Animals ; Cattle ; China ; Dairy Products ; Food Contamination ; Humans ; Infant ; Infant Formula ; chemistry ; Milk ; Triazines ; chemistry

OBJECTIVETo investigate the occurrence and concentrations of melamine and its analogues in tainted infant formula and to identify the etiologic factors for the urinary stones epidemic in infants and young children in China in 2008.

METHODSSanlu infant formula samples were collected from families of the affected children in Gansu province, and markets in Gansu and Hebei provinces and Beijing city. Melamine and its analogues, including cyanuric acid, ammeline, and ammelide were measured by gas chromatography/tandem mass spectrometry.

RESULTSHigh prevalence and concentrations of melamine were found in Sanlu infant formula samples, with low concentrations of cyanuric acid, ammeline and ammelide. Melamine were detected in 87 out of 111 Sanlu infant formula samples with a range of 118 to 4,700 mg/kg.

CONCLUSIONThe results provide strong evidence for melamine as the etiological factor for the urinary stones epidemic in infants and young children in China in 2008.

China ; Flame Retardants ; analysis ; Food Contamination ; Humans ; Infant ; Infant Formula ; chemistry ; Triazines ; chemistry

OBJECTIVETo estimate the dietary melamine exposure in Chinese infants and young children from the consumption of melamine adulterated Sanlu infant formula.

METHODSFour age groups of infants and young children (3, 6, 12, and 24 months) were chosen as the assessed subjects and the maximum amount of infant formula consumption was estimated based on the recommended usage level in the package insert of Sanlu infant formula and other brands. Melamine was analyzed in 111 Sanlu infant formula samples collected from the markets in Beijing and Gansu province using the LC-MS-MS with a limit of quantification of 0.05 mg/kg. Four levels of melamine concentration were chosen to estimate the dietary intakes, including the mean, median, 90th percentile, and maximum.

RESULTSThe infants of 3 months had the highest intake of melamine, and with the increase of the age (month), the intake decreased. Based on the median melamine concentration (1,000 mg/kg) as an example, the melamine intakes for the infants of 3, 6, 12, and 24 months were 23.4, 21.4, 15.0, and 8.6 mg/kg bw/d, respectively.

CONCLUSIONDietary melamine intakes from tainted Sanlu infant formula significantly exceeded the TDI level (0.2 mg/kg bw/d) recommended by the WHO Expert Meeting in 2008. However, the present assessment has some limitations including the poor representative samples, the varied melamine concentrations in the adulterated Sanlu infant formula, and other brand infant formula possibly consumed by these infants.

China ; Diet ; Eating ; Female ; Flame Retardants ; analysis ; metabolism ; Food Contamination ; Humans ; Infant ; Infant Formula ; chemistry ; Male ; Triazines ; chemistry ; metabolism

OBJECTIVETo evaluate the effects of infant formula containing palm oil on the nutrient absorption and defecation in infants.

METHODSA search in Cochrane Library, PubMed, OVID, Springer, China National Knowledge Infrastructure, Vip Chinese Periodical Database, Wanfang Chinese Periodical Database and Chinese Bio-medicine Database was performed to identify relevant English and Chinese language articles between January 1990 and March 2009. Two reviewers independently performed data extraction and appraised using Jadad instrument. Double data were input and analyzed by software of Review Manager 4.2 recommended by Cochrane Collaboration. Intestinal nutrient absorption, electrolyte content of fecal excretion, in vivo calcium deposition, and defecation were included as the target outcomes. These outcomes were evaluated as the combined standardized mean difference (SMD) and relative risk (RR) value and 95% CI of them.

RESULTSThirteen articles were included. Three articles meeting inclusion criteria were analyzed for the effects between infant formula containing palmitic acid at the Sn-2 positions and palmitic acid at the Sn-1, 3 positions; five articles were analyzed for the effects between infant formula containing palmitic acid at the Sn-1, 3 and without palmitic acid; another five articles were analyzed for the effects between infant formula containing palmitic acid at the Sn-2 positions and without palmitic acid. Absorption of fat and calcium was higher, the Ca(2+) of fecal excretion was lower when the infant formula provided palmitic acid at the Sn-2 positions or without palmitic acid than that determined when formula containing palmitic acid at the Sn-1 and Sn-3 positions was given (P < 0.01). The bone mineral content (BMC) and bone mineral density (BMD) increased at 3, 6 months when the infant formula without palmitic acid as compared with using the formula containing palmitic acid at the Sn-1 and Sn-3 positions (P < 0.01). The formation of calcium soaps in stool was reduced, the BMC increased when the infant formula provided palmitic acid at the Sn-2 positions as compared with using the infant formula without palmitic acid (P < 0.01). The incidence of soft stools was higher, and the incidence of hard stools was lower when the infant formula provided palmitic acid at the Sn-2 positions or without palmitic acid than that when formula containing palmitic acid at the Sn-1 and Sn-3 positions was used (P < 0.01).

CONCLUSIONAbsorption of fat and calcium was lower, the Ca(2+) of fecal excretion was higher, the BMC was reduced, the incidence of hard stools increased when the infant formula provided the palmitic acid at the Sn-1 and Sn-3 positions as compared with using formula contained palmitic acid at the Sn-2 positions or without palmitic acid. However, this conclusion should be used cautiously because of the limited quality of studies included into the analysis.

Defecation ; Humans ; Infant ; Infant Formula ; chemistry ; Infant Nutritional Physiological Phenomena ; Intestinal Absorption ; Palm Oil ; Palmitic Acid ; Plant Oils

OBJECTIVES: To systematically evaluate the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical development in preterm infants. METHODS: A computerized search was performed in the databases including China National Knowledge Infrastructure, Wanfang Data, Weipu, PubMed, Embase, and the Cochrane Library to identify randomized controlled trials of the effect of prophylactic use of hydrolyzed protein formula on gastrointestinal diseases and physical growth in preterm infants. RevMan 5.3 software was used to perform a Meta analysis for the included studies. RESULTS: A total of 7 randomized controlled studies were included. The results of Meta analysis showed that compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula could reduce the risk of neonatal necrotizing enterocolitis (RR=0.40, P=0.04) and feeding intolerance (RR=0.40, P=0.005), and had no significant effect on the growth of weight, length and head circumference (P>0.05). CONCLUSIONS Compared with the whole protein formula, the prophylactic use of hydrolyzed protein formula in preterm infants may reduce the occurrence of necrotizing enterocolitis and feeding intolerance, and can meet the nutrient requirement of physical development. However, the evidence is limited, and the results of this study cannot support the routine prophylactic use of hydrolyzed protein formula in preterm infants.
Enterocolitis, Necrotizing/prevention & control* ; Gastrointestinal Diseases/prevention & control* ; Humans ; Infant ; Infant Formula/chemistry* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Randomized Controlled Trials as Topic

Child ; Child, Preschool ; China ; epidemiology ; Food Contamination ; Humans ; Infant ; Infant Formula ; chemistry ; Infant, Newborn ; Triazines ; poisoning ; Urinary Calculi ; chemically induced ; epidemiology

OBJECTIVETo evaluate the lactic acid productivity of Lactobacillus acidophilus (La) exposed to formula milk containing different concentration of erythritol.

METHODSLa was cultured under anaerobic condition (80% N(2), 10% CO(2), 10% H(2)) at 37 °C in five experimental groups (formula milk mixed with different concentrations of erythritol). The five experimental groups contained 1%, 2%, 4%, 6%, and 8% erythritol, respectively (groups 1% E-M, 2% E-M, 4% E-M, 6% E-M, 8% E-M). Formula milk served as control group (group M). The lactic acid was analyzed by high performance liquid chromatography (HPLC) at 4 h intervals during 24 h. The peak-area of lactic acid was recorded and used to calculate the concentration of lactic acid through the equation of a standard curve (y = 590 244x + 67 507). ANOVA and Tukey HDS analysis were used to analyze the data.

RESULTSThe concentration of lactic acid at 24 h was group M [(4.693 ± 0.105) g/L], group 1% E-M[(4.114 ± 0.186) g/L], group 2% E-M[(3.720 ± 0.158) g/L], group 4% E-M[(3.045 ± 0.152) g/L], group 6% E-M[(2.971 ± 0.086) g/L], group 8% E-M[(2.789 ± 0.142) g/L]. Statistically significant differences in lactic acid concentrations were found between different time points (P < 0.05) and between different groups (F = 187.448, P < 0.05). Moreover, the concentrations of lactic acid in each experimental group was lower than that in control group (P < 0.05). The difference among groups 4% E-M, 6% E-M, and 8% E-M were not statistically significant (P > 0.05).

CONCLUSIONSErythritol showed the inhibition potential against La in metabolizing lactic acid in formula milk. The effect of erythritol was concentration depended. The higher concentration of erythritol contained in the milk, the better the inhibition potential against La in metabolizing lactic acid.

Animals ; Chromatography, High Pressure Liquid ; Dose-Response Relationship, Drug ; Erythritol ; pharmacology ; Humans ; Infant ; Infant Formula ; chemistry ; metabolism ; microbiology ; Lactic Acid ; analysis ; metabolism ; Lactobacillus acidophilus ; drug effects ; metabolism ; Milk ; chemistry ; metabolism ; microbiology ; Time Factors

INTRODUCTION: Lactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump. METHODS: Mothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control (n = 29) groups. The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding. Control mothers directly breastfed without regular pump expression. Expressed milk volumes were analysed for citrate, lactose, sodium and protein. RESULTS: Median time of LaII was Day 3 (interquartile range [IQR] 1 day) with intervention and on Day 4 (IQR 1 day) among controls (p = 0.03). Biochemical steady-state concentrations were achieved around early Day 4 (sodium, total protein) and Days 4-5 (citrate, lactose). Sodium, protein and lactose levels were similar in both groups over seven days, at 5.80 mM, 0.68 mM and -13.38 mM, respectively. Mean daily milk volume with intervention was 73.9 mL on Day 3 and 225.2 mL on Day 7, greater than controls (25.4 mL on Day 3 and 69.2 mL on Day 7; p < 0.2). Mean infant weights were similar on Day 8 at 3,477 g with intervention and 3,479 g among controls. CONCLUSION LaII is established by postnatal Day 3 with early initiation of regular breast milk expression, a useful intervention for mothers at risk of early-onset breastfeeding failure.
Adult ; Breast Feeding ; methods ; Breast Milk Expression ; methods ; Citrates ; analysis ; Female ; Humans ; Infant Formula ; Infant, Newborn ; Lactation ; physiology ; Milk, Human ; chemistry ; physiology ; Mothers ; Proteins ; analysis ; Sodium ; analysis ; Young Adult