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Infections in infants fed formula supplemented with bovine milk fat globule membranes
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland.
Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland.
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2015 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 60, no 3, p. 384-389Article in journal (Other academic) Published
Abstract [en]

Objectives: Observational studies have shown that even in high-income countries formula-fed infants have a higher incidence of acute otitis media (AGM), and gastrointestinal and respiratory tract infections during the first year of life compared with breast-fed infants. We hypothesized that components of the milk fat globule membrane (MFGM) may be responsible for some of these differences and that supplementation with bovine MFGM would decrease the infectious morbidity in formula-fed infants.

Methods: In a double-blind randomized controlled trial, 160 formula-fed infants received experimental formula (EF) supplemented with bovine MFGM (EF) or unsupplemented standard formula (SF) from <2 months until 6 months of age. A breast-fed reference group consisted of 80 infants. Disease symptoms, health care contacts, and medication were recorded by the parents until 12 months of age. Serum immunoglobulin G for 10 pneumococcal serotypes was analyzed at 6 months of age.

Results: The cumulative incidence of AOM during the intervention was lower in the EF group than in the SF group (1% vs 9%, P = 0.034), and did not differ from the breast-fed reference group (0%, P = 1.0). The incidence (25% vs 43%, P = 0.021) and longitudinal prevalence (P = 0.012) of antipyretic use were significantly lower in the EF group than in the SF group. Serum immunoglobulin G concentrations against pneumococcal serotypes 1, 5, and 14 were lower in the EF group than in the SF group.

Conclusions: Supplementation of formula with bovine MFGM reduces the risk of AOM, decreases antipyretics use in formula-fed infants, and has immunomodulatory effects on humoral response against pneumococcus vaccine.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2015. Vol. 60, no 3, p. 384-389
Keywords [en]
breast-feeding, infant formula, infections, milk fat globule membranes, otitis media
National Category
Pediatrics Nutrition and Dietetics Gastroenterology and Hepatology
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-88188DOI: 10.1097/MPG.0000000000000624ISI: 000350527100023PubMedID: 25714582OAI: oai:DiVA.org:umu-88188DiVA, id: diva2:713923
Funder
VINNOVA, 2009-00209Available from: 2014-04-24 Created: 2014-04-24 Last updated: 2018-06-07Bibliographically approved
In thesis
1. Effects of feeding term infants low energy low protein formula supplemented with bovine milk fat globule membranes
Open this publication in new window or tab >>Effects of feeding term infants low energy low protein formula supplemented with bovine milk fat globule membranes
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Observational studies have shown that early nutrition influences short- and long-term health of infants. Formula-fed infants have higher protein and energy intakes and lower intakes of several biologically active components present in human milk. Some of these are present in the milk fat globule membrane (MFGM). The aim of the present study was to examine the effects of feeding term infants an experimental low energy low protein formula supplemented with bovine milk fat globule membranes. Our hypothesis was that infants fed experimental formula (EF), compared to infants fed standard formula (SF), would have outcomes more similar to a breast-fed reference (BFR) group.

Methods In a double-blinded randomized controlled trial, 160 exclusively formula-fed, healthy, term infants were randomized to receive EF or SF from <2 to 6 months of age. A BFR group consisted of 80 breast-fed infants. Measurements were made at baseline, 4, 6 and 12 months of age. The EF had lower energy (60 vs. 66 kcal/100 mL) and protein (1.20 vs. 1.27 g/100 mL) concentrations, and was supplemented with a bovine MFGM concentrate.

Results At 12 months of age, the EF group performed better than the SF group in the cognitive domain of Bayley Scales of Infant Development, 3rd Ed. During the intervention, the EF group had a lower incidence of acute otitis media than the SF group, less use of antipyretics and the EF and SF groups differed in concentrations of s-IgG against pneumococci. The formula-fed infants regulated their intakes by increasing meal volumes. Thus, there were no differences between the EF and SF groups in energy or protein intakes, blood urea nitrogen, insulin or growth including body fat percent until 12 months of age. Pressure-to-eat score at 12 months of age was reported lower by parents of formula-fed infants than by parents of breast-fed infants, indicating a low level of parental control of feeding in the formula-fed groups. Neither high pressure-to-eat score nor high restrictive score was associated with formula feeding. During the intervention, the EF group gradually reached higher serum cholesterol concentrations than the SF group, and closer to the BFR group. At 4 months of age, there was no significant difference in the prevalence of lactobacilli in saliva between the EF and SF groups.

Conclusions Supplementation of infant formula with a bovine MFGM fraction enhanced both cognitive and immunological development in formula-fed infants. Further, the intervention narrowed the gap in serum cholesterol concentrations between formula-fed and breast-fed infants. The lower energy and protein concentrations of the EF were totally compensated for by a high level of self-regulation of intake which might, at least partly, be explained by a low level of parental control of feeding in the study population. The findings are of importance for further development of infant formulas and may contribute to improved short- and long-term health outcomes for formula-fed infants.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2014. p. 55
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1644
Keywords
infant formula, milk fat globule membranes, energy, protein, growth, cognition, parental control, infection, cholesterol, oral microbiota
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-88192 (URN)978-91-7601-044-0 (ISBN)
Public defence
2014-05-16, Sal E04, Biomedicinarhuset (byggnad R1), Norrlands Universitetssjukhus, Umeå, 13:00 (English)
Opponent
Supervisors
Funder
Vinnova, 2009-00209
Available from: 2014-04-25 Created: 2014-04-24 Last updated: 2018-06-07Bibliographically approved

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Timby, NiklasHernell, OlleDomellöf, Magnus

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