Composition and distribution of fatty acids in triglycerides from goat infant formulas with milk fat

Advanced Tandem Mass Spectrometric Analysis of Complex Mixtures of Triacylglycerol Regioisomers: A Case Study of Bovine Milk Fat

Comprehensive analysis of triacylglycerol (TAG) regioisomers is extremely challenging, with many variables that can influence the results. Previously, we reported a novel algorithmic method for resolving regioisomers of complex mixtures of TAGs. In the current study, the TAG Analyzer software and its mass spectrometric fragmentation model were further developed and validated for a much wider range of TAGs. To demonstrate the method, we performed for the first time a comprehensive analysis of TAG regioisomers of bovine milk fat, a very important and one of the most complex TAG mixtures in nature containing FAs ranging from short to long carbon chains. This analysis method forms a solid basis for further investigation of TAG regioisomer profiles in various natural fats and oils, potentially aiding in the development of new and healthier foods and nutraceuticals with targeted lipid structures.

3-Monochloropropane-1,2-diol reduced bioaccessibility of sn-2 palmitate via binding with pancreatic lipase in infant formula during gastrointestinal digestion

Infant formula contains 3-monochloropropane-1,2-diol esters (3-MCPDE), which are formed during the deodorization step of vegetable oil refining. The European Food Safety Authority stated that 3-MCPDE can be hydrolyzed in the gastrointestinal tract to free-form 3-monochloropropane-1,2-diol (3-MCPD), which has potential toxicity and can be rapidly absorbed. Evaluating the effect of 3-MCPD on nutrition absorption is a prerequisite for establishing effective management strategies. A total of 66 crucial lipid molecules associated with 3-MCPD were identified based on debiased sparse partial correlation analysis. 3-MCPD affected triglyceride hydrolyzation and increased the concentration of undigested sn-2 palmitate (9.57 to 17.06 mg kg-1). 3-Monochloropropane-1,2-diol reduced the bioaccessibility of fatty acids, and more short- (31.42 to 58.02 mg kg-1) and medium-chain fatty acids (17.03 to 26.43 mg kg-1) remained unabsorbed. Lipidomic profiles of infant formula models spiked with different 3-MCPDE levels were investigated, and the results were consistent with the experiments with the commercial formula indicating lipid alteration was mainly affected by the digestive 3-MCPD. The formation of 3-MCPD ester-pancreatic lipase with the binding energy of -4.9 kcal mol-1 was more stable than triglyceride-pancreatic lipase (-4.0 kcal mol-1), affecting triglyceride hydrolyzation. 3-Monochloropropane-1,2-diol was bound to Glu13 and Asp331 residues of the pancreatic lipase via hydrogen bonds, which resulted in a conformational change of pancreatic lipase and spatial shielding effect. The existence of the spatial-shielding effect reduced the accessibility of pancreatic lipase and further affected triglyceride hydrolyzation. These findings indicated that 3-MCPD obstructed nutrient acquisition and laid the foundation for the subsequent nutrition enhancement design.

Phenylalanine free infant formula in the dietary management of phenylketonuria

BACKGROUND

Phenylalanine-free infant formula is an essential source of safe protein in a phenylalanine restricted diet, but its efficacy is rarely studied. We report a multicentre, open, longitudinal, prospective intervention study on a phenylalanine-free infant formula (PKU Start: Vitaflo International Ltd.).

RESULTS

This was a 2-part study: part I (28 days short term evaluation) and part II (12 months extension). Data was collected on infant blood phenylalanine concentrations, dietary intake, growth, and gastrointestinal tolerance. Ten infants (n = 8 males, 80%), with a median age of 14 weeks (range 4-36 weeks) were recruited from 3 treatment centres in the UK. Nine of ten infants completed the 28-day follow-up (one caregiver preferred the usual phenylalanine-free formula and discontinued the study formula after day 14) and 7/9 participated in study part II. The phenylalanine-free infant formula contributed a median of 57% (IQR 50-62%) energy and 53% (IQR 33-66%) of total protein intake from baseline to the end of the part II extension study. During the 12-month follow-up, infants maintained normal growth and satisfactory blood phenylalanine control. Any early gastrointestinal symptoms (constipation, colic, vomiting and poor feeding) improved with time.

CONCLUSION

The study formula was well tolerated, helped maintain good metabolic control, and normal growth in infants with PKU. The long-term efficacy of phenylalanine-free infant formula should continue to be observed and monitored.

Comparative Lipidomics Analysis of Human and Ruminant Milk Reveals Variation in Composition and Structural Characteristics

In the present study, the different lipidomes between human milk and ruminant milk were compared. The 471, 376, 467, and 87 differential lipids were identified in human versus cow, goat, sheep, and camel groups, respectively. According to multivariate statistical analysis, lipids in human and camel milk were closer but differed from other milk. The distributions of long-chain and polyunsaturated fatty acids of triglycerides (TGs), the proportions of functional TGs (OPO, OPL, and PPO), and many kinds of phospholipids (PLs) (PS, PI, GD, GM3, and Cer) in human milk were similar to those in camel milk. The similar structure of TGs and proportion of PLs in human milk to camel milk might contribute to their similar digestion and bioactivity properties. Camel milk could be considered as a new resource of lipid base for infant formula. Minor PLs should also be considered for designing formula. Our results provide a new sight for humanized lipids in infant formula.

A Comparative Study of Milk Fat Extracted from the Milk of Different Goat Breeds in China: Fatty Acids, Triacylglycerols and Thermal and Spectroscopic Characterization

Goat milk (GM) is an excellent alternative to cow milk and has recently been used in commercial infant formula preparation due to its superior fat composition. Here, the fatty acid (FA) composition, triacylglycerol (TAG) molecular species, thermal behavior and infrared spectra of extracted milk fat from the milk of the two main breeds of dairy goat bred in China (Guanzhong GM (GZG) and Xinong Saanen GM (XSG)) are investigated. Gas chromatography, Fourier-transform infrared spectroscopy, differential scanning calorimetry and ultra-performance convergence chromatography with quadrupole time-of-flight mass spectrometry are applied. The obtained results evidence significant fat compositional differences based on the breed that produced the considered GM. The major FAs in both GM fats were capric (C10:0), myristic (C14:0), palmitic (C16:0), stearic (C18:0) and oleic (C18:1 n-9c). GZG presented a higher content of medium-chain saturated FAs, while XSG had higher unsaturated FAs with higher ratios of L/Ln and n-6/n-3. A total of 339 and 359 TAGs were detected and quantified in GZG and XSG, and the major TAGs were those of m/z 740.6712 (14.10 ± 0.27%) and m/z 684.6094 (10.94 ± 0.02%), respectively. Milk TAGs of GZG and XSG showed 24–54 and 26–54 total acyl carbon numbers with a 0–4 and 0–5 double bond number at 68 and 72 various retention times, respectively. Thermal analysis showed that all GM fat samples melted below normal body temperature. Infrared spectra revealed higher absorption values of GZG milk fat. This study provides valuable information to the dairy industry sector about GM fat produced in China, assessing the appropriateness of Chinese GM fat to be applied in Chinese infant formula.

Compositional and Functional Considerations for Bovine-, Caprine- and Plant-Based Infant Formulas

Breastmilk is the optimal source of nutrition for infants. However, in circumstances where breastfeeding is not possible or feasible, infant formula provides an essential alternative to fulfil the nutritional requirements of the developing infant. Traditionally, the manufacture of infant formula has involved utilisation of bovine milk as a base ingredient, formulated with other nutrients and bioactive ingredients to closely match the composition of human breastmilk. While it is the most widely available type of formula on the market, bovine-based infant formula is not suitable for all infants, and therefore alternatives such as those based on caprine milk, soy and rice protein are becoming increasingly available. This review provides a detailed examination of the composition of infant formula prepared from bovine milk, caprine milk, soy, and rice protein sources. Available literature on nutrient bio-accessibility and aspects of protein functionality relevant to infant formula is discussed.

Acceptability of "High sn-2" Infant Formula in Non-Breast Fed Healthy Term Infants Regarding Gastrointestinal Tolerability by Both Parents and Pediatrician: An Open-Label Pilot Study in the Gulf Cooperation Council (GCC) Countries

Recent studies have highlighted the positive impact of high sn-2 formulas on gastrointestinal (GI) tolerance. We assessed the GI tolerance, acceptability, and safety of high sn-2 infant formula among non-breastfed healthy term infants in the Gulf countries. A multicenter observational study was conducted on 227 healthy-term infants who were prescribed high sn-2 palmitate infant formula and received a minimum of two formula feedings per day for the past two weeks prior to the study's initiation. The number of stools per day decreased significantly from a median of four (interquartile range [IQR] = 4) at baseline to 3.0 (2) stools per day at the end of follow-up (p = 0.015). The percentage of stool amount changed significantly, where 61.2% and 33.7% of the infants had an amount of 25-50% of the diaper and >50% of the diaper, respectively (p < 0.001) at the end of the follow-up. Similarly, the percentage of hard stool decreased significantly from 17.4% at baseline to 0.4% of the population at week 12 (p < 0.00). The prevalence of colic and abdominal distention declined from 21.4% and 39.9% at baseline to 2.9% and 9.4% at week 12, respectively (p < 0.05). The same decline was observed in abdominal distension and regurgitation score (p < 0.05).

Comparative Structural and Compositional Analyses of Cow, Buffalo, Goat and Sheep Cream

Factors affecting milk and milk fraction composition, such as cream, are poorly understood, with most research and human health application associated with cow cream. In this study, proteomic and lipidomic analyses were performed on cow, goat, sheep and Bubalus bubalis (from now on referred to as buffalo), bulk milk cream samples. Confocal laser scanning microscopy was used to determine the composition, including protein, lipid and their glycoconjugates, and the structure of the milk fat globules. BLAST2GO was used to annotate functional indicators of cream protein. Functional annotation of protein highlighted a broad level of similarity between species. However, investigation of specific biological process terms revealed distinct differences in antigen processing and presentation, activation, and production of molecular mediators of the immune response. Lipid analyses revealed that saturated fatty acids were lowest in sheep cream and similar in the cream of the other species. Palmitic acid was highest in cow and lowest in sheep cream. Cow and sheep milk fat globules were associated with thick patches of protein on the surface, while buffalo and goat milk fat globules were associated with larger areas of aggregated protein and significant surface adsorbed protein, respectively. This study highlights the differences between cow, goat, sheep, and buffalo milk cream, which can be used to support their potential application in functional foods such as infant milk formula.

Comparative Analysis of Lipid Digestion Characteristics in Human, Bovine, and Caprine Milk Based on Simulated In Vitro Infant Gastrointestinal Digestion

Lipid digestion characteristics in human, bovine, and caprine milk were investigated using an infant in vitro digestion model. Our results suggested that particle size in bovine and caprine milk increased initially and then decreased over time, whereas the particle size in human milk continuously decreased. The lipolysis degree of human milk (86.8%) was higher than that in bovine (80.2%) and caprine (82.7%) milk (P < 0.05). Compared to human milk, bovine and caprine milk released higher unsaturated fatty acids and lower SFAs. In addition, 12 and 84 glyceride species were significantly different between bovine and human milk, during gastrointestinal digestion (P < 0.05). Another 13 and 92 glyceride species were found to be significantly different between caprine and human milk. A total of 30 and 31 lipids were screened as biomarkers to further clarify the differences related to lipid digestion properties of human, bovine, and caprine milk.

Formation of Self-Assembled Mesophases During Lipid Digestion

Lipids play an important role in regulating bodily functions and providing a source of energy. Lipids enter the body primarily in the form of triglycerides in our diet. The gastrointestinal digestion of certain types of lipids has been shown to promote the self-assembly of lipid digestion products into highly ordered colloidal structures. The formation of these ordered colloidal structures, which often possess well-recognized liquid crystalline morphologies (or “mesophases”), is currently understood to impact the way nutrients are transported in the gut and absorbed. The formation of these liquid crystalline structures has also been of interest within the field of drug delivery, as it enables the encapsulation or solubilization of poorly water-soluble drugs in the aqueous environment of the gut enabling a means of absorption. This review summarizes the evidence for structure formation during the digestion of different lipid systems associated with foods, the techniques used to characterize them and provides areas of focus for advancing our understanding of this emerging field.

Total and Sn-2 Fatty Acid Profile in Human Colostrum and Mature Breast Milk of Women Living in Inland and Coastal Areas of China

INTRODUCTION

Although lipid is the major energy source and exerts beneficial effects on infant growth, research on the composition of fatty acid (FA) at the sn-2 position of human milk (HM) in China and abroad is limited.

OBJECTIVES

This study aimed to investigate the FA positional distribution in colostrum and mature HM of women living in the inland and coastal areas of China and explore the potential influences of geographical region and lactation stage on the FA profile of Chinese women.

METHODS

Colostrum milk (n = 61) and mature milk (n = 56) samples were obtained longitudinally from healthy lactating women in Guangzhou and Chengdu, China. Gas chromatography was used to determine the total and sn-2 FA composition.

RESULTS

Significant differences were observed in the FA profile of HM between different regions and lactation stages, with differences in polyunsaturated FA levels being the most pronounced. Nearly 70% of sn-2 FAs were saturated FAs, of which C16:0 accounted for approximately 75%. C8:0, C10:0, C18:0, C20:0, C22:0, and all of the unsaturated FAs were mainly located at the sn-1 and sn-3 positions, while C14:0, C15:0, and C16:0 were mainly at the sn-2 position. The proportion of C12:0 and C17:0 at sn-2 was approximately equivalent to that at the sn-1, 3 positions.

CONCLUSIONS

The results indicate the variability in the FA profile of HM between regions and lactation stages. The contents of polyunsaturated FAs and sn-2 FAs, especially palmitic acid, should be paid more attention when optimizing infant formula.

Neonatal Diet Impacts the Large Intestine Luminal Metabolome at Weaning and Post-Weaning in Piglets Fed Formula or Human Milk

The impact of human milk (HM) or dairy milk-based formula (MF) on the large intestine’s metabolome was not investigated. Two-day old male piglets were randomly assigned to HM or MF diet (n = 26/group), from postnatal day (PND) 2 through 21 and weaned to a solid diet until PND 51. Piglets were euthanized at PND 21 and PND 51, luminal contents of the cecum, proximal (PC) and distal colons (DC), and rectum were collected and subjected to metabolomics analysis. Data analyses were performed using Metaboanalyst. In comparison to MF, the HM diet resulted in higher levels of fatty acids in the lumen of the cecum, PC, DC, and rectum at PND 21. Glutamic acid was greater in the lumen of cecum, PC, and DC relative to the MF group at PND 21. Also, spermidine was higher in the DC and rectal contents of HM relative to MF at PND 21. MF diet resulted in greater abundances of amino acids in the cecal lumen relative to HM diet at PND 21. Additionally, several sugar metabolites were higher in various regions of the distal gut of MF fed piglets relative to HM group at PND 21. In contrast, at PND 51, in various regions there were higher levels of erythritol, maltotriose, isomaltose in HM versus MF fed piglets. This suggests a post weaning shift in sugar metabolism that is impacted by neonatal diet. The data also suggest that infant diet type and host-microbiota interactions likely influence the lower gut metabolome.

Whole Goat Milk as a Source of Fat and Milk Fat Globule Membrane in Infant Formula

Cow milk is the most common dairy milk and has been extensively researched for its functional, technological and nutritional properties for a wide range of products. One such product category is infant formula, which is the most suitable alternative to feed infants, when breastfeeding is not possible. Most infant formulas are based on cow milk protein ingredients. For several reasons, consumers now seek alternatives such as goat milk, which has increasingly been used to manufacture infant, follow-on and young child formulas over the last 30 years. While similar in many aspects, compositional and functional differences exist between cow and goat milk. This offers the opportunity to explore different formulations or manufacturing options for formulas based on goat milk. The use of whole goat milk as the only source of proteins in formulas allows levels of milk fat, short and medium chain fatty acids, sn-2 palmitic acid, and milk fat globule membrane (MFGM) to be maximised. These features improve the composition and microstructure of whole goat milk-based infant formula, providing similarities to the complex human milk fat globules, and have been shown to benefit digestion, and cognitive and immune development. Recent research indicates a role for milk fat and MFGM on digestive health, the gut–brain axis and the gut–skin axis. This review highlights the lipid composition of whole goat milk-based infant formula and its potential for infant nutrition to support healthy digestion, brain development and immunity. Further work is warranted on the role of these components in allergy development and the advantages of goat milk fat and MFGM for infant nutrition and health.

Monitoring the composition, authenticity and quality dynamics of commercially available Nigerian fat-filled milk powders under inclement conditions using NIRS, chemometrics, packaging and microbiological parameters

Fat-filled milk powders (FMP) are inexpensive milk alternatives predominantly exported to developing countries to satisfy growing demands for dairy proteins. Harsh climatic and sanitary conditions, poor border controls and relatively long periods for distribution and storage enhance the inherent vulnerability of FMP to fraud and stability. Rapid, low-cost methods are needed for extensive routine authentication of FMP products. This study investigated, for the first time, the sample integrity and the quality dynamics of 7 Nigerian FMP brands stored for 7 weeks at 40 °C. The prominent melamine and urea absorption peaks were absent, but protein contents were below the permitted limit. The peak absorbance of the OH functional group increased while the tryptophan contents decreased with storage time. Multiclass analyses differentiated the fresh FMP brands from one another, and from those that were aged. Robust interval-PLS predictions obtained for storage time may be excellent indicators of FMP freshness and stability.

Lipid Profiling and Microstructure Characteristics of Goat Milk Fat from Different Stages of Lactation

Goat milk at different lactations show varied lipids distributions, which are potentially dietary influencing factors for the health of human consumers. Herein, the effects of lactation stages (colostral, transitional, and mature stages) on lipid profiling and microstructure of goat milk fat (GMF) were investigated. A total of 359 species of triacylglycerols (TAGs), 27 species of diacylglycerols (DAGs), and 10 classes of phospholipids (PLs) were identified using high resolution tandem mass spectrometry (HR-MS/MS). Of importance, goat transitional milk presented the highest levels of MUFA (29.51%) and lyso-phospholipids (7.95% of total PLs) among these three different lactations. A lactation-dependent attenuation was found at the level of PUFA in goat milk, particularly long-chain PUFA ω-6. Similar behavior was observed in the total proportions of POO (16:0/18:1/18:1) and PSL (16:0/18:0/18:2), presenting a decrease from 3.70% to 3.23% as the proceeding period from colostrum to mature. The relative contents of sphingomyelin and cholesterol in goat colostrum were approximately twice and three times that in mature milk, respectively. Unlikely, both PMCy+MCaM (16:0/14:0/8:0 + 14:0/10:0/14:0) and BuPO (4:0/16:0/18:1) TAGs, the foremost saturated and monounsaturated TAGs in goat colostrum, respectively, showed upward trends over the period from colostrum to mature. Interestingly, no significant variation in milk fat globule morphology was monitored at different lactation periods. Therefore, all our results demonstrated that the main influences of lactation stages on GMF were the lipid profiling, providing a theoretical guidance for rational implement of lipids in goat milk.

Modulating Sterol Concentrations in Infant Formula Influences Cholesterol Absorption and Synthesis in the Neonatal Piglet

Formula-fed infants present higher cholesterol synthesis rates and lower circulating cholesterol during the postnatal feeding period compared to breast-fed infants, though the mechanisms underlying this phenotype are not fully understood. Typical infant formulas contain vegetable-based fats, inherently including phytosterols (PS), which are structurally similar to cholesterol and may interfere with their absorption. A seven-day old piglets model was used to test the inhibitory effects of PS on cholesterol absorption during postnatal feeding. Following feeding for 21 days with milk-based formulas containing PS and cholesterol levels resembling those in formulas or human-milk, apparent cholesterol digestibility was analyzed in ileal digesta, and cholesterol, PS, and cholesterol synthesis markers were analyzed in plasma and liver samples. Ileal cholesterol digestibility content was increased in the piglets fed low PS formulas and the rate of the hepatic cholesterol synthesis, as determined by the lathosterol-to-cholesterol ratios (L:C), was decreased in the piglets fed LP-formulas and corresponded to reduced nuclear expression of SREBP2 relative to those fed HP-formulas. These results are consistent with the hypothesis that PS in formula can inhibit cholesterol absorption and enhance cholesterol synthesis. Whether or not this leads to entrainment of cholesterol synthesis later in life via early programming awaits further research.

Human Milk Fat Globule Membrane Contains Hundreds of Abundantly Expressed and Nutritionally Beneficial Proteins That Are Generally Lacking in Caprine Milk

BACKGROUND

Bioactive proteins from milk fat globule membrane (MFGM) play extensive roles in cellular processes and defense mechanisms in infants. The aims of this study were to identify differences in protein compositions in human and caprine MFGM using proteomics and evaluate possible nutritional benefits of caprine milk toward an infant's growth, as an alternative when breastfeeding or human milk administration is not possible or inadequate.

MATERIALS AND METHODS

Human and caprine MFGM proteins were isolated and analyzed, initially by polyacrylamide gel electrophoresis, and subsequently by quadrupole time-of-flight liquid chromatography-mass spectrometry. This was then followed by database search and gene ontology analysis. In general, this method selectively analyzed the abundantly expressed proteins in milk MFGM.

RESULTS

Human MFGM contains relatively more abundant bioactive proteins compared with caprine. While a total of 128 abundant proteins were detected in the human MFGM, only 42 were found in that of the caprine. Seven of the bioactive proteins were apparently found to coexist in both human and caprine MFGM.

RESULTS/DISCUSSION

Among the commonly detected MFGM proteins, lactotransferrin, beta-casein, lipoprotein lipase, fatty acid synthase, and butyrophilin subfamily 1 member A1 were highly expressed in human MFGM. On the other hand, alpha-S1-casein and EGF factor 8 protein, which are also nutritionally beneficial, were found in abundance in caprine MFGM. The large number of human MFGM abundant proteins that were generally lacking in caprine appeared to mainly support human metabolic and developmental processes.

CONCLUSION

Our data demonstrated superiority of human MFGM by having more than one hundred nutritionally beneficial and abundantly expressed proteins, which are clearly lacking in caprine MFGM. The minor similarity in the abundantly expressed bioactive proteins in caprine MFGM, which was detected further, suggests that it is still nutritionally beneficial, and therefore should be included when caprine milk-based formula is used as an alternative.

Evaluation of sn-2 fatty acid composition in commercial infant formulas on the Chinese market: A comparative study based on fat source and stage

The sn-2 fatty acid composition of 180 commercial infant, follow-on and growing-up formulas with three fat sources (plant oil, cows' milk and goats' milk) was investigated and compared with mature human milk (MHM). Sn-2 fatty acids in formulas were mostly dependent on fat source and stage. Compared with MHM, all types of formulas contained lower levels of palmitic acid (PA), saturated fatty acid and long-chain polyunsaturated fatty acids (LC-PUFA), and higher levels of oleic acid (OA), linoleic acid (LA) and α-linolenic acid (LNA) at the sn-2 position. Even some formulas were supplemented with 1,3-dioleoyl-2-palmitoylglycerol, the proportions of relative PA at the sn-2 position in formulas were much lower than that in MHM. Moreover, formulas had higher proportions of relative OA, LA and LNA, and lower LC-PUFAs at the sn-2 position. This study indicated that there were significant differences in the positional distribution of fatty acids between formulas and MHM.

Dietary Effects on Plasma Glycerophospholipids

OBJECTIVE

Human milk provides a complex mixture of animal lipids, whereas the fat supply of most modern infant formula is based on vegetable oils. We studied the effects of breast-feeding and of feeding infant formula either without or with dairy goat lipids on the composition of infant plasma glycerophospholipids.

METHODS

Healthy-term infants were randomized double blind to feeding with infant formula based on whole goats' milk (GIF, approximately 60% milk fat and 40% vegetable oils) or a control cows' milk infant formula based on vegetable oils (VIF) from 2 weeks after birth. A reference group of fully breast-fed infants was also followed. At the age 4 months, blood samples were collected and plasma glycerophospholipids were analyzed with liquid chromatography coupled to triple quadrupole mass spectrometry.

RESULTS

The group of breast-fed infants showed significantly higher contents of glycerophospholipid species containing sn-2 palmitic acid [PC(16:0/16:0) and PC(18:0/16:0)] and significantly higher contents of glycerophospholipid species containing long-chain polyunsaturated fatty acids than infants in both formula groups. The GIF group demonstrated significantly higher glycerophospholipid species containing myristic acid [LPC(14:0), PC(14:0/18:1), PC(16:0/14:0)] and palmitoleic acid [LPC(16:1), PC(16:0/16:1), and PC(16:1/18:1)] than the VIF group.

CONCLUSIONS

We conclude that breast-feeding induces marked differences in infant plasma glycerophospholipid profiles compared with formula feeding, whereas the studied different sources of formula fat resulted in limited effects on plasma glycerophospholipids.

Association of infant feeding practices in the general population with infant growth and stool characteristics

This was a prospective cohort study of 976 infants from birth to 12 months of age. Infants were fed breast milk, goat infant formula, cow infant formula, or a combination of formula and breast milk during the first 4 months of age. Data on type of milk feeding and infant growth (weight and height) were collected at birth and at 4, 8, and 12 months during routine clinical assessment. The number and consistency of bowel motions per day were recorded based on observational data supplied by the mothers. Infants fed breast milk or goat or cow infant formula during the first 4 months displayed similar growth outcomes. More of the infants fed cow infant formula had fewer and more well-formed bowel motions compared with breast-fed infants. The stool characteristics of infants fed goat formula resembled those of infants fed breast milk.