References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2021-1-30-35

medsovet-6024

Research Article

НЕОНАТОЛОГИЯ

NEONATOLOGY

Смеси на основе козьего молока при выборе искусственного вскармливания новорожденного и ребенка первого года жизни

Goat’s milk-based formula when choosing artificial feeding for a newborn and a first-year baby

https://orcid.org/0000-0003-1831-887X

Рюмина

И. И.

Ryumina

Irina I.

Рюмина Ирина Ивановна, д.м.н., руководитель отделения патологии новорожденных и недоношенных детей

117997, Москва, ул. Академика Опарина, д. 4

Irina I. Ryumina, Dr. of Sci. (Med.), Head of the Department of Pathology of Newborns and Premature Babies

4, Academician Oparin St., Moscow, 117997

i_ryumina@oparina4.ru

Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian Federation

2021

16032021

013036

2021

Рюмина И.И.

Ryumina I.I.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/6024

Материнское молоко является самым подходящим продуктом для вскармливания новорожденного ребенка, его уникальность очевидна. Однако возникают ситуации, когда вскармливание ребенка грудным молоком невозможно вообще или его объем ограничен, поэтому при определенных обстоятельствах матери вынуждены частично или полностью кормить ребенка искусственной смесью. Несмотря на то что по ингредиентному составу большинство современных искусственных смесей достаточно близки между собой, тем не менее эти продукты различаются; есть также отличия в обработке ингредиентов, входящих в смеси. Кроме того, у ребенка могут быть индивидуальные вкусовые предпочтения, а также неожиданные негативные реакции на любую адаптированную молочную смесь. В обзоре представлены достижения последних лет в создании адаптированных смесей на основе козьего молока для вскармливания новорожденных и детей первого года. Смеси на основе козьего молока имеют ряд преимуществ в отличие от смесей на основе коровьего молока. Одни из представителей современных искусственных смесей – содержащие козье молоко, отличающееся низким генотипом α-s1-казеина и высоким содержанием β-лактоглобулина, что обеспечивает более легкую перевариваемость белков, способствует более комфортному пищеварению и лучшему усвоению. Знание биологической и пищевой ценности козьего молока с учетом особенностей желудочно-кишечного тракта новорожденных и их потребностей позволило разработать и ввести в состав детской смеси на основе козьего молока липидный комплекс DigestX, который представляет собой комплекс растительных масел с высоким содержанием пальмитиновой кислоты в sn-2-положении в молекуле триглицерида, что аналогично грудному молоку. Козье молоко, по сравнению с коровьим, содержит в 4–6 раз больше олигосахаридов, которые при производстве искусственной смеси из козьего молока сохраняют свои полезные свойства. Представлены последние данные научной литературы, в т. ч. с позиций доказательной медицины, свидетельствующие об эффективности и безопасности использования искусственных смесей на основе козьего молока. Обоснованы необходимость консультирования матерей, психологическая поддержка и практическая помощь не только по вопросам грудного, но и искусственного вскармливании ребенка.

Mother’s milk is the most suitable product for feeding a newborn baby, its uniqueness is obvious. However, there are situations when breastfeeding is not possible at all or its volume is limited, so under certain circumstances mothers are forced to partially supplement or completely feed the child with an artificial formula. Although the composition of the ingredients in most modern formula feeds is similar, there are nevertheless differences in their composition and in the processing of the ingredients in the formula. In addition, the child may have individual taste preferences as well as unexpected negative reactions to any adapted milk formula. This review presents the achievements of recent years in creating adapted goat’s milk-based formulas for feeding newborns and first-year infants. Goat’s milk-based formulas have a number of advantages over cow’s milk-based formulas. One of the representatives of modern artificial formulas are those containing goat’s milk, which is characterized by low α-s1-casein genotype and high β-lactoglobulin content, which provides easier protein digestibility, contributes to more comfortable digestion and better absorption. Knowledge of the biological and nutritional value of goat milk, taking into account the peculiarities of the gastrointestinal tract of newborns and their needs, made it possible to develop and introduce into the goat’s milk-based formula the DigestX lipid complex, which is a complex of vegetable oils with a high content of palmitic acid in the sn-2-position in the triglyceride molecule, which is similar to breast milk. Goat’s milk, compared to cow’s milk, contains 4-6 times more oligosaccharides, which retain their beneficial properties in the production of artificial goat’s milk formula.Recent scientific literature data is presented, including that from the standpoint of evidence-based medicine, proving the effectiveness and safety of artificial goat’s milk-based formulas. The necessity of consulting mothers, psychological support and practical assistance not only in breastfeeding, but also in artificial feeding is substantiated.

вскармливаниеноворожденныеискусственные смесикозье молококонсультирование

infant feedingartificial baby formulagoat’s milkconsulting

References1

Palmquist А.E., Perrin М.T., Cassar-Uhl D., Gribble K.D., Bond A.B., Cassidy T. Current Trends in Research on Human Milk Exchange for Infant Feeding. J Hum Lact.2019;35(3):453–477. doi: 10.1177/0890334419850820.

Tarrant M., Fong D.Y., Wu K.M., Lee I.L., Wong E.M., Sham A. et al. Breastfeeding and Weaning Practices among Hong Kong Mothers: A Prospective Study. BMC Pregnancy Childbirth.2010;10:27. doi: 10.1186/1471-2393-10-27.

Cloherty M, Alexander J, Holloway I. Supplementing Breastfed Babies in the UK to Protect Their Mothers from Tiredness or Distress. Midwifery. 2004;(20):194–204. doi: 10.1016/j.midw.2003.09.002.

Brown A., Raynor P., Lee M. Healthcare Professionals’ and Mothers’ Perceptions of Factors that Influence Decisions to Breastfeed or Formula Feed Infants: A Comparative Study. J Adv Nurs.2011;(67):1993–2003. doi: 10.1111/j.1365-2648.2011.05647.x.

Tarrant M., Lok K.Y., Fong D.Y., Lee I.L., Sham A., Lam C. et al. Effect of a Hospital Policy of Not Accepting Free Infant Formula on In-Hospital Formula Supplementation Rates and Breast-Feeding Duration. Public Health Nutr.2015;18(14):2689–2699. doi: 10.1017/S1368980015000117.

Ku C.M., Chow S.K. Factors Influencing the Practice of Exclusive Breastfeeding among Hong Kong Chinese Women: A Questionnaire Survey. J Clin Nurs.2010;(19):2434–2445. doi: 10.1111/j.1365-2702.2010.03302.x.

Leung J. Current Role of Maternal and Child Health Service. Med Bull. 2009;14(3):16–19. Available at: http://www.fmshk.org/database/articles/03mb04_3.pdf.

Tarrant M., Wu K.M., Fong D.Y., Lee I.L., Wong E.M., Sham A. et al. Impact of Baby-Friendly Hospital Practices on Breastfeeding in Hong Kong. Birth.2011;38(3):238–245. doi: 10.1111/j.1523-536X.2011.00483.x.

Chan M.Y., Ip W.Y., Choi K.C. The Effect of a Self-Efficacy-Based Educational Programme on Maternal Breast Feeding Self-Efficacy, Breast Feeding Duration and Exclusive Breast Feeding Rates: A Longitudinal Study. Midwifery.2016;36:92–98. doi: 10.1016/j.midw.2016.03.003.

Bai D.L., Wu K.M., Tarrant M. Association between Intrapartum Interventions and Breastfeeding Duration. J Midwifery Womens Health. 2013;58(1):25–32. doi: 10.1111/j.1542-2011.2012.00254.x.

Sze K.Y., Chan Z.C.Y., Chiang V.C.L. Women’s Experiences of Formula Feeding Their Infants: An Interpretative Phenomenological Study. Frontiers of Nursing. 2018;5(1):49–59. doi: 10.1515/fon-2018-0008.

Appleton J., Laws R., Russell C.G., Fowler C., Campbell K.J., Denney-Wilson E. Infant Formula Feeding Practices and the Role of Advice and Support: An Exploratory Qualitative Study. BMC Pediatr.2018;18(1):12. doi: 10.1186/s12887-017-0977-7.

Almaas H., Cases A.L., Devold T.G., Holm H., Langsrud T., Aabakken, L. et al. In Vitro Digestion of Bovine and Caprine Milk by Human Gastric and Duodenal Enzymes. Int Dairy J.2006;16(9):961–968. doi: 10.1016/j.idairyj.2005.10.029.

Smith H.A., O’B Hourihane J., Kenny L.C., Kiely M., Leahy-Warren P., Murray D.M. Infant Formula Feeding Practices in a Prospective Population Based Study. BMC Pediatr. 2016;16(1):205. doi: 10.1186/s12887-016-0754-z.

Delplanque B., Gibson R., Koletzko B., Lapillonne A., Strandvik B. Lipid Quality in Infant Nutrition: Current Knowledge and Future Opportunities. J Pediatr Gastroenterol Nutr.2015;61(1):8–17. doi: 10.1097/MPG.0000000000000818.

EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies). Scientific Opinion on the Essential Composition of Infant and Follow-On Formulae. EFSA J.2014;12(7):3760. doi: 10.2903/j.efsa.2014.3760.

Ruiz Morales F.A., Castel Genís J.M., Guerrero Y.M. Current Status, Challenges and the Way Forward for Dairy Goat Production in Europe. AsianAustralas J Anim Sci. 2019;32(8):1256–1265. doi: 10.5713/ajas.19.0327.

Crawley H., Westland S. Infant Formula – An Overview. London; 2019.64 p. Available at: https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5c593769c830252ca2c13d01/1549350764651/Infant_formula_an_overview_Feb_2019_final.pdf.

Lifschitz C., Szajewska H. Cow’s Milk Allergy: Evidence-Based Diagnosis and Management for the Practitioner. Eur J Pediatr.2015;174(2):141–150. doi: 10.1007/s00431-014-2422-3.

Zeiger R.S., Sampson H.A., Bock S.A., Burks A.W. Jr., Harden K., Noone S. et al. Soy Allergy in Infants and Children with IgE-Associated Cow’s Milk Allergy. J Pediatr.1999;134(5):614–622. doi: 10.1016/s0022-3476(99)70249-0.

Verduci E., D’Elios S., Cerrato L., Comberiati P., Calvani M., Palazzo S. et al. Cow’s Milk Substitutes for Children: Nutritional Aspects of Milk from Different Mammalian Species, Special Formula and Plant-Based Beverages. Nutrients.2019;11(8):1739. doi: 10.3390/nu11081739.

Mennella J.A., Beauchamp G.K. Flavor Experiences during Formula Feeding are Related to Preferences during Childhood. Early Hum Dev.2002;68(2):71–82. doi: 10.1016/s0378-3782(02)00008-7.

Bahtia J., Greer F. Use of Soy Protein-Based Formulas in Infant Feeding. Pediatrics.2008;121(5):1062–1068. doi: 0.1542/peds.2008-0564.

Kao H.F., Wang Y.C., Tseng H.Y., Wu L.S.H., Tsai H.J., Hsieh M.H. et al. Goat Milk Consumption Enhances Innate and Adaptive Immunities and Alleviates Allergen-Induced Airway Inflammation in Offspring Mice. Front Immunol.2020;(11):184. doi: 10.3389/fimmu.2020.00184.

Mazzocchi A., D’Oria V., De Cosmi V., Bettocchi S., Milani G.P., Silano M., Agostoni C. The Role of Lipids in Human Milk and Infant Formulae. Nutrients. 2018;10(5):567. doi: 10.3390/nu10050567.

Hodgkinson A.J., Wallace O.A.M., Boggs I., Broadhurst M., Prosser C.G. Gastric Digestion of Cow and Goat Milk: Impact of Infant and Young Child in Vitro Digestion Conditions. Food Chem.2017;245:275–281. doi: 10.1016/j.foodchem.2017.10.028.

Maathuis A., Havenaar, R., He T., Bellmann S. Protein Digestion and Quality of Goat and Cow Milk Infant Formula and Human Milk under Simulated Infant Conditions. J Pediatr Gastroenterol Nutr.2017;65(6):661–666. doi: 10.1097/MPG.0000000000001740.

Wang Y., Eastwood B., Yang, Z., de Campo L., Knott R., Prosser C. et al. Rheological and Structural Characterization of Acidified Skim Milks and Infant Formulae Made form Cow and Goat Milk. Food Hydrocoll. 2019;(96):161–170. doi: 10.1016/j.foodhyd.2019.05.020.

Ruhaak L.R., Lebrilla C.B. Advances in Analysis of Human Milk Oligosaccharides. Adv Nutr.2012;3(3),406s–414s. doi: 10.3945/an.112.001883.

Hageman J.J.J., Danielsen M., Nieuwenhuizen A.G., Feitsma A.L., Dalsgaard T.K. Comparison of Bovine Milk Fat and Vegetable Fat for Infant Formula: Implications for Infant Health. Int Dairy J.2019;(92):37–49. doi: 10.1016/j.idairyj.2019.01.005.

Bronsky J., Campoy C., Embleton N., Fewtrell M., Mis N.F., Gerasimidis K. et al. Palm Oil and Beta-palmitate in Infant Formula: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2019;68(5):742–760. doi: 10.1097/MPG.0000000000002307.

Innis S.M. Dietary Triacylglycerol Structure and Its Role in Infant Nutrition. Adv Nutr.2011;2(3):275–283. doi: 10.3945/an.111.000448.

Giuffrida F., Marmet C., Tavazzi I., Fontannaz P., Sauser J., Lee L.Y., Destaillats F. Quantification of 1,3-olein-2-palmitin (OPO) and Palmitic Acid in sn-2 Position of Triacylglycerols in Human Milk by Liquid Chromatography Coupled with Mass Spectrometry. Molecules. 2018;24(1):22. doi: 10.3390/molecules24010022.

Facinelli B., Marini E., Magi G., Zampini L., Santoro L., Catassi C. et al. Breast Milk Oligosaccharides: Effects of 2’-fucosyllactose and 6’-sialyllactose on the Adhesion of Escherichia coliand Salmonella fyristo Caco-2 Cells. J Matern Fetal Neonatal Med.2019;32(17):2950–2952. doi: 10.1080/14767058.2018.1450864.

Asakuma S., Hatakeyama E., Urashima T., Yoshida E., Katayama T., Yamamoto K. et al. Physiology of Consumption of Human Milk Oligosaccharides by Infant Gut-Associated Bifidobacteria. J Biol Chem. 2011;286(40):34583-92. doi: 10.1074/jbc.M111.248138.

Bode L. Recent Advances on Structure, Metabolism, and Function of Human Milk Oligosaccharides. J Nutr.2006;136(8):2127–2130. doi: 10.1093/jn/136.8.2127.

Bode L. Human Milk Oligosaccharides: Every Baby Needs A Sugar Mama. Glycobiology.2012;22(9):1147–1162. doi: 10.1093/glycob/cws074.

Gopal P.K., Gill H. Oligosaccharides and Glycoconjugates in Bovine Milk and Colostrum. Br J Nut.2000;84(Suppl 1):S69–S74. doi: 10.1017/s0007114500002270.

Triantis V., Bode L., van Neerven R. Immunological Effects of Human Milk Oligosaccharides. Front Pediatr. 2018;(6):190. doi: 10.3389/fped.2018.00190.

Urakami H., Saeki M., Watanabe Y., Kawamura R., Nishizawa S., Suzuki Y. et al. Isolation and Assessment of Acidic and Neutral Oligosaccharides from Goat Milk and Bovine Colostrum for Use as Ingredients of Infant Formulae. Int Dairy J.2018;83:1–9. doi: 10.1016/j.idairyj.2018.03.004.

Martinez-Ferez A., Rudloff S., Guadix A., Henkel C., Pohlentz G., Boza J. et al.Goat Milk as a Natural Source of Lactose-Derived Oligosaccharides: Isolation by Membrane Technology. Int Dairy J.2006;16(2):173–181. doi: 10.1016/j.idairyj.2005.02.003.

Leong A., Liu Z., Almshawit H., Zisu B., Pillidge C., Rochfort S., Gill H. Oligosaccharides in Goats’ Milk-Based Infant Formula and Their Prebiotic and Anti-Infection Properties. Br J Nutr.2019;122(4):441–449. doi: 10.1017/S000711451900134X.

Gallier S., Van den Abbeele P., Prosser C. Comparison of the Bifidogenic Effects of Goat and Cow Milk-Based Infant Formulas to Human Breast Milk in an in vitroGut Model for 3-Month-Old Infants. Front Nutr. 2020;7:608495. doi: 10.3389/fnut.2020.608495.

Grant C., Rotherham B., Sharpe S., Scragg R., Thompson J., Andrews J. et al. Randomized, Double-Blind Comparison of Growth in Infants Receiving Goat Milk Formula Versus Cow Milk Infant Formula. J Paediatr Child Health.2005;41(11):564–568. doi: 10.1111/j.1440-1754.2005.00722.x.

Zhou S.J., Sullivan T., Gibson R.A., Lönnerdal B., Prosser C.G., Lowry D.J., Makrides M. Nutritional Adequacy of Goat Milk Infant Formulas for Term Infants: A Double-Blind Randomised Controlled Trial. Br J Nutr.2014;111(9):1641–1651. doi: 10.1017/S0007114513004212.

The authors declare that there are no conflicts of interest present.