Observations and Conversations: Home Preparation of Infant Formula Among a Sample of Low-Income Mothers in the Southeastern US

Ellison, Rebecca G.; Greer, Betty; Burney, Janie; Goodell, Lela; Bower, Katherine B.; Nicklas, Jennifer C; Lou, Zixin; Kavanagh, Katie

doi:10.1016/j.jneb.2017.04.027

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…Low RBP can be a consequence of illness (7), but also reflects conditions of malnutrition when individuals in low-income families have limited access to nutrient-rich foods (8–10). Whereas, infants in the United States may receive government-funded, vitamin-fortified formulas, comparable support is not given to older children (11). Instead, diets for older children and adults may be calorie-dense and nutrient-poor.…”

Section: Introductionmentioning

confidence: 99%

Influences of Vitamin A on Vaccine Immunogenicity and Efficacy

et al. 2019

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Vitamin A deficiencies and insufficiencies are widespread in developing countries, and may be gaining prevalence in industrialized nations. To combat vitamin A deficiency (VAD), the World Health Organization (WHO) recommends high-dose vitamin A supplementation (VAS) in children 6–59 months of age in locations where VAD is endemic. This practice has significantly reduced all-cause death and diarrhea-related mortalities in children, and may have in some cases improved immune responses toward pediatric vaccines. However, VAS studies have yielded conflicting results, perhaps due to influences of baseline vitamin A levels on VAS efficacy, and due to cross-regulation between vitamin A and related nuclear hormones. Here we provide a brief review of previous pre-clinical and clinical data, showing how VAD and VAS affect immune responses, vaccines, and infectious diseases. We additionally present new results from a VAD mouse model. We found that when VAS was administered to VAD mice at the time of vaccination with a pneumococcal vaccine (Prevnar-13), pneumococcus (T4)-specific antibodies were significantly improved. Preliminary data further showed that after challenge with Streptococcus pneumoniae , all mice that had received VAS at the time of vaccination survived. This was a significant improvement compared to vaccination without VAS. Data encourage renewed attention to vitamin A levels, both in developed and developing countries, to assist interpretation of data from vaccine research and to improve the success of vaccine programs.

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Section: Introductionmentioning

confidence: 99%

Influences of Vitamin A on Vaccine Immunogenicity and Efficacy

et al. 2019

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“…The CDC recommends against feeding watered-down formula as it can impair growth and development and result in electrolyte and mineral disturbances (15). Prior to the infant formula shortage, WIC recipients were at risk for watering-down infant formula to increase their allocated supply (23). Contributory factors include the structure of WIC which is a supplemental program that only partially provides infant formula to families at no cost.…”

Section: Discussionmentioning

confidence: 99%

Infant Feeding Practices and Parental Perceptions during the 2022 United States Infant Formula Shortage Crisis

Cernioglo

Smilowitz

2022

Preprint

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Background In May of 2022, parents living in the United States experienced a dramatic infant formula shortage caused by supply chain issues and the recent recall of several infant formula products over contamination concerns. Methods An anonymous, electronic, cross-sectional survey was designed to understand infant feeding practices, parental experience and perceived support during the crisis. Results Ninety-nine parents that lived in the U.S. and fulfilled study criteria completed the survey. Sixty-six percent of respondents were female, and 75% of respondents were recipients of the Special Supplemental Nutrition Program for Women Infant Children (WIC). Parental mean age was 30.0 years and the mean infant age was 26.8 weeks. In response to the infant formula shortage crisis, parents changed their infant feeding practices, of which several were unsafe. Seventy-nine percent of parents fed their infants U.S. infant formula brands and 39% of parents fed their infants imported infant formula brands before the shortage which were significantly reduced during the shortage to 27% (p < 0.005) and 11% (p < 0.005), respectively. The percentage of parents that reported infant feeding practices before and during the infant formula shortage significantly increased from 2–28% for donor milk use (p < 0.005); 5–26% for use of breast milk from community sharing (p < 0.005); and 2–29% for use of watered-down infant formula (p < 0.005). The resources that parents reported as most helpful in navigating the crisis differed by parental sex and WIC recipient status and included other parents, friends, and family; lactation consultants; healthcare providers; and WIC. Conclusions Our study found that feeding practices in response to the infant formula shortage may pose health risks to infants. These data suggest the need for policy changes within regulatory and the healthcare system to provide families with clinical prenatal and postnatal lactation support, access to donor milk, and access to more commercially-available products.

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“…In a systematic review that did not include Japanese reports, at least 11 studies showed that formula was given to children without being prepared according to the prescribed concentrations [3]. Observational studies on formula feeding have reported the addition of cereal to baby bottles in the USA [4]. Moreover, in Brazil, formulas prepared by parents of lower socioeconomic status contained less protein and fat, suggesting that the prepared formula was diluted more than prescribed (i.e., with lower than prescribed concentrations of the formula) [5].…”

Section: Introductionmentioning

confidence: 99%

Some Japanese mothers do not follow package instructions of infant formula: a web-based analytical cross-sectional study

Endoh

2022

BMC Nutr

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Background: Not following the infant formula package instruction endangers infant health. Although infant formula misuse has been reported abroad, its incidence in Japan remains unknown. Furthermore, it is reasonable to assume that experience in childcare reduces the likelihood of making mistakes in using infant formula. This study aimed to examine the association between compliance with infant formula package instruction and childcare experience in Tokyo and surrounding prefectures in Japan. Methods: Using a web-based questionnaire, mothers with infants were analyzed cross-sectionally and surveyed regarding their infants’ nutrition and formula preparation methods in August 2021. Compliance with the infant formula package was determined according to (a) using unlabeled infant formula, (b) preparing infant formula without reading package instructions, (c) giving formula to children ≥ 2 h after preparing, and (d) adding other ingredients to the formula bottle. The association between the misuse of infant formula and childcare experience was examined by grouping the participants by infant age (< 6 months and ≥ 6 months), and by comparing first-born child status with later-born. Of the 333 mothers with infants, 3 were excluded due to out-of-scope responses, and 330 were included in the analysis. Results: The major sources of information on infant feeding methods among the participants were obstetric facilities (92.1%), internet (36.1%), and family (20.9%). The proportions of participants using infant formulas not labeled as “infant formula,” such as follow-up milk, not preparing at prescribed concentrations, feeding infant formulas > 2 h after preparation, and adding additional ingredients to the bottle were 7.9%, 4.1%, 23.1%, and 15.9%, respectively, which suggest the misuse of infant formula. These four answers did not differ significantly between mothers of children aged < 6 months and ≥ 6 months or between those with first-born and later-born children. Conclusion: This study suggested that some Japanese mothers do not follow package instructions of infant formula in Japan. The misuse of infant formula may not be related to the length of time spent in childcare or the presence or absence of childcare experience. Providing appropriate information on the correct use of infant formula to all caregivers, regardless of their parenting experience, is required.

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Observations and Conversations: Home Preparation of Infant Formula Among a Sample of Low-Income Mothers in the Southeastern US

Abstract: Targeting knowledge or skills gaps and behavioral motivators in the formula-feeding population could positively affect infant-feeding practices that occur outside of recommendations.

Cited by 10 publications

References 16 publications

Influences of Vitamin A on Vaccine Immunogenicity and Efficacy

Influences of Vitamin A on Vaccine Immunogenicity and Efficacy

Infant Feeding Practices and Parental Perceptions during the 2022 United States Infant Formula Shortage Crisis

Some Japanese mothers do not follow package instructions of infant formula: a web-based analytical cross-sectional study

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