Lecture 9 Flashcards

Complementary feeding -Infant formula

1
Q

Infant Formula Feeding Recommendation

A

If an infant is not BF, then an infant formula should be used until the infant is one year of age

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2
Q

Three types of products on the shelves

A

-Infant formula (suitable for infants 0-<12 months)

-Follow on formula (suitable for infants 6-<12 months)

-Infant formula products for special dietary use

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3
Q

Regulation of Infant Formula

A

We need to regulate our infant formula so it is safe for our infants to consume

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4
Q

New Zealand standard and schedule

A

Standard 2.9.1- Infant formula Products

Schedule 29- Special purpose foods

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5
Q

All commercially produced infant formula products available in Australia and NZ must

A

comply with the composition and safety requirements outlined in the code

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6
Q

Standard 2.9.1 specifies

A

The mandatory nutrient content for infant formula and flow on formula to ensure that the nutrition requirements of infants aged up to 12 months are met

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7
Q

Includes labelling requirements for infant formula products and specifically

A

prohibits some types of claims, images and symbols on product labels

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8
Q

The standard also controls

A

food additives that can be added

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9
Q

Proposal P1028
what is it?

A

Review of the regulatory requirements (June 2024)

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10
Q

Proposal P1028
Purpose?

A

To ensure infant formula ramains safe, suitable and takes account of current science, market developments and the international regulatory context

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11
Q

Proposal P1028

Revision of …. standards and …. schedules

Transition period of …. years

A

5 standards and 8 schedules

transition period of 5 years

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12
Q

Proposal P1028
Key amendements:

A

-Prohibiting cross promotion of similar products on infant formula product labels

-Mandating NIP to better assist caregivers in informed choice

-Restriction on the scale of special medical purpose products, to ensure appropriate access and use

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13
Q

Infant formula products:
Current and amended Division 1

A

Current:
Preliminary
-Definitions
-Interpretation of compositional requirements

Amended:
-preliminary matters
-Definitions
-Interpretation of compositional requirements

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14
Q

Infant formula products:
Current and amended Division 2

A

Current:
General compositional requirements for infant formula products

Amended:
Compositional requirements for infant formula and follow on formula

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15
Q

Infant formula products:
Current and amended Division 3

A

Current:
Infant formula and follow on formula
- compositional requirements

Amended:
Labelling and packaging requirements for infant formula and follow on formula

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16
Q

Infant formula products:
Current and amended Division 4

A

Current:

Infant formula products for special dietary use
Three subcategories:
- Products formulated for premature or low birthweight infants
-Products for metabolic, immunological renal, hepatic, and malabsorptive conditions
-Products for special dietary use based on a protein substitute

Amended:
Special Medical purpose products for infants (SMPPi)
-Sale
-Compositional requirements
-Labelling requirements

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17
Q

Current has a Division 5 and 6 as well

A

5-Labelling and packaging requirements

6- Guidlines

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18
Q

Food giant warns that ….

A

441 jobs and $1b of exports at risk from infant formula labelling plan

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19
Q

They are advertising this formula to pregnant women who are…

A

Tired and in pain

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20
Q

Majority of infant formula health claims are poorly supported

41 groups of ingredients tied to…..

A

1884 claims

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21
Q

What percentage of these claims were not specific to an ingredient

A

50%

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22
Q

what percentage of these claims were supported by evidence

A

26%

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23
Q

what percentage was funded by formula companies or had authors with industry connections

A

88%

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24
Q

A lot of these health claims on infant formula have very

A

small or limited literature

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25
Q

They believe by removing health claims its going to

A

benefit to the purchaser

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26
Q

Home made infant formula

A

Safety concerns of the Paleo diet for infant and paleo DIY infant formula

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27
Q

Paleo DIY infant formula recipe was available online made from liver, cod liver oil, bone broth with no assurance for the safety, nutritional quality or appropriateness for infants

A

-Immature kidneys and GI tract

-Upper limits Vitamin A, high in sodium, protein and iron

-Microbiological risk with ingredients such as honey (botulism risk), runny eggs (salmonella) and raw liver, raw milk (listeria and salmonella)

28
Q

Even famous cooks can make dangerous inventions for young ones

A

Pete Evans -2015
- Bubba Yum Yum

Chelsea Winter- 2020
Dairy-free toddler milk

29
Q

Alternatives NOT recommended for infants <12 months

A

-Cows milk as a drink (instead of infant formula or breastmilk
-Plant-based milk alternatives (soy, oat, almond, coconut)as a drink
-Condensed milk
-Evaporated milk

30
Q

There is two types of protein in infant formula

A

Casein and whey

31
Q

Whey is ……..whereas casein …..

A

Whey is quickly digested whereas casein forms curds that are more slowly digested, resulting in slower gastric emptying

32
Q

Expressed as casein:whey ratio

Breastmilk……
Whey dominant infant formula ……
Casein dominant infant formula…..

A

40:60

40:60

80:20

33
Q

Whey and casein protein in breastmilk

A

Dominant whey protein in BM is alpha-lactoalbumin (low levels in formula)

Dominant casien is beta Casein (same as goats milk formula)

34
Q

whey and casein protein in Cows milk formula

A

Dominnat whey protein in formula is beta-lactoglobulin (not found in BM)

Dominant casein is alpha casein

35
Q

Infants who are struggling to digest cows milk they will be suggested to …

A

goats but this doesn’t usually work because if they struggle with cows they most likely will struggle with other mammalian milk

36
Q

Soy based infant formula

Soy formulas contain….

The protein is…..

A

Soy formulas contain no cows milk, no casein and whey

Protein is soy protein isolate

37
Q

Soy protein isolate is a

A

High digestible protein with high amounts of essential amino acids, it os supplemented with methionine, taurine and carnitine (EAAs)

Recommended for babies >6 months

38
Q

Protein -infant weight regulation

A

Breastmilk: 1.5g/100kcal
Formula 2.2g/100kcal

formula-fed infants have tend to have greater weight gain than breastfed infants

Led to early protein hypothesis

39
Q

Protein quality in in infant formula is positively associated with…..

A

Increased risk of overweight and obesity, and these effects may have a long-term impact beyond the first 2 years of life

40
Q

FSANZ proposed standar changed because of

A

Growing interest in lowering the reuirements to potentially lower risk of obesity in childhood

41
Q

2019 Nestle dropped

A

follow up formula only from 0.45g/100kJ to 0.38g/100kJ

42
Q

July 2021 FSANZ considers that

A

More evidence is required to demonstrate the advantages of lower protein intakes for younger infants
- Proposed to keep minimum 0.45g/100kJ

43
Q

Carbohydrate

A

Lactose is the major carbohydrate in human breast milk, cows milk and in most milk based infant formulas

44
Q

Lactose intolerance is … in infants

A

Rare

45
Q

Primary lactase enzyme deficiency

A

-Uncommon before 203 years of age
-Symptoms: Diarrhea, cramps, bloating, vomiting and gas

46
Q

Secondary lactase enzyme deficiency

A

-More common
-Results from bowel injury, as an example infants who have experienced non-IgE-mediated cows milk allergy or viral gastroenteritis

47
Q

Lactose free formulas generally contain

A

Corn syrup solids rather than lactose
-Many soy-protein formulas also do not contain lactose

48
Q

FSANZ proposed standard changes

A

Codex STAN 72-1981 includes guidance on the type of digestible carbohydrate to be used (e.g preffered sources of carbohydrate and that sucrose and fructose should be avoided but this is not mandatory

49
Q

Lactose and glucose polymers are the preferred carbohydrate

A

source in infant formula

50
Q

Fat

A

Provides a significant percentage of energy 40-50%

51
Q

Ratio of PUFA to saturated fat in milk affects…

A

Digestibility and facilitates absorption of calcium and fat from the gut

52
Q

Main sources pf the fat

A

Vegetable oils, including : corn, soy, Linolenic acid within a specific ration and range

53
Q

LCPUFAS are added to formulas at..

A

at a cost to the consumer (premium formula or “Gold”)

54
Q

FSANZ proposed standard changes (fat)

A

Proposed to lower the maximum amount of trans fatty acids to 3% (from 4%)

55
Q

Trans-fatty acids are?

A

Manufactured fats created during a process called hydrogenation, which is aimed at stabilzing polyunsaturated oils to prevent them from becoming rancid and to keep them solid at room temperature. Linked with heart disease and my pose a risk for cancers.

56
Q

Other Optional substances ????

A

Prebiotic -Oligosaccharides

Probiotic

57
Q

Organic Infant formula still need to

A

Meet regulations they need to meet their organic regulations which results in a higher price in organic infant formulas

58
Q

Guide to choosing infant milk

Soy, lactose free, cow or goat protein based, partially hydrolysed or amino acid infamt formulas are…

A

suitable from birth

59
Q

Codes applies to infant formula marketing

A

NZIFMA applies to the manufacturers, marketers and sistributors of infant formula

60
Q

New Zealand Infant formulas in 2020 and expected in 2025

A

In 202 the revenue generated from infant formula exports from NZ exceeded $1.8 billion. By 2025, forcasted to reach $2.7 billion

61
Q

Contaminated with melamine

A

Organic base chemical most commonly found in the form of white crystals rich in nitrogen

  • added to milk powdered to increase the volume

Cause kidney stones and kidney failure

62
Q

2008 melamine

A

Estimated 300 000 victims with six infants dying from kidney damage and 54, 00 infants hospitalised

63
Q

Covid 19

A

Supply issues of infants formula

  • Lead to increased demand for breast milk donations in milk banks
64
Q

In covid 19 google searches for homemade formula recipes increased by

A

2400%

65
Q

Society’s collective responsibility

A

Prevention of reocurrence
- Public education to increase confidence
-Strategy for production -multiple sites
-Breastfeeding support