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Nutrients
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Advances in Infant and Pediatric Feeding and Nutrition
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Advances in Infant and Pediatric Feeding and Nutrition

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: 25 April 2024 | Viewed by 15756

Special Issue Editor

Dr. Jann Foster

E-Mail Website
Guest Editor
School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
Interests: pain management of neonates, infants and children; nutrition and feeding of neonates and infants including gastrointestinal disorders; infant development and assessment

Special Issue Information

Dear Colleagues，

The purpose of this Special Issue “Advances in Infant and Pediatric Feeding and Nutrition” is to explore the most updated available evidence about the role of nutrition for the short- and long-term health of infants born preterm.

Nutrition in early life plays a key role in shaping an infant’s future health. Human milk (HM) is indisputably the gold standard for feeding all neonates. This is because of its unique macronutrient composition with optimal bioavailability and myriad bioactives and diseases such as necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and bacterial sepsis can be avoided with appropriate feeding throughout one’s life.

The current Special Issue aims to include original works and literature reviews that further explore the effect of specific feeding strategies on individual anthropometric growth and neurofunctional development, from lactation to complementary feeding through the first years of life.

Dr. Jann Foster
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infant nutrition
  • infant feeding
  • human milk
  • preterm infants
  • gut microbiota

Published Papers (7 papers)

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Research

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17 pages, 2890 KiB  
Article
Safety and Suitability of Infant Formula Manufactured from Extensively Hydrolyzed Whey Protein Compared to Intact Protein: A Combined Analysis of Two Randomized Controlled Studies
by Manja Fleddermann, Anette Knoll and Berthold Koletzko
Nutrients 2024, 16(2), 245; https://doi.org/10.3390/nu16020245 - 12 Jan 2024
Viewed by 792
Abstract
Our aim was to assess the nutritional safety and suitability of an infant formula manufactured from extensively hydrolyzed protein in comparison to infant formula manufactured from intact protein (both with low and standard protein content). We performed a combined analysis of raw data [...] Read more.
Our aim was to assess the nutritional safety and suitability of an infant formula manufactured from extensively hydrolyzed protein in comparison to infant formula manufactured from intact protein (both with low and standard protein content). We performed a combined analysis of raw data from two randomized infant feeding studies. An analysis of covariance (ANCOVA) model was used to determine the non-inferiority of daily weight gain (primary outcome; margin −3 g/day), with the intervention group as a fixed factor and geographic region, sex, and baseline weight as covariates (main model). The data of 346 infants exposed to the formula were included in the analysis. The sample size of the per-protocol analysis with 184 infants was too small to achieve sufficient statistical power. The lower limit of the 97.5% confidence interval (−0.807) of the mean group difference in daily weight gain (i.e., 2.22 g/day) was above the −3 g/day margin (full analysis set). Further anthropometric parameters did not differ between the infant formula groups throughout the study. Growth was comparable to breastfed infants. We conclude that the infant formula manufactured from extensively hydrolyzed protein meets infant requirements for adequate growth and does not raise any safety concerns. Full article
(This article belongs to the Special Issue Advances in Infant and Pediatric Feeding and Nutrition)
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17 pages, 2602 KiB  
Article
Impact of Maternal Fish Consumption on Serum Docosahexaenoic Acid (DHA) Levels in Breastfed Infants: A Cross-Sectional Study of a Randomized Clinical Trial in Japan
by Ayu Kasamatsu, Hiroshi Tachimoto and Mitsuyoshi Urashima
Nutrients 2023, 15(20), 4338; https://doi.org/10.3390/nu15204338 - 11 Oct 2023
Cited by 1 | Viewed by 1264
Abstract
Docosahexaenoic acid (DHA), an essential n-3 long-chain polyunsaturated fatty acid (LCPUFA) abundant in fish, is crucial for infant brain development. We investigated the associations between maternal dietary habits, infant feeding patterns, and serum levels of DHA and other LCPUFAs in infants aged 5–6 [...] Read more.
Docosahexaenoic acid (DHA), an essential n-3 long-chain polyunsaturated fatty acid (LCPUFA) abundant in fish, is crucial for infant brain development. We investigated the associations between maternal dietary habits, infant feeding patterns, and serum levels of DHA and other LCPUFAs in infants aged 5–6 months in Japan, where fish consumption is high. This cross-sectional study used serum samples from 268 infants enrolled in a randomized clinical trial. The frequency of mothers’ consumption of 38 food items and infant feeding patterns were prospectively surveyed. Cow’s milk formula (CMF) supplemented with 15.9% linolenic acid, 1.6% α-linolenic acid, 0.40% DHA, and 0.27% arachidonic acid was used. Significant positive associations with infants’ serum DHA levels were found for “Blue-back fish” (rho = 0.24; p = 0.0001) and “White fish” (rho = 0.25, p = 0.0001). The combined variable “Blue-White fish” was found to be significantly associated with higher serum DHA levels in infants (rho = 0.29, p < 0.0001). Predominantly breastfed infants had significantly higher serum DHA levels than those fed more CMF (rho = 0.32, p < 0.0001). After multivariate analysis, “Blue-White fish” and “Feeding patterns” remained significantly and independently associated with serum DHA levels. These findings suggest that frequent consumption of “Blue-back fish” and/or “White fish” by lactating mothers, along with prioritizing breastfeeding over DHA-supplemented CMF, might effectively increase infants’ serum DHA levels. Full article
(This article belongs to the Special Issue Advances in Infant and Pediatric Feeding and Nutrition)
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19 pages, 3618 KiB  
Article
Validation of the Scale on Parental Feeding Behaviors (ECOPAL) for Caregivers of Mexican Children
by Marina Liliana González-Torres, Xochitl Garza-Olivares, Gabriela Navarro-Contreras and Lidia Alejandra González-Orozco
Nutrients 2023, 15(17), 3698; https://doi.org/10.3390/nu15173698 - 24 Aug 2023
Viewed by 774
Abstract
Parental feeding practices can be crucial to preventing childhood obesity. This study aimed to validate a self-applicable instrument for evaluating the diverse parental feeding behaviors of Mexican caregivers based on the theoretical constructs of coercive control, structure, and autonomy support. The scale’s content [...] Read more.
Parental feeding practices can be crucial to preventing childhood obesity. This study aimed to validate a self-applicable instrument for evaluating the diverse parental feeding behaviors of Mexican caregivers based on the theoretical constructs of coercive control, structure, and autonomy support. The scale’s content validity achieved significant values when assessed by expert judges, with moderate intensity in congruence (Kendall’s W = 0.462; p = 0.000) and clarity (Kendall’s W = 0.369; p = 0.001). The participants were 1185 Mexican adults (32.7 ± 7.6 years of age, 97% women, and 90% mothers) responsible for the main meal of at least one child (4.8 ± 3 years old). The data were subdivided randomly for an exploratory factor analysis (n = 581) and a confirmatory factorial analysis (n = 604). The first analysis grouped the items into 11 factors, with an accumulated variance of 63.9%. In the confirmatory analysis, a 10-factor model showed a better fit (CMIN = 1531.5, p < 0.001, CMIN/df = 2.20, RSEA = 0.045, CFI = 0.92, TLI, 0.91, and NFI = 0.87). The factors in this model were (1) the disposition of non-recommended foods, (2) nutritional education, (3) pressure to eat, (4) praise for healthy eating, (5) monitoring of consumption, (6) structured offer of fruits and vegetables, (7) consumption conditioning, (8) overt restriction, (9) guided choices, and (10) covert restriction. The Cronbach’s alpha value was 0.816. Therefore, this scale presents good psychometric properties with which to evaluate the frequency of child caregivers’ feeding behaviors in the context of ten different feeding practices in Mexico’s urban areas and contributes to the knowledge of current practices in the Mexican population. It also evaluates changes resulting from future interventions that promote eating practices that favor the formation of healthy eating habits. Full article
(This article belongs to the Special Issue Advances in Infant and Pediatric Feeding and Nutrition)
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15 pages, 302 KiB  
Article
Prevalence of Feeding Problems in Children and Associated Factors—A Cross-Sectional Study among Polish Children Aged 2–7 Years
by Agnieszka Białek-Dratwa and Oskar Kowalski
Nutrients 2023, 15(14), 3185; https://doi.org/10.3390/nu15143185 - 18 Jul 2023
Cited by 4 | Viewed by 1841
Abstract
Food neophobia is an aversion to eating or a reluctance to try unfamiliar or new foods. From an evolutionary perspective, this behaviour may minimise the risk of consuming foods that are harmful to health. However, such aversion causes food monotony, which may result [...] Read more.
Food neophobia is an aversion to eating or a reluctance to try unfamiliar or new foods. From an evolutionary perspective, this behaviour may minimise the risk of consuming foods that are harmful to health. However, such aversion causes food monotony, which may result in nutritional deficiencies. This study aimed to assess the prevalence of feeding problems among Polish children aged 2–7 years using the Montreal Children’s Hospital Feeding Scale and to investigate the correlation between age, gender, mode of feeding in infancy, including complementary feeding, and the prevalence of feeding difficulties in the study group of children. Material and method: The study group consisted of 585 children: 299 boys (51.11%) and 286 girls (48.89%). The study was conducted using a questionnaire-based method, with an indirect survey technique using a web-based form (CAWI). The research tool used was the Montreal Children’s Hospital-Pediatric Feeding Program. Results: Groups with the lowest risk feeding problems, risk 0, comprised 445 children (76.06%); group 1, middle difficulties, 59 children (10.08%); group 2, moderate difficulties, 40 children (6.84%); and group 3, most difficulties, 40 children (7.01%). The mean MCH-FS score for the entire study group was calculated and was 37.29 points ± 12.02; for 2 year olds, 35.69 points; for 3 year olds, 37.41 points; for 4 year olds, 38.31 points; for 5 year olds, 38.46 points; for 6 year olds, 37.95 points; and for 7 year olds, 36.06 points. The mean value of the MCH-FS scale for girls was 37.44 points, and for boys, 37.32 points. None of the above parameters correlated with the risk of feeding problems, including age, except with a non-significative tendency to be higher in the youngest age. Conclusion: Breast milk feeding and the time of complementary feeding (CF) in the study group did not influence the risk of feeding problems. Using the full BLW method during CF can protect the child against the occurrence of feeding problems such a food selectivity or picky eating in the future. In our study, children with difficulties during CF, mainly the vomiting reflex, were more likely to develop feeding problems such as food neophobia. Based on our study, we did not observe a correlation between age, gender, and the occurrence of feeding problems, and there was only a non-significant tendency to be higher in the youngest age. However, further research needs to be undertaken to assess how such behaviour affects subsequent feeding difficulties. Full article
(This article belongs to the Special Issue Advances in Infant and Pediatric Feeding and Nutrition)
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16 pages, 3167 KiB  
Article
Infants Fed Breastmilk or 2′-FL Supplemented Formula Have Similar Systemic Levels of Microbiota-Derived Secondary Bile Acids
by David R. Hill and Rachael H. Buck
Nutrients 2023, 15(10), 2339; https://doi.org/10.3390/nu15102339 - 17 May 2023
Cited by 5 | Viewed by 2766
Abstract
Human milk represents an optimal source of nutrition during infancy. Milk also serves as a vehicle for the transfer of growth factors, commensal microbes, and prebiotic compounds to the immature gastrointestinal tract. These immunomodulatory and prebiotic functions of milk are increasingly appreciated as [...] Read more.
Human milk represents an optimal source of nutrition during infancy. Milk also serves as a vehicle for the transfer of growth factors, commensal microbes, and prebiotic compounds to the immature gastrointestinal tract. These immunomodulatory and prebiotic functions of milk are increasingly appreciated as critical factors in the development of the infant gut and its associated microbial community. Advances in infant formula composition have sought to recapitulate some of the prebiotic and immunomodulatory functions of milk through human milk oligosaccharide (HMO) fortification, with the aim of promoting healthy development both within the gastrointestinal tract and systemically. Our objective was to investigate the effects of feeding formulas supplemented with the HMO 2′-fucosyllactose (2′-FL) on serum metabolite levels relative to breastfed infants. A prospective, randomized, double-blinded, controlled study of infant formulas (64.3 kcal/dL) fortified with varying levels of 2′-FL and galactooligosaccharides (GOS) was conducted [0.2 g/L 2′-FL + 2.2 g/L GOS; 1.0 g/L 2′-FL + 1.4 g/L GOS]. Healthy singleton infants age 0–5 days and with birth weight > 2490 g were enrolled (n = 201). Mothers chose to either exclusively formula-feed or breastfeed their infant from birth to 4 months of age. Blood samples were drawn from a subset of infants at 6 weeks of age (n = 35–40 per group). Plasma was evaluated by global metabolic profiling and compared to a breastfed reference group (HM) and a control formula (2.4 g/L GOS). Fortification of control infant formula with the HMO 2′-FL resulted in significant increases in serum metabolites derived from microbial activity in the gastrointestinal tract. Most notably, secondary bile acid production was broadly increased in a dose-dependent manner among infants receiving 2′-FL supplemented formula relative to the control formula. 2′-FL supplementation increased secondary bile acid production to levels associated with breastfeeding. Our data indicate that supplementation of infant formula with 2′-FL supports the production of secondary microbial metabolites at levels comparable to breastfed infants. Thus, dietary supplementation of HMO may have broad implications for the function of the gut microbiome in systemic metabolism. This trial was registered at with the U.S. National library of Medicine as NCT01808105. Full article
(This article belongs to the Special Issue Advances in Infant and Pediatric Feeding and Nutrition)
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Review

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37 pages, 676 KiB  
Review
Review on the Impact of Milk Oligosaccharides on the Brain and Neurocognitive Development in Early Life
by Yuting Fan, Arden L. McMath and Sharon M. Donovan
Nutrients 2023, 15(17), 3743; https://doi.org/10.3390/nu15173743 - 26 Aug 2023
Cited by 1 | Viewed by 2347
Abstract
Milk Oligosaccharides (MOS), a group of complex carbohydrates found in human and bovine milk, have emerged as potential modulators of optimal brain development for early life. This review provides a comprehensive investigation of the impact of milk oligosaccharides on brain and neurocognitive development [...] Read more.
Milk Oligosaccharides (MOS), a group of complex carbohydrates found in human and bovine milk, have emerged as potential modulators of optimal brain development for early life. This review provides a comprehensive investigation of the impact of milk oligosaccharides on brain and neurocognitive development of early life by synthesizing current literature from preclinical models and human observational studies. The literature search was conducted in the PubMed search engine, and the inclusion eligibility was evaluated by three reviewers. Overall, we identified 26 articles for analysis. While the literature supports the crucial roles of fucosylated and sialylated milk oligosaccharides in learning, memory, executive functioning, and brain structural development, limitations were identified. In preclinical models, the supplementation of only the most abundant MOS might overlook the complexity of naturally occurring MOS compositions. Similarly, accurately quantifying MOS intake in human studies is challenging due to potential confounding effects such as formula feeding. Mechanistically, MOS is thought to impact neurodevelopment through modulation of the microbiota and enhancement of neuronal signaling. However, further advancement in our understanding necessitates clinical randomized-controlled trials to elucidate the specific mechanisms and long-term implications of milk oligosaccharides exposure. Understanding the interplay between milk oligosaccharides and cognition may contribute to early nutrition strategies for optimal cognitive outcomes in children. Full article
(This article belongs to the Special Issue Advances in Infant and Pediatric Feeding and Nutrition)
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15 pages, 1610 KiB  
Review
Potential Epigenetic Effects of Human Milk on Infants’ Neurodevelopment
by Giannoula Gialeli, Ourania Panagopoulou, Georgios Liosis and Tania Siahanidou
Nutrients 2023, 15(16), 3614; https://doi.org/10.3390/nu15163614 - 17 Aug 2023
Cited by 1 | Viewed by 4697
Abstract
The advantages of human milk feeding, especially in preterm babies, are well recognized. Infants’ feeding with breast milk lowers the likelihood of developing a diverse range of non-communicable diseases later in life and it is also associated with improved neurodevelopmental outcomes. Although the [...] Read more.
The advantages of human milk feeding, especially in preterm babies, are well recognized. Infants’ feeding with breast milk lowers the likelihood of developing a diverse range of non-communicable diseases later in life and it is also associated with improved neurodevelopmental outcomes. Although the precise mechanisms through which human milk feeding is linked with infants’ neurodevelopment are still unknown, potential epigenetic effects of breast milk through its bioactive components, including non-coding RNAs, stem cells and microbiome, could at least partly explain this association. Micro- and long-non-coding RNAs, enclosed in milk exosomes, as well as breast milk stem cells, survive digestion, reach the circulation and can cross the blood–brain barrier. Certain non-coding RNAs potentially regulate genes implicated in brain development and function, whereas nestin-positive stem cells can possibly differentiate into neural cells or/and act as epigenetic regulators in the brain. Furthermore, breast milk microbiota contributes to the establishment of infant’s gut microbiome, which is implicated in brain development via epigenetic modifications and key molecules’ regulation. This narrative review provides an updated analysis of the relationship between breast milk feeding and infants’ neurodevelopment via epigenetics, pointing out how breast milk’s bioactive components could have an impact on the neurodevelopment of both full-term and preterm babies. Full article
(This article belongs to the Special Issue Advances in Infant and Pediatric Feeding and Nutrition)
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