A MALDI-TOF MS approach for mammalian, human, and formula milks’ profiling

Human milk composition is dynamic, and substitute formulae are intended to mimic its protein content. The purpose of this study was to investigate the potentiality of matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS), followed by multivariate data analyses as a tool to analyze the peptide profiles of mammalian, human, and formula milks. Breast milk samples from women at different lactation stages (2 (n = 5), 30 (n = 6), 60 (n = 5), and 90 (n = 4) days postpartum), and milk from donkeys (n = 4), cows (n = 4), buffaloes (n = 7), goats (n = 4), ewes (n = 5), and camels (n = 2) were collected. Different brands (n = 4) of infant formulae were also analyzed. Protein content (<30 kDa) was analyzed by MS, and data were exported for statistical elaborations. The mass spectra for each milk closely clustered together, whereas different milk samples resulted in well-separated mass spectra. Human samples formed a cluster in which colostrum constituted a well-defined subcluster. None of the milk formulae correlated with animal or human milk, although they were specifically characterized and correlated well with each other. These findings propose MALDI-TOF MS milk profiling as an analytical tool to discriminate, in a blinded way, different milk types. As each formula has a distinct specificity, shifting a baby from one to another formula implies a specific proteomic exposure. These profiles may assist in milk proteomics for easiness of use and minimization of costs, suggesting that the MALDI-TOF MS pipelines may be useful for not only milk adulteration assessments but also for the characterization of banked milk specimens in pediatric clinical settings

Predictors of breastfeeding duration among women in Kuwait: results of a prospective cohort study

The purposes of this paper are to report the prevalence of breastfeeding to six months among women in Kuwait and to determine the factors that are associated with the duration of breastfeeding. A cohort of 373 women recruited from maternity wards in four hospitals in Kuwait city were followed from birth to 26 weeks postpartum. The association of any and full breastfeeding duration and predictor variables were explored using multivariate Cox’s proportional hazards models. At six months, 39% of all infants were receiving some breast milk and only 2% of infants had been fully breastfed to 26 weeks. Women born in other Arab countries were less likely to discontinue breastfeeding than women born in Kuwait. Other factors positively associated with breastfeeding duration were level of maternal education, higher parity, infant being demand fed in hospital and a preference for breastfeeding on the part of the infant’s father and maternal grandmother. The introduction of a pacifier before four weeks of age and the mother intending to return to work by six months were negatively associated with duration. These findings present a number of opportunities for prolonging breastfeeding duration in Kuwait

Low zinc status and absorption exist in infants with jejunostomies or ileostomies which persists after intestinal repair.

There is very little data regarding trace mineral nutrition in infants with small intestinal ostomies. Here we evaluated 14 infants with jejunal or ileal ostomies to measure their zinc absorption and retention and biochemical zinc and copper status. Zinc absorption was measured using a dual-tracer stable isotope technique at two different time points when possible. The first study was conducted when the subject was receiving maximal tolerated feeds enterally while the ostomy remained in place. A second study was performed as soon as feasible after full feeds were achieved after intestinal repair. We found biochemical evidence of deficiencies of both zinc and copper in infants with small intestinal ostomies at both time points. Fractional zinc absorption with an ostomy in place was 10.9% ± 5.3%. After reanastamosis, fractional zinc absorption was 9.4% ± 5.7%. Net zinc balance was negative prior to reanastamosis. In conclusion, our data demonstrate that infants with a jejunostomy or ileostomy are at high risk for zinc and copper deficiency before and after intestinal reanastamosis. Additional supplementation, especially of zinc, should be considered during this time period

Formula versus maternal breast milk for feeding preterm or low birth weight infants

BACKGROUND: Artificial formula can be manipulated to contain higher amounts of macro-nutrients than maternal breast milk but breast milk confers important immuno-nutritional advantages for preterm or low birth weight (LBW) infants. OBJECTIVES: To determine the effect of feeding preterm or LBW infants with formula compared with maternal breast milk on growth and developmental outcomes. SEARCH METHODS: We used the standard strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), and Ovid MEDLINE, Ovid Embase, Ovid Maternity & Infant Care Database, and CINAHL to October 2018. We searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials that compared feeding preterm or low birth weight infants with formula versus maternal breast milk. DATA COLLECTION AND ANALYSIS: Two review authors planned independently to assess trial eligibility and risk of bias, and extract data. We planned to analyse treatment effects as described in the individual trials and report risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with 95% confidence intervals. We planned to use a fixed-effect model in meta-analyses and to explore potential causes of heterogeneity in subgroup analyses. We planned to use the GRADE approach to assess the certainty of evidence. MAIN RESULTS: We did not identify any eligible trials. AUTHORS' CONCLUSIONS: There are no trials of formula versus maternal breast milk for feeding preterm or low birth weight infants. Such trials are unlikely to be conducted because of the difficulty of allocating an alternative form of nutrition to an infant whose mother wishes to feed with her own breast milk. Maternal breast milk remains the default choice of enteral nutrition because observational studies, and meta-analyses of trials comparing feeding with formula versus donor breast milk, suggest that feeding with breast milk has major immuno-nutritional advantages for preterm or low birth weight infants

Nutrition in childhood

Childhood is the stage in a human’s life associated with growth and development. Growth proceeds rapidly in early life, slows down in middle childhood and accelerates at puberty before linear growth ceases. With increasing age there is also physical and psychomotor maturation, which influences activity, body composition, feeding skills and food choices (Geissler, 2011). Adequate nutrition is essential for growth, health and development of children. Poor nutrition increases the risk of illness, and is responsible directly or indirectly for one third of the estimated 9.5 million deaths that occurred in 2006 in children less than 5 years of age. Inappropriate nutrition can also lead to childhood obesity. (WHO, 2009a).peer-reviewe

Determining the relative validity and reproducibility of a complementary food frequency questionnaire to assess nutrient intake in New Zealand infants aged 9 to 12 months : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand

Background: Obtaining information on dietary intake in infants is challenging but necessary to help understand the relationship between diet and growth and development. Food frequency questionnaires (FFQ) are commonly used to investigate dietary intake as they are suited for use in large population groups, can determine intake over multiple days and minimise participant and researcher burden, and associated costs. FFQs need to be specific to the population they are to be used in and validated so that their results can be interpreted with greater confidence. There are currently no simple, validated dietary assessment methods that are available to assess nutrient intake for New Zealand infants. Objective: To validate a complementary food frequency questionnaire (CFFQ) against a reference method of a four-day weighed food record (4dWFR) for assessing nutrient intakes of New Zealand infants aged 9 to 12 months. A secondary objective was to assess the reproducibility of the CFFQ by having it completed on two separate occasions, four weeks apart. Methods: A cross-sectional study design was used including ninety-five infants aged 10 ± 1 months and their primary caregiver, who completed the CFFQ twice (CFFQ-1 and CFFQ-2), approximately four weeks apart (to assess reproducibility). Four days of weighed food records (4dWFR) were collected on non-consecutive days between CFFQ administrations (validity). Validity and reproducibility were assessed for intakes of energy, macronutrients and micronutrients using paired t-tests, Pearson’s correlation coefficients, cross-classification and Bland-Altman analysis. Two data sets were created, one that included milk intake (breast milk and formula) and one that excluded milk intake. The data was also adjusted for energy intake, before being reassessed for validity and reproducibility. Results: For validity, most nutrient intakes from the CFFQ were comparable to the 4dWFR (range <1% up to 27% different). The CFFQ produced significantly higher nutrient intakes for fat and saturated fat, but significantly lower nutrient intakes for carbohydrate, fibre, folate, potassium, thiamin, riboflavin, niacin and vitamin C (p<0.01). Correlation coefficients ranged from r=0.18 (saturated fat) to r=0.81 (iron; mean r=0.52). Over half of participants had the same tertile classification by both the 4dWFR and the CFFQ (mean 53.9%, range 39.0% (selenium) to 67.4% (iron)). Between 2.1% (iron and calcium) and 14.7% (saturated fat) of participants (mean 7.1%) were misclassified into opposite tertiles. Most of the nutrients showed acceptable agreement between methods (κ=0.20–0.60). Saturated fat and selenium showed poor agreement (κ<0.20) and iron showed good agreement (κ>0.60). Removing milk intake weakened the correlations (range r=0.21 for vitamin E to r=0.60 for niacin, mean r=0.44) and reduced the agreement between methods (50.3% correctly classified and 9.2% grossly misclassified). Adjustment for energy intake showed comparable correlation coefficients (range r=0.24 for fibre and r=0.78 for calcium and iron, mean r=0.52) and improved the agreement between methods (56.2% correctly classified and 6.8% grossly misclassified). The CFFQ had adequate performance for reproducibility for all nutrients and energy with acceptable correlations (r≥0.20) and good cross-classification (>50% correctly classified and <10% grossly misclassified) apart from fat and saturated fat (40.9% and 47.3% correctly classified, respectively). All nutrients showed acceptable to good agreement between the CFFQ-1 and CFFQ-2 (κ>0.20). When milk intake was excluded and when the data was adjusted for energy intake, there was comparable acceptable to good correlations and cross-classification. Conclusion: Although there were some differences in absolute energy and nutrient intakes between the methods, the CFFQ appears to have acceptable validity for assessing 14 nutrients and good reproducibility for assessing 18 nutrients and energy in infants aged 9-12 months. The CFFQ could be used in future research to investigate infant nutrient intakes where using a simple tool with little participant burden is beneficial