Longitudinal manganese and copper balances in young infants and preterm infants fed on breast-milk and adapted cow's milkformulas

Abstract

I . Mn and Cu intake and retention in twenty full-term infants and six preterm infants were studied on the basis of 72 h balances. The age of the infants was 2-16 weeks and the gestational age of the preterm infants (triplets) 34 and 36 weeks. Three nutrition schemes were pursued : breast-fed, formula-fed with unsupplemented adapted formula and formula-fed with trace element supplementation.2. The mean M n concentration of all breast-milk samples (n 2339) was 6.2 pg/l. The two formulas had similar Mn concentrations (77 and 99 pg/I) but had different Fe, Cu (121 and 619 ,ug/l), Zn and I contents. The mean Cu concentration in mother's milk was 833 yg/l.3 . The following mean daily Mn intakes and retentions (pg/kg) respectively were measured: breast-fed fullterm 1.06 (SD 0.43) and 0.43 (SD 0.65), formula-fed full-term 14.2 (SD 3.1) and 2.8 (SD 4%), formula-fed preterm 15.0 (SD 2.2) and 0.06 (SD 5.87). The results for Cu were 114.5 (SD 22.3) and 88.0 (SD 46.5) pg/kg in breast-fed, 19-8 (SD 4.2) and 4.6 (-11.5-9.6) in the unsupplemented formula-fed and 106.4 (SD 18.9) and 55.5 (SD 20.3) in the supplemented formula full-term infant group. No significant influence of the trace element contents of the formulas on the relative retention of Mn or Cu was found.4. Young preterm infants, and to some degree young full-term infants, often had negative Mn balances caused by a high faccal excretion. The formulas with a Mn concentration below 100 pg/l gave a sufficient supply of Mn. Preterm infants fed on the unsupplemented formula had a marginal Cu supply and their first balances were negative (-3.8 (SD 1.8) pglkg).5. In accordance with the estimated safe and adequate daily dietary intakes (recommended dietary allowances), formula-fed infants receive much more Mn than breast-fed infants and their absolute retention is higher.6. Cu from breast-milk had a significantly better biological availability than that from cow's milk formula. If retentions similar to those in breast-fed infants are intended, we conclude, therefore, that cow's milk formula should be fortified with Cu up to a level of at least 600 pg/l.The biological relevance of Mn was noted in poultry and rats showing defective calcification of the otoliths (resulting in ataxia) and the skeleton and other defects based on a depressed mucopolysaccharide synthesis (Hurley, 1985). Furthermore, Mn-deficient rats have second-generation offspring which show an abnormal glucose tolerance test, possibly caused by decreased insulin output (Hurley, 1985). Mn deficiency in man has been observed only once in a patient under parenteral nutrition (Doisy, 1974). He suffered from a prolonged prothrombin clotting time. In newborns and infants no symptoms of deficiency have yet been identified. The vitamin K-dependent coagulopathy in breast-fed infants, however, could be hypothetically connected to Mn deficiency by low Mn intake in these children. At this age it should be relatively easy to diagnose a deficiency, as body-weightrelated increase of tissues and the need for nutrients are highe...

The serum selenium concentrations in children and young adults: a long-term study during the Finnish selenium fertilization programme

“…The mean breast milk concentration of Se (when infants were at the age of 16 weeks) in Germany (Dorner et al, 1990) was reported to be 17.6 mgaL, being similar compared with that in this study. Robberecht et al (1985) reported that the Se content of breast milk (two months post partum) in Belgium was 10.2 mgaL and the estimated daily intake of Se for Belgian infants of three months of age was 8.1 mgaL (boys) and 7.1 mgaL (girls).…”

The Composition of Human Milk as a Model for the Design of Infant Formulas: Recent Findings and Possible Applications

“…At the present time, proper data on the selenium requirement of the infant are lacking; selenium intakes and status of the exclusively breast fed infant should therefore serve as the basis for recommendations on infant feeding. Selenium levels of mature human milk are in the range 12-20 pg/l, whereas unfortified milk based formulas generally contain between 3 and 9 pg/l of intrinsic selenium (Roekens et al 1985;Kumpulainen et al 1987;Dorner et al 1990). The higher selenium intake of the breast fed infant as well as the higher availability of human milk selenium are reflected in higher serum selenium concentrations and a higher selenium retention compared to formula fed infants (Kumpulainen et al 1987;Dorner et al 1990;McGuire et al 1993).…”

Prenatal exposure to manganese in South African coastal communities

“…An inverted U-shape relationship between maternal blood Mn levels and infant birth weight has been shown by other 15 . A number of studies on neonates and infants have confirmed decreased elimination mechanisms for Mn, making neonates and infants receiving total parenteral nutrition or formulas containing Mn highly susceptible to Mn neurotoxicity [16][17][18][19] . A significant increase in blood Mn concentrations with increasing gestational age and postpartum has been shown [20][21][22][23] .…”