For Healthcare Professionals only

Role of Natural and Synthetic Vitamin E in Infant Feeds
By - Danone Nutricia Academy

Background

Key function of Vitamin E in vivo is as an antioxidant. Being soluble in fat, it is mainly located in the cell membrane where it prevents lipid peroxidation, especially that of LCPUFAs. Lipid peroxidation may cause cellular damage and cell function.

Objective

In this study, the effect of feeding infant formulas containing different amounts and forms of vitamin E on antioxidant status was assessed in term infants.

Design

  • Controlled, blinded, multisite study
  • n= 116 term infants
  • 3 different infant-formula groups

Groups

No. of subjects (final)

Vit E (IU)

Vit E (mg/L)

Vit E (active 2 R isomer, mg/L)**

HighNAT - E

26

20

14.5

13.4

LowNAT - E

25

10

7.3

6.7

SYN- E

26

13.5

13.5

6.1

A human milk–fed group (n = 29) served as a reference. *NAT- Natural, SYN – Synthetic. **Calculated basis 2000 DRI report.

Results

1. No difference in plasma concentration of vitamin E between Low NAT- E and SYN-E groups: Plasma concentration of vitamin E depends on the amount of 2R isomers in the dose and not on the form (natural vs. synthetic) in which vitamin E is administered.

Plasma concentration of α- tocopherol (µmol/L)2


2. No significant difference in the RBC concentration of vitamin E between the 3 groups: RBC of newborn infants are more sensitive to in vitro oxidative stress. Most of the intracellular hemoglobin in a neonate is hemoglobin F, which has a greater tendency to denature and oxidize than does hemoglobin A. Denatured, oxidized hemoglobin is a potent catalyst for lipid peroxidation.

3. There were no significant differences in antioxidant status between the 3 groups when measured in terms of α-TQ : α-tocopherol and Plasma Isoprostane levels.

Antioxidant status of term infants:
α- TQ: α-tocopherol*

*α-TQ is an oxidized product of vitamin E. The plasma ratio of α-TQ to α-tocopherol is an index of the relative amount of oxidized α-tocopherol. This ratio is referred to as the vitamin E redox status.

Antioxidant status of term infants:
Isoprostanes (pg/mL)*

*Isoprostanes are Formed in vivo by free radical oxidation of arachidonyl-containing lipids; plasma isoprostane concentrations have been suggested to be indicative of in vivo oxidative stress

Conclusions

1. Despite higher plasma appearance of vitamin E of the high Nat-E group, the RBC concentrations were the same of all the 3 groups.

2. Infant formulas with synthetic vitamin E support adequate antioxidant status similar to formulas containing natural vitamin E.

References:

  1. Stone WL et al. Infants discriminate between natural and synthetic vitamin E. Am J Clin Nutr. 2003 Apr;77(4):899-906.

IMPORTANT NOTICE: MOTHER’S MILK IS BEST FOR YOUR BABY

The World Health Organization (WHO)* has recommended that pregnant women and new mothers be informed of the benefi¬ts and superiority of breast-feeding, in particular, the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for and maintenance of lactation, with special emphasis on the importance of the well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle feeding or other foods and drinks should be discouraged since it will have a negative effect on breast-feeding. Similarly, mothers should be warned of the diffi¬culty of reversing a decision not to breastfeed. Before advising a mother to use an infant formula, she should be advised of the social and ¬financial implications of her decision. For example, if a baby is exclusively bottle-fed, more than one can (500g) per week will be needed, so the family circumstances and cost should be kept in mind. Mother should be reminded that breast milk is not only the best but also the most economical food for babies. If a decision to use infant formula is taken, it is important to give instruction on correct preparation methods, emphasizing that unboiled water, unsterilized bottles or incorrect dilution can lead to illness.

*See: International Code of Marketing of Breast Milk Substitutes, adopted by the World Health Assembly in Resolution WHA 34.22, May 1981.

Importance of Breastfeeding:

(i) Immediately after delivery, breast milk is yellowish and sticky. This milk is called colostrum, which is secreted during the fi¬rst week of delivery. Colostrum is more nutritious than mature milk because it contains more protein, more anti-infective properties which are of great importance for the infant's defense against dangerous neonatal infections. It also contains higher levels of, Vitamin 'A', (ii) breast miIk- A) is, a complete and balanced food and provides all the nutrients needed by the infant [for the ¬first six months of life] (B) has anti-infective properties that protect the infants from infection in the early months (C) is always available; (D) needs no utensils or water (which might, carry germs) or fuel for its preparation, (iii) breastfeeding is much cheaper than feeding infant milk substitutes as the cost of the extra food needed by the mother is negligible compared to the cost of feeding infant milk substitutes, (iv) mothers who breast-feed usually have longer periods of infertility after child birth than non-lactators; (b) details of management of breast feeding, as under:- (i) breast-feeding- (A) immediately after delivery enables the contraction of the womb and helps the mother to regain her ¬figure quickly; (B) is successful when the infant suckles frequently and the mother wanting to breast-feed is confi¬dent in her ability to do so (ii) in order to promote and support breast-feeding the mother’s natural desire to breast feed should always be encouraged by giving, where needed, practical advice and making sure that she has the support of her relatives. (iii) adequate care for the breast and nipples should be taken during pregnancy. (iv) it is also necessary to put the infant to the breast as soon as possible after delivery, (v) let the mother and the infant stay together after the delivery, the mother and her infant should be allowed to stay together (in hospital, this is called "rooming-in"); (vi) give the infant colostrum as it is rich in many nutrients and anti-infective factors protecting the infants from infections during the few days of its birth; (vii) the practice of discarding colostrum and giving sugar water, honey water, butter or other concoctions instead of colostrum should be very strongly discouraged; (viii) let the infants suckle on demand; (ix) every effort should be made to breast-feed the infants whenever they cry; (x) mother should keep her body and clothes and that of the infant always neat and clean. Breast-feeding is the best form of nutrition for babies and provides many benefi¬ts to babies and mothers. It is important that, in preparation for and during breast-feeding, you eat a healthy, balanced diet. Combined breast and bottle-feeding in the ¬first weeks of life may reduce the supply of your own breast-milk and reversing the decision not to breast-feed is dif¬ficult. Always consult your Healthcare Professional for advice about feeding your baby. The social and fi¬nancial implications of using infant formula should be considered. Improper use of an infant formula or inappropriate foods or feeding methods may present a health hazard. If you use infant formula, you should follow manufacturer's instructions for use carefully - failure to follow the instructions may make your baby ill.

IMPORTANT NOTICE

Breast milk is best for babies. At Danone, we support breast feeding and believe that breast milk is the best food for babies as the sole source of nutrition for the first 6 months of life and is recommended to be continued until 2 years with the introduction of appropriate complementary foods after 6 months of age.

IMPORTANT NOTICE: Breastfeeding is the best for babies and a healthy diet / maternal nutrition is important when breastfeeding. A decision not to breastfeed can be difficult to reverse. Infant formula is suitable from birth when babies are not breastfed. It is recommended that all formula milks be used on the advice of a doctor, midwife, health visitor, public health nurse, dietitian, pharmacist, or other professional responsible for maternal and child-care and the financial implications should be considered. All preparation and feeding instructions should be followed carefully as inappropriate preparation could lead to health hazards.

For the use of healthcare professionals only, not for distribution to general public.

Published by: Nutricia International Pvt. Ltd. Building A, unit no. 304, 3rd Floor, Agastya Corporate Park, Kamani Junction, L.B.S. Marg, Opp. Fire Brigade, Kurla (West), Mumbai 400070

CVM code: 1638528993688

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