Cholesterol - an essential component of infant milk formulae?

It is recognized that breast milk is the ideal food for newborns. Indeed breast milk can provide basic guidelines to improve the composition of ingredients in adapted infant formulae. One of the main parts of breast milk is milk fat. Although the exact functionality of the entire spectrum of fat is not yet fully understood, it is known that various lipids present in breast milk, can modulate functions of the gastrointestinal tract, the lipoprotein metabolism, the structure and function of cell membranes, as well as many signal pathways in the infant's organism. In this paper we tried to present evidence that dietary cholesterol (CHOL) is a very important component of the infant's nutrition. Meanwhile, almost all infant formulae, both cow and goat milk based, use nearly only vegetable oils as their fat component providing phytosterols, rather than CHOL as in breast milk. It is known that breast milk is a rich source of CHOL and phytosterols cannot perform the functions of CHOL. One can imagine that when the infant is transferred to artificial feeding with such formulae, and denied the opportunity to receive dietary CHOL in any useful amounts, this may affect outcomes like optimal child development, and may have a major long-term 'programming' effect on the metabolism of CHOL. We propose to discuss the thesis of the great importance of the presence of CHOL in infant formulae. The applied value of this thesis is the need to optimize the fat component of breast milk substitutes by introducing CHOL, for example, in the composition of milk fat. Although it is clear that compelling evidence of the potential benefits of adding various sources of CHOL infant formula is insufficient, at this stage, there is cause for a critical discussion and review of the composition of functional components of breast milk substitutes.