Browsing by Subject "early nutrition"
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(2023)Background and aim: Formula fed (FF) infants show consistently higher rates of infections, and accelerated growth rate during the first year of life compared to breastfed (BF) infants. Lipid components of bovine origin, such as the lipid membrane structure, and phospholipids have been suggested as promising in narrowing the gap in health and development between FF and BF infants. The aim of this master’s thesis was to identify differences in the development and health of infants primarily fed with either milk-fat (MF) or vegetable-oil (VO) based formula, during the first year of life, and to elucidate the relativeness of lipid source and structure in currently commercially available formulas for infant growth and infectious morbidity. Methods: This study was a secondary analysis of the observational, longitudinal Health and Early Life Microbiota (HELMi) cohort data, collected among healthy, term infants and their families during 2016 and 2019 in the capital region of Finland. FF infants were divided into two groups (MF, VO), and observational BF group was included as a reference. Infant growth was analysed with general linear model for repeated measures of WHO z-scores: weight-for age (WFA), weight-for-length (WFL), BMI-for-age (BMIFA), and length-for-age (LFA). Infectious morbidity was assessed as the odds ratio (OR) with 95% confidence interval (CI) for doctor visit and antibiotics use during the first year of life based on parental reports and using binary logistic regression model. Results: Type of feeding (FF vs BF) was significantly (p<0.001) associated with the pattern of growth during the first year of life. FF groups showed slower weight gain for age during the first 3 months of life, but MF were then characterized with rapid catch-up growth (≥0.67 mean change in z-score) from 3 to 12 months of life, compared to BF infants. After inclusion of formula, the adjusted OR of doctor visit for respiratory infections was 2.58 (CI 1.14-5.86, p=0.024) from 3 to 6, and 3.25 (CI 1.46-7.25, p=0.004) from 6 to 9, among MF, compared to BF infants. For the antibiotics use the adjusted OR was 2.98 (CI 1.03-8.64, p=0.043) among MF infants from 6 to 9 months, compared to BF. No significant differences were detected between the two formula groups in any of the outcome parameters. Conclusions: Type of feeding is significantly associated with infant growth pattern and infectious morbidity during the first year of life, but no significant association could be determined with the lipid source of formula. Infant feeding is certainly an area of high importance and based on the current findings commercially available formulas are lacking in terms of health outcomes and growth compared to BF infants.
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(2022)Background and aim Complementary feeding is defined as the period during which there is a progressive reduction of breastfeeding or formula while the infant is gradually introduced to solid foods at 4-6 months of age. Improper complementary feeding practices, such as introducing solid foods beyond 6 months of age or having a low dietary diversity could lead to negative infant health outcomes. Therefore, it is important to identify factors that might detrimentally affect complementary feeding, such as maternal stress. This thesis aimed to study the associations between maternal stress indicators, the age of solid food introduction, and dietary diversity during complementary feeding within a Finnish birth cohort. Methods The Health and Early Life Microbiota (HELMi) is a longitudinal birth cohort study. Participants of the HELMi cohort included 1055 healthy infants and their parents, mainly residing in the capital region of Finland. Pre-collected data from the HELMi study were used. The data collection occurred between 2016-2018. The main variables used in this thesis were collected via extensive online questionnaires. Binomial logistic regression analyses were used to study whether prenatal and postpartum stress indicators were associated with the age of solid food introduction and/or the infant’s dietary diversity during complementary feeding. Results Late introduction of solid foods (> 6 months) was less likely among infants whose mothers reported moderate or high prenatal stress (moderate prenatal stress OR=0.66, 95%CI 0.45-0.97, high prenatal stress OR 0.62, 95%CI 0.39-0.98), when compared to infants whose mothers reported low prenatal stress. Maternal stress indicators were not associated with low dietary diversity (0-3 food groups introduced) at 6 months of life. Among infants with a low dietary diversity at 9 months of age, mothers were more likely to report high levels of prenatal stress (OR=4.88, 95%CI 1.27-18.79), when compared to mothers with low levels of prenatal stress. Further, infants with a low dietary diversity at 9 months were less likely to have mothers report low to moderate levels of life satisfaction (OR=0.25, 95%CI 0.06-1.02) when compared to mothers with very high life satisfaction. They were also less likely to report moderate levels of infant health worry (OR=0.18, 95%CI 0.05-0.67) when compared to mothers with no infant health worry. Conclusions This is the first study to look at the associations between maternal stress indicators and dietary outcomes during complementary feeding. Maternal stress indicators were associated with the age of solid food introduction and the infant’s dietary diversity at 9 months, but not at 6 months. In future studies on this topic, a more socio-demographically representative sample should be recruited, and validated tools should be used to collect dietary and psychological data. Health practitioners and family clinic workers should be made aware of the possibly long-lasting effects of prenatal stress and consider its possible effects on dietary outcomes during complementary feeding.
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