1. Rapid weight gain in infancy is associated with an increased risk of later obesity^{1,2 & 3}
2. Bottle-fed babies have historically tended to put on more weight in the first year of life than those that are breastfed⁴
3. Current evidence suggests that a slower pattern of growth in infancy could potentially reduce the risk of later obesity⁵
4. New recommended UK-WHO growth standards, based on the growth of predominantly breastfed infants, reflect slower rates of growth⁶

References:
1. Baird J et al. Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ 2005; 331: 929–31.
2. Monteiro POA, Victora CG. Rapid growth in infancy and childhood and obesity in later life a systematic review. Obes Rev 2005; 6: 143–54.
3. Ong KK, Loos RJF. Rapid infancy weight gain and subsequent obesity: systematic reviews and hopeful suggestions. Acta Paediatr 2006; 95: 904-8.
4. Cole TJ et al. Weight reference charts for British long-term breast-fed infants. Acta Paediatr 2002; 91: 1296-300.
5. Joint SACN/RCPCH Expert Group on Growth Standards (2007). Application of WHO Growth Standards in the UK. The Royal College of Paediatrics and Child Health.
6. De Onis M et al. The WHO Multicentre Growth Reference Study; planning study design and methodology. Food Nutr Bull 2004; 25(1):S15-S26

Proteins are found in every cell in the body and perform many different functions that are necessary for life. Proteins, which include enzymes, hormones and antibodies, are important for healthy growth and development,^1,2 immune system development,³ and repair of body tissues.¹ They are particularly important during the first six months of life when infants grow very quickly and⁴ their dietary protein requirements are at their highest.⁵ Infants are totally reliant on milk to supply all their nutritional needs, so it’s important that they receive all the protein they need to grow from the milk they are given.

References:
1. American Academy of Pediatrics. Committee on Nutrition Handbook, Fifth Edition, 2004 p.229.
2. Department of Health (1991). Dietary reference values for food and energy and nutrients. London. HM Stationery Office. Report on Health and Social Subjects. No. 41. p.78-79, p.81.
3. Powanda M, Biesel WR. Symposium: Nutrition and infections prologue and progress since 1968. Metabolic effects of infection on protein and energy status. Journal of Nutrition 2003; 133: 3225-3275.
4. Lawson M. Contemporary aspects of infant feeding. Paediatric Nursing 2007; 19: 39-45.
5. Dupont C. Protein requirements during the first year of life. American Journal of Clinical Nutrition 2003; 77(Suppl.): 1544s-1549s.
 

For a normal infant’s healthy growth and development, breast milk provides all of the protein requirements.¹ Mature breast milk consists on average of 60% whey protein and 40% casein.² Whey proteins are more soluble and relatively easily digested, whereas casein is less soluble and tends to stay longer in the stomach^1,3. Cows’ milk is the primary ingredient of most infant formulas.⁴ It differs significantly from mature breast milk because its protein composition is 80% casein.⁴ When a baby is bottle-fed, it is important that they receive a formula that has been specially modified to contain a whey-dominant protein composition, similar to breast milk.^2,4

References:

1. Lawson M. Contemporary aspects of infant feeding. Paediatric Nursing 2007; 19: 39-45.
2. Fomon SJ. Nutrition of normal infants. St Louis, MO: Mosby; 1993.
3. Billeaud C et al. Gastric emptying in infants with or without gastro-oesophageal reflux according to the type of milk. European Journal of Clinical Nutrition 1990; 44(8): 577-583.
4. Lien EL et al. Growth and safety in term infants fed reduced-protein formula with added bovine alpha-lactalbumin. Journal of Pediatric Gastroenterology and Nutrition 2004; 38:170-176.

Infants are totally reliant on milk to supply all of their nutritional needs during the first few months of life, so the type and amount of protein found in the milk they ingest is vitally important for their healthy growth and development.¹ Protein that the body doesn’t need is not stored, but broken down and excreted by the kidneys. Feeding an infant too much protein results in a higher renal solute load, i.e. an extra burden on the infant’s developing kidneys.^2,3 The quantity and quality of protein intake of an infant may also have an impact upon future health,¹ such as an increased risk of obesity.⁴

It is no coincidence that breast milk contains less protein than cows’ milk.⁵

Breast milk provides all of the protein requirements for a normal infant’s healthy growth and development.

References:

1. Lawson M. Contemporary aspects of infant feeding. Paediatric Nursing 2007; 19: 39-45. 
2. Lien EL. Infant formulas with increased concentrations of alpha-lactalbumin. American Journal of Clinical Nutrition 2003; 77: 1555s-1558s. 
3. Lien EL et al. Growth and safety in term infants fed reduced-protein formula with added bovine alpha-lactalbumin. Journal of Paediatric Gastroenterology and Nutrition 2004; 38:170-176. 
4. Gunther AL et al. Early protein intake and later obesity risk: which protein sources at which time points throughout infancy and childhood are important for body mass index and body fat percentage at 7y of age. American Journal of Clinical Nutrition 2007; 86: 1765-1772.
5. Food Standards Agency (2002). McCance and Widdowsons. The compositions of foods. Sixth summary edition. Cambridge: Royal Society of Chemistry, p.24.
6. Lawson M. Contemporary aspects of infant feeding. Paed Nurs 2007; 19: 39-45.

The protein profile of SMA First Infant Milk has been improved and has undergone a reduction in total protein content from 1.4 g/100 ml to 1.3 g/100 ml.

Cows’ milk proteins include beta-protein^†† (9%) and alpha-protein^† (4%)¹,. Alpha-protein is the predominant protein in breast milk (20-25%)¹, while beta-protein is not normally found in breast milk.

Compared to the other first infant milks on the market, SMA First Infant Milk is the only infant milk to have a significantly higher level of alpha-protein, and a reduced level of beta-protein. As a consequence of the superior protein composition, the essential amino acid profile of SMA First Infant Milk more closely matches that of breast milk⁴ than the other first infant milks on the market.⁵  

In a recent clinical trial, infants fed SMA First Infant Milk had plasma concentrations of essential amino acids similar to breastfed infants.² Unlike any of the competitors, SMA First Infant Milk is supported by new clinical evidence, showing that babies fed the formula gained weight at a rate close to that of breastfed infants.² 

SMA First Infant Milk does not contain added GOS or FOS. However, clinical trials with  SMA First Infant Milk have clearly demonstrated a prebiotic effect: Our studies have shown that infants fed SMA First Infant Milk have lactobacilli and bifidobacteria concentrations similar to those observed in breastfed infants at week 8. ^2,3 These studies have shown better acceptance and gastrointestinal tolerance of formula for infants fed an alpha-protein enriched formula compared to those fed a non alpha-protein enriched formula.^1,2

References:

1. Lien EL et al. Growth and safety in term infants fed reduced-protein formula with added bovine alpha-lactalbumin. Journal of Pediatric Gastroenterology and Nutrition 2004; 38:170-176.
2. Trabulsi J et al. The effect of two different protein concentrations in term infant formula on growth. JPGN 2009; 48 (Suppl. 3): E78. PN1-12.
3. Bettler J, Kullen MJ. Infant formula enriched with α-lactalbumin has a prebiotic effect in healthy term infants. Journal of Paediatric Gastroenterology and Nutrition 2007; 44 (Suppl.1): e197. PN1-11
4. European Commission, Report of the Scientific Committee on food. Revision of Essential Rquirements of Infant Formula and Follow-on Formulae. 2003
5. Heinz Nutritional Handbook, July 2008. Cow & Gate First, Datacard, September 2008. Aptamil First, Datacard, April 2008

^† alpha-lactalbumin
^†† beta-lactoglobulin
 

SMA First Infant Milk is enriched with alpha-protein^† – the predominant whey protein in mature breast milk.^1,2 Whey proteins are more soluble and relatively easily digested compared to casein, which is the predominant protein in cows’ milk. ^3,4 Alpha-protein enrichment benefits babies in several ways. It means SMA First Infant Milk has the closest whey protein composition to mature breast milk² and is tolerated similar to breast milk with fewer feeding related problems compared to typical whey-dominant infant formulae.⁵ SMA First Infant Milk is gentle on a baby’s stomach⁵ and easy to digest.5 It is also kind to kidneys^1,2 and has a prebiotic effect.^6,7

References:

1. Lien EL. Infant formulas with increased concentrations of alpha-lactalbumin. American Journal of Clinical Nutrition 2003; 77: 1555s-1558s.
2. Lien EL et al. Growth and safety in term infants fed reduced-protein formula with added bovine alpha-lactalbumin. Journal of Pediatric Gastroenterology and Nutrition 2004; 38:170-176.
3. Lawson M. Contemporary aspects of infant feeding. Paediatric Nursing 2007; 19: 39-45.
4. Billeaud C et al. Gastric emptying in infants with or without gastro-oesophageal reflux according to the type of milk. European Journal of Clinical Nutrition 1990; 44(8): 577-583.
5. Davis AM et al. α-lactalbumin-rich infant formula fed to healthy term infants in a multicenter study: plasma essential amino acids and gastrointestinal tolerance. European Journal of Clinical Nutrition 2008; 62(11): 1294-1301.
6. Trabulsi J et al. The effect of two different protein concentrations in term infant formula on growth. JPGN 2009; 48(Suppl. 3): E78. PN1-12.
7. Bettler J, Kullen MJ. Infant formula enriched with α-lactalbumin has a prebiotic effect in healthy term infants. Journal of Paediatric Gastroenterology and Nutrition 2007; 44 (Suppl.1): e197. PN1-11.

^† alpha-lactalbumin
^†† beta-lactoglobulin
 

Beta-protein is the principal whey protein in most typical whey-dominant formulae and cows’ milk,¹ but is not typically present in mature breast milk. It is thought that beta-protein is antigenic^2,3 and may contribute to the occurrence of cows’ milk allergy – the most common childhood food allergy affecting 2 - 7% of infants under 1 year old.⁴ Although SMA First Infant Milk has significantly less beta-protein^††1 than Cow & Gate First, Aptamil First and Heinz Nurture Newborn, no research has looked at whether the reduction in beta-protein results in reduced incidence of cows’ milk protein allergy. This is an interesting area for future research.

References:

1. Lien EL et al. Growth and safety in term infants fed reduced-protein formula with added bovine alpha-lactalbumin. Journal of Pediatric Gastroenterology and Nutrition 2004; 38:170-176.
2. Heine WE et al. The importance of α-lactalbumin in infant nutrition. Journal of Nutrition 1991; 121(3): 277-283.
3. Natale M et al. Cow's milk allergens identification by two-dimensional immunoblotting and mass spectrometry. Molecular Nutrition & Food Research 2004; 48(5): 363-369. 
4. Food Standards Agency website: (http://www.eatwell.gov.uk/healthissues/foodintolerance/
   foodintolerancetypes/milkallergy/?lang=en)

^†† beta-lactoglobulin

We have developed a complete SMA First Infant Milk range designed to suit babies and parents’ needs. SMA First Infant Milk is available as cans of powder, ready-to-use cartons or in the SMA First Infant Milk Starter Pack. The Starter Pack contains 100 ml bottles of SMA First Infant Milk with screw-on NUK teats providing 12 complete, ready-to-use hygienic feeding units. With the SMA First Infant Milk Starter Pack, there’s no need to sterilise bottles and make up formula, so it’s a practical solution for new mums or mums who need to bottle-feed away from home. We recommend the SMA First Infant Milk Starter Pack for mums-to-be who are planning to take infant milk with them to hospital.

There may be a period of about 24 hours when a baby is slightly unsettled when switching between new and an old formula. A baby’s bowel habits can change when moving from breast to bottle or changing infant formula. If you need any additional information on our products, please call the SMA Careline on 0800 081 81 80 (UK) or 1800 931 832 (ROI).