Diet Influences the Oral Microbiota of Infants during the First Six Months of Life

Background: Oral microorganisms contribute to oral health and disease, but few have studied how infant feeding methods affect their establishment. Methods: Infant (n = 12) feeding records and tongue and cheek swabs were collected within 48 h of birth, and after 2, 4, and 6 mo. DNA was extracted from samples, bacterial and fungal amplicons were generated and sequenced using Illumina MiSeq, and sequences were analyzed using Quantitative Insights Into Microbial Ecology (QIIME) and Statistical Analysis System (SAS) to evaluate differences over time and among breast-fed, formula-fed, mixed-fed, and solid food-fed infants. Results: Considering all time points, breast milk- and mixed-fed infants had lower oral species richness than solid food-fed infants (p = 0.006). Regardless of feeding mode, species richness was lower at birth than at other time points (p = 0.006). Principal coordinates analysis (PCoA) of unique fraction metric (UniFrac) distances indicated that bacterial communities were impacted by feeding method (p < 0.005). Considering all time points, breast-fed infants had higher Streptococcus, while formula-fed infants had higher Actinomyces and Prevotella. Regardless of feeding mode, Propionibacterium, Porphyromonas, Prevotella, Gemella, Granulicatella, Veillonella, Fusobacterium, Leptotrichia, Neisseria, and Haemophilus increased with age, while Cloacibacterium and Dechloromonas decreased with age. Oral fungi were detected in infants but were not impacted by diet. Conclusions: These findings demonstrate that the establishment of oral bacteria depends on dietary composition and age. More research is necessary to determine whether this affects risk of oral caries and other health outcomes later in life.

Examining Self-Efficacy and Self-Esteem in Healthcare Students Participating in an Interprofessional Critical Care Simulation

BACKGROUND: Interprofessional education (IPE) is becoming increasingly encouraged in healthcare. However, a lack of consensus exists in how IPE should be provided. The research at hand examines changes in self-efficacy and self-esteem in 132 nursing, dietetic, physician assistant, and social work students when participating in a critical care simulation. The simulation focused on a septic patient requiring cardiopulmonary resuscitation.METHOD: This quantitative, repeated measures and correlational study utilized the Generalized Self-Efficacy Scale and Rosenberg Self-Esteem Scale to examine a possible relationship between self-efficacy and self-esteem. In addition, exploration of changes in self-efficacy and self-esteem after participating in the cardiopulmonary simulation was conducted.RESULTS: There was a statistically significant medium, positive correlational relationship between self-efficacy and self-esteem in healthcare students participating in a cardiopulmonary resuscitation simulation (p&lt;0.001). Healthcare students did not experience statistically significant gains in self-efficacy and self-esteem (p&gt;0.05). During debriefing, students expressed experiencing role confusion when working with each other.CONCLUSION: More IPE experiences, including in mock code simulations, is necessary to enhance communication, collaboration, and prevent role confusion.HIGHLIGHTS:More interprofessional education is necessary to prevent role confusionSelf-efficacy and self-esteem have a positive correlation in IPE critical care simulationHealthcare students did not have significant gains in self-efficacy and self-esteem

Comparison of Feeding Practices in Infants in the WIC Supplemental Nutrition Program Who Were Enrolled in Child Care as Opposed to Those with Parent Care Only

BACKGROUND

The environment or setting to which an infant is exposed is crucial to establishing healthy eating habits and to preventing obesity. This study aimed to compare infant feeding practices and complementary food type between parent care (PC) and childcare (CC) settings among infants receiving the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

MATERIALS AND METHODS

This study sampled 105 dyads of mothers and infants between 2 to 8 months of age from a WIC office in Central Illinois. Mothers completed a cross-sectional survey to assess their infant feeding practices and demographic characteristics. CC was defined as infants receiving 10 hours or more per week of care from a nonparental caregiver.

RESULTS

Almost half of the infants (44%) were enrolled in CC. Infants in CC had an average of 29 hours of care per week compared with 0.64 hours in the PC group (p<0.01). There were no differences between the two groups in age, sex, race/ethnicity, preterm birth, and birth weight. Overall, there were no significant differences in breastfeeding initiation and duration. The average age at formula introduction was earlier for PC infants (0.90 ± 1.16 months) than for CC infants (1.66 ± 1.64 months) (p = 0.03). PC infants stopped breastfeeding at 1.96 ± 1.15 months compared with 2.31 ± 1.64 months for CC infants (p = 0.080). Among complementary foods introduced to infants, the primary food type was infant cereal, followed by baby food of fruits and vegetables, 100% fruit juice, and meat-based baby food. The timing of introduction and the types of complementary foods were similar between study groups.

CONCLUSIONS

CC use is not a significant influence on breastfeeding rates, introduction of complementary foods, and types of complementary foods; however, it does influence when formula is introduced. The findings support the need for infant nutrition education and breastfeeding promotion targeting WIC mothers, regardless of their pattern of CC.

Associations of infant feeding practices and picky eating behaviors of preschool children

Picky eating behaviors are prevalent during childhood and are often linked to nutritional problems. However, information on the determinants of picky eating behaviors during infancy, when food acceptance patterns develop, is scarce. This study was conducted to evaluate the impact of infant feeding practices on the development of picky eating behaviors during preschool years. Baseline survey data from the Synergistic Theory and Research on Obesity and Nutrition Group Kids (STRONG Kids) program were used for this retrospective data analysis. Primary caregiver-child dyads were recruited from child-care centers in Eastern Illinois between February and July of 2009. A total of 129 self-reported responses from mothers of preschool-aged children were analyzed. Logistic regression was used to evaluate the association between infant feeding practices and picky eating behaviors. Children who were introduced to complementary foods before 6 months of age had 2.5 times higher odds of developing food neophobia and limited variety of foods (95% confidence interval [CI]: 1.01 to 5.93 and 1.06 to 5.73, respectively). Children who were breastfed exclusively for 6 months had lower odds of developing a preference for specific food-preparation methods by 78% (95% CI: 19% to 94%), food rejection by 81% (95% CI: 31% to 94%), and food neophobia by 75% (95% CI: 11% to 93%). Breastfeeding and introduction of complementary foods after 6 months of age reduced the odds of picky eating during early childhood. This study documents an association between infant-feeding practices and the development of picky eating behaviors in early childhood.

Noninvasive stool-based detection of infant gastrointestinal development using gene expression profiles from exfoliated epithelial cells

We have developed a novel molecular methodology that utilizes stool samples containing intact sloughed epithelial cells to quantify intestinal gene expression profiles in the developing human neonate. Since nutrition exerts a major role in regulating neonatal intestinal development and function, our goal was to identify gene sets (combinations) that are differentially regulated in response to infant feeding. For this purpose, fecal mRNA was isolated from exclusively breast-fed (n = 12) and formula-fed (n = 10) infants at 3 mo of age. Linear discriminant analysis was successfully used to identify the single genes and the two- to three-gene combinations that best distinguish the feeding groups. In addition, putative "master" regulatory genes were identified using coefficient of determination analysis. These results support our premise that mRNA isolated from stool has value in terms of characterizing the epigenetic mechanisms underlying the developmentally regulated transcriptional activation/repression of genes known to modulate gastrointestinal function. As larger data sets become available, this methodology can be extended to validation and, ultimately, identification of the main nutritional components that modulate intestinal maturation and function.