Abstract
In parts of Canada including Newfoundland and Labrador and among Aboriginal peoples, infants still consume evaporated milk (EM) formulas for cultural and economic reasons. At 3 and 6 months, full-term infants fed EM (n=30) received low intakes of iron, thiamine, selenium and had higher weight velocity than breastfed (BF, n=29) infants. EM infants had greater anemia, lowered transketolase activity (thiamine) and lowered glutathione peroxidase (selenium) activity (p<0.05).
To determine the later effect of early feeding deficit on nutritional status, we examined these same infants at 18 months of age. At that time, there were no differences in dietary intakes of energy, protein, zinc, copper, selenium and iron, nor in plasma levels of zinc, copper, vitamin C, nor in red blood cell activity levels of glutathione reductase (riboflavin), transketolase, glutathione peroxidase, nor in superoxide dismutase. However, EM infants weighed more and were more likely to visit a physician, have anemia, and have iron depletion than were BF infants. We conclude that infants consuming evaporated milk formulas should receive iron supplements throughout infancy.
Résumé
Dans plusieur régions du Canada y compris Terre-Neuve et le Labrador, et parmi les peuples autochtones, les bébés sont toujours nourris de lait évaporé pour des raisons culturelles et économiques. À trois mois et à six mois, les bébés nés à terme, nourris de lait évaporé (n=30) recevaient de moindres quantités de fer, de thiamine, de sélénium et pesaient plus que ceux nourris de lait maternel (n=29). Les bébés nourris de lait évaporé souffraient plus souvent d’anémie, d’un niveau d’activité réduit de transcétolase (thiamine) et d’un niveau d’activité réduit de glutathion peroxydase (sélénium) (p<0,05).
Afin de connaître les répercussions à long terme d’une alimentation déficiente chez le nourrisson, nous avons examiné les mêmes enfants à l’âge de 18 mois. À cet âge, il n’y avait aucune différence dans la consommation d’énergie, de protéine, de zinc, de cuivre, de sélénium et de fer, ni dans les niveaux de zinc, de cuivre, de vitamine C dans le plasma, ni dans les niveaux d’activité de glutathion réductase (riboflavine), de transcétolase, de glutathion, ni de superoxide dismutase dans les cellules rouges du sang. Cependant, les bébés nourris au lait évaporé pesaient plus et avaient plus souvent besoin de soins médicaux, souffraient d’anémie et avaient des niveaux plus bas de fer en comparaison avec des enfants nourris de lait maternel. Nous en concluons que les bébés nourris au lait évaporé devraient recevoir des suppléments de fer pendant leur petite enfance.
Footnotes
This project was supported by the Medical Research Council of Canada and the Janeway Research Foundation
References
- 1.Fomon SJ. Nutrition of Normal Infants. St. Louis: Mosby; 1993. [Google Scholar]
- 2.HealthWelfare Canada. Feeding Babies. 1986. [Google Scholar]
- 3.Friel JK, Andrews WL, Simmons BS, et al. An evaluation of full-term infants fed an evaporated milk formula. Acta Paediatrica. 1997;86:448–53. doi: 10.1111/j.1651-2227.1997.tb08910.x. [DOI] [PubMed] [Google Scholar]
- 4.Matthews K, Webber K, McKim E, et al. Infant feeding practices in Newfoundland and Labrador. Can J Public Health. 1995;86(5):296–300. [PubMed] [Google Scholar]
- 5.American Academy of Pediatrics Committee on Nutrition. The use of whole cow’s milk in infancy. Pediatrics. 1992;89:1105–9. [PubMed] [Google Scholar]
- 6.Foucard T. Development of food allergies with special reference to cow’s milk allergy. Pediatrics. 1985;75:177–81. [PubMed] [Google Scholar]
- 7.Fomon SJ, Ziegler EE, Nelson SE, Edwards BB. Cow milk feeding in infancy: Gastrointestinal blood loss and iron nutritional status. J Pediatr. 1981;98(4):540–45. doi: 10.1016/S0022-3476(81)80756-1. [DOI] [PubMed] [Google Scholar]
- 8.Ziegler EE, Fomon SJ. Potential renal solute load of infant formulas. J Nutr. 1989;119(125):1785–88. doi: 10.1093/jn/119.suppl_12.1785. [DOI] [PubMed] [Google Scholar]
- 9.HealthWelfare Canada. Nutrient Value of Some Common Foods. 1987. [Google Scholar]
- 10.Friel JK, Matthew JD, Andrews WL, et al. Comparison of two kits for measuring ferritin in blood. Clin Pediatr. 1993;3:4–5. doi: 10.1177/000992289303200317. [DOI] [PubMed] [Google Scholar]
- 11.American Academy of Pediatrics Committee on Nutrition. Iron deficiency. In: Forbes GR, Woodruff CW, editors. Pediatric Nutrition Handbook. 2nd ed. Elk Grove, IL: American Academy of Pediatrics; 1985. [Google Scholar]
- 12.Yip R. The epidemiology of childhood iron deficiency. In: Dobbing J, editor. Brain, Behaviour, and Iron in the Infant Diet. London: Springer-Verlag; 1990. pp. 27–42. [Google Scholar]
- 13.Makino T, Takahara K. Direct determination of plasma copper and zinc in infants by atomic absorption with discrete nebulization. Clin Chem. 1991;27:1445–47. [PubMed] [Google Scholar]
- 14.L’Abbe MR, Friel JK. Copper status of very low birth weight infants during the first 12 months of infancy. Pediatr Res. 1992;32:183–88. doi: 10.1203/00006450-199208000-00012. [DOI] [PubMed] [Google Scholar]
- 15.Paglia DE, Valentine WN. Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase. J Lab Clin Med. 1967;70:158–68. [PubMed] [Google Scholar]
- 16.Brin M, Dibble MV, Peela EA. Some preliminary findings on the nutritional status of the aged in Onondaga county. Am J Clin Nutr. 1965;17:240–45. doi: 10.1093/ajcn/17.4.240. [DOI] [PubMed] [Google Scholar]
- 17.Tillotson JA, Baker EM. An enzymatic measurement of the riboflavin status in man. Am J Clin Nutr. 1972;25:425–31. doi: 10.1093/ajcn/25.4.425. [DOI] [PubMed] [Google Scholar]
- 18.Omaye ST, Turnbull JD, Sauberlich HE. Selected methods for the determination of ascorbic acid in animal cells, tissues and fluids. Methods Enzyme. 1979;62:3–12. doi: 10.1016/0076-6879(79)62181-X. [DOI] [PubMed] [Google Scholar]
- 19.Blishen BR, McRoberts HA. A revised socio-economic index for occupations in Canada. Can Rev Soc Anthrop. 1976;13:71–84. doi: 10.1111/j.1755-618X.1976.tb00759.x. [DOI] [Google Scholar]
- 20.Nie NH, Hull CH, Jenkins JG, et al., editors. Statistical Package for the Social Sciences (SPSSx) New York: McGraw Hill Inc.; 1975. [Google Scholar]
- 21.Gibson RS. Principles of Nutritional Assessment. NY: Oxford University Press; 1990. [Google Scholar]
- 22.Yeung DL, Pennell MD, Hall J, Leung M. Growth and development of infants in Toronto and Montreal. Can J Public Health. 1982;73:278–82. [PubMed] [Google Scholar]
- 23.Walravens PA. Nutritional sources of iron in infants and toddlers. In: Filer LJ Jr., editor. Dietary Iron: Birth to Two Years. New York: Raven Press; 1989. pp. 91–102. [Google Scholar]
- 24.HealthWelfare Canada. Nutrition Recommendations. The report of the scientific review committee. Minister of Supply and Services. 1990. [Google Scholar]
- 25.Heinig MJ, Nommsen LA, Peerson JM, et al. Intake and growth of breast-fed and formula fed infants in relation to the timing of introduction of complementary foods: The DARLING study. Acta Paediatr. 1993;82:999–1005. doi: 10.1111/j.1651-2227.1993.tb12798.x. [DOI] [PubMed] [Google Scholar]
- 26.Tsang RC, Nichols BL. Nutrition During Infancy. Philadelphia: Hanley and Belfus Inc.; 1988. Appendix. [Google Scholar]
- 27.Litov RE, Combs GF. Selenium in pediatric nutrition. Pediatrics. 1991;87:339–51. [PubMed] [Google Scholar]
- 28.Andelman MB, Sered BR. Utilization of dietary iron by term infants. Am J Dis Child. 1966;111:45–55. doi: 10.1001/archpedi.1966.02090040081007. [DOI] [PubMed] [Google Scholar]
- 29.Nutrition Committee. Meeting the iron needs of infants and young children: An update. CMAJ. 1991;148(11):1451–54. [PMC free article] [PubMed] [Google Scholar]
- 30.Owen GM, Garry PJ, Hooper EM, et al. Iron nutriture of infants exclusively breast-fed the first five months. J Pediatr. 1981;99(2):237–40. doi: 10.1016/S0022-3476(81)80461-1. [DOI] [PubMed] [Google Scholar]
- 31.Innis SM, Nelson CM, Wadsworth LD, et al. Incidence of iron-deficiency anaemia and depleted iron stores among nine-month-old infants in Vancouver, Canada. Can J Public Health. 1997;88(2):80–84. doi: 10.1007/BF03403865. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Phillips MB, Wardlaw JM. Effect of preparation technique and storage time on vitamin C content of infant formulas made with vitamin-enriched commercial evaporated milk. CMAJ. 1967;97:1384–88. [PMC free article] [PubMed] [Google Scholar]