First Bites-Why, When, and What Solid Foods to Feed Infants

Functional adaptation of the infant craniofacial system to mechanical loadings arising from masticatory forces

The morphology and biomechanics of infant crania undergo significant changes between the pre- and post-weaning phases due to increasing loading of the masticatory system. The aims of this study were to characterize the changes in muscle forces, bite forces and the pattern of mechanical strain and stress arising from the aforementioned forces across crania in the first 48 months of life using imaging and finite element methods. A total of 51 head computed tomography scans of normal individuals were collected and analysed from a larger database of 217 individuals. The estimated mean muscle forces of temporalis, masseter and medial pterygoid increase from 30.9 to 87.0 N, 25.6 to 69.6 N and 23.1 to 58.9 N, respectively (0-48 months). Maximum bite force increases from 90.5 to 184.2 N (3-48 months). There is a change in the pattern of strain and stress from the calvaria to the face during postnatal development. Overall, this study highlights the changes in the mechanics of the craniofacial system during normal development. It further raises questions as to how and what level of changes in the mechanical forces during the development can alter the morphology of the craniofacial system.

Plasma per- and polyfluoroalkyl substance mixtures during pregnancy and duration of breastfeeding in the New Hampshire birth cohort study

BACKGROUND

Prior studies suggest that prenatal per- and polyfluoroalkyl substances (PFAS) exposures are associated with shorter breastfeeding duration. Studies assessing PFAS mixtures and populations in North America are sparse.

METHODS

We quantified PFAS concentrations in maternal plasma collected during pregnancy in the New Hampshire Birth Cohort Study (2010-2017). Participants completed standardized breastfeeding surveys at regular intervals until weaning (n = 813). We estimated associations between mixtures of 5 PFAS and risk of stopping exclusive breastfeeding before 6 months or any breastfeeding before 12 months using probit Bayesian kernel machine regression. For individual PFAS, we calculated the relative risk and hazard ratio (HR) of stopping breastfeeding using modified Poisson regression and accelerated failure time models respectively.

RESULTS

PFAS mixtures were associated with stopping exclusive breastfeeding before 6 months, primarily driven by perfluorooctanoate (PFOA). We observed statistically significant trends in the association of perfluorohexane sulfonate (PFHxS), PFOA, and perfluorononanoate (PFNA) (p-trends≤0.02) with stopping exclusive breastfeeding. Participants in the highest PFOA quartile had a 28% higher risk of stopping exclusive breastfeeding before 6 months compared to those in the lowest quartile (95% Confidence Interval: 1.04, 1.56). Similar trends were observed for PFHxS and PFNA with exclusive breastfeeding (p-trends≤0.05). PFAS were not associated with stopping any breastfeeding before 12 months.

CONCLUSIONS

In this cohort, we observed that participants with greater overall plasma PFAS concentrations had greater risk of stopping exclusive breastfeeding before 6 months and associations were driven largely by PFOA. These findings further support the growing literature indicating that PFAS may be associated with shorter duration of breastfeeding.

Complementary Feeding Practices: Recommendations of Pediatricians for Infants with and without Allergy Risk

AIM

To investigate the routine guidance provided by pediatricians concerning the timing of complementary feeding (CF) for both healthy infants and those at a heightened risk of allergies.

METHODS

A total of 233 pediatricians participated in an anonymous online survey that included questions about demographics and recommendations for CF. Specifically, they provided guidance on the types of foods, preparation methods, supplements, time intervals for introducing new foods to infants at low and high allergy risk, and delayed food introductions for high-risk cases.

RESULTS

The respondents advised introducing certain foods at specific ages: fruits, starchy non-gluten grains, vegetables, olive oil, and meat were appropriate at 6 months; gluten-rich grains at 7 months; yogurt, hard-boiled eggs, and legumes at 8 months; fish at 8.5 months; and nuts at 9 months. Pediatricians, especially those with less than 15 years of practice, often introduced egg, seafood, gluten-rich grains, legumes, and nuts earlier for high-risk infants. Parenthood and male gender were associated with the earlier introduction of eggs and grains.

CONCLUSIONS

Greek pediatricians follow a structured food introduction schedule for CF in infants. Interestingly, they tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants. Key Notes: Despite recent evidence-based indications on healthy complementary feeding strategies for infants, discrepancies persist among pediatricians regarding food choices and the order and timing of food introduction, both for healthy infants and those at risk of allergy. Guidance on complementary feeding by pediatricians is influenced by their individual characteristics. Pediatricians tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants.

The amniotic fluid proteome changes across gestation in humans and rhesus macaques

Amniotic fluid is a complex biological medium that offers protection to the fetus and plays a key role in normal fetal nutrition, organogenesis, and potentially fetal programming. Amniotic fluid is also critically involved in longitudinally shaping the in utero milieu during pregnancy. Yet, the molecular mechanism(s) of action by which amniotic fluid regulates fetal development is ill-defined partly due to an incomplete understanding of the evolving composition of the amniotic fluid proteome. Prior research consisting of cross-sectional studies suggests that the amniotic fluid proteome changes as pregnancy advances, yet longitudinal alterations have not been confirmed because repeated sampling is prohibitive in humans. We therefore performed serial amniocenteses at early, mid, and late gestational time-points within the same pregnancies in a rhesus macaque model. Longitudinally-collected rhesus amniotic fluid samples were paired with gestational-age matched cross-sectional human samples. Utilizing LC-MS/MS isobaric labeling quantitative proteomics, we demonstrate considerable cross-species similarity between the amniotic fluid proteomes and large scale gestational-age associated changes in protein content throughout pregnancy. This is the first study to compare human and rhesus amniotic fluid proteomic profiles across gestation and establishes a reference amniotic fluid proteome. The non-human primate model holds promise as a translational platform for amniotic fluid studies.

The complementary feeding practices of low-income Black mothers with infants between 6 and 24 months of age: A qualitative study

BACKGROUND

The period from 6 to 24 months in an infant's life presents a critical window for understanding feeding practices and for designing culturally appropriate interventions. However, little is known about the complementary feeding practices of Black mothers and how this period can be used to optimise the long-term health of their children. The present study aimed to identify factors that influence the complementary feeding practices of low-income Black mothers with children aged 6-24 months.

METHODS

Participants were recruited through Research Match, Facebook advertising, flyers, and snowballing techniques. Low-income, Black mothers, with a 6-24-month-old infant, and who lived in Franklin County, Ohio, USA, were eligible for the study. A cross-sectional design using in-depth interviews was used. Reflexive thematic analysis was utilised to analyse and interpret the feeding practices of Black mothers.

RESULTS

Mothers (n = 8) were aged between 18 and 30 years old and most completed college or had some college education (n = 6). Half (n = 4) were married, employed, and rated their diet quality and their children's as very good. Three themes emerged: (a) complementary feeding at ≥ 6 months of age; (b) involvement of health care providers and service organisations in feeding decisions; and (c) use of responsive feeding cues.

CONCLUSIONS

All mothers breastfed exclusively and most (n = 6) initiated complementary feeding at 6 months. Paediatricians, other health providers and service organisations were instrumental in helping Black mothers adopt complementary feeding practices. Mothers also engaged in responsive feeding practices. These findings point to the critical nature of access and education in helping Black mothers in the study achieve feeding recommendations for their infants.

Nutritional Considerations for the First Year of Life

Feeding during the first year of life is a dynamic process with unique questions, concerns, and milestones emerging at every step. This article will review a small selection of specific questions and concerns related to feeding in the first 12 months of infancy. The aim of this article is to inform and support pediatric providers and parents during this crucial developmental period. [Pediatr Ann. 2023;52(9):e316-e321.].

Breastfeeding and Complementary Feeding Practices among Caregivers at Seshego Zone 4 Clinic in Limpopo Province, South Africa

Breastfeeding and complementary feeding are key components of infant and young child feeding that ensure healthy growth, survival, and development. Initiating breastfeeding within an hour after delivery, exclusively breastfeeding for six months, and introducing complementary feeding at six months while continuing breastfeeding up to 24 months or beyond, helps in the prevention of malnutrition, which is a public health problem. The aim of this study was to determine breastfeeding and complementary feeding practices among caregivers of children under 24 months in Seshego, Limpopo Province. A quantitative and cross-sectional design was applied to collect data from 86 caregivers using convenience sampling. A structured questionnaire was utilised to gather data and analysed through statistical software, using descriptive and inferential statistics. Chi-square tests were used to determine associations at a 95% confidence interval where a p-value of <0.05 was considered statistically significant. The findings show that 55% of participants had good breastfeeding and complementary feeding practices. Moreover, 94.2% of participants breastfeed within an hour after delivery at a healthcare facility. Only 43.6% of children were exclusively breastfed. Most participants (52.3%) gave children food before six months and 45.1% introduced complementary feeding at the appropriate age. Also, 69.7% of children across all age groups were not given infant formula. No statistical association was observed between feeding practices and sociodemographic. Breastfeeding was initiated within an hour after delivery at the healthcare facilities, however, post discharge exclusive breastfeeding maintenance remains a challenge. Few infants were introduced to complementary feeding at the appropriate age. A post discharge intervention to practice exclusive breastfeeding, continued breastfeeding, and introduction of appropriate complementary feeding is recommended.

The Occurrence of Squalene in Human Milk and Infant Formula

(1) Background: The aim of the conducted research was to analyze the squalene content in infants' food. (2) Methods: The experimental material included human milk collected from 100 women from Poland and three different infant formulas. The breast milk fat was extracted according to the Rose-Gottlieb method (AOAC), while the squalene content was determined using the high-performance liquid chromatography (HPLC) method. (3) Results: The highest amount of squalene was identified in the milk of women aged 18-25 (p < 0.05), and its content in milk decreased with the age of lactating women. Moreover, the greatest amount of squalene was identified in milk from the first lactation period (colostrum), while in mature milk, its content was more than two times lower. There was a correlation between breastfeeding BMI and the squalene content in milk (r = 0.78). (4) Conclusions: The conducted research shows that the level of squalene in human milk depends on physiological factors such as the lactation period and individual factors (age, BMI). The results of the conducted research indicate that breast milk is richer in squalene than modified milk. This study shows the importance of breastfeeding and indicates the superiority of breast milk over infant formulas.

The Effect of Infant Gastric Digestion on Human Maternal Milk Cells

SCOPE

Human breast milk contains a variety of cell types that have potential roles in infant immunity and development. One challenge associates with defining the purpose(s) of milk cells in the infant is a poor understanding of the effect of digestion on cell fate.

METHODS AND RESULTS

This study first demonstrates that milk cell death occurs after gastric digestion in mice. Then flow cytometry and RT-PCR are used to understand the mechanism of human milk cell death and quantify live cell types before and after simulated gastric digestion. This study finds that digestion in simulated gastric fluid for 30 min reduces cell viability from 72% to 27%, with most cell death is caused by the acidic pH. The primary mechanism of cell death is caspase-mediated apoptosis. The non-cellular components of milk offer only mild protection against cell death from stomach acid.

CONCLUSIONS

Gastric digestion does not select for a specific resilient cell population to survive-most cell types die in equal proportions in the gastric environment. Taken together, these results provide a foundation with which to understand the fate of human breast milk cells in the infant's intestine and beyond.