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A simple, rapid, and robust hydrophilic interaction liquid chromatography–tandem mass spectrometry method has been applied for the determination of acrylamide in bread, potato-based heat-processed products, and cereal-based infant food. The QuEChERS methodology was used for sample extraction and clean-up. Enzyme asparaginase was used to prepare an acrylamide-free bread-like matrix, thereby eliminating the lack of acrylamide-free food matrices as one of the limitations for method development and validation. The obtained linear range was 10–2500 µg/kg, and the limit of detection and the limit of quantification were 2.71 and 10.0 μg/kg (S/N = 3 and 10, respectively). The developed method demonstrated good recoveries (98.9–102.8%), intra-day (2.1–3.8%), and inter-day precision (2.9–4.0%). The acrylamide was found in all samples; the concentrations were lower than benchmark levels set by the European Union. In the baby food sample, the AA concentrations were below the limit of quantification (10 µg/kg), and the benchmark level set by the European Union is 40 µg/kg. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Food Safety & Quality is the property of Journal of Food Safety & Quality Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

High pressure processing (HPP) is a non-thermal technology with emerging application within the fruit and vegetable sector. The impact of the enumeration agar on the recorded HPP inactivation of L. monocytogenes, Salmonella spp. and E. coli in banana–apple and apple purees was evaluated. Additionally, the HPP inactivation and sublethal injury was quantified in apple puree, considering the impact of acid exposure (24 h before HPP) and sampling time. Inoculated purees were pressurized at 300 MPa for 2 min. Enumeration was performed immediately and 24 h after HPP. HPP inactivation was 0.9-to-4.5-fold higher in apple than banana–apple puree. Compared with nutrient-rich media, selective agar enumeration overestimated the inactivation. HPP inactivation and sublethal injury of L. monocytogenes, Salmonella and E. coli was variable, mainly dependent on the exposure to acid and the sampling time. The 24 h-delayed enumeration slightly increased the inactivation. In apple puree, the CECT5947 strain of E. coli O157:H7 was the most piezo-resistant strain (1.5 log reduction), while L. monocytogenes Scott A was the most piezo-sensitive (6-log reduction when exposed to acid and sampled 24 h after HPP). All the studied factors should be taken into account when designing HPP treatments, performing product-specific validation studies and setting verification procedures. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nutrition & Food Security is the property of Shahid Sadoughi University of Medical Sciences, Nutrition & Food Security Research Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study explores the impact of co-ingesting cereals and legumes on starch and protein during simulated infant in vitro digestion. Various legumes (chickpeas, lentils, peas) were added to cereals (durum wheat, brown rice, white maize), and their effects on starch and protein hydrolysis were analyzed. Substituting 50% of cereal with legumes increased proteins, minerals, and dietary fiber. Infant food with legumes exhibited smoother pasting properties. Legumes in cereal purées led to varying starch hydrolysis trends, with the lowest values in durum wheat with chickpea and all cereal blends with peas. Resistant starch levels exceeding 50% were found in infant food samples. Digested protein hydrolysis increased with legumes in durum wheat, except for peas. Brown rice mixtures decreased significantly compared to the control with chickpeas (61%) and peas (42%), while lentil blends increased by 46%. Legumes generally did not significantly affect starch bioavailability, even with α-amylase inhibitors. Lentil-cereal purées could enhance infant food nutritional value. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic increased food insecurity among US households, however, little is known about how infants, who rely primarily on human milk and/or infant formula, were impacted. We conducted an online survey with US caregivers of infants under 2 years of age (N = 319) to assess how the COVID-19 pandemic impacted breastfeeding, formula-feeding and household ability to obtain infant-feeding supplies and lactation support (68% mothers; 66% White; 8% living in poverty). We found that 31% of families who used infant formula indicated that they experienced various challenges in obtaining infant formula, citing the following top three reasons: the formula was sold out (20%), they had to travel to multiple stores (21%) or formula was too expensive (8%). In response, 33% of families who used formula reported resorting to deleterious formula-feeding practices such as diluting formula with extra water (11%) or cereal (10%), preparing smaller bottles (8%) or saving leftover mixed bottles for later (11%). Of the families who fed infants human milk, 53% reported feeding changes directly as a result of the pandemic, for example, 46% increased their provisioning of human milk due to perceived benefits for the infant's immune system (37%), ability to work remotely/stay home (31%), concerns about money (9%) or formula shortages (8%). Fifteen percent of families who fed human milk reported that they did not receive the lactation support they needed and 4.8% stopped breastfeeding. To protect infant food and nutrition security, our results underscore the need for policies to support breastfeeding and ensure equitable and reliable access to infant formula.

To understand the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) counselor experiences discussing responsive bottle feeding during counseling and WIC participants' knowledge, understanding, and use of responsive bottle feeding. Qualitative descriptive, semistructured interviews with 23 participants (8 WIC counselors and 15 WIC participants) were conducted online via Zoom. The WIC counselors and mothers of WIC-enrolled bottle-fed infants were recruited through a network of WIC clinics in North Carolina. Interviews were recorded, transcribed, and collaboratively analyzed using content analysis. The WIC participants received responsive infant feeding support from WIC counselors but often in the context of breastfeeding. WIC counselors provided valuable support for families but were challenged by limited training on responsive bottle feeding, balancing promoting breastfeeding with supporting mothers' feeding decisions, and time constraints. Findings provide preliminary support for the need to develop and pilot an intervention focused on promoting responsive feeding for parents of bottle-fed infants. [ABSTRACT FROM AUTHOR]

The article aims to identify NBCAL violations and analyze the content of messages posted on the Instagram social network. This qualitative-quantitative study consisted of a convenience sample of profiles identified through specific terms preceded by the hashtag symbol (#). Data were collected for two months by trained researchers using a structured questionnaire. We calculated the product promotion frequency that characterized violation of the NBCAL per category and manufacturer. The messages were analyzed using the content analysis technique. We identified 64 personal accounts of mothers with violations in 89 products, mainly food (n = 72), dairy compounds (54.2%), and infant formulas (45.8%) were the most publicized. Two thematic categories emerged from the posted texts, one related to the quality of the products and the other about breastfeeding difficulty, especially low milk production. The study identified NBCAL violations on the Instagram social network, alerting the need to recognize digital marketing to include it in the rules imposed by the Norm in the virtual context, considering the capillarity of social networks in disseminating information to the public in question. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to examine mothers’ knowledge levels on complementary foods and their perception of convenience complementary foods. Methods An online survey was conducted with mothers aged 20–49 years who had purchased convenience complementary foods and had a preschool child aged 4 months or older. The respondents were categorized into 3 groups based on their knowledge scores: low- (0–50 points), mid- (55–65 points), and high- (70–100 points) knowledge groups. Results The average score of mothers’ knowledge on complementary foods was 58.8 out of 100 points. Working mothers were found to have lower levels of knowledge compared to mothers who were housewives. Only 1/4 of responding mothers had educational experience on complementary foods. Mothers expressed a desire for information on the types of complementary foods (72.2%) and the intake amounts (60.3%) corresponding to each phase of their child’s development. Multivariate analysis of variance revealed significant differences in health (P = 0.002), variety (P = 0.039), and hygiene (P = 0.041) among the factors taken into consideration when purchasing convenience complementary foods according to the mothers’ knowledge levels. Mothers in the high-knowledge group placed a greater importance on ‘balanced nutrition’ (P = 0.022) and ‘hygienic cooking’ (P = 0.010) compared to mothers in the low-knowledge group. The results of the modified importance-performance analysis, which compared the importance and performance of the factors taken into consideration when purchasing convenience complementary foods, highlighted the need for efforts in ‘health,’ ‘hygiene,’ and ‘price,’ while also indicating an excessive effort in ‘convenience.’ Conclusions This study suggests expanding relevant education programs to enhance mothers’ knowledge on complementary foods, especially for working mothers. In the industry, marketing strategies for complementary food products could be developed that align with the needs of mothers, focusing on health, hygiene, and price.

ObjectiveA method involving derivatization combined with liquid chromatography-tandem mass spectrometry was developed for the determination of vitamin D in infant formula food.MethodsThe samples were treated with enzymolysis， saponification， liquid-liquid extraction， and 4-phenyl-1，2，4-triazoline-3，5-dion derivatization. Chromatographic separation was performed using an Atlantis® T3 column， and gradient elution was performed using the methanol-5 mmol/L ammonium format solution as the mobile phase. The method applied positive electrospray ionization and multiple reaction monitoring mode and was quantified with the isotope internal standard method.ResultsA good linearity was obtained with a correlation coefficient above 0.99. The average recovery levels from three different ranged from 92.3% to 94.2%， and the relative standard deviations were between 3.03% and 5.34% （n=6）. The limit of quantification was 1 μg/kg.ConclusionThis method is simple， accurate with high sensitivity and high selectivity， and suitable for the determination of vitamin D in infant formula food.

High pressure processing (HPP) is a non-thermal technology with emerging application within the fruit and vegetable sector. The impact of the enumeration agar on the recorded HPP inactivation of L. monocytogenes, Salmonella spp. and E. coli in banana–apple and apple purees was evaluated. Additionally, the HPP inactivation and sublethal injury was quantified in apple puree, considering the impact of acid exposure (24 h before HPP) and sampling time. Inoculated purees were pressurized at 300 MPa for 2 min. Enumeration was performed immediately and 24 h after HPP. HPP inactivation was 0.9-to-4.5-fold higher in apple than banana–apple puree. Compared with nutrient-rich media, selective agar enumeration overestimated the inactivation. HPP inactivation and sublethal injury of L. monocytogenes, Salmonella and E. coli was variable, mainly dependent on the exposure to acid and the sampling time. The 24 h-delayed enumeration slightly increased the inactivation. In apple puree, the CECT5947 strain of E. coli O157:H7 was the most piezo-resistant strain (1.5 log reduction), while L. monocytogenes Scott A was the most piezo-sensitive (6-log reduction when exposed to acid and sampled 24 h after HPP). All the studied factors should be taken into account when designing HPP treatments, performing product-specific validation studies and setting verification procedures.

Adequate iron intake is essential for optimal child development, but iron deficiency and anemia among infants and young children are widespread in low- and middle-income countries. Large-scale food fortification strategies hold great promise for reducing micronutrient deficiencies; however, for children

Infants younger than 4 months are not ready for complementary foods/drinks (any solid or liquid other than breast milk or infant formula). Almost half of US infants participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides nutrition education and support to low‐income families. We describe the prevalence of early introduction (<4 months) of complementary foods/drinks and examine the association of milk feeding type (fully breastfed, partially breastfed or fully formula fed) with early introduction of complementary foods/drinks. We used data from 3310 families in the longitudinal WIC Infant and Toddler Feeding Practices Study‐2. We described the prevalence of early introduction of complementary foods/drinks and modeled the association of milk feeding type at Month 1 with early introduction of complementary foods/drinks using multi‐variable logistic regression. Thirty‐eight percent of infants were introduced early to complementary foods/drinks (<4 months). In adjusted models, infants who were fully formula fed or partially breastfed at Month 1 were 75% and 57%, respectively, more likely to be introduced early to complementary foods/drinks compared with fully breastfed infants. Almost two in five infants were given complementary foods/drinks early. Formula feeding at Month 1 was associated with higher odds of early introduction of complementary foods/drinks. There are opportunities to support families participating in WIC to prevent early introduction of complementary foods/drinks and promote child health. Key messages: Almost two in five infants participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were given complementary foods/drinks early.The most common food to be introduced early was infant cereal (17%), while the most common drink introduced early was plain water (24%).Formula feeding at Month 1 was associated with higher odds of early introduction of complementary foods/drinks among infants participating in WIC.These findings suggest there are opportunities to support families participating in WIC to prevent early introduction of complementary foods/drinks and promote child health. [ABSTRACT FROM AUTHOR]

Diarrhoea is a considerable agent of disease and loss of life in children below age five in South Africa. Soweto, South Africa is an urban township in Johannesburg, with most of its population living in informal settlements. Informal settlements in areas such as Soweto are often impoverished communities that do not get water easily, inadequate sanitation is pervasive, and poor hygiene common (risk factors for diarrhoeal diseases). Among the age groups, infants are most vulnerable to diarrhoeal infection, mainly through the ingestion of food and water. The presence of undesirable microbiota is a food safety and health challenge. This study investigated the microbiome of infant food samples collected from formal (n = 19) and informal (n = 11) households in Soweto. A non-culture-dependent technique was used to characterise the bacterial diversity and composition of the infant food samples. The results indicated that household type did not influence microbial diversity and composition in Soweto. South Africa. Firmicutes, Proteobacteria, Cyanobacteria, and Tenericutes dominated the phyla rank in food samples from formal and informal households. Potential pathogens of public health significance, including diarrhoeal disease agents such as Salmonella spp., E. coli, and Campylobacter spp., were detected within the foods. We concluded that the infant food samples showed rich bacterial diversity, and the presence of potential pathogens of public health significance suggests a disease risk that infants may face upon consuming the foods. [ABSTRACT FROM AUTHOR]

Rice (Oryza sativa L.) is particularly susceptible to arsenic (As) accumulation. Currently, to decrease the level of As accumulated in rice, various post-harvest methods, i.e., polishing, parboiling, pH-dependent soaking, washing, and cooking at different rice-to-water ratios (r/w), are being focused, because it removes significant amount of As from rice grain. Depending upon the rice variety and type, i.e., rough (with husk), husked (without husk/brown), or polished rice, these methods can remove 39–54% As by parboiling, 38–55% by polishing, 37–63% by soaking, and 6–80% by washing and cooking. Infants are highly vulnerable to As exposure; thus, these methods can be helpful for the production of rice-based infant foods. Although concern arises during the use of these methods that apart from decreasing the level of As in rice grain, they also lead to a significant loss of nutrients, such as macro- and micro-elements present in rice. Among these discussed methods, parboiling curtails 5–59%, polishing curtails 6–96%, soaking curtails 33–83%, and washing and cooking in different r/w reduce 8–81% of essential nutrients resulting in 2–90% reduction in contribution to the RDI of these nutrients through rice-based diet. Thus, these post-harvest arsenic removal methods, although reduce arsenic induced health hazard, but may also lead to malnutrition and compromised health in the population based on rice diet. There is a need to explore another way to reduce As from rice without compromising the nutrient availability or to supplement these nutrients through grain enrichment or by introducing additional dietary sources by changing eating habits; however, this may impose an extra economic burden on people. [ABSTRACT FROM AUTHOR]

Abstract COVID-19 is a significant threat to humanity in the present day due to the rapid increase in the number of infections worldwide. While most children may be spared of the direct mortality effects of the disease, those with weak immune systems are prone to adverse effects. Child mortality increases due to the stress caused to the health care system that disrupts essential health care needs such as immunisation and antenatal care. The use of functional foods (FF) aids in disease-prevention as they are known to have protective effects against COVID-19 by boosting children’s cellular and humoral immunity. Plant components such as glycyrrhizin, epigallocatechin gallate, allicin, and fucoidan exhibit antiviral properties against various viruses, including SARS-CoV 2. Microbial foods that are made of probiotics, can enhance immunity against various respiratory viruses. Food enriched with additives such as lactoferrin, piperine, and zinc can boost immunity against COVID-19. With proper definitive drug therapy not available for treating COVID-19 and most of the disease management tools rely on symptoms and non-specific supportive care, developing a functional paediatric formulation will prevent further deterioration in infant health. It is wise to investigate the toxicological aspects of Functional Foods components especially when formulating for children. The safe limits of ingredients should be strictly followed during FFs formulation. Stronger regulations with advanced analytical techniques can help to formulate functional foods into the mainstream in child nutraceuticals. The purpose of this review is to compile collective information on the functional nutraceuticals specifically for infants and children up to the age of 10 years that could confer immunity against COVID-19 and other related viruses. Graphical Abstract

Abstract Infants younger than 4 months are not ready for complementary foods/drinks (any solid or liquid other than breast milk or infant formula). Almost half of US infants participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides nutrition education and support to low‐income families. We describe the prevalence of early introduction (

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

COVID-19 is a significant threat to humanity in the present day due to the rapid increase in the number of infections worldwide. While most children may be spared of the direct mortality effects of the disease, those with weak immune systems are prone to adverse effects. Child mortality increases due to the stress caused to the health care system that disrupts essential health care needs such as immunisation and antenatal care. The use of functional foods (FF) aids in disease-prevention as they are known to have protective effects against COVID-19 by boosting children's cellular and humoral immunity. Plant components such as glycyrrhizin, epigallocatechin gallate, allicin, and fucoidan exhibit antiviral properties against various viruses, including SARS-CoV 2. Microbial foods that are made of probiotics, can enhance immunity against various respiratory viruses. Food enriched with additives such as lactoferrin, piperine, and zinc can boost immunity against COVID-19. With proper definitive drug therapy not available for treating COVID-19 and most of the disease management tools rely on symptoms and non-specific supportive care, developing a functional paediatric formulation will prevent further deterioration in infant health. It is wise to investigate the toxicological aspects of Functional Foods components especially when formulating for children. The safe limits of ingredients should be strictly followed during FFs formulation. Stronger regulations with advanced analytical techniques can help to formulate functional foods into the mainstream in child nutraceuticals. The purpose of this review is to compile collective information on the functional nutraceuticals specifically for infants and children up to the age of 10 years that could confer immunity against COVID-19 and other related viruses. [ABSTRACT FROM AUTHOR]

BACKGROUND:As iodine is a requisite micronutrient for infant brain development, infants are at risk for iodine deficiency during the weaning period when their diet transitions from milk (breast-milk, infant formula, or follow-on formula) to solid food. Dietary iodine intake during this weaning period is likely minimal, as the iodine content of commercial baby food is not regulated, and the addition of salt to baby food is not recommended. This study reports the current status of iodine nutrition among weaning infants in the United States. METHODS:Subjects (n = 60; 50% Caucasian, 30% black) were infants

BackgroundThe impact of feeding a slightly sweet nutrient supplement early in life on later sweet taste preference is unknown.ObjectiveWe tested the hypothesis that the level of sucrose most preferred by 4-6-y-old children exposed to a slightly sweet lipid-based nutrient supplement (LNS) early in life would not be higher than that of children never exposed to LNS.DesignWe followed up children born to women (n = 1,320) who participated in a randomized trial in Ghana. In one group, LNS was provided to women on a daily basis during pregnancy and the first 6 mo postpartum and to their infants from age 6 to 18 mo (LNS group). The control groups received daily iron and folic acid or multiple micronutrients during pregnancy and the first 6 mo postpartum, with no infant supplementation (non-LNS group). At age 4-6 y, we randomly selected a subsample of children (n = 775) to assess the concentration of sucrose most preferred using the Monell 2-series, forced-choice, paired-comparison tracking procedure. We compared LNS with non-LNS group differences using a noninferiority margin of 5% weight/volume (wt/vol).ResultsOf the 624 children tested, most (61%) provided reliable responses. Among all children, the mean ± SD sucrose solution most preferred (% wt/vol) was 14.6 ± 8.6 (LNS group 14.9 ± 8.7; non-LNS group 14.2 ± 8.4). However, among children with reliable responses, it was 17.0 ± 10.2 (LNS group 17.5 ± 10.4; non-LNS group 16.5 ± 10.0). The upper level of the 95% CI of the difference between groups did not exceed the noninferiority margin in either the full sample or those with reliable responses, indicating that the LNS group did not have a higher sweet preference than the non-LNS group.ConclusionExposure to a slightly sweet nutrient supplement early in life did not increase the level of sweet taste most preferred during childhood. This trial was registered at clinicaltrials.gov as NCT00970866.

Objectives: This study sought to evaluate the relative efficacy of expressed breast milk (EBM) fortified using human milk fortifier (HMF) compared to commercial preterm formula (PF) on preterm and very low birth weight (VLBW) infants in a major tertiary healthcare center in Oman. Methods: This retrospective cohort study included two cohorts of preterm (< 32 weeks gestation) or VLBW infants (birth weight < 1500 g) treated in the neonatal intensive care unit (NICU). Cohort one included infants who were given PF-fortified EBM between January and December 2016, and cohort two were given newly-introduced HMF-fortified EBM between November 2018 and December 2019. Analysis was performed to compare the cohorts with respect to baseline characteristics, primary outcomes, and secondary outcomes. Results: A total of 103 neonates were included (cohort 1: n = 55, cohort 2: n = 48). There were no significant differences in the growth of the weekly length, the growth of the head circumference, or discharge growth parameters. Compared to PF, HMF was associated with significantly better weight gain velocity (g/kg/day) during the first week (p =0.009) and second week (p =0.050) after starting fortification, lower need for other adjunctive forms of fortification (p =0.035), and lower rates of necrotizing enterocolitis in premature infants or VLBW (p =0.018). Conclusions: This is likely to be the first study to analyze the relative efficacy of HMF and PF in the Middle East. The results of this study will be helpful in guiding standards of nutritional care in NICUs in Oman.

The study aimed to determine the trace metal concentrations and assess the associated health risk of consuming cereal-based infant foods sold in supermarkets and local shops (baltena) in Arba Minch town, Ethiopia. Samples were subjected to a microwave digestion process and the trace elements were analyzed using Flame Atomic Absorption Spectrometry (FAAS). The method's accuracy was validated through a recovery test, yielding optimal results within the range of 94–100 %. The average concentrations of trace elements in the infant food samples were as follows: Iron (36.51–47.58 mg/kg), Copper (1.86–2.57 mg/kg), Zinc (13.90–21.56 mg/kg), Nickel (0.02–0.04 mg/kg), Chromium (0.034–0.10 mg/kg), Cobalt (0.012–0.02 mg/kg). Notably, potentially toxic heavy metals like Cadmium and Lead were not detected in the samples. The hazard quotient (HQ) for (6−9) month old infants was less than one (HQ<1) for all the trace elements analyzed. The same holds good for (9−12) month old infants except few food samples such as Selam, Zini, Mimi and Mulga baltena, which had HQ values greater than one (HQ>1). It is inferred that the continuous consumption of these foods might cause risk over a longer period. • Trace elements in infant foods sold in Arba Minch, Ethiopia, were analyzed in the study. • Method validation was performed by spiking and recovery of trace elements using FAAS. • No traces of Pb and Cd were found in supplementary foods and water samples. • EDI for infants (6–12 months) revealed high iron and low cobalt levels • HQ levels below 1 indicate that infant foods in Arba Minch are safe for consumption. [ABSTRACT FROM AUTHOR]

The presence of mycotoxins in cereal-based baby foods is undesirable, especially because infants are considered more vulnerable to toxin exposure than adults. In this context, this study evaluated the occurrence of multiple mycotoxins in 60 samples of cereal-based baby foods from Brazil and assessed the risk of the consumption of these products by children. Aflatoxins B1 and B2 (AFB1, AFB2), deoxynivalenol (DON), 3-acetyl deoxynivalenol (3-ADON), 15-acetyl deoxynivalenol (15-ADON) and zearalenone (ZEN) were evaluated by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The results revealed that 98.3% of the samples were contaminated by at least one mycotoxin, with 80% of them demonstrating co-contamination. DON was detected in 80% of the samples, followed by 15-ADON (71.7%), 3-ADON (65%), ZEN (56.7%) and AFB1 (5%), with none of the samples contaminated by AFB2. The maximum concentrations found were 75.6 μg/kg for DON, 18.9 μg/kg for ZEN, 9.6 μg/kg for 15-ADON, 3.5 μg/kg for AFB1 and 2.8 μg/kg for 3-ADON. The occurrence of AFB1 was low, however, some products exceeded the limits established by the current regulations. Although the estimated daily intake (EDI) of DON, 3-ADON, 15-ADON and ZEN were below the safety values currently established, the margin of exposure (MOE) values for AFB1 indicate a concern for public health. [Display omitted] • Mycotoxin contamination was observed in 98.3% of the samples. • 80% of the samples showed contamination by more than one mycotoxin. • The occurrence of AFB1 was low, but one product exceeded regulatory limits. • The estimated daily intake of DON, 3-ADON, 15-ADON, and ZEN was within safe limits. • The Margin of Exposure values for AFB1 indicate concern for public health. [ABSTRACT FROM AUTHOR]

Diarrhoea is a considerable agent of disease and loss of life in children below age five in South Africa. Soweto, South Africa is an urban township in Johannesburg, with most of its population living in informal settlements. Informal settlements in areas such as Soweto are often impoverished communities that do not get water easily, inadequate sanitation is pervasive, and poor hygiene common (risk factors for diarrhoeal diseases). Among the age groups, infants are most vulnerable to diarrhoeal infection, mainly through the ingestion of food and water. The presence of undesirable microbiota is a food safety and health challenge. This study investigated the microbiome of infant food samples collected from formal (n = 19) and informal (n = 11) households in Soweto. A non-culture-dependent technique was used to characterise the bacterial diversity and composition of the infant food samples. The results indicated that household type did not influence microbial diversity and composition in Soweto. South Africa. Firmicutes, Proteobacteria, Cyanobacteria, and Tenericutes dominated the phyla rank in food samples from formal and informal households. Potential pathogens of public health significance, including diarrhoeal disease agents such as Salmonella spp., E. coli, and Campylobacter spp., were detected within the foods. We concluded that the infant food samples showed rich bacterial diversity, and the presence of potential pathogens of public health significance suggests a disease risk that infants may face upon consuming the foods.

The study evaluated nutrient composition (protein, mineral & amino acid profile), energy value and sensory attributes of complementary foods from the following flour blends: 100% maize (MAI, control); 70% maize, 30% defatted melon seed flour (MTH); 70% maize, 27.5% defatted melon seed flour, 2.5% moringa leaf powder (MAT); 70% maize, 25% defatted melon seed flour, 5% moringa leaf powder (MET); and 70% maize, 20% defatted melon seed flour, 10% moringa leaf powder (MIT). Protein and energy values of the foods varied from 14.98 - 16.60 g/100 g and 352.53 - 374 kcal/100 g, respectively. Calcium/phosphorous (5.14 - 12.55) and sodium/potassium (0.009 - 0.012) molar ratios were higher than >0.5 and lower than (

Protein digestion is critical for infants. Dissimilarities between infants and adults in food intake and digestive physiology lead to distinct patterns of proteolysis between individuals. However, such differences are not well represented in many studies on protein digestion of baby foods. The complex biological structures of baby foods and the physiology of the infant digestive system are key factors affecting proteolysis during the first two years of life. Well-controlled in vitro studies have demonstrated that varying digestion conditions alter the specificity, rate, and extent of proteolysis of baby foods. Nonetheless, these models do not completely replicate in vivo proteolysis or the complex biogeography of the gastrointestinal tract. Animal and clinical studies have revealed the fate of dietary proteins along the digestive tract and the overall health impact on subjects. Building comprehensive and annotated datasets from human infants will require innovative and standardized measurement. Now, more systematic evaluations of digestion are emerging to advance the knowledge and its translation as food design for effective diet and health management in infants.

Humans, including infants are exposed to complex mixtures of anthropogenic chemicals, and food is a major exposure route. Current risk assessment, however, typically does not evaluate mixture toxicity but rather focuses on single chemical exposure scenarios. Nevertheless, there is ample evidence that combined exposures to chemicals is involved in the etiology of major human diseases, and that infants are often more vulnerable than adults. Surprisingly hardly any efficient practical tools and guidelines have been defined to adequately assess mixture effects of food. Evaluation of levels of mixtures of dioxins and related compounds are a notable exception, although also in that area novel insights warrant reevaluation of the relevant compounds to be included in evaluation. Novel approaches are needed, since our knowledge on the toxicity of chemicals is lagging behind and even most of the industrial chemicals that are in common use have undergone no or limited safety testing, while the situation with natural compounds in food is even more challenging. Novel untargeted chemical analytical techniques and quantitative bioanalytical techniques that respond to toxic chemicals independent of prior knowledge on their structure or toxicity can be used to increase the knowledge on chemical mixtures. We discuss the complementarities between these bio- and chemical analytical methods that can be used in an integrated system to improve infant food safety by avoiding hazards of chemical mixture effects.

OBJECTIVE Rice, one of the first solid foods introduced to infants, is 10 times more absorbent of inorganic arsenic than any other grain. An evaluation has not been performed about practitioner knowledge of arsenic content in infant foods. The purpose of this survey was to determine pediatric practitioners' knowledge of current US Food and Drug Administration (FDA) recommendations to limit exposure to arsenic-containing foods in infants. METHODS This was a convenience sample of pediatric practitioners conducted as an online survey. The survey contained 19 questions related to knowledge of arsenic-containing foods, FDA recommendations, practitioner recommendations on feeding infants, and demographic information. Participants were recruited using organization list servs. Participants were reminded to complete the survey 2 months after the initial email. An infographic on arsenic was provided at the end of the survey. RESULTS One hundred thirty-seven individuals completed the survey. The majority of respondents were physicians or pharmacists and have been in practice less than 6 years. Nine percent of respondents (11/123) stated the FDA arsenic limit of 100 ppb. Sixteen percent (20/123) identified white rice as having a lower inorganic arsenic content than brown rice and 27% (36/132) identified that there is no difference in inorganic arsenic content between organic infant rice cereal and conventional infant rice cereal. CONCLUSIONS The vast majority of participants were not aware of the FDA's proposed limit on arsenic consumption or the concern of heavy metals in baby foods. More education is needed to increase knowledge regarding arsenic in baby foods. ABBREVIATIONS FDA, US Food and Drug Administration; PPA, Pediatric Pharmacy Association. [ABSTRACT FROM AUTHOR]

BackgroundBrown adipose tissue (BAT) is associated with higher energy expenditure and lower adiposity in adults. However, the relationship between BAT composition and adiposity in early life is unknown. The objective of this study was to test the hypothesis that brown fat composition at birth is prospectively associated with adiposity gain during the first 6 months of postnatal life.MethodsN=35 healthy infants were followed up prospectively from intrauterine life and birth through 6 months of age. Dixon magnetic resonance imaging (MRI) scans were conducted during the neonatal period to characterize supraclavicular BAT composition. Dual-energy X-ray absorptiometry to assess total body composition was performed within the first and sixth months of life.ResultsAfter adjusting for potential confounding factors, a more brown-like composition (smaller fat fraction) of the supraclavicular BAT depot was associated with a smaller increase in percent body fat over the first 6 months of postnatal life.ConclusionsA more brown-like BAT composition at birth appears to be protective against excess adiposity gain in early life. Newborn BAT tissue may constitute a target for prevention strategies against the subsequent development of obesity.

Background: While a variety of health apps abound, less than half of adults in the United States report using a health app, despite the ubiquity of smartphones among users aged 18 to 49 years. Several studies have examined the use of breastfeeding apps; however, less is known about the types of features found on these apps and what factors might influence app ratings. Objective: This paper seeks to characterize breastfeeding apps, assess whether apps with higher user ratings differ from apps with lower user ratings in their tracking and nontracking features, and analyze whether the type and number of features predict user star ratings and whether an app is higher- or lower-rated. Methods: Using a cross-sectional design, a convenience sample of breastfeeding apps was culled from the Apple App Store (iOS) and Google Play Store (Android). Content analysis of the apps (N=82) was conducted using a schema of 87 items, which was then compiled into 9 topical indices for breastfeeding, bottle feeding, solid foods, infant health, infant care, technical characteristics, informatics, informational characteristics, and interactivity. Analysis consisted of descriptive statistics, the Mann-Whitney U test, and Spearman rank correlations. Linear regression and binary logistic regression analyses were conducted to determine which features predicted user star ratings. Results: On average, users rated breastfeeding apps 4.4 of 5 stars. Two-thirds of apps (n=54) were higher rated (=4.5 stars), and one-third (n=28) were lower rated (<4.5 stars). Higher-rated apps offered more tracking features for breastfeeding, bottle feeding, solid foods, infant health, and infant care than lower-rated apps. The breastfeeding, solid-food, and technical indices explained 17% of user star ratings. For each additional breastfeeding and solid-food feature, we can expect to see a 27% and 35% increase, respectively, in user star ratings. Additionally, as the number of solid-food features increased, the odds that the app is higher rated increased 1.58 times. Conclusions: Our findings suggest user ratings are driven in part by tracking features, specifically those related to breastfeeding and solid foods. The proliferation of mobile health apps offers opportunities for parents and caregivers to track behaviors associated with infant feeding and other health metrics in a dynamic, detailed, and comprehensive manner. Hence, breastfeeding apps have the potential to promote and support breastfeeding among users. [ABSTRACT FROM AUTHOR]

The electrochemical immunosensor is one of the most promising detection approaches for pathogenic microorganism. In this study, a label-free electrochemical immunosensor based on chitosan/gelatin was fabricated for the detection of Bacillus cereus. Anti-Bacillus cereus polyclonal antibodies were immobilized through a cross-linking method on a chitosan/gelatin-modified electrode. Antibody immobilization on the electrode surface was investigated using scanning electron microscopy, Fourier transform infrared spectroscopy, contact angle, and cyclic voltammetric techniques. Bacillus cereus was detected using square wave voltammetry under optimal conditions, based on a current change that occurred during the specific interaction between antibody and Bacillus cereus. The fabricated immunosensor exhibited a LOD of 101 CFU/mL, LOQ of 103 CFU/mL, detection time < 50 min, linearity ranged from 101 to 108 CFU/mL, high specificity, and good reproducibility and regeneration efficiency. With a recovery of 85–107%, it confirmed accurate identification of B. cereus in a complex matrix sample such as infant food and rice-based products. The immunosensor was found to be stable for 3 weeks with 70% relative activity. The fabricated sensor would be utilized for real-time analysis of Bacillus cereus in food systems to ensure food safety. [ABSTRACT FROM AUTHOR]

Complementary foods (CFs) commonly consumed by infants and young children (IYC) in sub-Saharan Africa (SSA) are processed using either single or multi-grain ingredients through simple technologies such as fermentation, malting and roasting. Interestingly, CFs (e.g., ogi, kunu, and dabo) are prepared and fed to infants alongside breastmilk until they are completely weaned up to the infant's second birthday. The grains used for preparing CFs can be contaminated with bacterial and chemical contaminants as a result of poor harvesting, handling or storage practices. The stage at which IYC are introduced to CFs is of utmost importance as it aids in addressing malnutrition and improving their overall health and well-being. Complementary feeding practices across SSA are influenced by socio-economic, cultural and geographical factors such that improper introduction can result in dire health consequences including immune suppression, severe foodborne diseases, poor child growth and development, and sometimes death from malnutrition. Malnutrition often occurs from inadequacies of nutrient intakes and assimilation which affect the ability to maintain normal body functions such as growth, learning abilities, resistance to and recovery from diseases. In SSA, IYC malnutrition still poses an enormous concern, therefore indicating the need for intervention strategies such as the promotion of indigenous crops and elevating traditional knowledge and technologies for formulating CFs. This paper clearly highlights the diversity of CFs in SSA, ingredients utilized, processing techniques, contamination by bacteria and chemicals, and demonstrates the consequences of consuming contaminated CFs, and their influence on IYC health as well as approaches to ensuring safety and scaling up indigenous CFs., (© 2024 The Author(s). Comprehensive Reviews in Food Science and Food Safety published by Wiley Periodicals LLC on behalf of Institute of Food Technologists.)

There are two main complementary feeding (CF) approaches: traditional spoon-feeding (TSF) and baby-led weaning (BLW). Many parents and healthcare professionals have concerns about the risk of choking associated with BLW. Since asphyxia is one of infants' main causes of death, this study aims to understand the influence of the CF approach adopted by caregivers on infants' risk of choking. A systematic review was performed. The search was conducted through PubMed, Scopus, and Web of Science databases. We included randomized controlled trials or observational studies published between January 2010 and November 2023, with a clear definition of the intervention and directly assessing the risk of choking. After the selection procedure, 7 of the 165 studies initially identified were included. No study reported statistically significant differences in the risk of choking between babies following BLW, baby-led introduction to solids (BLISS), and TSF. In five studies, although not statistically significant, infants in the TSF group had more choking episodes than those in the BLW or BLISS groups. The risk of choking does not seem to be associated with the CF approach. Instead, it may be related to the familiarity of the baby with each texture and the parent's understanding of the information about how to minimize the risk of choking. Recall bias may be present in all included studies. Advice on how to modify foods to make them safer needs to be clearer and reinforced to all parents., (© 2024 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

In the transition period from breastfeeding to the introduction of complementary feeding, the choice of food is extremely important for the child's development as many factors may be related. This study aims to investigate, through a systematic review and qualitative meta-synthesis, influence in the selection of foods in the introduction of complementary foods for children, including qualitative studies without language or publication period restrictions. Searches were performed in PubMed, LILACS, SciELO, Cinahl, Embase, Web of Science, and Scopus. Initially, 12,489 articles were selected for tittle reading, 13 were included in the review. Four analytical themes related to factors influencing complementary feeding were identified: family socioeconomic conditions, cultural and family aspects, guidance and advice from health professionals, and factors inherent to the infant. Economic factors, such as the opportunity to offer foods not consumed during the parents' childhood, were emphasized. The influence of grandmothers' opinions and community beliefs and traditions were considered. Trust in pediatricians and community health agents' advice, although considered, conflicted with cultural and family traditions. Mothers/caregivers often preferred to offer foods the child shows preference for, rather than introducing new flavors. The findings underscore the need for a better understanding of qualitative aspects., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest related to this research. There are no financial, personal, or professional relationships that could influence or be perceived to influence the work presented in this manuscript. This research is conducted with the utmost objectivity and transparency., (Copyright © 2024. Published by Elsevier Ltd.)

Parents play a crucial role in deciding what foods to introduce to their infants during the transition from milk to solids. This study examined the challenges they face, including adherence to official complementary feeding recommendations and the struggles and concerns across different stages of feeding. Specifically, this study focused on the initial stage (transition from breastmilk/formula to mashed foods), middle stage (consumption of mashed foods and some fingerfoods, transitioning towards family foods) and late stage (complete transition to family diet). Findings from 22 semi-structured interviews with Swiss parents reveal that, despite being well-informed, practical obstacles such as returning to work, limited time for preparing homemade foods, managing multiple children, and food preferences often hinder adherence. Safety concerns like allergies and choking were prominent early on but decreased as infants grew older and parents gained confidence. In the middle phase, concerns shifted towards pesticides, indicating a growing awareness of food quality. Maintaining a healthy diet was a constant concern, with early reassurance from breastfeeding or formula feeding giving way to worries about balanced nutrition as solids became more prominent. Time constraints were particularly significant in the first two stages, due to the effort of preparing small amounts of mash and later cooking separate meals. Tailored support and clear communication can help parents navigate these challenges and promote healthier feeding practices., Competing Interests: Declaration of competing interest Co-author Luisma Sanchez-Siles works for the Institute for Research Nutrition, Hero Group., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: While complementary feeding can be challenging, little emphasis has been placed on the introduction to food texture/pieces, especially in terms of neurodevelopmental outcomes. This study aims to determine the association between the timing of introduction to food pieces during infancy and neurodevelopment in early childhood. We hypothesized that late introduction to food texture/pieces relates to unfavorable neurodevelopmental outcomes., Methods: Families (n = 18329) were recruited from the general population during the nationwide ELFE (Étude Longitudinale Française depuis l'Enfance) birth cohort in France, and 8511 were selected for a complete case analysis. Age at introduction to food pieces was determined based on repeated assessments during the first year. A range of neurodevelopmental outcomes among children were assessed using validated instruments, i.e. composite scores at 1 and 3.5 years, and a score for language acquisition at 2 years. Risk for developmental delay at 3.5 years was defined based on a developmental quotient (DQ) below 90 according to the child's chronological age and the respective composite score at this age. We used linear regression modelling to evaluate associations between age at introduction to food pieces and the standardised neurodevelopmental scores, while logistic regression models were used in the analyses according to the risk for developmental delay., Results: Our findings highlight consistent associations between late introduction to food pieces (i.e., after 10 months, compared to early (before 8 months)) and lower estimates of standardised neurodevelopmental scores at ages 1, 2 and 3.5 years (-0.35 [-0.40; -0.30], -0.15 [-0.20; -0.10] and - 0.18 [-0.23; -0.13], respectively). Infants introduced to pieces late were also more likely to be at risk for developmental delay according to DQ < 90 (OR [95%CI] = 1.62 [1.36; 1.94])., Conclusions: This study shows that late introduction to food pieces (> 10 months) is related to lower neurodevelopmental scores. Given the challenges that complementary feeding may pose, concerted efforts are required to enhance our understanding of the sensory aspects of early diets and to ultimately provide guidance., (© 2024. The Author(s).)

Background/Objectives: Very low birth weight (VLBW) infants may require enhanced nutrition, even during complementary feeding. However, there are limited data on macronutrient intake during this period, particularly concerning the individual timing of the introduction of solid foods in a representative VLBW infant population. Methods: This prospective observational study analyzed macronutrient intake in VLBW infants with a gestational age < 32 weeks based on whether solid foods were introduced early (<17 weeks corrected age (CA)) or late (≥17 weeks corrected age) Nutritional intake was analyzed using a 24 h recall at 6 weeks CA and 3-day dietary records at 12 weeks, 6, 9, and 12 months CA. Results: In total, 115 infants were assigned to the early and 82 to the late group. The timing of solid food introduction did not affect macronutrient intake, except for a lower fat and higher carbohydrate intake (% of energy) in the early group at 12 weeks and 6 months CA: early vs. late, fat-12 weeks: 47.0% vs. 49.0%, 6 months: 39.2% vs. 43.3%; carbohydrates-12 weeks: 44.9% vs. 43.2%, 6 months: 51.3% vs. 48.0%. Apart from docosahexaenoic acid (DHA) and arachidonic acid (AA), dietary intake recommendations were met in both groups. While nutrient intakes varied significantly between breastfed and formula-fed infants, those with comorbidities exhibited similar nutrient intake levels compared to those without. Conclusions: Our findings suggest adequate macronutrient intakes in VLBW infants irrespective of the timing of solid introduction. However, there is a notable need to enhance dietary intakes of DHA and AA. Future research is crucial to assess whether current nutrient intakes are sufficient for VLBW infants with comorbidities.

Objective: To explore how professionally qualified, working Indian mothers conceptualize healthy foods in general, perceive processed infant and baby foods available commercially and what feeding practices they actually follow with their children at home., Design: Five focus groups with 8-12 participants were conducted around the participants' conceptualization of healthy food, their perceptions about commercially available processed baby and infant foods and their actual feeding practices that they routinely follow with their children. Discussion transcripts were analyzed using an inductive coding approach., Setting: India., Participants: Fifty-one professionally qualified, working women with at least one child under 5 years of age., Results: Participants agreed that fresh food is healthiest. They also had favorable opinions about processed infant and baby foods with regards to healthfulness, hygiene and safety. Healthy foods were largely conceptualized in relation to nutrient claims, ingredients and discernible health outcomes. They use cues, such as health claims, brand, price, package design and others to determine healthfulness of the product. Perception was heavily influenced by these extrinsic cues rather than by participants' own nutrition knowledge. Despite having the knowledge, most participants admitted to using these foods on account of factors such as their own inability to lactate, social pressure, lack of time and convenience., Conclusions: Most educated and well off people continue to use these products. While they rue the lack of stringent regulatory measures in India, they feel there is an urgent need to address this huge policy gap by way of legislation and regulation., (© 2024. The Author(s).)

Recommendations about allergy prevention through diet are rapidly changing. In just the past several years, multiple organizations have provided updated guidance and recommendations about infant feeding based on recent studies and meta-analyses. In addition to the increased number of studies supporting the benefit of early introduction of allergenic foods, in particular peanut and egg, recent studies demonstrate that infant and maternal diet diversity may also reduce risk of food allergy and atopy. Skin emollients have not been found to be helpful in prevention of food allergy, and more evidence is needed to determine if emollients play a role in prevention of atopic dermatitis., Competing Interests: Disclosure A. Shah has no financial conflict of interest to disclose. S.H. Sicherer reports royalty payments from UpToDate, Elsevier and from Johns Hopkins University Press; grants to his institution from the National Institute of Allergy and Infectious Diseases, United States, from Food Allergy Research and Education, United States, and from Pfizer, United States; and personal fees from the American Academy of Allergy, Asthma and Immunology as Deputy Editor of the Journal of Allergy and Clinical Immunology: In Practice, outside of the submitted work. A. Tsuang has no financial conflict of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Complementary feeding is a critical milestone for parents, who must decide the extent to which they feed their infants with homemade foods (HMFs) or commercial infant foods (CIFs). The current study focused on how parents perceive and evaluate CIFs and what drives them to use these products. Understanding the wide variety of factors that influence parents' decisions to use CIFs as a food source is crucial to helping them make more balanced food choices for their infants. Data from an online survey with 858 German parents revealed their negative perceptions of CIFs, particularly in terms of nutritional quality and texture, and concerns that CIFs contain higher levels of pesticides and heavy metals compared to HMFs, despite acknowledging the expertise of the infant nutrition industry. These perceptions were likely to be driven by the 'natural-is-better' belief and parents' desire for control over the ingredients in their infants' meals, contributing to their skepticism towards CIFs. Additionally, our study found that while many parents know traditional nutrition guidelines, they are less familiar with recent updates. Parents' benefit beliefs about CIFs and parents' trust in the food industry strongly influenced the use of CIFs, while infant age and parent gender had a less strong, yet significant influence on CIFs consumption. Overall, the present study offers new quantitative insights into the factors that motivate parents to use CIFs. Furthermore, it underscores the need for health authorities to improve their communication strategies towards parents concerning new dietary guidelines., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The current study aims to characterise the complementary feeding practice and identify locally available climate-resilient crops that can be used for complementary feeding among agro-pastoralists in Ethiopia. A phenomenological study in Benna-Tsemay district, comprising focused group discussions, key informant interviews, and household observations, was conducted. A pretested guide was used to capture information regarding types of complementary food, lists of food items, and ingredients included in their complementary formulation. A thematic analysis for emerging points of discussion was carried out. Three major themes, including infant and young child feeding practices, food items included in complementary food, and their consumption frequencies, as well as the incorporation of climate-resilient crops into complementary foods as coping mechanisms, emerged. Breastfeeding was common and regarded as essential. Gruel and porridge from grains, roots, and tubers were regular parts of complementary foods in the study area. Moringa and sorghum were dominantly identified as climate-resilient crops regularly grown and used in complementary foods. Growing these crops was regarded as a coping strategy for drought and seasonal constraints. The district is one of the most drought-prone areas in Ethiopia, compromising the quality of complementary food. Unlike the World Health Organization recommendation, the grains, roots, and tubers-based diet formed the basis of complementary food lacking flesh foods, eggs, pulses, and other fruits and vegetables. Thus, it is recommended to improve complementary food quality through value-addition using locally accessible crops., Competing Interests: The authors declare that they have no competing interests., (© The Author(s) 2024.)

Objective: Most wet commercial infant foods are now sold in squeezable 'pouches'. While multiple expert groups have expressed concern about their use, it is not known how commonly they are consumed and whether they impact energy intake or body mass index (BMI). The objectives were to describe pouch use, and determine associations with energy intake and BMI, in infants and young children., Methods: In this observational cross-sectional study of 933 young New Zealand children (6.0 months-3.9 years), pouch use was assessed by a questionnaire ('frequent' use was consuming food from a baby food pouch ≥5 times/week in the past month), usual energy intake using two 24-h recalls, and BMI z-score calculated using World Health Organization standards., Results: The sample broadly represented the wider population (27.1% high socioeconomic deprivation, 22.5% Māori). Frequent pouch use declined with age (infants 27%, toddlers 16%, preschoolers 8%). Few children were both frequent pouch users and regularly used the nozzle (infants 5%, toddlers 13%, preschoolers 8%). Preschoolers who were frequent pouch users consumed significantly less energy than non-users (-580 kJ [-1094, -67]), but infants (115 [-35, 265]) and toddlers (-206 [-789, 378]) did not appear to have a different energy intake than non-users. There were no statistically significant differences in the BMI z-score by pouch use., Conclusions: These results do not support the strong concerns expressed about their use, particularly given the lack of evidence for higher energy intake or BMI.

Introduction: Complementary feeding (CF) is the process of introducing solid or liquid foods (complementary foods, CFs) other than human breast milk (HBM) or infant formula into infants' diet when HBM or infant formula is no longer sufficient to meet infants' nutritional needs. Primary care pediatricians (PCPs) are paramount in guiding and educating infants' families during CF. Materials and Methods: Our exploratory survey aimed to investigate PCPs' current clinical approach to managing CF. From 1 March 2024 to 30 April 2024, a digital questionnaire composed of 32 multiple-choice questions investigating PCPs' attitudes toward CF in healthy, full-term infants was proposed to 1620 PCPs contacted through scientific societies. Results: The questionnaire was completed voluntarily; 707 PCPs (79.5% female, 66.1% aged over 50 years) fully responded to the survey in the proposed timeframe (participation rate 43.6%). Among the responders, 47.5% recommended traditional CF; 42.1% declared to know the baby-led weaning (BLW) approach and on-demand CF (ODCF), but only 32.8% and 12.5% of them recommended these types of CF, respectively. The vast majority (95%) of participants recommended that CF start between 4 to 6 completed months of age. CF routinely based on vegetarian or plant-based diets was supported by 45/707 (6.1%), only if planned by a specialist by 253/707 (35.8%), and only upon request by caregivers by 257/707 (36.3%). Egg and fish introduction was mostly advised in the first year of life, although in case of a positive family history of food allergy, 13.3% of participants recommended the introduction of egg and fish after 12 months. Conclusions: In conclusion, PCPs did not display a homogenous approach to CF; further studies and educational programs are needed to achieve more flexibility and knowledge on this important nutritional issue.

This study aimed to analyze the association between sociodemographic factors, maternal and neonatal characteristics and the time taken to introduce complementary feeding in low birthweight and preterm newborns. This is a prospective cohort study of 79 preterm newborns weighing less than or equal to 1,800g. Data were collected at the time of hospital discharge and at the 6th, 9th ,and 12th months of corrected gestational age (CGA), using a structured questionnaire to analyze the time taken to introduce complementary feeding and the texture of the foods introduced. Furthermore, the Survey of Well-being of Young Children (SWYC-BR) was used to assess the risk of developmental delay. Cox proportional hazards regression was used to analyze the variables. The introduction of complementary feeding was assessed in preterm newborns based on the median age of introduction of liquid foods (3.50; IQR: 2.50-5.00), followed by solid (4.70; IQR: 3.20-5.20) and soft foods (5.00; IQR: 4.50-5.50). There was also an association with gestational age (RR = 1.25; 95%CI: 1.02-1.52) throughout the process of food introduction. For solid and soft foods, those with the longest length of stay (RR = 1.03; 95%CI: 1.10-1.05) and on mixed breastfeeding (RR = 2.97; 95%CI: 1.24-7.09) delayed the introduction of complementary feeding the longest. For liquid foods, less severe preterm newborns (Score for Neonatal Acute Physiology and Perinatal Extension - SNAPPE II [RR = 0.96; 95%CI: 0.94-0.98]) and mothers who were breastfeeding at hospital discharge (RR = 11.49; 95%CI: 1.57-84.10) delayed the introduction of complementary feeding. Guidelines are needed to better advise professionals and parents and/or guardians on the ideal time to introduce feeding.

Milk and dairy products are unique and essential for growth and healthy development not only for the young but also for all ages, the present work was performed to determine some toxic heavy metals in some dried dairy products sold in Alexandria City. A total of 120 samples representative as 60 milk powder,30 infant foods and 30 dried ice cream mix were collected from groceries and supermarkets and analysed for toxic heavy metal residues including (Pb, Cd, Al and Sn) by using atomic absorption flame emission spectrophotometer. The obtained results revealed that the mean (SD) level of Lead in the examined of milk powder, infant food and dried ice cream mix samples were 0.185 ± 0.138, 0.134 ± 0.033 and 0.159 ± 0.185 ppm, the samples exceeded the permissible stated by Egyptian standards (0.02ppm) were 23(38.33%), 8(26.66%), and 13(43.33%), respectively. While Cadmium residues was detected in 13 (21.66%), 7 (23.33%) and 11 (36.66%), the samples exceeded the Egyptian standards permissible limit (0.05 ppm) were 7 (11.66%), 3 (10%) and 6 (20%), respectively. Aluminium was detected in 10 (16.66%), 5 (16.66 %) and 7 (23.33 %) of examined milk powder, infant food and dried ice cream mix, only 3(5%) of examined milk powder samples were exceeded the permissible limit (0.5 ppm). Tin was detected in 13(21.66%), 9 (30 %) and 10 (33.33 %) of examined milk powder, infant food and dried ice cream mix, respectively. All positive samples were within the Egyptian standards permissible limit (200 ppm). Suggestive measures were discussed to prevent or minimize the levels of toxic heavy metals in dried dairy products. [ABSTRACT FROM AUTHOR]