Infant Nutrition and Feeding

Objective: To investigate the factors affecting the duration of continuous breastfeeding of infants within 2 years of age, and to explore intervention strategies that may promote breastfeeding duration in China. Method: A self-made electronic questionnaire was used to investigate the breastfeeding duration of infants, and the influencing factors were collected from three levels of individual, family, and social support. The Kruskal–Wallis rank sum test and the multivariable ordinal logistic regression model were used for data analysis. Subgroup analysis was carried out according to region and parity. Results: A total of 1001 valid samples from 26 provinces across the country were obtained. Among them, 9.9% breastfed for less than 6 months, 38.6% for 6 to 12 months, 31.8% for 12 to 18 months, 6.7% for 18 to 24 months, and 13.1% for more than 24 months. Barriers to sustained breastfeeding included the mother’s age at birth being over 31, education level below junior high, cesarean delivery, and the baby’s first nipple sucking at 2 to 24 h after birth. Factors that promote continued breastfeeding included freelancer or full-time mother, high breastfeeding knowledge score, supporting breastfeeding, baby with low birth weight, first bottle feeding at 4 months and later, first supplementary food at over 6 months old, high family income, the mother’s family and friends supporting breastfeeding, breastfeeding support conditions after returning to work, etc. Conclusion: The breastfeeding duration in China is generally short, and the proportion of mothers breastfeeding until the age of 2 years and above, recommended by WHO, is very low. Multiple factors at the individual, family, and social support levels influence the duration of breastfeeding. It is suggested to improve the current situation by strengthening health education, improving system security, and enhancing social support. Full article

(1) Background: Nutrition for optimum growth and physical development is acquired by adequate infant feeding practices. (2) Methods: One hundred seventeen different brands of infant formulas (n = 41) and baby food products (n = 76) were selected from the Lebanese market and were analyzed for their nutritional content. (3) Results: Saturated fatty acid content was detected to be the highest in follow-up formulas (79.85 g/100 g) and milky cereals (75.38 g/100 g). Among all saturated fatty acids, palmitic acid (C16:0) accounted for the greatest proportion. Moreover, glucose and sucrose were the predominant added sugars in infant formulas, while sucrose was the main added sugar in baby food products. Our data showed that the majority of the products were non-compliant to the regulations and the manufacturers’ nutrition facts labels. Our results stated also that the contribution to the daily value for the saturated fatty acids, added sugars, and protein exceeded the daily recommended intake for most infant formulas and baby food products. (4) Conclusions: This requires careful evaluation from policymakers in order to improve the infant and young children feeding practices. Full article

Human milk (HM) is a complex biofluid containing a wide cell variety including epithelial cells and leukocytes. However, the cellular compositions and their phenotypic properties over the course of lactation are poorly understood. The aim of this preliminary study was to characterize the cellular metabolome of HM over the course of lactation. Cells were isolated via centrifugation and the cellular fraction was characterized via cytomorphology and immunocytochemical staining. Cell metabolites were extracted and analyzed using ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC–QqTOF-MS) in the positive and negative electrospray ionization modes. Immunocytochemical analysis revealed a high variability of the number of detected cells with relative median abundances of 98% of glandular epithelial cells, 1% of leukocytes, and 1% of keratinocytes. Significant correlations between the milk postnatal age with percentage of epithelial cells and leukocytes, and with total cell count were observed. Results from the Hierarchical Cluster Analysis of immunocytochemical profiles were very similar to those observed in the analysis of the metabolomic profiles. In addition, metabolic pathway analysis showed alterations in seven metabolic pathways correlating with postnatal age. This work paves the way for future investigations on changes in the metabolomic fraction of the cellular compartment of HM. Full article

Both linoleic acid (LA) and α-linolenic acid (ALA) are essential dietary fatty acids, and a balanced dietary supply of these is of the utmost importance for health. In many countries across the globe, the LA level and LA/ALA ratio in breast milk (BM) are high. For infant formula (IF), the maximum LA level set by authorities (e.g., Codex or China) is 1400 mg LA/100 kcal ≈ 28% of total fatty acid (FA) ≈ 12.6% of energy. The aims of this study are: (1) to provide an overview of polyunsaturated fatty acid (PUFA) levels in BM across the world, and (2) to determine the health impact of different LA levels and LA/ALA ratios in IF by reviewing the published literature in the context of the current regulatory framework. The lipid composition of BM from mothers living in 31 different countries was determined based on a literature review. This review also includes data from infant studies (intervention/cohort) on nutritional needs regarding LA and ALA, safety, and biological effects. The impact of various LA/ALA ratios in IF on DHA status was assessed within the context of the current worldwide regulatory framework including China and the EU. Country averages of LA and ALA in BM range from 8.5–26.9% FA and 0.3–2.65% FA, respectively. The average BM LA level across the world, including mainland China, is below the maximum 28% FA, and no toxicological or long-term safety data are available on LA levels > 28% FA. Although recommended IF LA/ALA ratios range from 5:1 to 15:1, ratios closer to 5:1 seem to promote a higher endogenous synthesis of DHA. However, even those infants fed IF with more optimal LA/ALA ratios do not reach the DHA levels observed in breastfed infants, and the levels of DHA present are not sufficient to have positive effects on vision. Current evidence suggests that there is no benefit to going beyond the maximum LA level of 28% FA in IF. To achieve the DHA levels found in BM, the addition of DHA to IF is necessary, which is in line with regulations in China and the EU. Virtually all intervention studies investigating LA levels and safety were conducted in Western countries in the absence of added DHA. Therefore, well-designed intervention trials in infants across the globe are required to obtain clarity about optimal and safe levels of LA and LA/ALA ratios in IF. Full article

Poor complementary feeding is a common practice in developing regions, including South Africa (SA), and is one of the main contributing factors to childhood malnutrition. This paper reviews the literature on complementary feeding practices in SA and the potential of fortifying home-prepared complementary foods with Moringa oleifera to improve their nutritional composition. Studies that investigated complementary feeding practices, indigenous crops, nutritional benefits of Moringa oleifera, and the use of MOLP as a fortificant both locally and globally were included in this review. In SA, maize meal and commercial cereal are the most commonly used complementary infant foods. The diet consumed by children from vulnerable households commonly has insufficient nutrients. Foods consumed are generally high in starch and low in other essential nutrients, including good-quality protein. Impoverished individuals consume poor-quality foods as they are unable to afford a diversified diet with food from different food groups, such as protein, fruits, and vegetables. In SA, various programs have been implemented to reduce the incidence of childhood malnutrition. However, childhood malnutrition remains on the rise. This shows a need for complementary food-based strategies that can be implemented and sustained at a household level. This can be conducted through the use of accessible indigenous crops such as Moringa oleifera. Moringa oleifera contains essential nutrients such as proteins, amino acids, vitamins, and minerals. Therefore, it could possibly be used as a home-prepared complementary food fortificant to enhance nutritional composition. Before complementary foods can be fortified with Moringa oleifera, popular home-prepared complementary foods must be identified. Full article

Galactosemia is an inborn metabolic disorder caused by a deficient activity in one of the enzymes involved in the metabolism of galactose. The first description of galactosemia in newborns dates from 1908, ever since complex research has been performed on cell and animal models to gain more insights into the molecular and clinical bases of this challenging disease. In galactosemia, the newborn appears to be born in proper health, having a window of opportunity before developing major morbidities that may even be fatal following ingestion of milk that contains galactose. Galactosemia cannot be cured, but its negative consequences on health can be avoided by establishing precocious diagnosis and treatment. All the foods that contain galactose should be eliminated from the diet when there is a suspicion of galactosemia. The neonatal screening for galactosemia can urge early diagnosis and intervention, preventing complications. All galactosemia types may be detected during the screening of newborns for this disorder. The major target is, however, galactose-1-phosphate uridyltransferase (GALT) deficiency galactosemia, which is diagnosed by applying a combination of total galactose and GALT enzyme analysis as well as, in certain programs, mutation screening. Most critically, infants who exhibit symptoms suggestive of galactosemia should undergo in-depth testing for this condition even when the newborn screening shows normal results. The decision to enroll global screening for galactosemia among the specific population still faces many challenges. In this context, the present narrative review provides an updated overview of the incidence, clinical manifestations, diagnosis, therapy, and prognosis of galactosemia, questioning under the dome of these aspects related to the disease the value of its neonatal monitoring. Full article