Reduced crying in term infants fed high beta-palmitate formula: a double-blind randomized clinical trial

BMC Pediatrics

Dan Nemet²  Rivka H Regev⁴  Alon Eliakim²  Keren Davidson³  Yael Lifshitz¹  Fabiana Bar-Yoseph¹  Ita Litmanovitz⁴ 

[1] Infant Nutrition R&D, Enzymotec LTD, Sagi 2000 Industrial Park, Migdal HaEmeq (23106), Israel;Pediatric Department Meir Medical center, (Tchernichovsky 59), Kfar Saba (4428164), Israel;Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot (76100), Israel;Sackler School of Medicine, Tel-Aviv University, Tel Aviv (6997801), Israel

关键词: Breastfeeding;    Stool characteristics;    Crying;    Infant formula;    sn-2 palmitate;    Beta-palmitate;   

Others  :  1138770
DOI  :  10.1186/1471-2431-14-152

 received in 2013-12-29, accepted in 2014-06-12,  发布年份 2014

【 摘 要 】

Background

Beta-palmitate (sn-2 palmitate) mimics human milk fat, enabling easier digestion.

Therefore, we hypothesized that infants consuming high beta-palmitate formula would have more frequent, softer stools and reduced crying compared to infants consuming low beta-palmitate formula.

Methods

Formula-fed infants were randomly assigned to receive either (1) formula with high beta-palmitate (HBP, n = 21) or (2) regular formula with a standard vegetable oil mix (LBP, n = 21). A matched group of breastfed infants served as a reference (BF, n = 21). Crying and stool characteristics data were recorded by the parents for 3 days before the 6- and 12-week visits.

Results

We found no significant differences in the stool frequency or consistency between the two formula groups. The percentage of crying infants in the LBP group was significantly higher than that in the HBP and BF groups during the evening at 6 weeks (88.2% vs. 56.3% and 55.6%, p < 0.05) and during the afternoon at 12 weeks (91.7% vs. 50.0% and 40%, p < 0.05). The infants fed HBP had significantly shorter crying durations when compared with infants fed LBP formula (14.90 ± 3.85 vs.63.96 ± 21.76 min/day, respectively; p = 0.047).

Conclusions

Our study indicates that consumption of a high beta-palmitate formula affects infant crying patterns during the first weeks of life. Comparable to breastfeeding, it reduced crying duration and frequency, primarily during the afternoon and evening hours, thereby improving the well-being of formula-fed infants and their parents.

Trial registration

NCT00874068.

Registration date March 31, 2009

【 授权许可】

   
2014 Litmanovitz et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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【 参考文献 】

• [1]Brazelton TB: Crying in infancy. Pediatrics 1962, 29:579-588.
• [2]Barr RG, Kramer MS, Pless IB, Boisjoly C, Leduc D: Feeding and temperament as determinants of early infant crying/fussing behavior. Pediatrics 1989, 84(3):514-521.
• [3]Evanoo G: Infant crying: a clinical conundrum. J Pediatr Health Care 2007, 21(5):333-338.
• [4]Baildam EM, Hillier VF, Ward BS, Bannister RP, Bamford FN, Moore WM: Duration and pattern of crying in the first year of life. Dev Med Child Neurol 1995, 37(4):345-353.
• [5]St James-Roberts I, Hurry J, Bowyer J: Objective confirmation of crying durations in infants referred for excessive crying. Arch Dis Child 1993, 68(1):82-84.
• [6]St James-Roberts I, Halil T: Infant crying patterns in the first year: normal community and clinical findings. J Child Psychol Psychiatry 1991, 32(6):951-968.
• [7]Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS: Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006, 130(5):1527-1537.
• [8]Breckenridge WC, Marai L, Kuksis A: Triglyceride structure of human milk fat. Can J Biochem 1969, 47(8):761-769.
• [9]Giovannini M, Riva E, Agostoni C: Fatty acids in pediatric nutrition. Pediatr Clin North Am 1995, 42(4):861-877.
• [10]Tomarelli RM, Meyer BJ, Weaber JR, Bernhart FW: Effect of positional distribution on the absorption of the fatty acids of human milk and infant formulas. J Nutr 1968, 95(4):583-590.
• [11]Innis SM, Dyer R, Nelson CM: Evidence that palmitic acid is absorbed as sn-2 monoacylglycerol from human milk by breast-fed infants. LIPIDS 1994, 29(8):541-545.
• [12]Nelson CM, Innis SM: Plasma lipoprotein fatty acids are altered by the positional distribution of fatty acids in infant formula triacylglycerols and human milk. Am J Clin Nutr 1999, 70(1):62-69.
• [13]Mattson FH, Volpenhein RA: The specific distribution of fatty acids in the glycerides of vegetable fats. J Biol Chem 1961, 236:1891-1894.
• [14]Small DM: The effects of glyceride structure on absorption and metabolism. Annu Rev Nutr 1991, 11:413-434.
• [15]Quinlan PT, Lockton S, Irwin J, Lucas AL: The relationship between stool hardness and stool composition in breast- and formula-fed infants. J Pediatr Gastroenterol Nutr 1995, 20(1):81-90.
• [16]Kennedy K, Fewtrell MS, Morley R, Abbott R, Quinlan PT, Wells JC, Bindels JG, Lucas A: Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization. Am J Clin Nutr 1999, 70(5):920-927.
• [17]Weaver LT, Ewing G, Taylor LC: The bowel habit of milk-fed infants. J Pediatr Gastroenterol Nutr 1988, 7(4):568-571.
• [18]Litmanovitz I, Davidson K, Eliakim A, Regev RH, Dolfin T, Arnon S, Bar-Yoseph F, Goren A, Lifshitz Y, Nemet D: High Beta-Palmitate Formula and Bone Strength in Term Infants: A Randomized, Double-Blind, Controlled Trial. Calcif Tissue Int 2013, 92(1):35-41.
• [19]Lucas A, St James-Roberts I: Crying, fussing and colic behaviour in breast- and bottle-fed infants. Early Hum Dev 1998, 53(1):9-18.
• [20]Newman JD: Neural circuits underlying crying and cry responding in mammals. Behav Brain Res 2007, 182(2):155-165.
• [21]St James-Roberts I: Persistent infant crying. Arch Dis Child 1991, 66(5):653-655.
• [22]James-Roberts IS, Conroy S, Hurry J: Links between infant crying and sleep-waking at six weeks of age. Early Hum Dev 1997, 48(1–2):143-152.
• [23]Howard CR, Lanphear N, Lanphear BP, Eberly S, Lawrence RA: Parental responses to infant crying and colic: the effect on breastfeeding duration. Breastfeed Med 2006, 1(3):146-155.
• [24]Savino F, Palumeri E, Castagno E, Cresi F, Dalmasso P, Cavallo F, Oggero R: Reduction of crying episodes owing to infantile colic: A randomized controlled study on the efficacy of a new infant formula. Eur J Clin Nutr 2006, 60(11):1304-1310.
• [25]Carnielli VP, Luijendijk IH, van Goudoever JB, Sulkers EJ, Boerlage AA, Degenhart HJ, Sauer PJ: Feeding premature newborn infants palmitic acid in amounts and stereoisomeric position similar to that of human milk: effects on fat and mineral balance. Am J Clin Nutr 1995, 61(5):1037-1042.
• [26]Carnielli VP, Luijendijk IH, Van Goudoever JB, Sulkers EJ, Boerlage AA, Degenhart HJ, Sauer PJ: Structural position and amount of palmitic acid in infant formulas: effects on fat, fatty acid, and mineral balance. J Pediatr Gastroenterol Nutr 1996, 23(5):553-560.
• [27]Yaron S, Shachar D, Abramas L, Riskin A, Bader D, Litmanovitz I, Bar-Yoseph F, Cohen T, Levi L, Lifshitz Y, Shamir R, Shaoul R: Effect of High Beta-Palmitate Content in Infant Formula on The Intestinal Microbiota of Term Infants: A Double-Blind, Randomized Pilot Study. J Pediatr Gastroenterol Nutr 2013, 56(4):376-381.
• [28]Barr RG: The normal crying curve: what do we really know? Dev Med Child Neurol 1990, 32(4):356-362.