Growth and Development of Preschool Children (12-60 Months): A Review of the Effect of Dairy Intake

A Longitudinal Study on the Influence of Parental Interaction on Preschool Children's Cognitive Development: A Retrospective Analysis

To investigate the impact of parental interaction on cognitive development in preschool children, a study was conducted involving 198 preschool children selected between June 2021 and January 2022. These children were divided into a control group and an observation group based on their participation in parent-child interaction education. The propensity score matching method was employed to ensure baseline equivalence between the 2 groups. Post-matching, comparisons were made regarding language ability, social communication skills, social life skills, intelligence, and neurodevelopment. No significant differences were observed between the groups at baseline. Following the intervention, the observation group demonstrated significantly higher scores in language ability (P < .05), communication and life skills (P < .05), as well as intelligence and neurodevelopment, compared with the control group (P < .05). These findings suggest that parental interaction interventions can effectively enhance language abilities, social skills, social life skills, intelligence, and neurodevelopment in preschool children, and thus, are recommended for adoption.

Linear Programming Optimization of Local Food-Based Recommendations for Undernourished Urban Poor Malaysian Children Aged 2 to 5 Years

BackgroundPoor diet quality may contribute to undernutrition, particularly affecting young children from low-income households. Therefore, affordable and healthy local food-based recommendations (FBRs) are needed.ObjectivesThis study aimed to (1) identify problem nutrient(s), (2) identify locally available nutrient-dense food sources that can provide adequate nutrients to meet the recommended dietary intakes of undernourished urban poor children aged 2-5 years, and (3) use linear programming to recommend a daily diet based on the current food patterns that achieves dietary adequacy and meets average food costs for these children.MethodsA cross-sectional study was conducted in Seremban, Malaysia. Three-day 24-hour dietary recalls were collected from the mothers (n = 168). Food costs were estimated using market surveys. The FBRs were formulated by linear programming analysis using Optifood software.ResultsFolate was an "absolute problem nutrient" (such a nutrient does not achieve the 100% recommended nutrient intake even upon diet optimization). Full-cream milk, chocolate malted milk, fortified cornflakes, and chicken egg were the common locally available nutrient-dense foods that would provide adequate nutrients to meet the recommended dietary intakes of undernourished urban poor children. The final FBR set would ensure dietary adequacy for 8 to 9 of 11 nutrients at a cost of ringgit Malaysia (RM) 4.80/day (US $1.05/day) and RM6.20/day (US $1.34/day), depending on the age group.ConclusionsInterventions are required to ensure dietary adequacy for undernourished urban poor children under 5 years old. Dietary adequacy could be improved via realistic changes in habitual food consumption practices.

Relationship between dietary intake and growth and development in Chinese pupils

Background

A nutritional diet is essential for children's growth and development. This study aimed to investigate the relationship between dietary intake and growth and development of pupils to provide more specific nutritional recommendations for their healthy growth.

Methods

This cross-sectional study included 592 pupils, and standardized questionnaires were used to collect information on students' sociodemographic characteristics, lifestyle habits and dietary intake. Growth and development assessment indicators were measured according to standard protocols. The multivariate generalized linear regression models adjusted for covariates were used to investigate the association between dietary intake and growth and development of pupils.

Results

The generalized linear regression model showed that standing long jump of all pupils (β = -6.735, 95% CI: -12.064, -1.406) and body fat rate (β = -2.650, 95% CI: -4.794, -0.507), fat weight (β = -1.283, 95% CI: -2.286, -0.280) and chest circumference (β = -1.456, 95% CI: -2.789, -0.123) of boys were negatively correlated with dietary diversity score. Among all pupils, meat intake was positively correlated with chest circumference (β = 0.420, 95% CI: 0.119, 0.721) and negatively correlated with standing long jump(β = -1.991, 95% CI: -3.902, -0.080); milk intake was positively correlated with waist circumference (β = 0.470, 95% CI: 0.007, 0.932); soybean intake was negatively correlated with body fat rate (β = -0.583, 95% CI: -1.125, -0.042), fat weight (β = -0.262, 95% CI: -0.517, -0.006), and waist circumference (β = -0.607, 95% CI: -1.050, -0.164); and vegetable intake was negatively correlated with height (β = -0.290, 95% CI: -0.496, -0.084), and positively correlated with stature-sitting height index and waist circumference (p < 0.05). Certain associations retained significance even after stratified analysis based on gender and frequency of dietary intake.

Conclusion

Dietary diversity score and their respective food groups such as meat, milk, coarse grain, soybean and vegetable will impact growth and development indicators, requiring purposefully controlled dietary intake.

Assessment of Milk and Beverage Intake Trends During Preschool Age and Modeling the Nutritional Impact of Replacing Nondairy Caloric Beverages with Milk

Background

Milk provides essential crucial public health nutrients, including 3-4 nutrients of public health concern, yet dairy consumption has declined over time, leading most Americans to fall short of meeting Dietary Guidelines recommendations.

Objectives

To investigate milk and beverage consumption trends in preschool-age children, along with nutrient intakes from beverages, and to analyze the potential impact of replacing nondairy beverages with milk through isocaloric substitution.

Methods

Data from the National Health and Nutrition Examination Survey 2001-2018 for children aged 1-5 y (n = 4696) were used, and milk and other beverages intakes were estimated from the first 24-h in-person dietary recall. Nutrient intakes were determined using the United States Department of Agriculture's food and nutrient database for dietary studies. Changes in nutrient intakes of children aged 2-5 y were modeled assuming isocaloric substitution with milk of all nondairy beverages consumed during lunch and dinner combined. Sample-weighted analyses were performed using SAS 9.4, and significance was set at P < 0.01.

Results

With the increasing age of children, the intake of milk decreased, whereas the intake of energy, caloric beverages excluding milk, and sugar-sweetened beverages increased. Daily intakes of energy, protein, fat, saturated fatty acids (SFA), calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B-12, and vitamin D from caloric beverages including milk decreased with age, whereas the daily intake of fiber and added sugar increased with age. With the isocaloric replacement of nondairy caloric beverages with milk at lunch and dinner among children aged 2-5 y, intake of protein, fat, SFAs, calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B-12, and vitamin D increased, whereas for intake of carbohydrate, fiber, total sugar, and added sugar decreased.

Conclusions

The current findings indicate that increased efforts are needed to reverse the decrease in milk intake over time and as preschool children age and provide additional evidence to support specific dietary recommendations for milk.

Toxic Elements in Sheep Milk, Whey, and Cheese from the Environmentally Burdened Area in Eastern Slovakia and Health Risk Assessment with Different Scenarios of Their Consumption

The study aimed to determine the content of 17 elements (Al, As, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Pb, Sb, Se, Sr, and Zn) in samples of sheep milk, cheese, and whey (36 samples in total) collected from a farm in an environmentally burdened area due to the long-term mining and industrial activity in Slovakia as well as to determine the possible risk of consumption via health risk assessment calculations. Consumption of 120 g of milk, 500 g of milk, 20 g of cheese, and 100 g of cheese were used in calculations for children and adults, respectively. According to the results, concentrations of four elements are controversial. Lead concentrations in all types of samples exceeded the maximum permissible lead limit in milk set by European Union legislation. The content of Se and As is problematic for children's consumption, and the target hazard quotient for As and Al is higher than one (considered potentially not safe) in all scenarios. According to the target system approach, lead concentrations in milk and cheese could adversely influence the nervous system and kidneys of adults' and children's developmental and reproductive systems. Considering the worst-case scenario, consuming sheep milk and cheese from the monitored areas could represent a risk and be potentially harmful to human health, mainly for children. However, further monitoring of the levels of elements and concentrations in environmentally burdened areas and more robust data on consumption are needed.

A review of dairy food intake for improving health among black infants, toddlers, and young children in the US

Adequate nutrition is paramount for proper growth and musculoskeletal, neurocognitive, and immunological development in infants, toddlers, and young children. Among breastfeeding mother-child dyads, this critical window of development, is impacted by both maternal and offspring dietary patterns. For mothers, their dietary patterns impact not only their own health and well-being, but also the nutrition of their breast milk - which is recommended as the sole source of food for the first 6 months of their infant's life, and as a complementary source of nutrition until at least 2 years of age. For infants and toddlers, the breast milk, formulas, and first foods they consume can have both short-term and long-term effects on their health and well-being - with important impacts on their taste perception, microbiome composition, and immune function. According to dietary intake data in the US, infants and young children meet a greater number of nutrient requirements than older children and adults, yet numerous disparities among socially disadvantaged racial/ethnic groups still provide significant challenges to achieving adequate nutrition during these early life stages. For example, Black children are at greater risk for disparities in breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and obesity relative to most other racial/ethnic groups in the US. For infants who do not receive adequate breast milk, which includes a disproportionate number of Black infants, dairy-based infant formulas are considered the next best option for meeting nutritional needs. Fermented dairy foods (e.g., yogurt, cheese) can serve as ideal first foods for complementary feeding, and cow's milk is recommended for introduction during the transitional feeding period to help meet the nutrient demands during this phase of rapid growth and development. Low dairy intake may put children at risk for multiple nutrient inadequacies and health disparities - some of which may have lifelong consequences on physical and mental health. A burgeoning body of research shows that in addition to breast milk, cow's milk and other dairy foods may play critical roles in supporting physical growth, neurodevelopment, immune function, and a healthy gut microbiome in early life. However, most of this research so far has been conducted in White populations and can only be extrapolated to Black infants, toddlers, and young children. Therefore, to better understand and support the health and development of this population, greater research and education efforts on the role of milk and dairy products are urgently needed. This review presents the current evidence on health disparities faced by Black children in the US from birth to four years of age, and the role that dairy foods can play in supporting the normal growth and development of this vulnerable population.

Longitudinal changes in home food availability and concurrent associations with food and nutrient intake among children at 24-48 months

OBJECTIVES

To describe changes in home food availability during early childhood, including modified, developmentally sensitive obesogenic scores, and to determine whether home food availability is associated with food and nutrient intakes of children concurrently, over time.

DESIGN

Data were drawn from the STRONG Kids 2 longitudinal, birth cohort to achieve the study objectives. Home food availability was assessed with the Home Food Inventory (HFI) and included fifteen food groups (e.g. fruit and vegetables) and three obesogenic scores (one original and two modified). Food and nutrient intakes were measured using the Block FFQ and included twenty-seven food groups and eighteen nutrients (e.g. vitamins A and C, protein). HFI and FFQ were completed by trained researchers or mothers, respectively, at 24, 36 and 48 months. Repeated-measures ANOVA and Spearman's correlations were used to achieve the study objectives.

SETTING

Central Illinois, USA.

PARTICIPANTS

Participants were 468 children at 24, 36 and 48 months of age.

RESULTS

Availability of less nutritious foods and obesogenic foods and beverages increased as children aged, and availability of both nutritious and less nutritious foods were associated with child food and nutrient intake. The three obesogenic scores demonstrated similar, positive associations with the intake of energy, saturated fat, added sugars and kilocalories from sweets.

CONCLUSION

These findings offer novel insight into changes in home food availability and associations with food and nutrient intake during early childhood. Additional attention is needed examining antecedents (e.g. built environments, purchasing behaviours) and consequences (e.g. child diet quality and weight) of home food availability.

Longitudinal changes in home food availability across the first 3 years of life and associations with family context predictors

Background

There is limited research tracking changes in home food availability during the first 3 years of life and whether the family context influences these changes.

Objective

This study examined changes in and predictors of home food availability across the first 3 years of life.

Design

This study utilized longitudinal data from the STRONG Kids2 birth cohort from the target child at 6 weeks to 36 months postpartum.

Participants

Mothers of 468 children were surveyed at 6 weeks, 3, 12, 24, and 36 months postpartum.

Methods

Home observations were completed by trained research assistants to complete the presence of foods in the home. The primary outcomes were the availability of 10 food groups and scores from the Home Food Inventory (HFI), including dairy (regular fat), dairy (reduced fat), processed meats, other meats and non-dairy protein, savory snacks, vegetables, vegetables (no potatoes), and three obesogenic scores. Repeated measures ANOVA were used to examine changes in the HFI food groups and obesogenic scores over time. Multilevel regressions were conducted to examine whether the presence of an older sibling, entry into childcare, and mother's return to full-time work were associated with the HFI.

Results

Significant changes were detected for dairy (regular fat), other meats and non-dairy protein, savory snacks, vegetables, vegetables (no potatoes), and all obesogenic scores across time. A linear trend occurred for most HFI groups, however, the third obesogenic score (without milk and cheese) was highest at 3 months, declined at 12 months, and then slowly increased from 12 to 36 months years. The presence of an older sibling was a consistent predictor of the HFI groups over time. Entry into childcare was only associated with the availability of processed meats.

Conclusion

The availability of food types shift as children age and their dietary needs alter. It is important to consider the whole family context such as the presence of older siblings whose dietary needs may differ from younger children. Future efforts are warranted to consider changes in food availability among diverse samples and different family structures.

Milk-cereal mix supplementation during infancy and impact on neurodevelopmental outcomes at 12 and 24 months of age: a randomised controlled trial in India

Inadequate protein intake and lack of micronutrients may affect neurodevelopment in infants. This randomised controlled trial was conducted to measure the effect of two milk-cereal mixes with modest and high amounts of protein and enriched with multiple micronutrients, given between 6 and 12 months, on cognitive, language, motor and behavioural scores at 12 and 24 months of age, compared with no-supplementation. The two supplements were also compared with each other. The study was conducted in urban Delhi, India, and the infants were randomised in a 1:1:1 ratio to the three study groups. At 12 and 24 months of age, 1134 and 1214 children were available, respectively. At 12 months of age, compared with no-supplement group, an increase in the motor scores (mean difference, MD 1·52, 95 % CI: 0·28, 2·75) and a decrease in the infant temperament scores (MD - 2·76, 95 % CI: -4·23, -1·29) in the modest-protein group was observed. Those in the high-protein group had lower socio-emotional scores (MD - 1·40, 95 % CI: -2·43, -0·37) and higher scores on Infant Temperament Scale (MD 2·05, 95 % CI: 0·62, 3·48) when compared with modest-protein group. At 24 months, no significant differences in any of the neurodevelopment scores between the three study groups was found. In conclusion, supplementation with modest amount of protein and multiple micronutrients may lead to short-term small improvements in motor function and infant temperament. There appears no advantage of supplementing with high protein, rather negative effects on infant behaviour were observed.

Determinants of nutritional status among primary school students in Dilla Town; Application of an ordinal logistic regression model

Background

One of the most frequent reasons for children's poor physical and mental development is malnutrition, becoming a more significant issue in most developing nations, including Ethiopia. Prior research used multiple anthropometric measurements separately to pinpoint undernutrition concerns in children. However, the impact of each explanatory variable on a single response category was not considered in these investigations. This study used a single composite index of anthropometric parameters to identify the factors affecting elementary school students' nutritional condition.

Methods

In Dilla, Ethiopia, 494 primary school students took part in a cross-sectional institutional survey during the 2021 academic year. Principal component analysis was used to create a single composite measure of nutritional status using z-scores for the anthropometric indices of height-for-age and body mass index-for-age. The relative effectiveness of a partial proportional odds model was compared with several other ordinal regression models to identify the important variables for children's nutritional status.

Results

27.94% of primary school students were undernourished (7.29% severely and 20.65% moderately). According to the fitted partial proportional odds model, the mother's education level (secondary or higher) was positively correlated with the nutritional status of primary school students, given that in this case the students ate three or more times per day and had a high dietary diversity score (OR = 5.94; CI: 2.2-16.0). Nevertheless, there was a negative correlation between larger family size (OR = 0.56; CI: 0.32-0.97), unprotected groundwater (OR = 0.76; CI: 0.6-0.96), and severely food insecure households (OR = 0.3; CI: 0.14-0.68).

Conclusion

In Dilla, Ethiopia, undernutrition among primary school students is a serious issue. It is essential to implement nutrition education and school feeding programs, improve drinking water sources, and boost the community's economy to alleviate the problems.

Dairy fortification as a good option for dietary nutrition status improvement of 676 preschool children in China: A simulation study based on a cross-sectional diet survey (2018-2019)

Background

Chinese children are deficient in several essential nutrients due to poor dietary choices. Dairy products are a source of many under-consumed nutrients, but preschool children in China consume dairy products significantly less than the recommended level.

Methods

From the cross-sectional dietary intake survey of infants and young children aged 0-6 years in China (2018-2019), preschool children (age: 3-6 years) (n = 676) were selected. The four-day dietary data (including 2 working days and 2 weekends) collected through an online diary with reference to the food atlas were used for analysis and simulation. In scenario 1, individual intake of liquid milk equivalents was substituted at a corresponding volume by soymilk, cow's milk, or formulated milk powder for preschool children (FMP-PSC). In scenario 2, the amount of cow's milk or FMP-PSC increased to ensure each child's dairy intake reached the recommended amount (350 g/day). In both scenarios, the simulated nutrient intakes and nutritional inadequacy or surplus were compared to the survey's actual baseline data.

Results

It was suggested suggested that replacing dairy foods with FMP-PSC at matching volume is better than replacing them with soymilk or cow's milk to increase the intake of DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₁₂, vitamin C and vitamin D. Moreover, our results suggested that adding FMP-PSC to bring each child's dairy intake to the recommended amount can bring the intakes of dietary fiber, DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₉, vitamin B₁₂, vitamin C and vitamin D more in line with the recommendations when compared with cow's milk.

Conclusion

Accurate nutrition information should be provided to the parents of preschool children so as to guide their scientific consumption of dairy products and the usage and addition of fortified dairy products can be encouraged as needed.

Recognizing the importance of protein quality in an era of food systems transformation

A transformation of current food systems is needed to nourish the growing global population in more sustainable ways. To support this, some are advocating for a shift to plant-based or -exclusive diets. These recommendations – typically borne out of concerns for the environment – often fail to account for unintended nutritional consequences, which could be particularly pronounced for protein intake. While there is enough protein to meet current global needs, the issue of protein quality is often overlooked and oversimplified. High-quality protein, including from animal source foods (ASF), is needed to meet nutritional demands in low- and middle-income countries (LMIC), particularly among vulnerable population groups. In high-income countries (HIC), protein quality is important for at-risk populations who have higher protein requirements and lower energy and/or protein intakes. Further, as the global population increases, driven primarily by population growth in LMIC, it is possible that protein production will need to increase in HIC to support exports to help feed the global population. The global dialogue and resulting dietary recommendations must therefore become more nuanced to consider the interaction between nutritional value and environmental impact to help better reflect trade-offs across multiple domains of sustainability. Nutritional life cycle assessments are one way to help accomplish this nuance and evaluate how all types of food production systems should be refocused to improve their environmental efficiency and nutritional impact.

Association of waist circumference with blood pressure and familial dietary habits in preschool children: a cross-sectional study in northeastern China

Background

Childhood obesity increases the risk of elevated blood pressure (BP) in children. Body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) are traditional obesity indices, but the extent to which these indices are associated with elevated BP in childhood remains debatable. Moreover, the familial dietary environment plays an important role in obesity, so it is necessary to determine the most relevant dietary factors for childhood obesity to prevent elevated BP. Our study aimed to identify the obesity indices that are most closely associated with elevated BP and then to determine the independent familial dietary factors for those obesity indices.

Method

A total of 605 children aged 2 to 6 years, as well as their parents, were involved in this study. The weight, height, WC and BP of the children were measured. Information on familial environments was obtained by questionnaires completed by the parents. BMI, WC and WHtR were standardized into z scores, and categorical variables of these three obesity indices were defined as BMI Category, WC Category and WHtR Category. Logistic regression was used to analyse the associations between all obesity indices and elevated BP. Multivariate linear regression and logistic regression were used to determine the independent factors for obesity indices.

Results

The obesity indices that were most closely associated with elevated BP were WC and WC Category. Parental BMI, birth weight, eating wheat as a staple food, appetite, eating speed, snacking while watching TV, parental encouragement to eat a diverse assortment of foods and drinking milk were independently associated with WC in both males and females. The risk of abdominal obesity increased 1.375 times in males and 1.631 times in females if appetite increased one level. If eating speed increased one level, the risk of abdominal obesity increased 1.165 times in males and 0.905 times in females. Females who drank milk more than 6 times per week had a 0.546 times lower risk of abdominal obesity.

Conclusion

WC was an anthropometric parameter more closely associated with elevated BP. In addition to genetics, some familial dietary factors involving eating preference, eating habits and parental feeding practice were independently associated with WC and abdominal obesity in preschool children.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13052-022-01236-3.

Total dairy consumption in relation to overweight and obesity in children and adolescents: A systematic review and meta-analysis

A systematic review and meta-analysis of cross-sectional and prospective cohort studies was conducted to assess the associations between total dairy consumption and its different subtypes with the prevalence and incidence of overweight, obesity, and overweight/obesity in children and adolescents. A literature search was conducted in Medline through PUBMED and Cochrane Library databases until October 18, 2021. Articles reporting the risk estimates as odd ratios (OR), risk ratios (RR), or hazard ratios and their corresponding 95% confidence interval (CI) for the association between dairy product consumption and the risk of overweight and/or obesity were included. In the meta-analysis from cross-sectional studies, results showed an inverse association between total dairy consumption and obesity prevalence (OR (95% CI): 0.66 (0.48-0.91). No significant associations were found between milk or yogurt and obesity prevalence risk. Regarding prospective studies, total milk consumption was positively associated with overweight prevalence (OR (95% CI): 1.13 (1.01-1.26)) and incidence (RR (95%CI): 1.17 (1.01-1.35)) risk. Evidence from pooled analysis of cross-sectional studies suggested an inverse association between total dairy consumption and obesity. However, there is limited and no conclusive evidence to confirm an inverse relationship from pooled analysis of prospective studies in children and adolescents.

Nutrient and Food Group Intakes among U.S. Children (2-5 Years) Differ by Family Income to Poverty Ratio, NHANES 2011-2018

Family income may influence nutrient and food group intakes among preschool children, thus increasing risk of nutrient deficiencies. This study compared nutrient and food group intakes and diet quality among a U.S. sample of children 2–5 years of age by family income to poverty ratio (PIR) based on National Health and Nutrition Examination Survey (2011–2018) data (n = 2249). Regression analyses were used to compare dietary intakes based on proxy-reported 24-h dietary recalls and Healthy Eating Index-2015 total scores by low PIR versus mid-high PIR levels adjusted for covariates. PIR levels varied by child race/ethnicity and household reference person’s sex, marital status, and education. More than half of the children in the low PIR group (56%) were reported to have received WIC benefits in the past year. Marginally lower calcium (p = 0.008) and lower fiber intakes, lower total HEI-2015 scores, and lower intakes of fruits and whole grain foods (all p < 0.007) were observed among children in low PIR households compared to mid-high PIR households. However, iron intakes were higher (p = 0.0003) among children in low PIR households compared to mid-high PIR households. Lack of other differences in nutrient and food group intakes may be attributable to WIC benefits.

Potential Benefits of Bovine Colostrum in Pediatric Nutrition and Health

Bovine colostrum (BC), the first milk produced from cows after parturition, is increasingly used as a nutritional supplement to promote gut function and health in other species, including humans. The high levels of whey and casein proteins, immunoglobulins (Igs), and other milk bioactives in BC are adapted to meet the needs of newborn calves. However, BC supplementation may improve health outcomes across other species, especially when immune and gut functions are immature in early life. We provide a review of BC composition and its effects in infants and children in health and selected diseases (diarrhea, infection, growth-failure, preterm birth, necrotizing enterocolitis (NEC), short-bowel syndrome, and mucositis). Human trials and animal studies (mainly in piglets) are reviewed to assess the scientific evidence of whether BC is a safe and effective antimicrobial and immunomodulatory nutritional supplement that reduces clinical complications related to preterm birth, infections, and gut disorders. Studies in infants and animals suggest that BC should be supplemented at an optimal age, time, and level to be both safe and effective. Exclusive BC feeding is not recommended for infants because of nutritional imbalances relative to human milk. On the other hand, adverse effects, including allergies and intolerance, appear unlikely when BC is provided as a supplement within normal nutrition guidelines for infants and children. Larger clinical trials in infant populations are needed to provide more evidence of health benefits when patients are supplemented with BC in addition to human milk or formula. Igs and other bioactive factors in BC may work in synergy, making it critical to preserve bioactivity with gentle processing and pasteurization methods. BC has the potential to become a safe and effective nutritional supplement for several pediatric subpopulations.