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A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants
Yvan Vandenplas,Zakiudin Munasir,Badriul Hegar,Dewi Kumarawati,Ahmad Suryawan,Muzal Kadim,Julistio Tb Djais,Ray Wagiu Basrowi,Deni Krisnamurti 대한소아청소년과학회 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.5
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow’s milk and processed to adjust for the nutritional needs of infants. However, cow’s milk is one of the most common causes of food allergy, affecting 2%–5% of all formula-fed infants during their first year of life. One strategy to prevent cow’s milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.
A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants
Vandenplas, Yvan,Munasir, Zakiudin,Hegar, Badriul,Kumarawati, Dewi,Suryawan, Ahmad,Kadim, Muzal,Djais, Julistio Tb,Basrowi, Ray Wagiu,Krisnamurti, Deni The Korean Pediatric Society 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.5
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%-5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.
Verawati Sudarma,Diana Sunardi,Nanis Sacharina Marzuki,Zakiudin Munasir,Asmarinah,Adi Hidayat,Badriul Hegar 대한소아소화기영양학회 2023 Pediatric gastroenterology, hepatology & nutrition Vol.26 No.5
Purpose: Human milk oligosaccharides (HMOs) may be genetically determined based on the secretor and Lewis status of the mother. This study aims to determine the HMO profile and the secretor and Lewis gene status of Indonesian lactating mothers. Methods: Baseline data of 120 mother-infant pairs between 0-4 months post-partum obtained from a prospective longitudinal study was used. The concentrations of 2'-fucosyllactose (2’FL), lacto-N-fucopentaose I (LNFP I), lacto-N-tetraose (LNT), lacto- N-neotetraose (LNnT), 3'-sialyllactose (3’SL), and 6'-sialyllactose (6’SL) were measured. Genetic analysis was performed for mothers using targeted next-generation sequencing and Sanger sequencing. Wild-type AA with the rs1047781 (A385T) polymorphism was categorized as secretor positive, while heterozygous mutant AT was classified as a weak secretor. The presence of rs28362459 (T59G) heterozygous mutant AC and rs3745635 (G508A) heterozygous mutant CT genes indicated a Lewis negative status, and the absence of these genes indicated a positive status. Subsequently, breast milk was classified into various groups, namely Group 1: Secretor+Lewis+ (Se+Le+), Group 2: Secretor−Lewis+ (Se−Le+), Group 3: Secretor+Lewis− (Se+Le−), and Group 4: Secretor−Lewis− (Se−Le−). Data were analyzed using the Mann–Whitney and Kruskal–Wallis rank tests, and a p-value of 0.05 indicated statistical significance. Results: A total of 58.3% and 41.7% of the samples had positive and weak secretor statuses, respectively. The proportion of those in Group 1 was 85%, while 15% were Group 3. The results showed that only 2'FL significantly differed according to the secretor status (p-value=0.018). Conclusion: All Indonesian lactating mothers in this study were secretor positive, and most of them had a Lewis-positive status.
Association between feeding intolerance and intestinal dysbiosis in very premature infants
Putri Maharani Tristanita Marsubrin,Agus Firmansyah,Rinawati Rohsiswatmo,Zakiudin Munasir,Saptawati Bardosono,Safarina Golfiani Malik,Yuditiya Purwosunu,Ina Susianti Timan,Tetty Yuniati,Maya Yulindhin 대한소아청소년과학회 2023 Clinical and Experimental Pediatrics (CEP) Vol.66 No.11
Badriul Hegar,Yulianti Wibowo,Ray Wagiu Basrowi,Reza Gunadi Ranuh,Subianto Marto Sudarmo,Zakiudin Munasir,Alpha Fardah Atthiyah,Ariani Dewi Widodo,Supriatmo,Muzal Kadim,Ahmad Suryawan,Ninung Rose Dian 대한소아소화기영양학회 2019 Pediatric gastroenterology, hepatology & nutrition Vol.22 No.4
Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2′-fucosyllactose (2′-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2′-FL and LNnT is a promising innovation for infant nutrition.
Hegar, Badriul,Wibowo, Yulianti,Basrowi, Ray Wagiu,Ranuh, Reza Gunadi,Sudarmo, Subianto Marto,Munasir, Zakiudin,Atthiyah, Alpha Fardah,Widodo, Ariani Dewi,Supriatmo, Supriatmo,Kadim, Muzal,Suryawan, A The Korean Society of Pediatric Gastroenterology 2019 Pediatric gastroenterology, hepatology & nutrition Vol.22 No.4
Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2'-fucosyllactose (2'-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2'-FL and LNnT is a promising innovation for infant nutrition.