Human milk is widely considered to be the ideal feeding
for
newborn infants.
Its composition is thought to have resulted from the effects
of time and evolution on nutritional compromise between mother and infant.
Thousands of years ago antibodies directed at pathogens encountered by the
mother were certainly important for the survival of the infant.
Human milk also contains an incredible array of functional
enzymes, growth factors, gastrointestinal protective factors, functional immune
cells and non-protein nitrogen sources. Changes in composition occurring over
the course of lactation render human milk a remarkably complex infant food.
The ultimate goal of an infant formula manufacturer cannot
possibly be to match this amazing complexity using industrial cow’s milk
preparations. Rather, their goal is to make the second best infant feeding
available by targeting the major differences between human milk and infant
formulas.
Cow’s milk protein-based infant formulas are relied upon to
provide optimal nutritional support for infants that, for a variety of reasons,
cannot be, or are not, breastfed.
Comparatively, limited numbers of infants are fed formulas
based on protein sources other than milk. Yet some of the desirable components
of human milk (pathogenspecific human milk IgA) are either too variable or
costly to be considered for addition to infant formula. Cow’s milk itself does
not match the superb, evolutionary adaptation of human milk to the nutritional needs
of the infant. One of the primary compositional gaps between human milk and
cow’s milk-based infant formula is the difference in whey protein content.
Technical advances in milk protein chemistry have led to a number of solutions
to this ‘deficiency’ in cow’s milk-based infant formula.
The question for the infant formula manufacturer is, to what degree does infant formula need to be humanized? Plausible answers to this question range from humanizing the whey to casein ratio to the use of modified whey proteins to serve a particular, and sometimes critical, function in infants. Examples of the latter are hydrolyzed whey proteins for cow milk protein allergy and increased whey to casein ratio to support favorable metabolic balance in premature infants.
Traditionally, infant
formulas were based on
whey protein is used
worldwide in a variety
Alimentarius Commission guidelines
and development.
The concentration of
whey protein
ranges from 48%
to100% of total protein.
Supplemental whey
protein is also being
There has been an interest in the use of cow’s milk whey protein enriched in alphalactalbumin due to its high concentration in human milk and its beneficial amino acid
profile. In particular, it is hypothesized that an alpha-lactalbumin-enriched whey protein
concentrate would facilitate a very close plasma amino acid profile match for human milk. Alpha -lactalbumin has high concentrations of cystine and unusually high concentrations of tryptophan.
Increased concentrations of alphalactalbumin in protein-reduced cow’s milk-based infant formula elevated plasma tryptophan concentration to the same level seen in breast-fed infants. In these studies,
protein-reduced formulas were fed to enhance the plasma ratio of tryptophan to the other large neutral amino acids as discussed above. Recent technological
advances would likely obviate the
requirement for protein reduction
in order to see breast-fed plasma
concentrations of tryptophan.
While the incidence of allergy to cow’s milk protein is low, the symptoms are severe and in some cases life-threatening. The
symptoms include vomiting, diarrhea, gastrointestinal disturbances, excessive crying, eczema, loss of weight and even anaphylactic shock. Traditionally, formulas made with extensively hydrolyzed casein have been used to manage infants with severe milk protein allergies. In the1990’s, extensively hydrolyzed whey protein formulas have been found to be an effective treatment in infants and children with cow’s
milk allergy. These formulas tend to have significant cost, taste and odor advantages over their casein counterparts. In addition, recent evidence suggests that extensively
hydrolyzed whey protein formulas are an effective means of treating the symptoms of colic in milk-allergic infants.
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