Plasma selenium in preterm and term infants during the first 12 months of life

The goal of the present study was to prospectively assess the plasma selenium (Se) concentrations of term and preterm infants during the first year of life in relation to gestational age and nutrition.

Blood specimens were collected from orally formula-fed preterm infants (gestational age < 32 weeks, birth weight < 1500 g): 1.) in hospital and 2.) corrected for gestational age parallel to healthy term breast and formula-fed infants at the ages of 1, 4 and 12 months. All infants were fed according to a standardized nutritional concept, solids and follow-up formula were introduced at the age of 4 months.

Plasma selenium in preterm infants in hospital was 11.7 (6.5–20.8) g/l and 11.6 (8.8–16.7) g/l at 4 weeks corrected for gestational age. At the age of 4 months plasma selenium was still significantly lower than in the other groups: Preterm infants: 17.1 (10.4–30.5) g/l; formula-fed term infants: 31.3 (24.3–47.5) g/l; breast-fed term infants: 45.6 (27.1–65.1) g/l). The levels of breast-fed infants were significantly higher than those of both formula-fed groups up until the introduction of solids.

Preterm infants had significantly low plasma selenium levels up until a postnatal age of at least 6 months. The levels were lower than those of term infants fed an identical unsupplemented infant formula during the first 4 months of life. These data support routine monitoring in hospital and selenium supplementation of preterm infants, preferably in hospital before discharge.     

Iodine nutrition and breast feeding

A survey of the databanks Medline and Web of science identified studies dealing with maternal and infant iodine nutrition during breast feeding. The iodine concentration of human milk varies widely due to maternal iodine intake. Mean breast milk iodine concentrations are reported as ranging from 5.4 to 2170 μg/L (median 62 μg/L) in worldwide studies. In the few studies that compared length of lactation, gestation length, and parity number, these factors did not significantly affect milk-iodine concentrations. In studies of maternal iodine deficiency, untreated goiter had no impact on breast milk iodine when compared with controls. Iodine in human milk responds quickly to dietary iodine intake, either supplemented or consumed in natural foods. Easily absorbable iodine from foods, supplemental sources, iodine-based medication or iodine-based antiseptic solutions used during parturition, is taken up by the maternal thyroid and mammary glands through the Na⁺/I⁻ symporter system. This transmembrane carrier protein transports iodine against a high concentration gradient. Hormonal iodine in breast milk occurs mainly as T-4, but depending on maternal iodine intake, high concentrations of the inorganic form (iodide) are found. In less developed countries, where natural-food-iodine intake is low, adequate maternal iodine nutritional status depends exclusively on enforcement of food iodination. In industrialized countries, maternal iodine intake has increased as a function of increasing consumption of dairy products. The human infant is sensitive to maternal iodine nutrition during fetal development and later during breast feeding. Environmental factors, not directly related to maternal iodine intake, such as intake of selenium and organochlorine pollutants, can affect thyroid hormone homeostasis in breast-fed infants. In spite of low iodine concentrations found in milk of mothers consuming low-iodine natural foods, long lasting or even life-lasting benefits to the breast-fed infant are demonstrable.     

Reference values of selenium in plasma in population from Barcelona. Comparison with several pathologies

Plasma selenium reference values from healthy donors in the metropolitan area of Barcelona are determined. A random sample from 156 healthy adults (control group) is analysed by using electrothermal atomic absorption spectrometry with Zeeman effect background correction.

The relationship between several pathologies and Se content is also evaluated. Se content from 64 samples from subjects with chronic renal failure and 54 from subjects suffering from several malignancies are determined and the results are compared to the reference values. Moreover, Se contents are determined and compared in two groups of children, healthy (19 samples) and children of mothers infected with HIV-1 (16 samples).

In the control group, Se plasma concentration ranges between 50 and 145 μg · L⁻¹ (82.2 ± 17.5 μg · L⁻¹). Significantly lower values are found in the two pathologies studied (malignancy and chronic renal failure), compared to the control group. However, no significant differences in Se content are found between the two groups studied regarding malignancy and chronic renal failure.

In children of mothers infected with HIV-1, Se status is significantly lower than that of healthy children.     

Maternal Milk Concentration of Zinc,Iron, Selenium,and Iodine and Its Relationship to Dietary Intakes

The dietary intake of zinc (Zn), iron (Fe), selenium (Se), and iodine (I) of 31 lactating Mexican–American women attending the Hidalgo County WIC program in Rio Grande Valley (RGV), Texas was estimated from 24-h dietary recall interviews. Milk samples were obtained from lactating mothers who had infants 3 months of age and younger. Milk samples were collected in two visits to assess change in breast milk composition after 1–3 months postpartum: group A—after 30–45 days and group B—75–90 days. Dietary intakes indicated that the study participants had significantly inadequate percent energy intakes than the DRI (Dietary Recommended Intakes) percent recommended kilocalorie values but protein intakes were substantially higher than the percent recommended values. The estimated percent Zn, Fe, Se, and I intakes were also significantly lower than the DRI percent recommended values. The lactating mothers consumed significantly less Zn, Se, and I when compared to the Recommended Dietary Allowances (RDA) even though Fe intake was higher than the RDA value. Breast milk concentration of Zn, Fe, and Se were in agreement within the range of representative values for Constituents of Human Milk but I has significantly less concentration than the representative value. There was no statistically significant correlation observed between dietary intake and milk concentration of Zn, Fe, Se, and I. This study compares the estimated dietary intake of zinc, iron, selenium, and iodine to the concentration of these trace elements in the maternal milk of lactating women of Mexican–American heritage who attend the Rio Grande Valley WIC clinic.     

Selenium concentration and glutathione peroxidase activity in cow’s milk

Samples of raw or pasteurized cow’s milk and infant formula were assayed for glutathione peroxidase (GSH-Px) activity, selenium (Se), and total protein. GSH-Px activity was detected in raw milk, but not in market-pasteurized milk or infant formula. The correlation between GSH-Px activity and Se levels was significant, even when the influence of protein level was removed. This result implies a role of GSH-Px as one of biologically active forms of Se in raw milk. Absence of GSH-Px activity in pasteurized milk and infant formula result from the heating process in these productions, because the heating of raw milk gave an irreversible inactivation of GSH-Px. Both GSH-Px activity and Se levels had significant correlation with protein level, but not so when the respective influences of Se and GSH-Px levels were removed. In raw cow’s milk, Se content was 23 ng/mL and GSH-Px activity was 20 U/mL. About 12% of Se was bound to GSH-Px, and 0.003% of protein was GSH-Px. Raw milk obtained in July contained higher levels of Se, GSH-Px, and protein than that in November. Data for cow’s milk were discussed in relation to those for human milk and those in New Zealand.     

Daily dietary intake of copper,zinc, and selenium of exclusively breast-fed infants of middle-class women in Burundi,Africa

Copper (Cu), zinc (Zn), and selenium (Se) in human milk of middle-class Burundian women during the first 10 mo of lactation have been determined. Wet acid digestion, using nitric and perchloric acids, and atomic absorption spectrometric analysis have been used. Daily intakes have been calculated and proven to decrease from 0.39±0.05 (colostrum) to 0.16±0.02 (mature milk), 2.3±0.3 (colostrum), to 1.2±0.2 mg (mature milk) and 10.9±1.5 (colostrum) to 5.3±0.8 μg (mature milk) for Cu, Zn, and Se, respectively. Since values for this African country are nonexistent, intake levels are compared with literature data and found to be somewhat higher than those observed in other poorly nourished countries. The recommended safe and adequate daily intake for infants of 0–6 mo of age, as proposed by the National Research Council of the USA, is only met for Burundian infants <1 mo of age. The function of copper (Cu) and zinc (Zn) as essential trace elements has been known for quite a number of years (1). Also, selenium (Se) is a trace element essential for the activity of glutathione peroxidase (2) and type I iodothyronine 5-deiodinase (3). For all three elements, an adequate intake is necessary for satisfactory infant growth and development (4). In view of the almost total lack of relevant data on Burundi (Africa), we have determined Cu, Zn, and Se in human milk of middle-class Burundian women during the first 10 mo of lactation (5). The aim of this study is to assess infants' elemental intake for this country and compare this with literature data on trace elemental intake of exclusively breast-fed infants.     

How much energy does the breast fed infant consume and expend?

Energy intake in breast fed infants is uncertain. The doubly labelled water method was used to measure, simultaneously and non-invasively, energy expenditure, energy intake, milk volume intake, energy deposition, and the energy content of breast milk in 12 "free living" breast fed babies at 5 and 11 weeks of age. The validity of this new approach was assessed in a parallel study in 12 formula fed infants. The babies who were exclusively breast fed expended 1.28 and 1.68 MJ/day at five and 11 weeks and had intakes of 1.81 and 2.22 MJ/day; these intakes were associated with normal growth but were well below those recommended previously. At five and 11 weeks the calculated energy content of breast milk was 0.24 and 0.25 MJ/100 ml, which is substantially lower than that commonly reported in milk obtained unphysiologically by expression of the breast. These data cast doubt on the widely used published standards for infant feeding.     

Protein Intake and Plasma Amino-acids of Infants of Low Birth Weight

The plasma amino-acid levels in infants of low birth weight fed on expressed human milk and on a proprietary breast-milk substitute, S26, with a protein intake of not more than 4·5 g/kg/day were compared with those in infants fed on an evaporated milk formula whose protein intake ranged from 6·15 to 12·3 g/kg/day, as well as with normal infants on normal feeds and protein intake. In general, there was little difference between the levels in infants of low birth weight and in normal infants on the same protein intake. The five infants of low birth weight on high protein intake had generally higher levels of plasma amino-acids compared with the group on the lower protein intake, and in particular the levels of tyrosine, phenylalanine, methionine, and cystathionine could be extremely high. Apart from methionine these high levels may be the result both of a reduction in activity of the enzymes involved in the metabolism of these amino-acids, due to the immaturity of the infant, and of the increased stress of a high protein intake. In view of a possible long-term effect of abnormally high plasma amino-acid levels it is suggested that the protein intake of infants of low birth weight should not exceed 6 g/kg/day.     

Feeding low-fat milk during infancy

Despite the widespread agreement that low-fat milk should not be used during infancy, there is a sizable portion of infants in the United States who were fed a diet that included low-fat milk (less than or equal to 2% fat). In 1985, 14% of infants 8 months old, 20% of infants 10 months old, and 32% of infants 12 months old were fed low-fat milk. The reasons given most often by mothers for low-fat milk use was their consideration that low-fat milk has less fat than whole cow's milk and that low-fat milk use was recommended/suggested by their physician. Nutrient intakes of infants fed low-fat milk are compared to those of infants fed whole cow's milk and infant formula. Except for fat, nutrient intakes of infants fed low-fat milk or whole cow's milk were similar. A majority of infants fed either low-fat milk or whole cow's milk received amounts of sodium, potassium, and chloride that exceeded the recommended safe and adequate ranges and amounts of iron below the RDA. These data are considered in relation to dietary requirements during infancy.     

Daily protein and energy intakes of infants fed a commercial infant formula with a reduced protein concentration of 2.2 g/100 kcal: an impact of feeding interval on energy intake

ABSTRACT

We evaluated the protein and energy intakes of infants fed commercial infant Formula A (protein, 2.2 g/100 kcal; energy, 68 kcal/100 mL) and examined whether changes in feeding intervals are involved in constant energy intake. Daily nutritional intake of 378 Formula A-fed infants was assessed using reference values and compared to that of infants fed Formulas B (protein: 2.3 g/100 kcal, energy: 68 kcal/100 mL) and C (protein: 2.4 g/100kcal, energy: 70 kcal/100 mL). From 15 to 149 days of age, the mean formula volume and protein intake were 758–887 mL/day and 11.4–13.3 g/day, respectively, higher than the protein intake of breast-fed infants. Daily energy intake (86–129 kcal/kg/day) was comparable to the estimated energy requirements. Feeding intervals were shorter in infants fed Formulas A and B than in those fed Formula C, whereas energy intake was similar. The protein intake of infants decreased as the protein concentration per energy in infant formula was reduced, and accordingly the protein intake of Formula A-fed infants was significantly lower than that of Formula C-fed infants. In conclusion, the new composition of Formula A is suitable in protein and energy intake of infants, and daily energy intake remains constant by shortening in feeding intervals when the energy concentration in infant formula is reduced.

Clinical Trial Registration: UMIN000023110     

Longitudinal study of the dietary selenium intake of exclusively breast-fed infants during early lactation in Korea and Japan.

213 samples of human breast milk were collected from 51 healthy Korean women. Selenium content of the samples was determined by atomic absorption spectrometry with hydride generation. The selenium content of Korean milk decreased with increase of days after birth: The arithmetic mean of selenium content was higher in colostrum (< 4 days) 34 micrograms/kg (SD +/- 11, n = 44) than in transitional milk 21 micrograms/kg (SD +/- 8, n = 78) or in mature milk (> 10 days) 13 micrograms/kg (SD +/- 6, n = 91). The daily dietary selenium intake of 0-1 month aged Korean infants fed on breast milk is estimated to be around 10 micrograms per day (3 micrograms/kg body weight) regardless of days postpartum, resulting from the calculation of our selenium data and daily milk intake during early lactation. The same result on selenium intake for Japanese newborns, as well as Korean infants, is also estimated to be around 10 micrograms per day (3 micrograms/kg body weight) regardless of days postpartum.     

Selenium levels in infant milk formula

Twenty-four brands of commercial infant milk formula were collected and analysed for selenium by inductively coupled plasma spectrometry with the hydride t-system after an acid digestion procedure. The mean selenium concentration was 49.0 ± 11.55 g l, with a range from 26-68 g l, resulting in an adequate daily selenium intake for infants aged from zero to six months consuming 0.75 l milk daily as set by the US National Research Council in 1989.     

Metabolic acidosis and infant feeding.

Most cows'' milk based formulae for infant feeding present a greater acid load to the infant than breast milk. To determine the effect of this difference the acid base state of 180 healthy term infants was measured on the sixth day of life and related to the type of feed. Those infants fed on cows'' milk formula (SMA) had a mean pH of 7-34 +/- 0-05 and a base deficit of 8-8 +/- 3-1, while those fed on breast milk had a mean pH of 7-38 +/- 0-05 and a base deficit of 5-6 +/- 3-1. The difference between the two groups of infants was significant for both these measurements. Metabolic acidosis was defined as a base deficit greater than 10 mmol/l. Seventy-four per cent of the 34 infants who were acidotic at six days were bottle-fed. There was a significant correlation between the pH of the feed and the degree of acidosis in the infant as measured by the base deficit. The findings suggest that when breast milk is not available a pH-adjusted milk formula would be desirable for preventing and treating neonatal metabolic acidosis.     

Copper,selenium, and zinc concentrations in human milk during the first three weeks of lactation

Human milk samples were analyzed by neutron activation analysis (NAA) for three essential trace elements (Cu, Se, and Zn). Mothers' milk samples were collected from 25 lactating mothers from the Central Hospital, Tripoli, Libya. The average concentration level of Cu, Se, and Zn declined from 0.84 +/- 0.06 mg/L, 104 +/- 9.46 microg/L, and 16.1 +/- 2.67 mg/L at d 0 to 0.39 +/- 0.045 mg/L, 41.8 +/- 6.66 microg/L, and 4.95 +/- 1.3 mg/L, respectively, at d 20 of lactation. Copper and Zn levels in the Libyan mothers' milk were in agreement with reported levels from other countries, whereas Se was at a higher level. The Cu daily intake level is slightly higher than the RDA (Recommended Daily Allowance) value. Selenium and Zn have higher intake levels than the RDA values but within the tolerable upper intake levels.     

Selenium supplementation of infant formula: uptake and retention of various forms of selenium in suckling rats

Formula-fed infants often have lower serum selenium levels than breast-fed infants. Although no deleterious effects have been correlated to this finding, supplementation of formula with selenium is considered. In this study, we investigated the uptake and retention by suckling rat pups of ⁷⁵Se from selenite, selenate, and selenomethionine added to infant formula. The molecular distribution of ⁷⁵Se in liver, kidney, intestine, and plasma was followed by gel-filtration chromatography on Superose 12. ⁷⁵Se-uptake was most rapid from selenomethionine (70% at 1 hr), followed by selenate (51%) and selenite (29%). This difference was explained by a higher retention of ⁷⁵Se in the stomach and small intestinal wall of pups given selenite supplement. Plasma distribution of ⁷⁵Se as studied by gel filtration was also different, with a higher proportion of ⁷⁵Se from selenomethionine being protein-bound than from selenite or selenate. Similarly, a larger proportion of ⁷⁵Se from selenomethionine became protein-bound in the liver than from selenite or selenate. In conclusion, although whole body retention after 24–48 hr was similar, the metabolic fate of selenium varies considerably with the form of selenium added to formula. Further studies are needed to study the long-term consequences of selenium accumulated in different body compartments.     

Comparison of selenium level and glutathione peroxidase activity in tissues of vitamin B6-deficient rats fed sodium selenite or DL-selenomethionine

The effect of vitamin B₆ on the levels of tissue selenium (Se) and glutathione peroxidase (GSH-Px) was studied. Male Wistar 4-week-old rats were fed a vitamin B₆-Se-deficient basal diet for 2 weeks, then divided into 10 groups of five or six rats and fed their respective diets for 4 weeks. The experimental design was a 2×2×2 factorial with two levels of vitamin B₆, two forms of Se, and two levels of Se, plus two extra groups (vitamin B₆-supplemented and deficient without Se). Vitamin B₆ was 0 and 250 μg pyridoxine-HCl/100 g of diet; Se forms were Na₂SeO₃ and DL-selenomethionine; Se levels were 0.5 and 5.0 mg Se/kg of diet. Regardless of form or level of Se, vitamin B₆-deficient rats had lower body weights and organ weights than vitamin B₆-supplemented rats. At 5.0 mg Se/kg of diet, Na₂SeO₃ caused a further depression. Vitamin B₆ deficiency resulted in a higher Se level and GSH-Px activity in plasma of rats fed selenomethionine. However, Se content an GSH-Px activity in erythrocytes were significantly elevated in vitamin B₆-supplemented rats compared with vitamin B₆-deficient rats. Se levels in muscle and heart were significantly lower in vitamin B₆-deficient groups fed Na₂SeO₃ than in vitamin B₆-supplemented groups. Vitamin B₆-deficient rats fed selenomethionine had higher Se levels in muscle, heart, spleen, liver, and kidneys than vitamin B₆-supplemented rats. Activity of GSH-Px in muscle, heart, and spleen was significantly lower in vitamin B₆-deficient groups than in vitamin B₆-supplemented groups, regardless of form of Se. A significant decrease of GSH-Px in liver was observed in vitamin B₆-deficient rats fed selenomethionine compared with vitamin B₆-supplemented rats, whereas no significant decrease was observed in those fed Na₂SeO₃. These results suggest that vitamin B₆ is involved in the distribution and transportation of Se in body and the metabolism of selenomethionine in liver.     

The Effect of Different Levels of Selenium in Mineral Mixtures and Salt Licks on Selenium Status in Sheep

This paper describes 3 experiments comparing the effect of 10, 25 and 40 mg Se/kg, as sodium selenite, in mineral mixtures and salt licks fed to sheep. The supplement was given during the indoor season from October to May to 7 different flocks, each consisting of 50 to 100 sheep, in areas with selenium deficiency problems. The average selenium level in the basic diets did not exceed 0.05 mg/kg. Selenium status was monitored in the blood of ewes and lambs, and in milk. Blood selenium in lambs correlated well with blood selenium in their dams (r = 0.85). Selenium levels in milk on day 1 (colostrum) correlated well with selenium levels in dams (r = 0.92) and in offspring (r = 0.87). Statistically significant differences were found between the different flocks. In areas with extreme selenium deficiency, 10 mg Se/kg in mineral mixtures and salt licks proved insufficient. A content of 25 mg Se/kg, providing a daily intake of about 0.4 mg selenium, resulted in selenium levels in ewes’ blood, ewes’ milk and in the offspring that should prevent selenium deficiency disease without causing any toxic effects.     

The effect of diet, parity, year and number of kids on milk yield and milk composition in Maltese goat

The aim of the present study was to study the effects of forage/concentrate ratio, year, parity and number of kids on milk yield (MY), lactation length (LL) and milk composition (fat, protein and lactose) on 180 Maltese goats analysing 530 milk samples collected from 2000 to 2002.

The main average results were: MY = 288.2 kg, LL = 254 d with 3.5% fat, 3.4% protein and 4.6% lactose.

Forage/concentrate ratio significantly affected MY and fat being highest in goats receiving a ratio of 65/35. Milk yield in goats fed with a ratio of 35/65 was richer in fat (3.6%). The protein and lactose content was not affected by the different ratios. The effect of diet on fat content was small but significant. Parity influenced all the factors considered, in particular goats in ≥4th parity, had longer LL (257 d) and consequently a higher milk yield (302.1 kg). Goats kidding twins yielded more milk and had longer lactation (P < 0.001).     

The protective effect of breast feeding in relation to sudden infant death syndrome (SIDS): II. The effect of human milk and infant formula preparations on binding of Clostridium perfringens to epithelial cells

Breast feeding is known to protect an infant against gastrointestinal pathogens and epidemiological studies indicate that compared to breast fed infants, formula fed infants are at a greater risk of dying from sudden infant death syndrome (SIDS). Many SIDS infants have symptoms of gastrointestinal infections prior to death and one gastrointestinal pathogen associated with SIDS is Clostridium perfringens. Studies have found that a significantly higher number of formula fed SIDS infants have C perfringens and its enterotoxin in their faeces compared to breast fed infants. The aim of the study was to compare the effects of human milk and infant formula on binding of C perfringens to epithelial cells. Two protocols were used to assess the effect of human milk and infant formula to inhibit binding of C perfringens to epithelial cells. Binding was assessed by flow cytometry. For the in vivo protocol which more closely represents interactions on the mucosal surface, breast milk enhanced bacterial binding but infant formula caused inhibition of binding; however for the in vitro method, both human milk and infant formula resulted in consistent enhancement of binding. Flow cytometry studies indicated that enhancement of binding was due to the formation of bacterial aggregates. Lewis(a) and Lewis(b) antigens, found in both breast milk and infant formula, inhibited C. perfringens binding in a dose dependent manner. The Lewis(a) and Lewis(b) antigens in human milk and infant formula can inhibit C. perfringens binding to epithelial cells. While infant formula reduced binding of C. perfringens to epithelial cells in the experiments carried out with the in vivo protocol, the protective effects of breast feeding in relation to colonisation with C. perfringens are more likely to be due to formation of bacterial aggregates. These findings have implications for improving infant formula preparations.     

Energy intake and the nature of growth in low birth weight infants

Growth is accompanied by and depends on energy storage in growing tissue. The rate of energy storage in growing low birth weight infants depends on the rate of energy intake and on the rates of energy excretion and expenditure, both of which (on a body weight basis) are much higher than in adults, and both of which increase with increments of gross energy intake. Energy-balance studies of growing low birth weight infants on gross energy intakes approximating 500 kJ X kg-1 X d-1 of mothers' milk or of infant formula indicate that the composition of extrauterine weight gain of the low birth weight infant differs from that of the fetus of similar gestation, in that the energy storage cost of growth is much higher. Attempts to increase metabolizable energy intake beyond 500 kJ X kg-1 X d-1 by energy supplementation alone do not result in proportionately increased rates of weight gain; low birth weight formulae, in which energy, protein, and mineral contents are all increased can result in large weight gains with proportionate increases in rates of protein and fat accretion.