Evaluation of plaque pH changes following oral rinse with eight infant formulas

Inappropriate feeding habits have been identified as major factors associated with the development of baby bottle tooth decay or nursing caries. An in vivo/in vitro combination technique was developed to investigated the plaque pH changes associated with rinsing with eight different infant formulas. These eight formulas represented four categories: 1) formulas with iron, 2) formulas with low iron, 3) soy formulas 4) and protein hydrolyzate formulas (from the manufacturers Mead Johnson Nutritionals and Ross Laboratories). All formulas had the ability to reduce the pH significantly below the pre-rinse plaque pH. Furthermore, the average minimum pH for formulas from the two manufacturers did not differ within each formula category except for the soy-based formulas, where, rinsing with Isomil produced a significantly lower plaque pH than ProSobee. These results suggest that infant formulas are acidogenic and therefore may play a significant role in the development of baby bottle tooth decay.     

Infant formula, past and future: opportunities for improvement

Infant formulas provide nutritional support to health infants that promotes growth and development equivalent to that in healthy infants fed human milk. Formula-fed infants are not as well protected against infections, and there remain infants whose health, growth, and development may not be supported optimally by either the formulas currently available or human milk. Some infants may be better supported by genetically engineered formulas that contain immunity-enhancing antibodies or antigens. Formulas that contain cytokines promoting epithelial cell growth and integrity may be protective against necrotizing enterocolitis. Formulas containing proteins with genetically excluded allergenic epitopes or formulas with tolerogenic peptides may be useful in treating allergic diseases of suppressing the development of autoimmune disorders later in life. Formulas with genetically engineered biologically active substances might increase the absorption of nutrients in infants with compromised absorption or digestion, enhance host immunity and mucosal integrity, and, potentially militate or protect against the risk of disease.     

Effect of feeding methods in infants on serum lipid profile

Mothers very often do not start to breast feed their children, or stop very quickly and introduce various formulas based either on modified or unmodified cow's milk. These infant formulas differ from human milk in their chemical composition. Breast milk is the most suitable source of all nutrients required for the development of a newborn or infant. The serum levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and phospholipids were determined. The influence of the type of feeding on the levels of the above-mentioned lipids was analyzed. Higher serum levels of triglycerides in babies fed formulas based on modified cow's milk than in those fed formulas based on unmodified milk were found. Higher serum levels of phospholipids were found in breast-fed babies than in those fed formulas based on unmodified cow's milk.     

World trends in infant feeding

Analysis of the dyadic nature (nutritional, psychological, and biological interaction between mother and infant with each affecting the other) and the economics of infant feeding strongly suggests the superiority of breastfeeding over artificial feeding, regardless of the socioeconomic status of societies. Universally, there are 3 main guidelines for scientifically guided biological infant feeding: 1) to feed the pregnant and lactating mothers with a mixed diet of locally available foods; 2) to breastfeed alone for 4 to 6 months, and 3) to introduce least cost weaning foods based on the concept of multimixes from 4 to 6 months onward, preferably prepared from locally available foods but with continuing lactation into the second year of life, particularly in poorer circumstances. Widespread increases in breastfeeding will protect some 10 million infants annually against marasmus and diarrheal diseases, some 1 million cases against infantile obesity and 100,000 cases against cow's milk allergy. The basic issue involved is the development of practical programs which would improve the pattern of breastfeeding or at least minimize its decline, and to optimize the quantity and quality of milk production, particularly by maternal feeding. This can be done by instituting changes in the emphasis in the education of health professionals, and in procedures at pediatric wards and maternity units in hospitals. The promotion and advertising of infant formulas, especially in poor areas, needs monitoring, and appropriate legislation and enforcement. Lactating mothers who are working should be provided with bonuses, creches, 'nursing pauses' in industry, and other methods which will encourage them to combine the roles of motherhood and salaried worker effectively. Interdisciplinary undertakings between economists, administrators and health professionals are needed in order to improve breastfeeding patterns on a community basis. Reappraisal of modern infant feeding practices should be based on modern scientific knowledge, awareness of successful traditional time-tested adaptation, and on man's ancient biological mammalian heritage.     

Estimation of the caries-related risk associated with infant formulas

PURPOSE: Baby bottle tooth decay (BBTD) affects 6% of children under three years of age and is associated with inappropriate bottle use. The objective of this study was to estimate the caries-related risk associated with 26 infant formulas and whole milk. METHODS: First, the plaque pH of adult volunteers was monitored before and after an oral rinse with infant formula to determine the minimum pH obtained in response to each formula. Second, Streptococcus sobrinus 6715 was cultured in each infant formula, and the increase in the number of colony forming units was measured. Third, each infant formula was incubated with powdered enamel and the solubility of enamel mineral was calculated in the absence of bacteria. Fourth, each formula was mixed with standardized concentrations of acid to determine the buffering capabilities. Finally, enamel windows were created on extracted permanent molars and exfoliated primary incisor crowns that were then colonized with mutans streptococci and incubated with infant formula. Caries was assessed visually and radiographically for 18 weeks. The length of time required for the development of enamel caries, dentinal caries and pulpal involvement was recorded. RESULTS: One-way or two-way ANOVA of these five assays demonstrated that 1. Plaque pH varied in response to oral rinsing with infant formula and most formulas did have the ability to reduce the pH significantly below the pH obtained after rinsing with water 2. Some infant formulas supported significant bacterial growth 3. Enamel mineral was dissolved by incubation with certain infant formula 4. The buffer capacity varied among the infant formulas tested 5. The length of time required for caries to reach dentin or pulp differed for the formulas, with some formulas causing dentinal caries by 3.4 weeks and pulpal involvement by 7.2 weeks.     

Isoflavones, soy-based infant formulas, and relevance to endocrine function

For more than 60 years, soy-based infant formulas have been fed to millions of infants worldwide and studied in controlled clinical research. These products provide essential nutrients required for normal growth and development. The safety of isoflavones in soy-based products, including infant formulas, has been questioned recently owing to reports of possible endocrine effects in animals and in cultured cells. The literature offers no evidence of endocrine effects in humans from infant consumption of modern soy-based formulas. Growth is normal and no changes in the timing of puberty or in fertility rates have been reported in humans who consumed soy formulas as infants. Consequently, soy-based infant formulas continue to be a safe, nutritionally complete feeding option for most infants.     

A double-blind study of paroxetine, fluoxetine, and placebo in outpatients with major depression

Human milk has a higher concentration of nucleotides than bovine milk which is the source of most infant formulas. As the composition of human milk is considered the 'gold standard,' an increasing number of infant formulas are supplemented with nucleotides. This review summarises the biology of human milk nucleotides and evaluates the studies which investigated the clinical benefits of feeding infants with nucleotide-supplemented formulas. Although dietary nucleotides have been suggested to have beneficial gastrointestinal and immunological effects, nucleotide-supplemented formula feeding has not been shown to confer the same benefits as breast feeding, and randomised controlled trials have yet to prove that healthy term infants fed nucleotide-supplemented formulas compared to those fed nonsupplemented formulas, have accelerated physical growth and neurological development, better growth and development of their gastrointestinal tract resulting in improved digestive and absorptive functions, enhanced development of their immune system resulting in increased resistance to infection and lower bacterial and viral infection rates during infancy, and a more favourable intestinal microflora associated with a lower rate of infectious diarrhoea. However, a randomised controlled trial has reported that term infants with severe intrauterine growth retardation do have better catch-up growth with nucleotide supplementation. The hypothesis that nucleotides are semi-essential nutrients needs to be further studied, in particular in the presence of prematurity, fetal growth retardation, intestinal injury and limited nutrient intake. As no deleterious effects have been reported with the use of nucleotide-supplemented formulas, the first of which was introduced over 30 years ago, such products are considered safe when nucleotides are supplemented to an amount equivalent to the free nucleotide concentration of human milk. More basic and clinical research studies are awaited to further define the biology and role of human milk nucleotides, and to critically assess the potential benefits and appropriate level of nucleotide supplementation of infant formula.     

Determination of the point position for brachytherapy from the shift-projection method using the least squares method and geometrical solutions

We have derived formulas by the least squares method and six sets of geometrical solutions for calculating the position for brachytherapy from shift-projection images on one or two films. There are four types of expression for each coordinate in both methods, the shift-film technique with double exposures on a film and the stereo-shift technique with two films. Some geometrical solutions for the shift-film technique are equal to well-known conventional formulas. In the case of the stereo-shift technique, each conventional formula for the two coordinates is equal to the mean of the two geometrical solutions of each coordinate, and the one for the other coordinate is equal to one of the geometrical solutions. Formulas for the shift-film technique can be easily reduced to those for the stereo-shift technique. The error of the position calculated by the least squares method was the smallest among all the formulas for the shift-film technique in simulation.     

Evaluation and Improvement of Bed Load Discharge Formulas based on Helley–Smith Sampling in an Alpine Gravel Bed River

Bed load discharge formulas have been evaluated by analyzing them in relation to measured Helley–Smith data for the gravel-bedded armored Drau River, Austria. Comparison of calculations with measurements leads to ranking of the formulas that depends on the evaluation parameters. The choice of formula is made with respect to our specific aims: the investigation of individual floods requires a different approach from that of long-term budgets. Formula performance is consistently improved when conditions for the threshold of motion are modified according to data measured up on the initiation of motion. Formulas such as those reported by Parker in 1990, Zanke in 1999, and Sun and Donahue in 2000 are capable of coping with partial transport, which is commonly found in Alpine rivers. These formulas therefore provide encouraging results, particularly after the introduction of modifications. The augmentation of field measurements, even if limited in scope, considerably improves the performance of bed load discharge formulas.     

Energy balance and metabolic rate in preterm infants fed with standard and high-energy formulas

1. Energy balances were performed on sixteen low birth weight preterm infants over 7-10 d periods on a standard low-solute infant formula (2600 kJ/l), and on four high-energy formulas, providing different energy densities up to 3760 kJ/l. In two of the high-energy formulas the additional fat energy was provided by peanut oil, and the other two by medium chain triglycerides (MCT). Anthropometric measurements and metabolic rate (MR) determinations were made during the balance periods. 2. Mean energy retention on the standard formula was 66% of the intake and declined to below 50% on the two feeds providing the highest energy. Extensive energy balance data on the standard formula are available for reference. 3. Net absorption of dietary energy increased on all the high-energy formulas, rising from 362 kJ/kg per d on the standard formula to 453 kJ/kg per d on the highest energy-formula (P < 0.001). There was no advantage in using MCT. 4. Net absorption of dietary energy improved with advancing maturity, irrespective of the formula. 5. In spite of the increased dietary energy retention, there was no increase in growth rate during periods of feeding with the high-energy formulas. 6. Fasting and postprandial MR increased by 10.4 and 12.8% respectively on the highest energy feeds. 7. It is concluded that, at least in the short term, this type of high-energy feeding increases MR at the expense of growth and thus is probably of no advantage to the infant.     

Evaluation of single cell sources of docosahexaenoic acid and arachidonic acid: a 4-week oral safety study in rats

Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are secreted in human milk and consumed by the nursing neonate but are not present in infant formulas currently available in the US. Supplementation of formulas with DHA and ARA may be particularly important for premature infants, who have less accretion of these fatty acids in utero than term infants. Some experts suggest that DHA and ARA should be added to infant formulas. Common sources of these fatty acids (e.g. fish oils, egg yolk lipids) are not optimal for infants in that they contain disproportionate amounts of other fatty acids. This 4-wk study examined the safety of a high-DHA algal oil and a high-ARA fungal oil, blended so that the DHA:ARA ratio approximates that in human milk. Rats were fed the blend at levels representing three, 11 and 22 times the anticipated infant exposure. Control animals were fed either a high-fat diet (13.1%, w/w; equivalent to the fat content of the treated groups) or a low-fat diet (5%, w/w). There were no treatment-related differences in body weight, food intake, organ weights, haematology or clinical chemistry. Thus, this study indicates that a blend of algal and fungal oils is a safe source of DHA and ARA as it produced no adverse effects in rats when administered for 4 wk at levels up to 22 times the expected infant exposure.     

Within- and between-person variations in portion sizes of foods consumed by the Japanese population

BACKGROUND: Addition of soy polysaccharide to infant formulas has previously been shown to reduce the duration of diarrhea in infants with acute gastroenteritis. Fiber is metabolized to short-chain fatty acids that have been shown to be beneficial in inducing adaptation in the small bowel. We therefore hypothesize that a soy-polysaccharide-supplemented infant formula may be potentially advantageous in the treatment of patients with short bowel syndrome and could have a trophic effect on the remaining small intestine. METHODS: Male Spraque-Dawley rats weighing 250 g were divided into two groups. One group received Isomil, a standard infant soy formula. The second group received Isomil supplemented with fiber, Isomil DF. Half the animals in each dietary group were subjected to 80% jejunoileal resection and the reminder were sham operated. Animals were pair-fed one of two diets for 14 days. At the conclusion of the 14-day period, mucosal weight and sucrase and lactase levels in the remaining duodenum and ileum were determined. RESULTS: Resected animals fed fiber-supplemented formulas had significantly higher sucrase and lactase levels in the proximal bowel. Comparable results were not observed in the sham-operated animals. CONCLUSIONS: The addition of soy polysaccharide to infant formulas fed to children with short bowel syndrome might potentially improve small intestinal functional adaptation as well as positively affecting stool consistency.     

Acute abdomen accompanying hepatic parenchymal changes

Total femur zinc of young rats was used to evaluate the biological availability of zinc in milk and soy protein-based infant formulas. A zinc deficient diet (0.8 mug Zn/g) containing egg white protein was supplemented with graded levels of zinc from zinc sulfate, milk and soy protein-based infant formulas. A plot of total femur zinc (log) after feeding the diet for 3 weeks versus the zinc added to the diet gave a linear relationship over the range of 0, 3, 6, 9 and 12 mug/g added zinc. By using a slope-ratio bioassay model, the relative biological availability of endogenous and added zinc in milk-based formula was estimated to be 0.86 and that of soy-based formula 0.67 (zinc sulphate = 1.00) with corresponding 95% fiducial limits being 0.82 to 0.91 and 0.62 to 0.71. Thus, to provide equivalent amounts of available zinc, the total zinc content of the soy protein-based formula would need to be at least 20% higher than that of the formula containing milk protein.     

Axial stress in the working cones of a composite drawplate

With specified deformation in double and single drawplates, the increments in axial stress and drawing power in the working cones of each drawplate segment are calculated by various formulas. Formulas for the total increment in axial stress in the working cones of the segments of a composite (multisection) drawplate are proposed.     

Effect of two types of fish oil supplementation on plasma and erythrocyte phospholipids in formula-fed term infants

We studied the effect of docosahexaenoic acid (DHA) supplementation of infant formulas on fatty acid composition of blood phospholipids in term infants. Two fish oil supplemented formulas containing 0.45 wt% DHA and high (0.35%) or low (0.10%) eicosapentaenoic acid (EPA) were fed for 42 days and compared with a standard formula and breast milk. Infants fed supplemented formulas and breast milk had similar time-dependent changes for DHA from birth to day 42, i.e., slight decreases in plasma phospholipids and erythrocyte phosphatidylcholine and no change in erythrocyte phosphatidylethanolamine. Low-EPA formula prevented EPA accumulation but did not limit the significant decrease in arachidonic acid (AA) noted in infants fed high-EPA formula. These results suggest that term infant formulas should be supplemented with DHA-rich EPA, low fish oil and AA to achieve a fatty acid status in formula-fed infants similar to that of breast-fed infants.     

Certain regularities in the strength of soft-fiber reinforced plastics with two-component warps

Summary Formulas are derived for the ultimate strength of fiber-reinforced plastics on an oriented two-component warp. on a crossed two-component warp, and on an oriented cotton—Kapron warp.The formulas make possible an analytical calculation of the strength of these materials, proceeding from the properties of the fibers, and thus selection of the optimal composition of the material ensuring the given properties.     

Large sample standard errors of kappa and weighted kappa.

2 statistics, kappa and weighted kappa, are available for measuring agreement between 2 raters on a nominal scale. Formulas for the standard errors of these 2 statistics are in error in the direction of overestimation, so that their use results in conservative significance tests and confidence intervals. Valid formulas for the approximate large-sample variances are given, and their calculation is illustrated using a numerical example. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of hydrolyzed formulas in nutritional allergy prevention in infants

BACKGROUND: In recent years, more and more discussions have arisen with regard to the role of (partially) hydrolyzed formulas as standard feedings for infants with a high risk to have allergy. METHODS: This review is based on an extensive overview of the literature dealing with the subjects of allergy prevention and hydrolyzed formulas. RESULTS: Although breast-feeding should receive absolute priority in the nutrition of infants, the existence of artificial milk formulas as an addition to or replacement of breast milk is a necessity. In high-risk infants with a family history of allergy, we might consider a hypoallergenic formula instead of the classical start formulas to reduce the risk of allergy. From a nutritional point of view, these formulas should only be hydrolyzed as much as necessary. On the other hand, for the treatment of food allergies, the peptides of the semi-elementary infant formulas should be as short as possible. This can, however, have an impact on the nutritional value of the formula. Therefore, a difference is made between partial and complete hydrolysates. CONCLUSION: While a firm recommendation is not yet possible, physicians might consider partial hydrolysate formulas in high-risk infants if parents can afford the higher-cost option.     

Effects of diet on the lipid and fatty acid status of full-term infants at 4 months

OBJECTIVE: To compare the effects of the exogenous supply of long-chain polyunsaturated fatty acids (LCP) and cholesterol on the lipid and fatty acid status in full-term, 4-month old infants. METHODS: Twenty-three infants received a standard infant formula while twenty-one were given a formula enriched with LCP and cholesterol in a prospective, randomized study. The composition of the two formulas differed only in fat quality. A group of fifteen breastfed infants fed was used as reference. No one was complemented with solid foods before blood sampling at 4 months of life. RESULTS: Differences in total-cholesterol and low-density lipoprotein-cholesterol (LDL-C) levels between feeding groups were mainly gender-related. Dietary cholesterol tended to increase LDL-C plasma levels. The breastfed and the enriched formula-fed groups had higher levels of circulating LCP than the group that received the standard formula. In the erythrocytes of infants fed the standard formula, C22:6 n-3 levels were less than 50% those of the breastfed and the enriched formula-fed ones. Higher C20:4 n-6 levels were found in the erythrocytes of the enriched formula-fed group. CONCLUSIONS: Formula-fed, full-term infants maintain a lipid and fatty acid status close to that of breastfed infants when supplied with dietary LCP and cholesterol.     

Feeding disorders in infancy: feeding interaction concept in diagnosis and treatment

In infancy clinical manifestations of psychological distress are mainly somatic. Feeding disorders are one of the most common and nonspecific manifestations of different kinds of disturbed parent-child relationships. These disturbances may have their origins in the baby's constitution and physical status, in the parent's personality structure, or both, as has been conceptualized in the transactional model of normal and abnormal development. Among the daily interactions a baby has with parents, feeding has special inherent impact on the early parent-child relationship because of its psychological meanings. Therefore, feeding disorders, with or without failure to thrive, often reflect various disorders of infancy, still not well recognized in the medical community, such as regulatory disorders, attachment disorders, depression of infancy, disorders of separation-individuation, and post-traumatic eating disorder. 3 clinical cases are brought to increase awareness of psychological distress in the infant, and of feeding disorders as 1 of its manifestations. Each illustrates a different kind of feeding disorder in terms of etiology and pathogenesis. Through these cases we emphasize the need for a multi-disciplinary, integrative approach in diagnosis and treatment. Our conceptual background is based both on the transactional model of development (infant and parental factors impact on each other) in a very dynamic paradigm, and on psychodynamic premises. Intrapsychic conflicts and past representations impact heavily on the parenting characteristics. We emphasize the psychological significance of disturbed feeding interactions, with or without failure to thrive.