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Background: Faecal calprotectin has been proposed as a sensitive marker for gastrointestinal inflammation in children and adults. High levels have been reported in healthy newborns and during the first months of life; the effect of the kind of feeding on the calprotectin concentration in stools is controversial. Objective: To evaluate faecal calprotectin values in healthy, exclusively breast-fed (BF) or formula-fed (FF) infants. Methods: Stool samples were obtained from 74 healthy infants (39 exclusively BF and 35 exclusively FF) with a median age of 51 days (range 13–90). Exclusion criteria were acute infections and treatment with anti-inflammatory drugs. Stool samples were stored at –20°C until they were analysed, and the faecal calprotectin concentration was detected using a commercial quantitative enzyme-linked immunoassay (Calprest; Eurospital SpA, Trieste, Italy). Results: The median faecal calprotectin concentration was significantly higher in BF infants (555.00 µg/g, range 122.5–2,000.0 µg/g) than in FF ones (206.60 µg/g, range 31.2–797.6 µg/g) (p < 0.001). We observed a significantly higher median stool frequency in BF infants than in FF ones (p < 0.001), but multiple regression analysis (independent variables: kind of feeding and stool frequency; dependent variable: calprotectin) showed a significant coefficient for the kind of feeding, but not for stool frequency (p = 0.937). Conclusions: Our findings show that the kind of feeding influences the faecal calprotectin concentration, with higher values in healthy exclusively BF infants than in FF ones. Our study does not allow us to clearly identify the reason for our finding; this could be due to hormones (such as ghrelin and leptin), cytokines and other immunostimulating and growth factors (such as epidermal growth factor and granulocyte colony-stimulating factor) in human milk, which contribute to the development of the gastrointestinal immune system. Further investigations are needed to better clarify the mechanism underlying the relationship between feeding and faecal calprotectin levels in young infants.

Nutrition and growth during infancy are an emerging issue because of their potential link to metabolic health disorders in later life. Moreover, prolonged breast-feeding appears to be associated with a lower risk of obesity than formula feeding. Human milk is a source of various hormones and growth factors, namely adipokines (leptin and adiponectin), ghrelin, resistin and obestatin, which are involved in food intake regulation and energy balance. These compounds are either not found in commercial milk formulas or their presence is still controversial. Diet-related differences during infancy in serum levels of factors involved in energy metabolism might explain anthropometric differences and also differences in dietary habits between breast-fed (BF) and formula-fed (FF) infants later in life, and may thus have long-term health consequences. In this context, the recent finding of higher leptin levels and lower ghrelin levels in BF than in FF infants suggests that differences in hormonal values together with different protein intake could account for the differences in growth between BF and FF infants both during infancy and later in life. In this review, we examine the data related to hormones contained in mothers' milk and their potential protective effect on subsequent obesity and metabolic-related disorders.

A study was carried out on 168 full-term infants with digestive problems such as regurgitation and/or constipation to evaluate the efficacy of new infant formulas containing partially hydrolysed whey protein, modified vegetable oil with a high β-palmitic acid content, prebiotic oligosaccharides and starch. Infants receiving the new formulas had an increase in stool frequency of 0.60 between day 1 and day 7 (95% CI0.19-1.01;p=0.004) and 0.53 (95% CI 0.11-0.90;p=0.015) between day 7 and day 14. A reduction of 1.06 in the number of regurgitation episodes was reported between day 1 and day 7 (95% CI 0.24-1.88; p=0.012) and 1.31 (95% CI 0.42-2.21; p=0.005) between day 7 and day 14. Conclusion: A prebiotic mixture ofgalacto-/fructo-oligosaccharides with a high β-palmitic acid content may reduce digestive problems and improve intestinal tolerance in infants during the first months of life.

Aim: To establish ghrelin, leptin and IGF-I serum levels in breastfed (BF) and formula-fed (FF) infants during the first period of life. Methods: A cross-sectional study was conducted on fasting blood venous samples obtained from exclusively BF (n=106) and FF (n=100) infants to measure total ghrelin (RIA test), leptin (RIA test) and IGF-I (chemiluminescence). Anthropometrical measurements of weight, length and cranial circumference were performed. Results: During the first 4 mo of life, FF infants compared to BF ones showed higher ghrelin levels (2654.86 vs 2132.96 pg/ml; p

Background: Recently, rice-based formulas have been widely used in hypoallergenic diets, but data on nutritional values are scarce. Aim: To evaluate the growth of infants fed with a rice-based hydrolysate formula, compared to those infants fed with a soy formula or an extensively hydrolysed casein formula, in the first 2 y of life. Methods: A total of 88 infants were enrolled between March 2002 and March 2004. Fifty-eight infants with atopic dermatitis (AD) and cow's milk allergy (CMA), confirmed by open challenge, were enrolled as study group: 15 were fed with a rice-based hydrolysate formula (RHF), 17 with a soy-based formula (SF) and 26 with an extensively hydrolysed casein formula (eHCF). Thirty infants with AD without cow's milk allergy were recruited as a control group (CG) and fed with a free diet. Weight was recorded on enrolment and at 3-monthly intervals in the first year of life, and at 6-monthly intervals in the second year. Infants were weighed naked, before feeding, by means of an electronic integrating scale. The z-scores of weight for age were calculated. Statistics: One-way analysis of variance and Student's t-test were used for statistical comparison. Significance was set at p

Aim: To evaluate the association between infantile colic and gastrointestinal, allergic and psychological disorders in childhood. Methods: A prospective study was conducted on 103 infants aged 31-87 d. After 10 y, between 2001 and 2003, the children were recalled and a paediatrician evaluated the selected disorders by anamnesis, medical examination, laboratory tests and parent interviews. Results: Of the 103 infants enrolled, 96 completed the study. There was an association between infantile colic and recurrent abdominal pain (p=0.001) and allergic disorders: allergic rhinitis, conjunctivitis, asthmatic bronchitis, pollenosis, atopic eczema and food allergy (p

OBJECTIVE. The goal was to test the hypothesis that oral administration of Lactobacillus reuteri in a prospective randomized study would improve symptoms of infantile colic.METHODS. Ninety breastfed colicky infants were assigned randomly to receive either the probiotic L reuteri (108 live bacteria per day) or simethicone (60 mg/day) each day for 28 days. The mothers avoided cow's milk in their diet. Parents monitored daily crying times and adverse effects by using a questionnaire.RESULTS. Eighty-three infants completed the trial: 41 in the probiotic group and 42 in the simethicone group. The infants were similar regarding gestational age, birth weight, gender, and crying time at baseline. Daily median crying times in the probiotic and simethicone groups were 159 minutes/day and 177 minutes/day, respectively, on the seventh day and 51 minutes/day and 145 minutes/day on the 28th day. On day 28, 39 patients (95%) were responders in the probiotic group and 3 patients (7%) were responders in the simethicone group. No adverse effects were reported.CONCLUSIONS. In our cohort, L reuteri improved colicky symptoms in breastfed infants within 1 week of treatment, compared with simethicone, which suggests that probiotics may have a role in the treatment of infantile colic.

Summary Aims This study aimed to investigate: (i) the relation between fasting time and serum ghrelin, motilin and insulin concentrations and (ii) the correlations between these hormones and anthropometrical parameters of infants in the first 18 months of life. Patients and methods A cross-sectional study on 62 term infants was performed. Blood samples for hormonal assay were obtained at least 1 h after feeding. Weight, length and head circumference were recorded. Plasma ghrelin, motilin and insulin concentrations were determined by radioimmunoassay. Results Ghrelin and motilin had a significant direct correlation with fasting time (r = 0·447; P

Aim To evaluate serum ghrelin and motilin concentration in infants with infantile colic. Methods A case-control study was conducted on fasting blood venous samples obtained from 18 infants with infantile colic and 20 healthy infants to measure ghrelin (RIA test) and motilin (RIA test). Results Colicky infants showed higher ghrelin serum levels (2534.2 +/- 600.0 pg/ml; ln 7.8 +/- 0.2) than controls (2126.1 +/- 281.3 pg/ml; ln 7.6 +/- 0.1) (p = 0.011). Serum motilin concentration was significantly higher in colicky infants (94.6 +/- 23.2 pmol/l) than in controls (64.1 +/- 30.1 pmol/l) (p = 0.001). Motilin concentrations were higher in formula-fed colicky infants (104.5 +/- 20.4 pmol/l) than in breastfed ones (82.2 +/- 21.3 pmol/l) (p = 0.038). Conclusion Our finding shows that ghrelin and motilin concentrations are higher in infants with colic than in controls, supporting an organicistic aetiopathogenesis of this disorder. Furthermore, the role of ghrelin on gastrointestinal motility may open new doors to better understand the aetiology of infantile colic.

Aim: To evaluate the relationship between serum leptin concentration in infants and infant and maternal BMI. Methods: 75 healthy term infants aged 0–12 mo, 51 exclusively breastfed (BF) for at least 4 mo and 24 formula fed (FF), were included in a cross-sectional study. Weight, length and cranial circumference of infants and their mothers were measured, body mass index (BMI) was calculated using the formula weight (kg)/height (m)2 and infant serum leptin concentration was determined. Results: A significant positive correlation between infant serum leptin concentration and maternal BMI was observed in BF infants (r = 0.389, p = 0.005), confirmed in a multiple regression model adjusted for infant age and infant BMI (β = 0.065, p = 0.006), but not in FF infants. As regards the first 4 mo of life, we have already observed a positive correlation between infant serum leptin concentration and maternal BMI in BF infants (β = 0.113, p = 0.005), but not in FF infants. Conclusion: In BF infants, serum leptin concentration correlates positively with maternal BMI. Higher maternal BMI values might increase leptin levels in breast milk, and maternal adiposity could be involved in infant energy balance.

Aim: To determine the concentration of insulin-like growth factor-I (IGF-I) in exclusively breast-fed (BF) and formula-fed (FF) infants in the first 5 months of life and to study the relationship between the IGF-I level and Z score for weight, body mass index (BMI) and tricipital skin-fold thickness. Methods: We performed a cross-sectional study in order to evaluate serum IGF-I in 97 age-matched healthy term infants: 50 FF and 47 BF. Results: FF infants showed higher values of IGF-I (38.9 ± 12 ng/ml) when compared to BF infants (26.7 ± 11.6 ng/ml; p < 0.05). A positive correlation was found between IGF-I values and Z score for weight (p < 0.001), BMI (p = 0.014), tricipital skin-fold thickness (p = 0.043) and age (p = 0.02). Conclusion: These results show that the IGF-I serum concentration is higher in FF infants. The observed association between IGF-I and Z score for weight, BMI, tricipital skin-fold thickness confirms the effect of different infant feeding on body size.

Aim: To compare epigastric impedance versus scintigraphy in monitoring the gastric emptying of the same adapted milk formula in infants. Methods: Seven infants with clinical symptoms of gastric motility disease underwent scintigraphy with 99mTc sulphur colloid for the 90 min following the ingestion of the same adapted milk formula, in order to evaluate gastric emptying. A bio-impedance device, connected to a PC, was prepared for this purpose with four standard electrodes placed anteriorly on the upper part of the body. The obtained graphs were compared to those of the scintigraphic method. Statistical analysis was performed using Pearson correlation. The confidence limits were set at 95%. Parental consent was obtained before each analysis. Results: The gastric emptying patterns obtained with epigastric impedance were closely correlated to those shown by the scintigraphy (r= 0.86 ± 0.08; p < 0.05). A significant correlation between the gastric emptying velocity measured by the two techniques was found (r= 0.94; p= 0.002). Conclusions: Epigastric impedance in infants provided estimates of gastric emptying that were closely correlated with scintigraphy. However, the limits derived from the epigastric impedance suggest that, at the moment, the two methods should not be used interchangeably.

Objective We assessed the bioelectrical impedance vector distribution in a sample of healthy infants in the first year of life, which is not available in literature. Methods The study was conducted as a cross-sectional study in 153 healthy Caucasian infants (90 male and 63 female) younger than 1 y, born at full term, adequate for gestational age, free from chronic diseases or growth problems, and not feverish. Z scores for weight, length, cranial circumference, and body mass index for the study population were within the range of ±1.5 standard deviations according to the Euro-Growth Study references. Concurrent anthropometrics (weight, length, and cranial circumference), body mass index, and bioelectrical impedance (resistance and reactance) measurements were made by the same operator. Whole-body (hand to foot) tetrapolar measurements were performed with a single-frequency (50 kHz), phase-sensitive impedance analyzer. The study population was subdivided into three classes of age for statistical analysis: 0 to 3.99 mo, 4 to 7.99 mo, and 8 to 11.99 mo. Using the bivariate normal distribution of resistance and reactance components standardized by the infant’s length, the bivariate 95% confidence limits for the mean impedance vector separated by sex and age groups were calculated and plotted. Further, the bivariate 95%, 75%, and 50% tolerance intervals for individual vector measurements in the first year of life were plotted. Results Resistance and reactance values often fluctuated during the first year of life, particularly as raw measurements (without normalization by subject’s length). However, 95% confidence ellipses of mean vectors from the three age groups overlapped each other, as did confidence ellipses by sex for each age class, indicating no significant vector migration during the first year of life. Conclusions We obtained an estimate of mean impedance vector in a sample of healthy infants in the first year of life and calculated the bivariate values for an individual vector (95%, 75%, and 50% tolerance ellipses).

Summary Background Egg skin prick test (SPT) and/or radioallergosorbent test (RAST) positivity has been described in infants and children with a food allergy, or in infants at high risk of atopy who have never eaten eggs. Clinical reactions are also observed when some of these children or infants eat eggs for the first time. Objective and method A prospective study was made of 107 atopic dermatitis (AD) children (66 boys, 41 girls) aged 1–19 months (median 5 months) who had never ingested egg, to compare the outcome of a first oral egg challenge and the results of albumen and yolk SPTs and RASTs. Results The egg challenge (conducted at age 12–24 months: mean 16 months, median 15 months) was positive in 72/107 children (67.3%). The reactions were immediate or early (first 6 h) in 56/72 (77.8%). The most severe (all within the first 6 h) were one case of anaphylactic shock (1.4%), three cases of laryngeal oedema (4.1%) and one serious attack of asthma (1.4%). The skin weal diameter at and above which reactions always occurred was 5 mm for both albumen and yolk. They were, however, also observed in the complete absence of a weal. The outcome of the challenge was always positive when the specific IgEs (sIgE) for albumen and yolk were > 99 KU/L and ≥ 17.5 KU/L, respectively. Here, too, reactions were noted even when sIgE levels were < 0.35 KU/L. Conclusion AD children who have never eaten eggs may be sensitized and display reactions at the first ingestion. The percentage of reactions in this series was by no means negligible. These findings were observed in children with mild as well as moderate–severe AD when first examined. SPT for albumen and yolk diameter ≥ 5 mm, and sIgE for albumen > 99 KU/L and for yolk ≥ 17.5 KU/L were 100% specific in predicting the outcome of the challenge. It may thus be concluded that children with AD whose SPT and/or RAST for albumen and/or yolk are equal to or higher than these cut-off values should not be subjected to the oral challenge when consideration is given to the introduction of egg in their diet. Even when these cut-offs are not reached, however, clinical reactions to the challenge cannot be ruled out a priori, and it should be preferably performed in a protected environment, such as a hospital.

Background: Coagulase-positive Staphylococcus aureus colonizes eczematous lesions in 78-100% of children and adults with atopic dermatitis (AD), whereas it is found on skin of healthy subjects in only 2-25% of cases. On unaffected skin of subjects with AD the bacterium has been isolated in 51-100% of cases. Objective and Methods: This paper examines rate and density of S. aureus colonization, using the swab technique and the contact plate method, respectively, on affected and unaffected skin in 72 infants with AD (age 3-24 months) and in a control group, to determine if there are significant differences with respect to what is reported for children and adults with AD. Results and Conclusions: The main differences is that on unaffected skin of our infants with AD, bacterium colonization rate is significantly lower than on affected skin.

Background The role of adipokines in early life is considered an emerging topic issue in nutritional researches. Aims To evaluate serum resistin and leptin concentrations and their relations in infants and in breast milk. Study design We enrolled 41 term, AGA, healthy infants, of which 23 exclusively breast-fed (BF) and 18 formula-fed (FF), aged less than 6months. Breast milk (BM) samples were collected from 23 breastfeeding mothers of the infants enrolled. Resistin concentration in serum and BM was determined by ELISA test (Human-Resistin-ELISA, Mediagnost, Reutlingen, Germany). Leptin concentration was determined by Radioimmunoassay method (LEP-R40, Mediagnost, Reutlingen, Germany). Infants weight, length and body mass index were measured. We used Mann–Whitney test. Spearman correlation was applied. Statistical significance was set at p Results Infants serum resistin concentration was 9.30 (5.02) ng/ml. Breast milk resistin concentration ( n =23) was 0.18 (0.44) ng/ml. Leptin concentration was 3.04 (3.68) ng/ml in infants serum and in BM was 2.34 (5.73) ng/ml. Serum resistin concentrations in BF infants correlated positively with BM resistin ( r =0.636, p =0.035). We have shown a positive correlation between resistin and leptin in total group of infants ( r =0.44, p =0.05), confirmed in breastfed subjects ( r =0.65, p =0.02). No correlations were found between serum hormones and anthropometric parameters of infants. Conclusion Our findings show interestingly a positive correlation between resistin concentrations in BF infants serum and in BM and between resistin and leptin in infants.

To assess bone status using quantitative ultrasound (QUS) applied to the second metacarpus and to evaluate the influence of vitamin D supplementation on bone mineralization in exclusively breast-fed infants. Seventy seven healthy exclusively breast-fed infants aged

AIM: To test if total ghrelin is present in infant formulas. METHODS: Using a radioimmunoassay, we measured total ghrelin concentrations in 19 samples of commercial infant formulas and in 20 samples of human milk. We also determined ghrelin concentration in the serum of infants and lactating mothers. RESULTS: Ghrelin concentrations were significantly higher in artificial milk (2007.1 ± 1725.36 pg/mL) than in human milk (828.17 ± 323.32 pg/mL) (P = 0.005). The mean ghrelin concentration in infant serum (n = 56) was 1115.86 ± 42.89 pg/mL, and was significantly higher (P = 0.023) in formula-fed infants (1247.93 ± 328.07 pg/mL) than in breast-fed infants (1045.7 ± 263.38 pg/mL). The mean serum ghrelin concentration (mean ± SD) in lactating mothers (n = 20) was 1319.18 ± 140.18 pg/mL. CONCLUSION: This study provides evidence that total ghrelin is present in infant formulas. This finding raises diverse questions regarding the uptake, absorption and metabolic effects of this hormone.

Growing evidence suggests that a complex relationship exists between the central nervous system and peripheral organs involved in energy homeostasis. It consists in the balance between food intake and energy expenditure and includes the regulation of nutrient levels in storage organs, as well as in blood, in particular blood glucose. Therefore, food intake, energy expenditure, and glucose homeostasis are strictly connected to each other. Several hormones, such as leptin, adiponectin, resistin, and ghrelin, are involved in this complex regulation. These hormones play a role in the regulation of glucose metabolism and are involved in the development of obesity, diabetes, and metabolic syndrome. Recently, their presence in breast milk has been detected, suggesting that they may be involved in the regulation of growth in early infancy and could influence the programming of energy balance later in life. This paper focuses on hormones present in breast milk and their role in glucose homeostasis.

Leptin is present in human milk, but it is not clear what the relationship between breast milk (BM) leptin levels and maternal and infant serum leptin concentrations is. The objective of this study was to evaluate the leptin concentration in BM and to investigate its relationship with infants’ and mothers’ anthropometric parameters and with serum leptin concentration in breast-fed (BF) infants and lactating mothers. We enrolled 36 adequate for gestational age healthy, exclusively BF, term infants aged

Data accumulated over recent years have significantly advanced our understanding of growth factors, cytokines, and hormones in breast milk. Here we deal with leptin, adiponectin, IGF-I, ghrelin, and the more recently discovered hormones, obestatin, and resistin, which are present in breast milk and involved in food intake regulation and energy balance. Little is known about these compounds in infant milk formulas. Nutrition in infancy has been implicated in the long-term tendency to obesity, and a longer duration of breastfeeding appears to protect against its development. Diet-related differences in serum leptin and ghrelin values in infancy might explain anthropometric differences and differences in dietary habits between breast-fed and formula-fed infants also later in life. However, there are still gaps in our understanding of how hormones present in breast milk affect children. Here we examine the data related to hormones contained in mother's milk and their potential protective effect on subsequent obesity.

Data accumulated over recent years have significantly advanced our understanding of growth factors, cytokines, and hormones in breast milk. Here we deal with leptin, adiponectin, IGF-I, ghrelin, and the more recently discovered hormones, obestatin, and resistin, which are present in breast milk and involved in food intake regulation and energy balance. Little is known about these compounds in infant milk formulas. Nutrition in infancy has been implicated in the long-term tendency to obesity, and a longer duration of breastfeeding appears to protect against its development. Diet-related differences in serum leptin and ghrelin values in infancy might explain anthropometric differences and differences in dietary habits between breast-fed and formula-fed infants also later in life. However, there are still gaps in our understanding of how hormones present in breast milk affect children. Here we examine the data related to hormones contained in mother's milk and their potential protective effect on subsequent obesity.

Nutrition and growth during infancy are an emerging issue because of their potential link to metabolic health disorders in later life. Moreover, prolonged breast-feeding appears to be associated with a lower risk of obesity than formula feeding. Human milk is a source of various hormones and growth factors, namely adipokines (leptin and adiponectin), ghrelin, resistin and obestatin, which are involved in food intake regulation and energy balance. These compounds are either not found in commercial milk formulas or their presence is still controversial. Diet-related differences during infancy in serum levels of factors involved in energy metabolism might explain anthropometric differences and also differences in dietary habits between breast-fed (BF) and formula-fed (FF) infants later in life, and may thus have long-term health consequences. In this context, the recent finding of higher leptin levels and lower ghrelin levels in BF than in FF infants suggests that differences in hormonal values together with different protein intake could account for the differences in growth between BF and FF infants both during infancy and later in life. In this review, we examine the data related to hormones contained in mothers' milk and their potential protective effect on subsequent obesity and metabolic-related disorders.

We carried out a cross-sectional study of 115 healthy infants, younger than 6 months old, exclusively breast-fed or formula-fed, to investigate correlations between circulating leptin concentrations and body composition measurements. Serum leptin was evaluated with radioimmunoassay, and body composition with bioelectrical impedance analysis. Multiple regression analysis showed a relationship between serum leptin and body mass index in the entire study population (P = 0.042). There was a significant negative relationship between serum leptin and phase angle (P = 0.006) in formula-fed infants. Serum leptin was positively related to subscapular skinfold thickness (P = 0.055) and negatively to reactance (P = 0.057) only in formula-fed infants, although the differences were just below significance. Serum leptin concentration was higher in breast-fed infants (P = 0.002), and was not correlated with body composition parameters. This study indicates that there is a relation between leptin and infant body composition in the first months of life, although the link needs to be explored further.

The aim of this study was to evaluate the efficacy on crying episodes owing to infantile colic of a new infant formula containing partially hydrolysed whey proteins, prebiotic oligosaccharides (OS), with a high β-palmitic acid content. Prospective randomized controlled study. Italy. Two hundred and sixty-seven formula-fed infants, aged less than 4 months, with infantile colic, were randomized to receive either the new infant formula (study treatment (ST)) or a standard formula and simethicone (6 mg/kg twice a day) (control treatment (CT)). A questionnaire was given to parents to evaluate for 14 days the daily number of colic episodes and crying time. Out of the 199 infants who completed the study, 96 were treated with the new formula and 103 were not treated. Infants receiving the new formula had a significant decrease in colic episodes after 1 week (2.47±1.94 at day 7 vs 5.99±1.84 at the study entry) compared to infants receiving the CT (3.72±1.98 at day 7 vs 5.41±1.88 at the study entry) (P

We describe a 3-year-old boy with complete agenesis of corpus callosum, developmental delay/mental retardation, anterior diaphragmatic hernia, Morgagni type, severe hypermetropia, and facial dysmorphism suggesting the diagnosis of Donnai–Barrow syndrome. Subtelomeric FISH analysis revealed a paternally-derived t(9;16) (q34.3;q24.3) translocation with partial 9q monosomy and partial 16q trisomy. As some facial features resemble the 9q emerging phenotype, we suggest the hypothesis that some patients with Donnai–Barrow syndrome might be abscribed to 9q terminal deletion. © 2006 Wiley-Liss, Inc.

Specific IgE (sIgE) for cow's milk proteins (CMP) have been reported to be present in blood sera of exclusively breast-fed infants. The aim of this study was to find whether the presence of sIgE to human milk proteins in the sera of exclusively breast-fed infants could explain the apparent detection of sIgE to CMP in infants that were never previously in contact with cow's milk. sIgE for human milk whey proteins were found in the blood sera of atopic infants, and these sIgE strongly cross-reacted with the corresponding CMP. In none of the sera examined were sIgE to bovine β-lactoglobulin detected.

The relation between mother's diet and breast milk composition is still an open question. An important issue is whether mothers who are breast feeding modify, respect to before lactation, food intake to satisfy the increased requirements.

In infants fed with supplemented formulas plasma and erythrocyte membrane phospholipid composition in AA and DHA is comparable to that of breast fed infants. In addition to their role in development, LCPUFA may also play a role in atopic disease 1,2 Reports describe disorders of essential fatty acids metabolism, specifically of impaired conversion of 18 carbon precursors to their LCPUFA products, that lead to modified fatty acids profiles in atopic children. Therefore, the supplementation of HA formulas with LCPUFA should be useful.

Objectives: Ghrelin, a recently discovered hormone mainly secreted by the stomach, has several metabolic functions including regulation of food intake, energy homeostasis and body weight. There are few studies on this hormone in healthy infants during the first year of life. The aim of this study was to examine the correlations between ghrelin and weight gain in healthy term infants in the first year of life. Methods: 104 healthy term infants aged 0 to 12 months were included in a cross-sectional study. Anthropometric measurements were assessed and mean weight gain was calculated. Serum ghrelin concentrations have been determined at least 3 hours after feeding by radioimmunoassay test. Results: Ghrelin concentrations were correlated negatively to weight gain (r = -0.302; P = 0.003) and positively to age (r = 0.412; P < 0.001), weight (r= 0.374; P < 0.001) and length (r = 0.387; P < 0.001). In breastfed infants a statistically significant negative correlation between ghrelin concentration and infant weight gain (r = -0.407; P = 0.001) was observed, whereas in formula-fed infants this correlation was not statistically significant (r = -0.067; P = 0.719). Conclusions: The negative correlation observed between ghrelin concentration and infant weight gain suggests that ghrelin might also play a role in the regulation of body weight in healthy infants with a physiologic energy balance. Further studies are needed to clarify how ghrelin might be involved in both short-term and long-term energy balance.

To establish ghrelin, leptin and IGF-I serum levels in breastfed (BF) and formula-fed (FF) infants during the first period of life.A cross-sectional study was conducted on fasting blood venous samples obtained from exclusively BF (n=106) and FF (n=100) infants to measure total ghrelin (RIA test), leptin (RIA test) and IGF-I (chemiluminescence). Anthropometrical measurements of weight, length and cranial circumference were performed.During the first 4 mo of life, FF infants compared to BF ones showed higher ghrelin levels (2654.86 vs 2132.96 pg/ml; p0.032), higher IGF-I levels (3.73 vs 3.15 ng/ml; p=0.00) and lower leptin levels (0.68 vs 1.16 ng/ml; p0.04). Leptin values were higher in females than in males (0.80 vs 0.47 ng/ml; p0.03), while no gender-related difference was found for ghrelin and IGF-I. No differences were found in anthropometrical measurements comparing the two groups of infants. A multiple regression analysis showed an inverse correlation between ghrelin and leptin values (p0.04) and between IGF-I and leptin levels (p=0.00).Our finding suggests that breastfeeding influences hormones such as ghrelin, leptin and IGF-I in infancy, mainly during the first 4 mo of life. Further evidence is needed to confirm and clarify the role of a protective link from mother to infants as seen in our observations.

Objective: The aim of this randomized, double-blind, placebo-controlled trial was to investigate the effectiveness and side effects of a phytotherapeutic agent with Matricariae recutita, Foeniculum vulgare and Melissa officinalis in the treatment of infantile colic. Methods: 93 breastfed colicky infants were enrolled, the diagnosis was made according to Wessel's criteria. After a 3 day observation period, the infants were randomly divided into two groups, one treated with phytotherapeutic agent (PA) and the other with placebo twice a day for 1 week. Crying time and side effects were recorded. Results: 88 infants completed the trial: 41 in the PA group and 47 in the control. The daily average crying time for the PA was 201.2 min/day (SD 18.3) at the baseline and 76.9 min/day (SD 23.5) at the end of the study; for the placebo it was 198.7 min/day (SD 16.9) and 169.9 min/day (SD 23.1) (p < 0.005). Crying time reduction was observed in 85.4% subjects for the PA and in 48.9% subjects for the placebo (p < 0.005). No side effects were reported. Conclusion: The present study shows that colic in breastfed infant improves within 1 week of treatment with an extract based on Matricariae recutita, Foeniculum vulgare and Melissa officinalis. Copyright © 2005 John Wiley & Sons, Ltd.

To evaluate the association between infantile colic and gastrointestinal, allergic and psychological disorders in childhood.A prospective study was conducted on 103 infants aged 31-87 d. After 10 y, between 2001 and 2003, the children were recalled and a paediatrician evaluated the selected disorders by anamnesis, medical examination, laboratory tests and parent interviews.Of the 103 infants enrolled, 96 completed the study. There was an association between infantile colic and recurrent abdominal pain (p=0.001) and allergic disorders: allergic rhinitis, conjunctivitis, asthmatic bronchitis, pollenosis, atopic eczema and food allergy (p0.05). Sleep disorders, fussiness, aggressiveness and feelings of supremacy are more frequent in children who suffered from colic during early infancy (p0.05). A family history of gastrointestinal diseases and atopic diseases was significantly higher in infants with colic than in controls (p0.05).Susceptibility to recurrent abdominal pain, allergic and psychological disorders in childhood may be increased by infantile colic. Our findings confirm that severe infantile colic might be the early expression of some of the most common disorders in childhood.

Intestinal colonization by lactobacilli is suggested to be a prerequisite to normal mucosal immune functions. An inadequate level of lactobacilli may be involved in appearance of allergic disease of which, infantile colic, is often considered an early clinical manifestation. The aim of the study is to evaluate intestinal lactobacilli in breast-fed infants with infantile colic and healthy infants. Fifty-six breast-fed infants, aged 15-60 days were enrolled in the study and divided into two groups: colicky (30 cases) and healthy (26 cases) according to Wessel's criteria. Stool samples were collected, diluted and cultured on selective media. The colonies were counted, reported as colony forming unit (cfu) per gram of faeces and identified by biochemical methods. Different colonization patterns of lactobacilli were found among colicky and healthy infants. Lactobacillus brevis (4.34 x 10 8 cfu/g) and L. lactis lactis (2.51 x 10 7 cfu/g) were found only in colicky infants while L. acidophilus (2.41 x 10 7 cfu/g) was found only in healthy infants. Lactobacillus brevis and L. lactis lactis might be involved in the pathogenesis of infantile colic increasing meteorism and abdominal distension. Further studies are required to understand how the observed differences may be involved in the pathogenesis of this common disorder.

Introduction: Leptin is a hormone present in breast milk, but not in formula, which regulates food intake and energy metabolism; it could be one of the factors involved in preventing obesity. Breast milk leptin provides a physiologic explanation for some of the advantages seen in normal growth, regulation of energy intake and immunological status in breast-fed (BF) compared with formula-fed (FF) infants. Aim: To see whether leptin levels are different in BF or FF infants in the first months of life. Methods: We studied 186 AGA healthy infants, in the first 22 m, without any disease of the gastrointestinal tract, admitted to our Department during the period between June 2000 and August 2003. Serum leptin concentration was determined at least 3 h post-feeding by RIA test (LEP-R44 Mediagnostic, Reutlingen, Germany). For each infant the parents filled up a form for the Ethical Committee. Statistical Analysis: Student t-test was performed. Statistical significance was set at p

Background: Leptin is a hormone present in breast milk, which regulates food intake and energy metabolism. Aim: To investigate whether leptin levels are different in breast-fed (BF) or formula-fed (FF) infants in the first months of life. Methods: We evaluated serum leptin by radioimmunoassay and anthropometric parameters in 51 infants at the average age of 62.8 ′ 30 days, 25 exclusively BF and 26 exclusively FF. Results: Leptin serum values were higher in BF (7.1 ′ 10.4 ng/ml) than in FF (3.7 ′ 3.87 ng/ml) infants (p

Background: Infantile colics are a common problem in the first months of life. During this period, a process of intestinal colonization rapidly occurs. A difference in the gut microflora could play an important role in the pathogenesis of colics, changing the metabolism of carbohydrates and fatty acids. Actually, in the literature, only few data have been collected about this topic. In this study, we evaluated intestinal microflora in breastfed colicky and non-colicky infants. Methods: Seventy-one breastfed infants, aged 3.2 ± 0.6 wk, free from episodes of gastroenteritis and without previous assumption of antibiotic and probiotic drugs, were enrolled in the study. They were divided into two groups: colicky (42 cases) and non-colicky (29 cases), according to Wessel's criteria. Stool samples were collected, diluted and cultured on several selective media to detect lactobacilli, clostridia, Gram-negative anaerobes and Enterobacteriaceae. Statistical analysis was performed using Student's t-test, χ2 test and a non-parametric test (Mann-Whitney U-test). Results: Differences in gut microflora were found among colicky and non-colicky infants: colicky infants were less frequently colonized by Lactobacillus spp., and more frequently by anaerobic Gram-negative bacteria. Conclusion: Our study indicates that colicky infants have different patterns of gut microflora. Further studies are required to understand whether gut microflora is the primary cause of colics or its consequence.

During the first months of life, modification of body composition occurs rapidly. Studies have reported that breastfed (BF) infants show a different growth pattern than formula-fed (FF) infants, particularly in the first years of life. Methods have been developed for estimating body composition. Even though the majority of these methods, such as isotope dilution techniques, total body nitrogen, and densitometry, provide precise analyses and estimations of the body mass, the use of invasive methods, which lead to an increasing risk of radiation exposure, cause difficulties, especially in pediatrics. Bioelectrical Impedance Analysis (BIA) estimates body composition in children and adults by measuring electrical impedance of body tissue. BIA has been accepted as a body composition measurement by the U.S. National Institutes of Health (NIH 1996). This test consists of applying an alternative current of 800 µA and 50 kHz, which is not perceivable and not dangerous. This technique is based on equations that translate the electrical signals in terms of body composition. The related theoretical assumptions and reference models are applicable and accurate only on selected groups of healthy adults and children.

Colic, regurgitation and constipation are common feeding problems in formula-fed infants that might benefit from dietary treatment. A formula containing fructo- and galacto-oligosaccharides, partially hydrolysed proteins, low levels of lactose and palmitic acid in the beta position and higher density has been tested to reduce the occurrence of these symptoms. The aim of this prospective study was to describe the effects of such a formula in infants with minor gastrointestinal disorders.An observational prospective trial involving practising Italian paediatricians was performed. Formula fed-infants up to 90 d of age with minor gastrointestinal problems such as infantile colics and/or regurgitation and/or constipation were enrolled in the study from January 2001 to May 2001. The study was completed within 14 d of treatment. On days 1, 7 and 14 the infants were visited by the paediatricians. Parents were given a structured diary to record daily episodes of colic, regurgitation and type and number of stools.Of the 932 infants enrolled, 604 completed the study. Of the 214 infants with colic, 169 (79%) demonstrated a reduction in frequency of colic from 4.1 +/- 2.0 per day at the beginning of the study to 2.0 +/- 1.8 at the end of the study (I.C. 95%: 1.72-2.39; p0.005). A reduction in the number of episodes of colic of 1.8 per day at the beginning of the study (I.C. 95%: 1.49-2.11; p0.05) was recorded between day 1 and day 7, and of 0.26 (I.C. 95%: 0.15-0.37; p0.05) between day 7 and day 14. Of the 201 infants with regurgitation problems, 141 (70%) demonstrated a reduction of frequency of the symptoms from 4.2 +/- 2.0 per day at the beginningof the study to 2.1 +/- 2.2 at the end of the study (I.C. 95%: 1.75-2.35; p0.005). A reduction of 1.87 in the number of regurgitation episodes was reported between day 1 and day 7 (I.C. 95%: 1.57-2.16; p0.05) and of 0.18 (I.C. 95%: 0.06-0.31; p0.05) between day 7 and day 14. Of the 232 infants with constipation, 147 (63%) demonstrated an increase in the daily number of stools of 0.42 (I.C. 95%: 0.5-0.3; p0.005). An increase in stool frequency of 0.41 (I.C. 95%: 0.51-0.23; p0.05) was reported between day 1 and day 7, and of 0.04 (I.C. 95%: 0.22-0.14; p = ns) between day 7 and day 14. Parents' evaluation of the formula was 7.9 +/- 1.8 (score 0-10); 550 parents (91%) gave a positive judgement (score6). The evaluation by the paediatricians of the improvement in symptoms after the treatment was 8.2 +/- 1.5; 574 (95%) a positive effect (score6).This study shows that the majority of infants followed by paediatricians for minor gastrointestinal symptoms improve within 2 wk of feeding with this new formula. Further double-blind, controlled studies are needed to confirm whether the amelioration of symptoms observed in this trial is in fact due to the new formula.

Background: Infants under evaluation for atopic dermatitis (AD) at our clinic undergo a battery of examinations that include urinalysis and urine culture tests with antibiograms. The prevalence of cases with significant bacteriuria and leukocyturia (SBL) appeared to be unexpectedly high. Objective: This study attempts to establish whether infants with AD should be suspected of having a higher prevalence of urinary tract infections (UTI). Methods: A retrospective analysis of urine and urine culture tests was performed in 131 infants (84 males and 47 females) aged 1–24 months with untreated AD and in 1,327 control subjects (621 male, 706 female) aged 1–24 months. Results: SBL was present in 27.5% of cases versus 3% of controls (p ––5). After routine treatment for AD and antibiotic treatment on the basis of a urine antibiogram, the recurrence rate of SBL, evaluated monthly over a 6-month period, was only 8.3%. Conclusion: Infants with AD might be at a greater risk for developing UTI, and when treated for AD this risk might be reduced.

BACKGROUND: Treatment of infantile colic remains an open issue. In Italy, cimetropium bromide is used extensively to treat infantile colic. The aim of this randomized, double-blind, placebo-controlled clinical trial was to investigate the effectiveness and side effects of cimetropium bromide in the treatment of infants with colic crisis. METHODS: Ninety-seven infants with colic were enrolled. The diagnosis of infantile colic in healthy infants with regular growth, aged 15 to 60 days was made according to the criteria of Wessel. The infants were divided into two groups, one treated with cimetropium bromide (1.2 mg/kg) and the other treated with placebo at onset of each crisis for 3 days. Duration of crying and side effects were recorded daily in a structured diary for the 3 days of therapy. Statistical analysis was performed using the chi-square and t tests. RESULTS: Eighty-six infants completed the trial. The average duration of crying for each crisis was 17.3 +/- 12.6 minutes in the cimetropium bromide group and 47.5 +/- 28.5 minutes in the placebo group (P < 0.005). Response to cimetropium bromide was 74%. Response to placebo was 33% (P < 0.05). Side effects did not differ significantly between the two groups, except sleepiness, which increased in the infants treated with cimetropium bromide. CONCLUSION: Cimetropium bromide was more effective than placebo in reducing the duration of crying in children with infantile colic. The use of the anticholinergic drugs, aside from the dicyclomine because of its dangerous side effects, should be revaluated for treating infantile colic.

Aim Leptin, a hormone that regulates food intake and energy metabolism, is present in breast milk and thus may be involved in body composition differences between breastfed and formula-fed infants. The aim of this study was to evaluate whether diet and gender affect plasma leptin concentration in breastfed and formula-fed infants during the first months of life. Methods Anthropometric and bioelectrical impedance measurements [total body water (TBW) calculated with the Fjeld equation] were made and venous blood plasma samples were analysed for leptin concentration in healthy, exclusively breastfed or formula-fed Italian infants in the first year of life. Infants were subdivided in two ways: three groups (periods) in relation to age, and five groups in relation to weight. Results The average serum concentration of leptin was 7.35 ng x ml(-1). Serum leptin values were higher in breastfed than in formula-fed infants. Breastfed infants in group I had a statistically higher serum leptin concentration (2,500-3,749 g). There were no significant differences in anthropometric measurements, body mass index or skinfold thickness between breastfed and formula-fed infants. In the periods I and II, breastfed infants had a significantly higher TBW than formula-fed infants. Males had a significantly higher TBW than females in periods I and II. Breastfed infants in group 2 (3,750-4,999 g) had a significantly higher TBW than formula-fed infants. Conclusion The data on TBW, weight and skinfold thickness suggest that the higher leptin concentration observed in breastfed infants in the first months of life may be due not only to adipose tissue production but also to human milk.