No abstract

We compared growth of infants whose mothers either did or did not receive docosahexaenoic acid (DHA) supplements during pregnancy and lactation. At 21 weeks' gestation, 144 women were enrolled into a randomized, double-blind clinical trial receiving: (1) a basic supplement consisting of vitamins and minerals (BS), or (2) BS plus 4.5 g fructooligosaccharide (BSF), or (3) BSF plus fish oil DHA (200 mg) until the end of the third month of lactation. Infants' length, weight and head circumference were measured at birth and at 1, 3 and 21 months. A total of 51 mothers/infants were lost to follow-up by the third month and 24 at 21 months. The two groups not receiving DHA were combined into a control group. Analysis with mixed models adjusted for confounding factors showed a significant time dependent effect for the DHA group on the development of the body mass index (BMI) (P=0.037), and of weight (P=0.046), but no effect on the development of length (P=0.537), or of head circumference (P=0.267). At 21 months, weight of the DHA group was lower by -601 g (95% CI -171; -1030 g) and BMI was lower by -0.76 kg/m(2) (95% CI -0.07; -1.46) compared to controls. The results indicate that DHA taken by pregnant and lactating mothers may reduce BMI in late infancy.

The Euro-Growth references that were developed reflect growth of a well-defined, large cohort of healthy infants and can be used for international comparisons.

A prospective longitudinal cohort study was performed to assess the prevalence of iron deficiency in European infants at 12 mo of age, and to study the influence of socio-economic status, dietary factors, growth and morbidity on iron status. The cohort consisted of 488 normal term infants from primary healthcare centres in 11 European areas. Assessed were socio-economic variables, dietary intake, anthropometry and morbidity at regular intervals from birth to 12 mo, and haemoglobin, serum ferritin, mean corpuscular volume, transferrin saturation and serum transferrin receptor concentrations at age 12 mo. The prevalence of anaemia was 9.4%, of iron deficiency 7.2%, and of iron deficiency anaemia 2.3%. More than 40% of anaemia was associated with normal iron status and associated with an increased frequency of recent infections. Iron deficiency anaemia was significantly more frequent with low (5.1%) than high socio-economic status (0%). Dietary factors accounted for most of this variation in multiple regression analysis. Early introduction of cows' milk was the strongest negative determinant of iron status. Feeding of iron-fortified formula was the main factor positively influencing iron status. Other dietary factors, including breastfeeding, did not play a significant role as determinants of iron status at age 12 mo. Conclusion. Iron deficiency anaemia is present in 2.3% of 12-mo-old European infants. The prevalence of iron deficiency anaemia varies strongly with socio-economic status. Avoidance of cows' milk feeding during the first year of life is the key measure in the prevention of iron deficiency.

Objectives:Infant formulas provide more protein than breast milk. High protein intakes, as well as maternal obesity, are risk factors for later obesity. The present study tested whether a formula with lower protein content slows weight gain of infants of overweight mothers (body mass index [BMI] > 25 kg/m2).Methods:In a randomized double-blind study infants of overweight mothers received from 3 months an experimental (EXPL) formula with 1.65 g of protein/100 kcal (62.8 kcal/100 mL) and containing probiotics, or a control (CTRL) formula with 2.7 g of protein/100 kcal (65.6 kcal/100 mL). Breast-fed infants were studied concurrently. Primary assessment was between 3 and 6 months, although formulas were fed until 12 months. Biomarkers of protein metabolism (blood urea nitrogen, insulin growth factor-1, insulinogenic amino acids) were measured.Results:Infants fed the low-protein EXPL formula gained less weight between 3 and 6 months (−1.77 g/day, P = 0.024) than infants fed the CTRL formula. In the subgroup of infants of mothers with BMI > 30 kg/m2 the difference was −4.21 g/day (P = 0.017). Weight (P = 0.011) and BMI (P = 0.027) of EXPL infants remained lower than that of CTRL infants until 2 years but were similar to that of breast-fed infants. Blood urea nitrogen, insulin growth factor-1, and insulinogenic amino acids at 6 months were significantly lower in EXPL compared with CTRL.Conclusions:A low-protein formula with probiotics slowed weight gain between 3 and 6 months in infants of overweight mothers. Weight gain and biomarkers were more like those of breast-fed infants.

Feeding practices vary considerably throughout Europe. High rates of breast-feeding initiation are found in Umea, Sweden, and in Athens, Greece; and low rates in Dublin, Ireland, in Toulouse, France, and in Glasgow, United Kingdom. The use of cow's milk as the main milk drink before the age of 12 months is still common in certain European centers.

No immunological effects of prebiotics were observed in this study.

The Euro-Growth references may be used to monitor length, weight, body mass index, and body circumferences of children who are fed according to WHO recommendations. The additional references, which were developed for breast-fed boys and girls, will be useful in view of the commitment of WHO to the collection of data for the development of a new international growth reference.