Randomised trial of a ready-to-feed compared with powdered formula.

Forty three infants were assigned randomly to a ready-to-feed infant formula or a standard formula that required reconstitution from powder. Despite similar nutrient composition of the two formulas those fed the powdered formula had significantly increased body weight and skinfold thickness gains, and became significantly heavier than a further group of 20 breast fed infants by 3 and 6 months. Of those fed the powdered formula 6/19 had become overweight (above the 90th or 97th centile) by 6 months, whereas 1/19 fed the ready-to-feed product was overweight at this age. While differences in fat absorption might have been contributory, our data suggest that errors in reconstitution of formula from powder might be the main cause for the growth differences observed. If it is appropriate to take the breast fed infant as a model, infants fed ready-to-feed formula in this study showed a more physiological pattern of growth than those fed a standard formula reconstituted from powder. These results require replication using other formulas as the findings have potentially important implications for infant feeding

Comparison of dried milk preparations for babies on sale in 7 European countries: I. Protein, fat, carbohydrate, and inorganic constituents

Thirty-two dried milk preparations, designed for infant feeding and obtained from 7 European countries, have been analysed for nitrogen, carbohydrate, fat, the distribution of fatty acids in the fat, and 8 inorganic constituents. The composition of the milks differed considerably. Some were full-cream dried milks. Many had carbohydrate added in the form of lactose, sucrose, or dextrimaltose. Some were `half-cream', others had had all the milk fat removed and replaced by a mixture of animal and vegetable fats or, in one instance, by maize oil alone. The fatty acid composition of these milks varied considerably, and linoleic acid accounted for up to 58% of the total fat in one as compared with 9% of the fat in human milk and 1 to 2% of that in cow's milk. All the milks contained considerably more calcium and phosphorus per 100 g solids than human milk, some of them four times as much. Some milks had had an iron salt added during manufacture, and a few contained added copper

Recognising failure to thrive in early childhood.

The maximum weight centile achieved by a child between 4 and 8 weeks of age was found to be a better predictor of the centile at 12 months than the birth weight centile. Children whose weight deviated two or more major centiles below this maximum weight centile for a month or more showed significant anthropometric differences during the second year of life from those who showed no such deviation. It is suggested that this leads to a logical and practical definition of failure to thrive