I . Mn and Cu intake and retention in twenty full-term infants and six preterm infants were studied on the basis of 72 h balances. The age of the infants was 2-16 weeks and the gestational age of the preterm infants (triplets) 34 and 36 weeks. Three nutrition schemes were pursued : breast-fed, formula-fed with unsupplemented adapted formula and formula-fed with trace element supplementation.2. The mean M n concentration of all breast-milk samples (n 2339) was 6.2 pg/l. The two formulas had similar Mn concentrations (77 and 99 pg/I) but had different Fe, Cu (121 and 619 ,ug/l), Zn and I contents. The mean Cu concentration in mother's milk was 833 yg/l.3 . The following mean daily Mn intakes and retentions (pg/kg) respectively were measured: breast-fed fullterm 1.06 (SD 0.43) and 0.43 (SD 0.65), formula-fed full-term 14.2 (SD 3.1) and 2.8 (SD 4%), formula-fed preterm 15.0 (SD 2.2) and 0.06 (SD 5.87). The results for Cu were 114.5 (SD 22.3) and 88.0 (SD 46.5) pg/kg in breast-fed, 19-8 (SD 4.2) and 4.6 (-11.5-9.6) in the unsupplemented formula-fed and 106.4 (SD 18.9) and 55.5 (SD 20.3) in the supplemented formula full-term infant group. No significant influence of the trace element contents of the formulas on the relative retention of Mn or Cu was found.4. Young preterm infants, and to some degree young full-term infants, often had negative Mn balances caused by a high faccal excretion. The formulas with a Mn concentration below 100 pg/l gave a sufficient supply of Mn. Preterm infants fed on the unsupplemented formula had a marginal Cu supply and their first balances were negative (-3.8 (SD 1.8) pglkg).5. In accordance with the estimated safe and adequate daily dietary intakes (recommended dietary allowances), formula-fed infants receive much more Mn than breast-fed infants and their absolute retention is higher.6. Cu from breast-milk had a significantly better biological availability than that from cow's milk formula. If retentions similar to those in breast-fed infants are intended, we conclude, therefore, that cow's milk formula should be fortified with Cu up to a level of at least 600 pg/l.The biological relevance of Mn was noted in poultry and rats showing defective calcification of the otoliths (resulting in ataxia) and the skeleton and other defects based on a depressed mucopolysaccharide synthesis (Hurley, 1985). Furthermore, Mn-deficient rats have second-generation offspring which show an abnormal glucose tolerance test, possibly caused by decreased insulin output (Hurley, 1985). Mn deficiency in man has been observed only once in a patient under parenteral nutrition (Doisy, 1974). He suffered from a prolonged prothrombin clotting time. In newborns and infants no symptoms of deficiency have yet been identified. The vitamin K-dependent coagulopathy in breast-fed infants, however, could be hypothetically connected to Mn deficiency by low Mn intake in these children. At this age it should be relatively easy to diagnose a deficiency, as body-weightrelated increase of tissues and the need for nutrients are highe...

Aim: The intention of this study performed in healthy breast- and formula-fed infants was to characterize physiological feeding patterns as a basis for counseling parents to feed their infants on demand. Methods:Ingested milk volumes of 10 breast-fed and 14 formula-fed infants were measured during five 72-hour investigation periods during the 3rd, 6th, 9th, 13th, and 17th weeks of life. Results: A comparable diurnal distribution of feeds was observed in both groups during the first 9 weeks of life, with a day-night asymmetry of feeding first observed at the age of 6 weeks. Thereafter, formula-fed infants showed a further decrease in their nightly milk intake. Within the investigation period, the milk volume per feed rose from 100 (range 40–200) g to 140 (range 30–300) g in the breast-fed group and from 100 (range 20–200) g to 200 (range 20–450) g in formula-fed infants. From the 6th week of life onwards, formula-fed infants had significantly higher feeding volumes. Conclusions: Parents should be informed about the variability of infant demands per feed and of feeding at night observed in breast-fed infants. The results suggest that feeding patterns similar to those of breast-fed infants are difficult to accomplish in formula-fed infants.

Knowledge of peripartum indicators of those mother-infant pairs that are at increased risk of early failure of lactation may improve specific support of breastfeeding. Mode of delivery, labor complications, hyperbilirubinemia, milk intake and weight development were evaluated in healthy term infants in a hospital (n = 338). Delayed onset of lactation was observed in primiparae and in study participants with peripartum complications. The quantitative intake of human milk, assessed by test weighing 0–24 h and 24–48 h after the onset of lactation, was not significantly different between these groups. In addition, volume intake, weight gain and lactation success were tracked in 77 infants. Partial feeding of infant formula or an intake of <150 g of human milk per day 24–48 h after the onset of lactation was linked to weaning within 4 weeks. Ninety-one percent of the infants were exclusively breastfed at discharge; this value had declined to 49, 35 and 20% at 4, 12 and 20 weeks, respectively. Peripartum factors may contribute to early lactation failure; the long-term success of breastfeeding was predominantly determined outside the hospital.

This study suggests that preventable society-specific determinants are important for early-life mortality in Turkish migrants in Europe. An active integration policy is consistent with a favourable neonatal mortality outcome in continental Europe, but not with patterns in Scandinavia and the UK.