During the manufacture of dried milks for infant feeding the composition of cow's milk may be modified by the addition of extra carbohydrate powder to lower the relative proportions of protein and minerals, and in practice various carbohydrates are used in a largely empirical manner. In other circumstances it is known that the quality of dietary carbohydrate affects intestinal tolerance, deposition of body fat (in rats), and concentrations of plasma lipids (in man). Therefore, in this study the effects of feeding newborn infants on added lactose formula and added sucrose formula have been investigated. 29 low birthweight babies were observed throughout the first 3 months of life. The added carbohydrate achieved a satisfactory composition in terms of mineral and protein concentration of the reconstituted milk, but the "added lactose" group experienced more diarrhoea and a greater degree of metabolic acidosis during the first week of life. The added lactose group was slightly fatter and the plasma triglyceride concentration slightly higher than in the "added sucrose" group. Despite teleological evidence in favour of lactose, we found no objective contraindication to the addition of sucrose to cow's milk in the manufacture of infant feeding formulae. Both milks contained only small quantities of linoleic acid and the polyunsaturated fatty acid content of the plasma and adipose tissue lipids fell to low levels, but no clinical evidence of "essential fatty acid deficiency" was found.
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