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LCP supplementation of premature infant formula has been shown to produce plasma and erythrocyte lipid profiles similar to human milk (HM)-fed preterm infants. Previous studies reported decreased growth with LCP supplemented formula. This prospective, double-blind, randomised, controlled, parallel trial compared safety, growth and phospholipid fatty acid (PFA) levels in preterm infants fed preterms formula with (L+) or without (Lo) LCP. The study consisted of Phase I: enrolment to 40 weeks (wk) postconceptual age (PCA); and Phase II: 40 to 48 wk PCA. Infants (birth weight 750-2000 g, 0-28 days of age) were fed L+ or L preterm formula, 24 Kcal/oz during Phase I, and 20 Kcal/oz during Phase II. A control group was exclusively HM-fed preterms who, if weaned at the end of Phase I, received L. HM and formula intake were unrestricted. Weight (wt), length (Lt), head circumference (OFC) and upper mid-arm circumference (MAC), and phospholipid profiles were measured at 40 and 48 wk PCA. Adverse events were monitored. 183/288 infants completed Phase II. There were no difference in growth rates between formula groups. At 48 wk PCA, mean PFA levels in infants fed L+ were similar to HM-fed and were significantly higher than the L fed group. Adverse events were similar between the 2 formula groups. The number of infants who were discontinued because of an adverse event was similar among all groups. In conclusion the LCP preterm infant formula is safe, support normal growth and maintains phospholipid profiles similar to HM-fed infants.(AU)

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Previous studies have demonstrated a strong association between breastfeeding incidence and ethnic background, indicating the presence of strong cultural influences on infant-feeding patterns within ethnic groups. This study analyzed the relationship of acculturation into the United States, one aspect of ethnicity, to the initiation of breastfeeding among a sample of 213 women recruited approximately 2 months prenatally in the United States-Mexico border city of Brownsville, Texas. An in-depth, structured interview was conducted at that time (n = 213), at the time of birth (n = 207), and 2 to 3 weeks postnatally (n = 206). In addition, male partners of the mothers were interviewed prenatally when available (n = 119). Acculturation scores and demographic characteristics were tested relative to breastfeeding initiation. The degree of acculturation, age, and marital status were associated significantly with breastfeeding initiation (with breastfeeding continued at 2 to 3 weeks postnatally), but occupational status, education, and income were not. Breastfeeding incidence was highest among older, married, or low-acculturated, Anglo mothers. These data suggest that women being assimilated into the United States are inhibited in the initiation of breastfeeding. These findings suggest that to be successful, intervention programs to increase breastfeeding incidence must consider the cultural adaptation of different groups as they meld with the larger population.

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Premature infants weighing less than 1550 gm at birth were randomly assigned to receive one of three formulas identical in composition except for protein content (2.2, 2.7, and 3.2 gm.100 kcal-1) to determine the effects on growth, protein nutritional status, and behavior. Data collected for 2 weeks from the time of achieving an enteral energy intake of 100 kcal.kg-1.day-1 included measurements of weight, length, head circumference, and skin-fold thickness, and concentrations of plasma amino acids, serum total protein, prealbumin, retinol-binding protein, and urea nitrogen. In a subset of infants, behavior was assessed at the end of the feeding study with the Neonatal Behavior Assessment Scale. Except for the concentrations of plasma amino acids, there were no significant differences in growth or in other biochemical measurements among the three groups, but there were significant differences in the orientation, habituation, and stability clusters of the behavior assessment. Further, there were significant correlations between the plasma amino acid values and the behavioral clusters. These preliminary data suggest a relationship between protein intake in the neonatal period and behavioral outcome at the end of the feeding period in the absence of differences in growth and gross markers of protein nutritional status. The behavioral items noted to differ among the groups may indicate later cognitive outcome; detailed studies about behavioral responses to neonatal dietary intakes and later outcome seem indicated.

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We conducted a double-blinded, randomized trial in premature infants after hospital discharge to test the hypotheses that growth and biochemical responses in those fed a formula with a reduced protein content (1.3 gm/dl) would be similar to those in infants fed a standard infant formula (protein 1.5 gm/dl). Twenty low birth weight infants were followed for 16 weeks from the time of hospital discharge. Growth (weight, length, and head circumference) and biochemical responses (total protein, prealbumin, retinol-binding protein, and blood urea nitrogen values) were similar in the two groups of infants. Plasma amino acids reflected the differences in protein intakes and were similar to previously reported values for premature infants fed human milk or formula. These results demonstrate similar growth and biochemical responses in preterm infants fed a standard infant formula and a formula with a protein content closer to that of human milk.

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The influence of sociodemographic factors on the initiation of breast-feeding was evaluated in a triethnic population from Galveston, Tex. Breast-feeding rates were 44.3% among Anglo-Americans, 13.5% among blacks, and 26.6% among Mexican-Americans. Mexican ethnicity, education levels among Anglo-Americans, and marital status were associated with the initiation of breast-feeding. Odds ratios for breast-feeding were 1.94 (95% confidence interval, 1.10 to 3.43) times higher in Mexican-American compared with black women, and 1.94 (95% confidence interval, 1.34 to 2.83) times higher in married than unmarried women. Anglo-American ethnicity and education, as main effects, were not significantly associated with breast-feeding, but their interaction was. Among Anglo-American women (in comparison with black women), the odds ratios of breast-feeding increased with education level, ranging from 1.84 for those with less than an eighth grade education to 7.46 for those with some college. In contrast to recent findings suggesting that education was more important than ethnicity in predicting breast-feeding, the odds of breast-feeding among Anglo-American compared with black women depended on the level of maternal education, but the odds of breast-feeding for Mexican-American vs black women did not depend on education.

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There has been professional concern that the type of milk used for infant-feeding may lead to adiposity. Studies of the relationship between infant milk-feeding and adiposity, however, have led to inconsistent results. This study investigated the relationship of infant-feeding practices to three indicators of adiposity: body weight, body mass index (BMI) and sum of seven skinfolds. The sample includes children at 3 or 4 years of age, in three ethnic groups. Multivariate techniques assessed the relationship among practices of infant-feeding with three indicators of adiposity, while considering potential confounding variables. Although a weak bivariate relationship was detected between the duration of breastfeeding and body weight, none of the measures of infant-feeding were related to the three indicators of adiposity. Black-American girls had smaller skinfolds than Anglo- or Mexican-American girls, with no ethnic group differences among boys. Concerns about adiposity due to methods of infant-feeding can be allayed, at least among 3- or 4-year-old children.

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To understand why some lower socioeconomic status mothers delivering at a state university hospital breastfeed, while others do not, 26 attitude items were administered in a survey of 358 mothers. A factor analysis of these items yielded four interpretable factors: benefits to infant, social inconvenience, personal inconvenience, and physical inconvenience-medical benefits to child. These factors were significantly related to breastfeeding within each level of ethnicity and marital status. The results imply that emphasizing the benefits for the infant, and providing strategies for minimizing personal inconveniences, should promote breastfeeding in these populations.

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Plasma and urinary taurine concentrations, growth, nitrogen balance, duodenal bile salt concentration and pattern, fecal bile acid excretion, and intestinal fat absorption were determined in appropriate for gestational age low-birth-weight infants fed either a whey-predominant cow milk formula or the same formula supplemented with taurine (45 mumol/kg/day). Mean plasma taurine concentration in the two groups did not differ. Mean urinary taurine concentration in the control and supplemented groups over the entire study period were 2.67 +/- 0.69 and 12.41 +/- 5.20 mumol/dl, respectively (P less than 0.05). Urinary taurine concentration in the supplemented infants, however, decreased significantly during the study period. Neither growth nor nitrogen retention differed between the two groups. Mean duodenal concentrations of taurine as well as glycine conjugates of both cholate and chenodeoxycholate were higher in supplemented infants. Total duodenal bile salt concentration correlated positively with taurine status as reflected by urinary taurine excretion (r = 0.71); this correlation plus the lower duodenal cholesterol concentration in supplemented infants suggests that conversion of cholesterol to bile acids was greater in supplemented infants. Mean intestinal fat absorption in control and supplemented infants, however, did not differ.

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A survey was conducted of all mothers delivering infants at a university medical center hospital in the month of July, 1981. The survey was conducted within 48 hours of delivery and addressed factors related to the breastfeeding decision. The mother's response to the question concerning choice of infant feeding was verified against the feeding records. One set of questions concerned the perceived general supportiveness toward breastfeeding of six individuals significant to the mother. Another set of questions identified who was most influential in the mother's breast or bottle feeding decision. The pattern of significant bivariate relationships between a person's supportiveness and breastfeeding varied across ethnic and maritial status groups. Single and multiple logistic analyses were conducted within ethnic groups to identify from whom support was most important for initiating breastfeeding. Among Black-Americans, support from a close friend was most important. Among Mexican-Americans, support from the mother's mother was most important. Among Anglo-Americans, support from the male partner was important. A broad variety of ensuing research issues are raised. An implication is that social support may be an important interventive variable, but the potentially supportive individual to be reached by an interventive program varies by ethnic group.

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Patients with homocystinuria due to cystathionine synthase deficiency do not have free homocystine in the liver when it is present in high concentrations in the plasma and the urine. The liver of these patients is capable of maintaining normal concentrations of cystine at a time when the plasma cystine concentration is severely reduced. There is an increase in the methionine concentration of the liver which is reduced to normal concentrations during pyridoxine therapy.

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Well, appropriate-for-gestational age, low-birth-weight infants weighing 2,100 gm or less were divided into three gestational age groups and assigned randomly within each age group to one of five feeding regimens: pooled human milk; formula 1 (F1) = 1.5gm/dl protein, 60 parts bovine whey proteins: 40 parts bovine caseins; F2 = 3.0 gm/dl, 60:40; F3 = 1.5 gm/dl, 18:82; F4=3.0 gm/dl, 18:82. Plasma and urine concentrations of methionine and of cystathionine were higher in the infants fed F1 to F4 than in the infants fed BM. The plasma cystine concentrations of infants fed F2 (which had a cystine content at least twice that of any of the other formulas) were significantly higher than those of infants fed BM. Plasma taurine concentrations of infants fed F1 or F4, which were virtually devoid of taurine, decreased steadily during the course of study becoming lower than those of infants fed BM. Urine taurine concentrations of infants fed F1, F3, or F4 (but not F2 which had more taurine than F1, F3, or F4) were lower than those of infants fed BM. These results provide further evidence for the limited capacity of the preterm human infant to convert methionine to cystine, owing to delayed maturation of cytathionase, and suggest a limited capacity to convert cystine to taurine. The latter suggestion is consistent with low human hepatic cysteinesulfinic acid decarboxylase activity 0.26 (fetal) and 0.32 (adult) nmoles/mg protein/hour vs 468 in rat liver.

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Well, appropriate-for-gestational age, low-birth-weight infants were divided into three gestational age groups and assigned randomly within each age group to one of five feeding regimens: pooled human milk (BM); formula 1 (F1) = 1.5 gm/dl protein, 60 parts bovine whey proteins: 40 parts bovine caseins; F2 = 3.0 gm/dl, 60:40; F3 = 1.5 gm/dl, 18:82; F4 = 3.0 gm/dl, 18:82. Plasma and urine concentrations of tyrosine and phenylalanine were far higher in the infants fed F1 to F4, especially F2 and F4, than in the infants fed BM. These findings offer further evidence for the limited capacity of the low-birth-weight infant to catabolize tyrosine. Infants fed F3 had significantly higher plasma tyrosine concentrations than infants fed F1, and those fed F4 had higher concentrations than those fed F2. Thus, increased plasma tyrosine concentrations in low-birth-weight infants are related directly both to the quantity and to the quality of the protein in their diets.

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