and 3.5%; anemia prevalence was 74.3%. After one and half year intervention, the growth and anemia status were significantly improved; the percentages of wasting, stunting underweight prevalence were decreased from 3.5%, 8.9% and 4.5% to 1.7%, 5.0% and 3.3% respectively, and the anemia rates were significantly decreased.

Conclusions

Our results indicated that an intervention using complementary food supplements could improve nutritional status and elevate hemoglobin level in elder infants and young children, which would significantly decrease the prevalence of malnutrition and anemia.

Rethinking Red Meat as a Prevention Strategy for Iron Deficiency

The possibility that iron-deficiency anemia may lead to neurodevelopmental deficits has led some to recommend red meat as an early complementary food for infants; however, 2 new lines of evidence put this advice in a new light. First, recent studies show an association between consumption of red meat and cancer, diabetes, cardiovascular disease, and overall mortality. Second, new research has elucidated the role of plant ferritin as a readily available source of iron. There is an abundance of options for plant-based iron-rich foods that are consistent with long-term healthful eating that can meet infants’ nutritional needs while sidestepping red meat’s potential adverse health effects.

Effect of breastfeeding on serum zinc levels and growth in healthy infants

BACKGROUND

This study investigated the association among breastfeeding, serum zinc levels, and nutritional status of children.

SUBJECTS AND METHODS

One hundred healthy infants were included in the study. Anthropometric measurements of the children were taken, and their plasma zinc levels were determined. The mothers were interviewed about the duration of breastfeeding and nutrition pattern of the children at the time of zinc measurement.

RESULTS

Low zinc levels were associated with lower weight measurements (r=0.49, p<0.001), but the association between height and zinc level was not statistically significant (r=0.18, p>0.05). There was a negative correlation between breastfeeding duration and weight-for-age percentile (r=-0.2, p<0.05), height-for-age percentile (r=-0.3, p<0.05), and serum zinc level (r=-0.3, p=0.002). The pattern of nutrition correlated only with the weight of the infant (r=0.2, p<0.05) and not with either height or serum zinc levels (p>0.05).

CONCLUSIONS

Exclusive breastfeeding beyond 6 months of age has negative effects on serum zinc levels and can be associated with low weight gain, which will be especially important in developing countries.

Application of bifidobacterial phytases in infant cereals: effect on phytate contents and mineral dialyzability

Phytase activity was recently described in probiotic bifidobacterial strains, opening the possibilities for their use in foods, due to the generally regarded as safe/qualified presumption of safety status of these bacteria. Two raw materials for infant cereals (multicereal and gluten-free) were examined by measuring the myo-inositol phosphates content and the in vitro Ca, Fe, and Zn availability after a dephytinization process with purified phytases from Bifidobacterium longum spp. infantis and Bifidobacterium pseudocatenulatum. Treatment with both enzymes reduced the contents of phytate as compared to control samples (untreated or treated with fungal phytase) and led to increased levels of myo-inositol triphosphate. Dephytinization followed by an in vitro model of intestinal digestion increased the solubility of Zn. However, phytase treatment did not increase significantly the mineral dialyzability as compared to untreated samples. This is the first example of the application of purified bifidobacterial phytases in food processing and shows the potential of these enzymes to be used in products for human consumption.

The nutritional requirements of infants. Towards EU alignment of reference values: the EURRECA network

This paper presents a review of the current knowledge regarding the macro- and micronutrient requirements of infants and discusses issues related to these requirements during the first year of life. The paper also reviews the current reference values used in European countries and the methodological approaches used to derive them by a sample of seven European and international authoritative committees from which background scientific reports are available. Throughout the paper, the main issues contributing to disparities in micronutrient reference values for infants are highlighted. The identification of these issues in relation to the specific physiological aspects of infants is important for informing future initiatives aimed at providing standardized approaches to overcome variability of micronutrient reference values across Europe for this age group.

Lactation and neonatal nutrition: defining and refining the critical questions

This paper resulted from a conference entitled "Lactation and Milk: Defining and refining the critical questions" held at the University of Colorado School of Medicine from January 18-20, 2012. The mission of the conference was to identify unresolved questions and set future goals for research into human milk composition, mammary development and lactation. We first outline the unanswered questions regarding the composition of human milk (Section I) and the mechanisms by which milk components affect neonatal development, growth and health and recommend models for future research. Emerging questions about how milk components affect cognitive development and behavioral phenotype of the offspring are presented in Section II. In Section III we outline the important unanswered questions about regulation of mammary gland development, the heritability of defects, the effects of maternal nutrition, disease, metabolic status, and therapeutic drugs upon the subsequent lactation. Questions surrounding breastfeeding practice are also highlighted. In Section IV we describe the specific nutritional challenges faced by three different populations, namely preterm infants, infants born to obese mothers who may or may not have gestational diabetes, and infants born to undernourished mothers. The recognition that multidisciplinary training is critical to advancing the field led us to formulate specific training recommendations in Section V. Our recommendations for research emphasis are summarized in Section VI. In sum, we present a roadmap for multidisciplinary research into all aspects of human lactation, milk and its role in infant nutrition for the next decade and beyond.

An index measuring adherence to complementary feeding guidelines has convergent validity as a measure of infant diet quality

The complementary feeding period is an important stage of child development. The study aim was to develop an index reflecting the degree of adherence to complementary feeding guidelines, evaluate its convergent validity, and explore associations with socio-demographic factors and dietary pattern scores in childhood. Data were analyzed from the Avon Longitudinal Study of Parents and Children (n = 6065) using parent-completed dietary questionnaires at 6 mo of age, socio-demographic information, and dietary patterns derived by principal component analysis at age 3 y. The Complementary Feeding Utility Index (CFUI) consists of 14 components: breastfeeding duration, feeding to appetite, timing of introduction to solids, exposure to iron-rich cereals, fruit and vegetable intake, exposure to high-fat/-salt/-sugar foods including sugary drinks, food texture, and meal/snack frequency. Regression analyses were undertaken to investigate associations between index scores, socio-demographic factors, food and nutrient intakes, and dietary pattern scores at age 3 y. Milk and food intake at 6 mo and nutrient intake at 8 mo of age varied across quintiles of index score in largely the expected directions. Associations were found among index score, maternal age, education, social class, maternal smoking history, and prepregnancy BMI. After adjustment for socio-demographic factors, the index score was associated with "processed" [β = -0.234 (95% CI = -0.260, -0.209)] and "healthy" [β = 0.185 (95% CI = 0.155, 0.215)] dietary pattern scores at age 3 y. The CFUI is able to discriminate across food intake, nutrient intake, and socio-demographic factors and is associated with later dietary patterns.

The Youngest Vegetarians

As the popularity of vegetarian diets increases, practitioners are likely to encounter vegetarian infants and toddlers. Vegetarian and vegan diets can be developed to meet nutrient needs and support growth of infants and toddlers. Key nutrients whose adequacy should be monitored in vegetarian/vegan diets include vitamin B12, calcium, vitamin D, iron, omega-3 fatty acids, and zinc. As for all infants, for the first 4 to 6 months, vegetarian infants should solely receive breast milk or a commercial infant formula. Fortified infant cereal or firm tofu is an appropriate first complementary food. Either of these, along with breast milk or formula, can meet needs for protein, iron, and zinc. Additional foods are introduced with timing similar to that for nonvegetarians. A variety of nutrient-dense foods should be introduced by 1 year of age. Fortified soy or cow’s milk should be the primary beverage postweaning. Growth should be monitored, and toddlers should be served a diet that includes high-calorie, low-fiber foods if growth appears to be faltering. Practitioners can play important roles in assessing the growth of vegetarian infants and toddlers, helping families make appropriate feeding choices, evaluating the need for supplements, and assisting with planning meals that will meet the needs of infants and toddlers.

Zinc and iron deficiency and their interrelations in low-income African American and Hispanic children in Atlanta

BACKGROUND

Information about the zinc status of low-income minority children in the United States is lacking.

OBJECTIVE

The objective was to determine the prevalence of zinc deficiency and anemia and their interrelation among low-income African American and Hispanic preschool children.

DESIGN

This was a cross-sectional study in which a prospective 3-d food diary was completed, and hemoglobin, serum ferritin, zinc, copper, and C-reactive protein concentrations were measured. Children with elevated C-reactive protein concentrations were excluded from analysis.

RESULTS

Of 292 children recruited, 280 (mean +/- SD age: 2.5 +/- 1.2 y) qualified for analysis. One hundred forty-six (52%) children were African American and 134 (48%) were Hispanic; 202 (72%) were enrolled in the Women, Infants, and Children nutrition program. A low serum zinc concentration (<10.7 mumol/L) was present in 34 (12%) children, and 37 (13%) were anemic (hemoglobin < 110 g/L). African American (odds ratio: 3.47; 95% CI: 1.51, 7.96) and anemic (odds ratio: 2.92; 95% CI: 1.24, 6.90) children had an increased risk of zinc deficiency. Serum zinc correlated with hemoglobin (r = 0.24, P < 0.001). Children with a height/length less than the fifth percentile had significantly lower mean serum zinc concentrations than those with a height/length greater than the fifth percentile (12.4 +/- 1.8 compared with 13.0 +/- 2.2 micromol/L; P < 0.001). In a multiple logistic regression model, African American race-ethnicity was associated with zinc deficiency (odds ratio: 0.26; P = 0.02). The main sources of iron and zinc in the diets were meat products and cereals.

CONCLUSIONS

The prevalence of zinc deficiency and anemia was high in this population of low-income minority children, especially among African Americans. Further investigation of the incidence of zinc deficiency and the ability of anemia to screen for it is warranted.

Some similarities in dietary clusters of pre-school children and their mothers

The diet of pre-school children is determined by the parents and carers. The aim of the present study was to describe dietary clusters of pre-school children and their mothers in Finland, and analyse the similarity of dietary clusters within child–mother pairs. The present study comprised the mothers (n 4862) whose child was recruited in the Type 1 Diabetes Prediction and Prevention Nutrition Study and the children belonging to selected, cross-sectional age groups of 1 year (n 719), 3 years (n 708) and 6 years (n 841). The dietary data were collected from children by 3-d food records and from mothers by a FFQ validated for pregnant women. The food consumption data were analysed for patterns by hierarchical cluster analysis. Three main dietary clusters were identified in children: ‘healthy’ and ‘traditional’ in all three age groups, and ‘ready-to-eat baby foods’ in 1-year-olds and ‘fast foods, sweet’ in the older children. Six main clusters were identified among the mothers who completed a FFQ for their diet during pregnancy. Some familial dependence between dietary clusters of mother–child pairs was observed in 6-year-old children but not in younger children. Younger age and lower educational level of the mother were associated with the cluster ‘fast food, sweet’ only at the age of 3 years. The diets of pre-school children vary by age and only a slight similarity within dietary clusters of mother–child pairs was observed.

Effect of dephytinization and follow-on formula addition on in vitro iron, calcium, and zinc availability from infant cereals

Cereals are introduced to infants between the ages of 4 and 6 months to supplement breast milk and follow-on formula. Our objectives were to examine the content and in vitro availability of Fe, Ca, and Zn from five commercially available infant cereals mixed with water or follow-on formula before and after dephytinization. We estimated the bioaccessibility by measuring the soluble or dialyzable mineral fraction resulting from in vitro gastrointestinal digestion of the sample. For most infant cereals analyzed, dephytinization increased the in vitro availability of iron and zinc. This finding was especially dramatic among infant cereals mixed with follow-on formula rather than with water. However, the liquid used for reconstitution did not always show a significant (p < 0.05) interaction with phytase addition and in vitro mineral availability. The results of this study indicate that adding follow-on formula to infant cereals does not improve the bioaccessibility of iron, calcium, and zinc, despite the increase in mineral content it implies. Results obtained also showed that mineral solubility and dialyzability do not always follow parallel trends.