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Sample records for breastfed term infants

  1. The relationship of human milk leptin and macronutrients with gastric emptying in term breastfed infants.

    Science.gov (United States)

    Cannon, Anna M; Gridneva, Zoya; Hepworth, Anna R; Lai, Ching T; Tie, Wan J; Khan, Sadaf; Hartmann, Peter E; Geddes, Donna T

    2017-07-01

    BackgroundInfants breastfed on demand exhibit a variety of feeding patterns and self-regulate their nutrient intake, but factors influencing their gastric emptying (GE) are poorly understood. Despite research into appetite regulation properties of leptin, there is limited information about relationships between human milk leptin and infant GE.MethodsGastric volumes were calculated from ultrasound scans of infants' stomachs (n=20) taken before and after breastfeeding, and then every 12.5 min (median; range: 3-45 min) until the next feed. Skim milk leptin and macronutrient concentrations were measured and doses were calculated.ResultsThe leptin concentration was (mean±SD) 0.51±0.16 ng/ml; the leptin dose was 45.5±20.5 ng per feed. No relationships between both concentration and dose of leptin and time between the feeds (P=0.57; P=1, respectively) or residual stomach volumes before the subsequent feed (P=0.20; P=0.050) were found. Post-feed stomach volumes (GE rate) were not associated with leptin concentration (P=0.77) or dose (P=0.85).ConclusionGE in term breastfed infants was not associated with either skim milk leptin concentration or dose. Further investigation with inclusion of whole-milk leptin and other hormones that affect gastrointestinal activity is warranted.

  2. A prospective study of iron status in exclusively breastfed term infants up to 6 months of age.

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    Raj, Shashi; Faridi, Mma; Rusia, Usha; Singh, Om

    2008-03-01

    Can exclusive breastfeeding until six months of age maintain optimum iron status in term babies? We evaluated iron status of exclusively breastfed term infants in relation to breast milk iron and lactoferrin. In this prospective study in Delhi, India, during the period 2003-2004 normally delivered babies of non-anemic [(Hemoglobin (Hb) = 11 g/dl, n = 68] and anemic (Hb 7 - 10.9 g/dl, n = 61) mothers were followed until 6 months of age. Iron parameters were measured in the cord blood at 14 weeks and 6 months. Breast milk iron and lactoferrin were measured at the same intervals. Iron parameters in babies of both groups were within normal limits at birth, 14 weeks and 6 months. Mean breast milk iron and lactoferrin in non-anemic (day 1: 0.89, 6 months: 0.26 mg/l; day 1: 12.02, 6 months: 5.85 mg/ml) and anemic mothers (day 1: 0.86, 6 months: 0.27 mg/l; day 1: 12.91, 6 months: 6.37 mg/ml) were not different on day one or at other times. No relationship was found between breast milk iron, lactoferrin and iron status of the babies. Exclusively breastfed infants of non-anemic and anemic mothers did not develop iron deficiency or iron deficiency anemia by six months of age.

  3. Early additional food and fluids for healthy breastfed full-term infants.

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    Smith, Hazel A; Becker, Genevieve E

    2016-08-30

    Health organisations recommend exclusive breastfeeding for six months. However, the addition of other fluids or foods before six months is common in many countries. Recently, research has suggested that introducing solid food at around four months of age while the baby continues to breastfeed is more protective against developing food allergies compared to exclusive breastfeeding for six months. Other studies have shown that the risks associated with non-exclusive breastfeeding are dependent on the type of additional food or fluid given. Given this background we felt it was important to update the previous version of this review to incorporate the latest findings from studies examining exclusive compared to non-exclusive breastfeeding. To assess the benefits and harms of additional food or fluid for full-term healthy breastfeeding infants and to examine the timing and type of additional food or fluid. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 March 2016) and reference lists of all relevant retrieved papers. Randomised or quasi-randomised controlled trials in infants under six months of age comparing exclusive breastfeeding versus breastfeeding with any additional food or fluids. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two review authors assessed the quality of the evidence using the GRADE approach. We included 11 trials (2542 randomised infants/mothers). Nine trials (2226 analysed) provided data on outcomes of interest to this review. The variation in outcome measures and time points made it difficult to pool results from trials. Data could only be combined in a meta-analysis for one primary (breastfeeding duration) and one secondary (weight change) outcome. None of the trials reported on physiological jaundice. Infant mortality was only reported in one trial.For the majority of older trials, the description of study methods was inadequate to

  4. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants

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    Zoya Gridneva

    2016-12-01

    Full Text Available Human milk (HM components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE, a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo. Stomach volumes (SV were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001 GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001, and longer GE times (0.24 [0.03, 0.46], p = 0.033. Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023. Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002 and dose (0.02 [0.01, 0.03], p = 0.005, and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003. FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

  5. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants.

    Science.gov (United States)

    Gridneva, Zoya; Kugananthan, Sambavi; Hepworth, Anna R; Tie, Wan J; Lai, Ching T; Ward, Leigh C; Hartmann, Peter E; Geddes, Donna T

    2016-12-28

    Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (-0.07 [-0.10, -0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (-65.89 [-107.13, -2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

  6. Safety and tolerability of Bifidobacterium longum subspecies infantis EVC001 supplementation in healthy term breastfed infants: a phase I clinical trial.

    Science.gov (United States)

    Smilowitz, Jennifer T; Moya, Jackelyn; Breck, Melissa A; Cook, Chelsea; Fineberg, Annette; Angkustsiri, Kathleen; Underwood, Mark A

    2017-05-30

    Historically, bifidobacteria were the dominant intestinal bacteria in breastfed infants. Still abundant in infants in developing nations, levels of intestinal bifidobacteria are low among infants in developed nations. Recent studies have described an intimate relationship between human milk and a specific subspecies of Bifidobacterium, B. longum subsp. infantis (B. infantis), yet supplementation of breastfed, healthy, term infants with this organism, has not been reported. The IMPRINT Study, a Phase I clinical trial, was initiated to determine the safety and tolerability of supplementing breastfed infants with B. infantis (EVC001). Eighty mother-infant dyads were enrolled in either lactation support plus B. infantis supplementation (BiLS) or lactation support alone (LS). Starting with Day 7 postnatal, BiLS infants were fed 1.8-2.8 × 1010 CFU B. infantis EVC001 daily in breast milk for 21 days. Mothers collected fecal samples, filled out health questionnaires, and kept daily logs about their infants' feeding and gastrointestinal symptoms from birth until Day 61 postnatal. Safety and tolerability were determined from maternal reports. There were no differences in the mean gestational age at birth, weight 1 and 2 months postnatal, and breast milk intake between groups. The mean Log10 change in fecal Bifidobacterium from Day 6 to Day 28 was higher (p = 0.0002) for BiLS (6.6 ± 2.8 SD) than for LS infants (3.5 ± 3.5 SD). Daily stool number was higher (p < 0.005) for LS and lower (p < 0.05) for BiLS infants during supplementation than at Baseline. During supplementation, watery stools decreased and soft stools increased by 36% over baseline in BiLS infants (p < 0.05) with no significant changes in stool consistency for the LS infants. None of the safety and tolerability endpoints, including flatulence, bloody stool, body temperature, ratings of gastrointestinal symptoms, use of antibiotics or gas-relieving medications, infant colic, jaundice, number of

  7. Dietary habits of partly breast-fed and completely weaned infants at 9 months of age

    DEFF Research Database (Denmark)

    Gondolf, Ulla Holmboe; Tetens, Inge; Fleischer Michaelsen, Kim

    2012-01-01

    : Healthy term infants (n 312) at 9 months of age (mean 9?1 (SD 0?3) months). Results: The infants partly breast-fed (n 168) at 9 months had significantly lower body weight (P,0?0001), were significantly shorter (P50?0022) and were introduced to complementary foods significantly later (P,0?0001) than...... breast-fed compared with the completely weaned infants. These differences appear to be caused primarily by differences in the type and amount of milk consumed, as the energy derived from sources other than milk was similar except for fatty spread and vegetables as a side dish. Only small differences were...... found for absolute intakes of foods between feeding groups, although fatty spread had significantly higher intake rates and consumption (P50?031) among partly breast-fed compared with completely weaned infants. Conclusions: At 9 months the infants partly breast-fed did not eat a less diversified diet...

  8. Nutritional status of breastfed infants in rural Zambia : comparison of the National Center for Health Statistics growth reference versus the WHO 12-month breastfed pooled data set

    NARCIS (Netherlands)

    Hautvast, J.L.A.; Pandor, A.; Burema, J.; Tolboom, J.J.M.; Chishimba, N.; Monnens, L.A.H.; Staveren, van W.A.

    2000-01-01

    Cross-sectional data for breastfed infants in rural Zambia were used to evaluate the effect of applying two different data sets as a reference, i.e. the WHO 12-month breastfed pooled data set and the National Center for Health Statistics (NCHS) growth reference in terms of prevalence of malnutrition

  9. Oral Microbial Profile Discriminates Breastfed from Formula-Fed Infants

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    Holgerson, Pernilla Lif; Vestman, Nelly Romani; Claesson, Rolf; Öhman, Carina; Domellöf, Magnus; Tanner, Anne CR; Hernell, Olle; Johansson, Ingegerd

    2012-01-01

    Objectives Little is known about the impact of diet on the oral microbiota of infants although diet is known to affect the gut microbiota. The aims of the present study were to compare the oral microbiota in breastfed and formula-fed infants, and investigate growth inhibition of streptococci by infant-isolated lactobacilli. Subjects and Methods 207 mothers consented to participation of their three-month old infants. 146 (70.5%) infants were exclusively and 38 (18.4%) partially breastfed, and 23 (11.1%) were exclusively formula-fed. Saliva from all infants was cultured for Lactobacillus species, with isolate identifications from 21 infants. Lactobacillus isolates were tested for their ability to supress Streptococcus mutans and Streptococcus sanguinis. Oral swabs from 73 infants were analysed by the Human Oral Microbe Identification Microarray (HOMIM) and by q-PCR for Lactobacilius gasseri. Results Lactobacilli were cultured from 27.8% of exclusively and partially breastfed infants, but not from formula-fed infants. The prevalence of 14 HOMIM detected taxa, and total salivary lactobacilli counts differed by feeding method. Multivariate modelling of HOMIM detected bacteria and possible confounders clustered samples from breastfed infants separately from formula-fed infants. The microbiota of breastfed infants differed based on vaginal or C-section delivery. Isolates of Lactobacillus plantarum, L. gasseri and Lactobacillus vaginalis inhibited growth of the cariogenic S. mutans and the commensal S. sanguinis: L. plantarum > L. gasseri > L. vaginalis. Conclusion The microbiota of the mouth differs between breastfed and formula-fed three-month-old infants. Possible mechanisms for microbial differences observed include species suppression by lactobacilli indigenous to breast milk. PMID:22955450

  10. Forensic Investigation of Methadone Concentrations in Deceased Breastfed Infants.

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    Madadi, Parvaz; Kelly, Lauren E; Ross, Colin J; Kepron, Charis; Edwards, James N; Koren, Gideon

    2016-03-01

    There is a paucity of data to aid in assessing whether postmortem methadone findings in breastfed infants are clinically and/or toxicologically significant. Two cases are reported in which methadone was detected in deceased neonates whose mothers were enrolled in methadone maintenance programs and were breastfeeding. In addition to a complete autopsy and toxicological testing for alcohol, prescription medications, and drugs of abuse, pharmacogenetic analysis was performed for variants in genes related to methadone metabolism and response. In both cases, the postmortem methadone concentration measured in neonatal heart blood was higher than the maximum serum methadone concentration reported in living breastfed infants whose mothers were receiving methadone. However, additional analysis of antemortem blood indicated postmortem redistribution of methadone. Pharmacogenetic results were suggestive of a potential predisposition to methadone toxicity based on studies in adults; the significance of these findings in breastfed neonates requires further research. The medical cause of death was unascertained in both cases. © 2015 American Academy of Forensic Sciences.

  11. Impact of maternal fasting during Ramadan on growth parameters of exclusively breastfed infants in Shahroud, 2012

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    Hossein Haratipour

    2013-11-01

    Full Text Available Introduction: There are many advantages in breastfeeding of infants. The impact of fasting of breastfeeding mothers during Ramadan, on their exclusively breastfed infants’ growth, is still unclear. The objective of this study is to determine the impact of maternal Ramadan fasting on growth parameters of exclusively breastfed infants. Methods: This cohort study was conducted on 55 healthy, exclusively breastfed infants, aged 1 to 6 months, during Ramadan and three months after it. 20 infants, whose mothers fasted throughout Ramadan (case group and 35 infants, whose mothers did not fast (control group, were enrolled in the study. All infants underwent periodic physical examinations, twice in Ramadan and 3 times in the first, second and the third months after Ramadan. The data analyses were done using a repeated measure analysis of variance. Statistical significance was defined as PFindings: The average age was 3.43±1.38 months in the case group and 2.31±1.45 months in the control group that presence no significant difference between. From the total number of infants, 23 cases (41.8% were males and the rest were females. All growth parameters increased during the study period (P< 0.05, with the same rate of increase for both groups (P=0.125. Conclusion: Ramadan fasting by breastfeeding mothers did not adversely affect the growth parameters of exclusively breastfed infants in short-term.

  12. Feeding Patterns and Emotional Care in Breastfed Infants

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    Smith, Julie P.; Ellwood, Mark

    2011-01-01

    A number of studies have suggested breastfed infants have improved bonding and attachment or cognitive development outcomes. However, mechanisms by which these differences might develop are poorly understood. We used maternal time use data to examine whether exclusively breastfeeding mothers spend more time in close interactive behaviors with…

  13. Growth patterns of breastfed infants in seven countries.

    Science.gov (United States)

    2000-02-01

    An international effort is underway to develop a new international growth reference for assessing the growth of young children, especially breastfed infants who appear to falter relative to the currently recommended National Center for Health Statistics/World Health Organization reference. While limited data from high socioeconomic status children from different parts of the world suggest that their growth patterns are similar, there is no comprehensive study of breastfed infants. The WHO Multinational Study of Breastfeeding and Lactational Amenorrhea provides bi-weekly weights and 2-4 weekly length measurements on breastfed babies from selected sites in Australia, Chile, China, Guatemala, India, Nigeria and Sweden. Multi-level modelling was used to analyse between-site differences in the growth of approximately 120 infants per site, after adjustment for maternal stature and infant feeding pattern. All mothers were literate and mean educational levels were well above national averages, but the study was not restricted to infants of high socioeconomic status. Maternal education was significantly associated with infant weight only in India. The growth curves of infants from most sites were strikingly similar, but relative to the Australians (the reference category), the Chinese babies were about 3% shorter at 12 mo of age and the Indians up to 15% lighter. The present results suggest that breastfed babies from reasonably well-off families in different continents show very similar growth patterns. However, it is important that the growth of children from South and East Asian populations be rigorously assessed in the process of developing the new international growth reference. This paper discusses the relative importance of environmental versus genetic influences in the growth of young children and illustrates the complexities involved in the analysis of growth data.

  14. Vitamin Status among Breastfed Infants in Bhaktapur, Nepal

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    Ulak, Manjeswori; Chandyo, Ram K.; Thorne-Lyman, Andrew L.; Henjum, Sigrun; Ueland, Per M.; Midttun, Øivind; Shrestha, Prakash S.; Fawzi, Wafaie W.; Graybill, Lauren; Strand, Tor A.

    2016-01-01

    Vitamin deficiencies are known to be common among infants residing in low- and middle-income countries but relatively few studies have assessed several biochemical parameters simultaneously. The objective of the study was to describe the status of vitamins (A, D, E, B6, B12 and folate) in breastfed infants. We measured the plasma concentrations of trans retinol, 25 hydroxy vitamin D, α-tocopherol, pyridoxal 5′-phosphate, cobalamin, folate, methylmalonic acid, homocysteine, hemoglobin and C-reactive protein from 467 randomly selected infants. One in five (22%) was deficient in at least one vitamin. Mean (SD) plasma folate concentration was 73 (35) nmol/L, and no infant in the sample was folate deficient. Vitamin B6 deficiency and vitamin B12 deficiency was found in 22% and 17% of the infants, respectively. Elevated plasma methylmalonic acid or total homocysteine concentration was found in 82% and 62% of infants, respectively. Fifteen percent of infants were vitamin A deficient and 65% were marginally deficient in vitamin A. Fewer than 5% of infants had low plasma vitamin D concentration or vitamin E concentration (α-tocopherol supplementation campaigns and support the expansion of food fortification and dietary diversification programs that target children and women in Nepal. PMID:27005657

  15. Characteristics of allergic colitis in breast-fed infants in the absence of cow's milk allergy.

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    Molnár, Kriszta; Pintér, Petra; Győrffy, Hajnalka; Cseh, Aron; Müller, Katalin Eszter; Arató, András; Veres, Gábor

    2013-06-28

    To investigate the characteristics of mucosal lesions and their relation to laboratory data and long-term follow up in breast-fed infants with allergic colitis. In this study 31 breast-fed infants were prospectively evaluated (mean age, 17.4 wk) whose rectal bleeding had not ceased after a maternal elimination diet for cow's milk. Thirty-four age-matched and breast-fed infants (mean age, 16.9 wk) with no rectal bleeding were enrolled for laboratory testing as controls. Laboratory findings, colonoscopic and histological characteristics were prospectively evaluated in infants with rectal bleeding. Long-term follow-up with different nutritional regimes (L-amino-acid based formula or breastfeeding) was also included. Iron deficiency, peripheral eosinophilia and thrombocytosis were significantly higher in patients with allergic colitis in comparison to controls (8.4 ± 3.2 μmol/L vs 13.7 ± 4.7 μmol/L, P cow's milk allergy exclusion, is generally a benign and probably self-limiting disorder despite marked mucosal abnormality. Formula feeding results in shorter time to cessation of rectal bleeding; however, breast-feeding should not be discouraged in long-lasting hematochezia.

  16. [Historical evolution of utensils used to feed non breastfed infants].

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    Castilho, Silvia Diez; Barros Filho, Antonio de Azevedo; Cocetti, Monize

    2010-06-01

    The objective of this article is to describe the utensils used throughout history to feed non breastfed infants. The method used was article review, reference search on the MEDLINE, LILACS and SciELO databases from 1966 to 2007 and documental analysis based on data from the internet, encyclopedias, art and history books, and museums. Utensils manufactured in a variety of materials and shapes, depending on availability, purchasing power and culture have been used since early history to feed babies who for different reasons were not breastfed. Many objects coexisted at the same time and place, others at distant sites and times. New alternatives have been accepted without evidence to prove or point toward the benefits of the change. Some of these alternatives were adopted again, even if infant mortality was high at the time in which they were used at first. In the beginning of the 20th century, bottles became conic-cylindrical. Technology brought about progress as to improve hygiene and enable contamination control. Glass gave way to plastic, and rubber nipples to silicone ones, but the bottle as we know it today is still the same of a 100 years ago.

  17. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy

    National Research Council Canada - National Science Library

    Guez, Sophie; Chiarelli, Gabriella; Menni, Francesca; Salera, Simona; Principi, Nicola; Esposito, Susanna

    2012-01-01

    .... An exclusively breastfed 5-month-old Italian male infant, who was born after a normal full-term pregnancy to a vegan mother who was apparently daily treated with a multivitamin oral preparation...

  18. Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

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    M.K. Çaglar

    2006-04-01

    Full Text Available Data were prospectively obtained from exclusively breast-fed healthy term neonates at birth and from healthy mothers with no obstetric complication to determine risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Thirty-four neonates with a weight loss > or = 10% were diagnosed between April 2001 and January 2005. Six of 18 infants who were eligible for the study had hypernatremia. Breast conditions associated with breast-feeding difficulties (P < 0.05, primiparity (P < 0.005, less than four stools (P < 0.001, pink diaper (P < 0.001, delay at initiation of first breast giving (P < 0.01, birth by cesarean section (P < 0.05, extra heater usage (P < 0.005, extra heater usage among mothers who had appropriate conditions associated with breast-feeding (P < 0.001, mean weight loss in neonates with pink diaper (P < 0.05, mean uric acid concentration in neonates with pink diaper (P < 0.0001, fever in hypernatremic neonates (P < 0.02, and the correlation of weight loss with both serum sodium and uric acid concentrations (P < 0.02 were determined. Excessive weight loss occurs in exclusively breast-fed infants and can be complicated by hypernatremia and other morbidities. Prompt initiation of breast-feeding after delivery and prompt intervention if problems occur with breast-feeding, in particular poor breast attachment, breast engorgement, delayed breast milk "coming in", and nipple problems will help promote successful breast-feeding. Careful follow-up of breast-feeding dyads after discharge from hospital, especially regarding infant weight, is important to help detect inadequate breast-feeding. Environmental factors such as heaters may exacerbate infant dehydration.

  19. Breast Milk Iodine and Iodine Status of Breast-Fed Infants

    OpenAIRE

    Golam Morshed Molla; M Iqbal Arslan; Mafruha Tazkin Milky

    2015-01-01

    Background: Breast milk is the only source of iodine for exclusively breast-fed infants. Iodine status of breast-fed infants depends on iodine in breast milk and also number of feeding in 24 hours. Iodine deficiency and iodine excess both have bad impact on infant’s health. Objective: To measure the iodine in breast milk and to evaluate iodine status of their breast-fed infants. Materials and method: This observational analytical study was carried out in the department of Bioch...

  20. Comparison of Fecal Calprotectin in Exclusively Breastfed and Formula or Mixed Fed Infants in the First Six Months of Life

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    Masoumeh Asgarshirazi

    2017-02-01

    Full Text Available We conducted this study to compare fecal calprotectin between exclusively breastfed and formula or mixed fed infants aged one month and six months. Sixty term infants were enrolled from the labor ward of Valiasr Hospital between Oct 2011 and July 2015 and their fecal calprotectin was checked by the ELISA method and Hycult biotech kits. The enrolled infants had a birth weight of 2500-4000 g and no perinatal insults or hospitalization. Stool sampling was done at 1±1 week and at 6n±1 months. The six-month infants had no recent disease, antibiotic use or vaccination. The mean fecal calprotectin was higher in exclusively breastfed infants at first and sixth months than formula and mixed fed infants (368.85±204.49 and 283.21±381.41 µg/g versus 152.59±139.13 and 113.62±92.75 µg/g respectively. (P=0.0001 and 0.018 Fecal calprotectin was higher in infants with GERD than healthy babies in the first and sixth months (P=0.0001 and 0.004. Based on the role of calprotectin in inflammation, its higher levels in exclusively breastfed infants is contrary to breast milk benefits and may be a sign of enhanced mucosal immune maturity in them.

  1. Increased kidney growth in formula-fed versus breast-fed healthy infants

    DEFF Research Database (Denmark)

    Schmidt, Ida M; Damgaard, Ida N; Boisen, Kirsten A

    2004-01-01

    versus breast feeding on kidney growth in a cohort of 631 healthy children examined at birth, and at 3 and 18 months of age. Kidney size was determined by ultrasonography and related to gender, age, body size, and feeding category (fully breast fed, partially breast fed, or fully formula fed at 3 months......A high protein intake results in increased kidney growth and glomerular filtration rate in human adults and young rats. It is unknown whether kidney size in young infants is influenced by increased protein intake in formula-fed compared with breast-fed infants. We investigated the effect of formula...... in relative kidney size were temporary, as they did not persist at 18 months of age, when all children received a normal mixed diet. The immediate renal effects of formula feeding should be taken into consideration for recommendations concerning infant feeding. Whether there are any long-term effects of early...

  2. Staphylococcus epidermidis: A differential trait of the fecal microbiota of breast-fed infants

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    Fernández Leonides

    2008-09-01

    Full Text Available Abstract Background Breast milk is an important source of staphylococci and other bacterial groups to the infant gut. The objective of this work was to analyse the bacterial diversity in feces of breast-fed infants and to compare it with that of formula-fed ones. A total of 23 women and their respective infants (16 breast-fed and 7 formula-fed participated in the study. The 16 women and their infants provided a sample of breast milk and feces, respectively, at days 7, 14, and 35. The samples were plated onto different culture media. Staphylococcal and enterococcal isolates were submitted to genetic profiling and to a characterization scheme, including detection of potential virulence traits and sensitivity to antibiotics. Results The feeding practice had a significant effect on bacterial counts. A total of 1,210 isolates (489 from milk, 531 from breast-fed and 190 from formula-fed infants were identified. Staphylococcus epidermidis was the predominant species in milk and feces of breast-fed infants while it was less prevalent in those of formula fed-infants. Enterococcus faecalis was the second predominant bacterial species among the fecal samples provided by the breast-fed infants but it was also present in all the samples from the formula-fed ones. The biofilm-related icaD gene and the mecA gene were only detected in a low number of the S. epidermidis strains. Several enterococcal isolates were also characterized and none of them contained the cylA or the vanABDEG antibiotic-resistance genes. All were sensitive to vancomycin. Conclusion The presence of S. epidermidis is a differential trait of the fecal microbiota of breast-fed infants. Globally, the staphyloccal isolates obtained from milk and feces of breast-fed infants contain a low number of virulence determinants and are sensitive to most of the antibiotics tested.

  3. Anemia in low-income exclusively breastfed infants.

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    Torres, Marco Antonio A; Braga, Josefina A P; Taddei, José Augusto A C; Nóbrega, Fernando J

    2006-01-01

    To verify the behavior of hemoglobin levels and anemia prevalence in full term infants, aged 3 to 6 months and on exclusive breastfeeding. A cross-sectional study of 242 infants aged 3 to 6 months with birth weights of more than 2,500 g, on exclusive breastfeeding and monitored by the Program for the Promotion of Infant Growth and Development, part of the Paraisópolis Einstein Community Program. Hemoglobin was assayed by finger prick between the third and sixth months of life. Anemia was defined as Hb aged 3 to 5 months and as Hb aged 6 months. Mean hemoglobin concentration was 11.3 and 11.4 g/dL at 3 and 4 months and 11.2 and 11.1 g/dL at 5 and 6 months, respectively. The percentage of anemic infants varied depending on age and the cutoff adopted, being 11.8, 10.2 and 8.3% at 3, 4 and 5 months, respectively, according to the Brault-Dubuc criteria, and 20.6, 14.8 and 10.4% by the Saarinen criteria. Anemia prevalence at 6 months was 37.5%. Anemia prevalence rates observed among infants aged between 3 and 6 months varied from 8.3 to 37.5%, justifying increased attention on the part of pediatricians to the hemoglobin levels of infants who are on exclusive breastfeeding, come from low-income families and present risk factors for iron deficiency.

  4. Is the Macronutrient Intake of Formula-Fed Infants Greater Than Breast-Fed Infants in Early Infancy?

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    Shelly N. Hester

    2012-01-01

    Full Text Available Faster weight gain early in infancy may contribute to a greater risk of later obesity in formula-fed compared to breast-fed infants. One potential explanation for the difference in weight gain is higher macronutrient intake in formula-fed infants during the first weeks of life. A systematic review was conducted using Medline to assess the macronutrient and energy content plus volume of intake in breast-fed and formula-fed infants in early infancy. All studies from healthy, term, singleton infants reporting values for the composition of breast milk during the first month of life were included. The energy content of colostrum (mean, SEM: 53.6±2.5 kcal/100 mL, transitional milk (57.7±4.2 kcal/100 mL, and mature milk (65.2±1.1 kcal/100 mL was lower than conventional infant formula (67 kcal/100 mL on all days analyzed. The protein concentration of colostrum (2.5±0.2 g/100 mL and transitional milk (1.7±0.1 g/100 mL was higher than formula (1.4 g/100 mL, while the protein content of mature milk (1.3±0.1 g/100 mL was slightly lower. Formula-fed infants consume a higher volume and more energy dense milk in early life leading to faster growth which could potentially program a greater risk of long-term obesity.

  5. Nutritional status of vitamin D and the effect of vitamin D supplementation in Korean breast-fed infants.

    Science.gov (United States)

    Kim, Mi-Jung; Na, Bomi; No, So-Jung; Han, Heon-Seok; Jeong, Eun-Hwan; Lee, Wonkuk; Han, Younghee; Hyeun, Taisun

    2010-01-01

    We investigated the vitamin D status and the effect of vitamin D supplementation in Korean breast-fed infants. The healthy term newborns were divided into 3 groups; A, formula-fed; B, breast-fed only; S, breast-fed with vitamin D supplementation. We measured serum concentrations of vitamin D (25OHD3), calcium (Ca), phosphorus (P), alkaline phosphatase (AP), intact parathyroid hormone (iPTH) and bone mineral density (BMD) at 6 and 12 months of age. Using questionnaires, average duration of sun-light exposure and dietary intake of vitamin D, Ca and P were obtained. At 6 and 12 months of age, 25OHD3 was significantly higher in group S than in group B (Pvitamin D supplementation, BMD was lower in group B and S than in group A (Pvitamin D differed among 3 groups (PS>B), but total intake of Ca and P were higher in group A than in group B and S (Pvitamin D status and bone mineralization than formula-fed infants. Vitamin D supplementation (200 IU/day) in breast-fed infants increases serum 25-OH vitamin D(3), but not bone mineral density.

  6. Establishing causality of CNS depression in breastfed infants following maternal codeine use.

    Science.gov (United States)

    Madadi, Parvaz; Shirazi, Farshad; Walter, Frank G; Koren, Gideon

    2008-01-01

    We recently reported on a breastfed infant who succumbed to opioid toxicity following exposure to morphine, the active metabolite of codeine, which was prescribed to his mother who was a cytochrome P450 2D6 (CYP2D6) ultrarapid metabolizer. This report is believed to be the first case of neonatal fatality as a direct result of maternal drug excretion into breast milk and, therefore, it is critical to corroborate the causative relationship between maternal codeine use during breastfeeding and neonatal opioid toxicity with other existing evidence. To establish whether maternal use of codeine can be a cause of CNS depression in breastfed infants. A systematic review of the medical literature using several databases was conducted. The Naranjo Adverse Drug Reaction Probability Scale (NADRPS) was used to examine causality. In addition to our case report, three abstracts and two full-length studies reported adverse drug reactions (ADRs) in infants exposed to codeine in breast milk. In total, 35 infants were identified. Specifically, ADRs were described as unexplained episodes of drowsiness, apnea, bradycardia, and cyanosis in suckling infants. Using the NADRPS, codeine was found to be a definite cause of CNS depression in breastfed infants. The use of codeine by breastfeeding mothers can cause adverse CNS events in breastfed infants. Physicians should recognize codeine use during breastfeeding as a cause of CNS depression in infants, and breastfeeding mothers should be educated on these adverse events before receiving codeine.

  7. No difference in urinary iodine concentrations between Boston-area breastfed and formula-fed infants.

    Science.gov (United States)

    Gordon, Joshua H; Leung, Angela M; Hale, Andrea R; Pearce, Elizabeth N; Braverman, Lewis E; He, Xuemei; Belfort, Mandy B; Nelson, Sara M; Brown, Rosalind S

    2014-08-01

    Thyroid hormone is essential for normal mental and physical development in infancy and childhood and is dependent on adequate iodine intake. During the first few months of life, infants are reliant on breastmilk and/or infant formula as their sole sources of dietary iodine. The iodine status of U.S. infants has not been well studied. This was a cross-sectional study of 95 breastfed and/or formula-fed infants less than 3 months of age in the Boston area. We measured iodine content from infants' single spot urine samples and assessed associations with infant feeding type as well as maternal demographic data, salt and multivitamin use, smoking status, and diet. The median infant urine iodine concentration was 197.5 μg/L (range 40-897.5 μg/L). Median infant urine iodine concentrations were similar between infants who were exclusively breastfed (n=39, 203.5 μg/L; range 61.5-395.5 μg/L), formula-fed (n=44, 182.5 μg/L; range 40-897.5 μg/L), and mixed (n=10, 197.8 μg/L; range 123-592.5) (p=0.88). There were no significant correlations of infant urinary iodine with maternal salt or multivitamin use (regularly or in the past 24 hours), active or secondhand cigarette smoke exposures, infant weight, infant length, or recent maternal ingestion of common iodine-containing foods, although the correlations with iodine-containing foods are difficult to accurately determine due to the small sample sizes of these variables. Both breastfed and formula-fed infants less than 3 months of age in the Boston area were generally iodine sufficient. Larger studies are needed to confirm these observations among infants nationwide and elucidate other factors that may contribute to infant iodine nutrition.

  8. The first model of keeping energy balance and optimal psycho affective development: Breastfed infants.

    Science.gov (United States)

    Agostoni, Carlo; Mazzocchi, Alessandra; Leone, Ludovica; Ciappolino, Valentina; Delvecchio, Giuseppe; Altamura, Carlo A; Brambilla, Paolo

    2017-12-15

    Breastfed infants follow a peculiar growth fashion characterized by a rapid weight gain in the first weeks of life, then followed by a fast decrease in growth rates, a capacity to self-regulate the sense of hungry and satiety, and a minor propensity towards overweight and obesity later on, in parallel with a better neurodevelopmental performance. We searched studies investigating the relationship between the feeding mode in infancy and the energy balance, so the possible associations with total energy expenditure and intake regulation. We focused the research on the interaction with the neuropsychological development and the possible role of microbiome in determinating the normal generation and regular functioning of the brain through the so named "gut-brain axis". Total energy expenditure (TEE) is different for breast-fed and formula-fed infants, in particular the feeding mode seems to affect the sleep organisation. Long-term breastfeeding, is one of the most studied factors of neurodevelopment, several studies reporting beneficial effects on child neuropsychological development. Probably this effect is modulated by genetic variations in fatty acid metabolism. Increasing data also showed that the intestinal microbiome exerts several functions which are able to influence neurodevelopment. There is considerable controversy over whether nutrition in early life has a long-term influence on neurodevelopment. Other studies are needed to confirm the association between breastfeeding and brain development. The key points of energy disposal, the role and effects of the instestinal flora represent promising fields of investigation possibly leading to indications for the wide area of preventive medicine. Copyright © 2017. Published by Elsevier B.V.

  9. Effect of breast-feeding frequency on hyperbilirubinemia in breast-fed term neonate.

    Science.gov (United States)

    Chen, Ying-Juang; Yeh, Tsu-Fu; Chen, Chung-Ming

    2015-12-01

    Hyperbilirubinemic neonates have significantly less bodyweight gain from nursery discharge to outpatient department (OPD) follow up. We tested the hypothesis that discharge instructions encouraging frequent breast-feeding given in the nursery would increase infant bodyweight gain and decrease the incidence of hyperbilirubinemia. We enrolled consecutively live-born neonates who were discharged from the nursery and who received OPD follow up within the first 2 weeks of birth in 2011. The nursing staff discussed the discharge instructions with the parents at the time of nursery discharge. Parents were asked to fill in a nursing information form to record the frequency of breast-feeding and diaper change per day. Parents of 98 breast-fed term neonates provided complete nursing information forms. These 98 neonates were classified into two groups according to breast-feeding frequency, namely breast-feeding frequency and diaper change frequency per day indicated that the data were highly reliable. The gestational age, Apgar score, birthweight, and bodyweight at nursery discharge and at OPD were similar between the two groups. Neonates who were breast-fed ≥8 times/day had a significantly lower incidence of hyperbilirubinemia. Nursery discharge instructions that encouraged mothers to breast-feed their newborns frequently decreased the rate of hyperbilirubinemia in exclusively breast-fed term neonates. © 2015 Japan Pediatric Society.

  10. Ontogenesis of the Gut Microbiota Composition in Healthy, Full-Term, Vaginally Born and Breast-Fed Infants over the First 3 Years of Life: A Quantitative Bird's-Eye View.

    Science.gov (United States)

    Nagpal, Ravinder; Tsuji, Hirokazu; Takahashi, Takuya; Nomoto, Koji; Kawashima, Kazunari; Nagata, Satoru; Yamashiro, Yuichiro

    2017-01-01

    Early-life intestinal microbiota development is crucial for host's long-term health and is influenced by many factors including gestational age, birth and feeding modes, birth environment, ethnic/geographical background, etc. However, 'quantitative' data on the actual population levels of gut bacterial communities when these influences are controlled for is relatively rare. Herein, we demonstrate a quantitative perspective of microbiota development in natural and healthy milieus, i.e., in healthy, full-term, vaginally born and breast-fed infants ( n = 19) born at same clinic. Fecal microbiota at age 1 and 7 days, 1, 3, and 6 months and 3 years is quantified using highly sensitive reverse-transcription-quantitative-PCR assays targeting bacterial rRNA molecules. At day 1, we detect one or more bacteria in all (100%) of the babies, wherein the microbiota is composed mainly of enterobacteria (35%), Bacteroides fragilis group (23%), enterococci (18%), staphylococci (13%), and bifidobacteria (9%). Altogether, facultative anaerobes predominate during first few weeks whereafter obligate anaerobes including bifidobacteria, B. fragilis group, Clostridium coccoides group, and Clostridium leptum subgroup gradually start prevailing. At 3 years, the composition is represented almost entirely (99%) by obligate anaerobes including C. leptum subgroup (34%), bifidobacteria (22%), B. fragilis group (21%), C. coccoides group (17%), Atopobium cluster (4%), and Prevotella (1%). The overall obligate/facultative proportion is 32/68, 37/63, 54/46, 70/30, 64/36, and 99/1% at 1 and 7 days, 1, 3, and 6 months and 3 years, respectively. However, interestingly, considerable individual-specific variations in the obligate/facultative ratios as well as in the proportions of Firmicutes, Bacteroides, Actinobacteria, and Proteobacteria communities are seen among these babies. This disparity even within this highly homogenous cohort manifests the magnitude of diverse patterns of gut microbiota

  11. Breast Milk Iodine and Iodine Status of Breast-Fed Infants

    Directory of Open Access Journals (Sweden)

    Golam Morshed Molla

    2015-07-01

    Full Text Available Background: Breast milk is the only source of iodine for exclusively breast-fed infants. Iodine status of breast-fed infants depends on iodine in breast milk and also number of feeding in 24 hours. Iodine deficiency and iodine excess both have bad impact on infant’s health. Objective: To measure the iodine in breast milk and to evaluate iodine status of their breast-fed infants. Materials and method: This observational analytical study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka with active cooperation of Kumudini Women’s Medical College Hospital, Mirzapur, Tangail involving fifty lactating mothers and their exclusively breast-fed infants. Early morning urine and breast milk samples were collected in dry and clean plastic container free from any chemical contamination. Urinary iodine was used as indicator for assessing iodine status. All statistical analyses were done by using SPSS (statistical programme for social science 12 version software package for Windows. Results: The median (range urinary iodine concentration of lactating mothers and their breast-fed infants were 225.25 μg/L (61.50-530.00 and 225.75 μg/L (100.50-526.00 respectively. The median (range breast-milk iodine concentration was 157 μg/L (54.50-431.50 which was more than three times of recommended minimum concentration (50 μg/L. Only 2 (4% lactating mothers had mild biochemical iodine deficiency (UIE, 50-99 μg/L. There was no biochemical iodine deficiency of breast-fed infants. Iodine in breast milk of lactating mothers was positively correlated with their urinary iodine excretion (p<0.01. Infant’s urinary iodine was positively correlated with iodine concentration in breast milk (p<0.01 and with urinary iodine of lactating mothers (p<0.01. Conclusion: Lactating mothers and their breast-fed infants in this study were iodine sufficient. If iodine content of breast-milk is within normal range, 10-12 numbers of

  12. Characterization and in vitro properties of oral lactobacilli in breastfed infants

    Science.gov (United States)

    2013-01-01

    Background Lactobacillus species can contribute positively to general and oral health and are frequently acquired by breastfeeding in infancy. The present study aimed to identify oral lactobacilli in breast and formula-fed 4 month-old infants and to evaluate potential probiotic properties of the dominant Lactobacillus species detected. Saliva and oral swab samples were collected from 133 infants who were enrolled in a longitudinal study (n=240) examining the effect of a new infant formula on child growth and development. Saliva was cultured and Lactobacillus isolates were identified from 16S rRNA gene sequences. Five L. gasseri isolates that differed in 16S rRNA sequence were tested for their ability to inhibit growth of selected oral bacteria and for adhesion to oral tissues. Oral swab samples were analyzed by qPCR for Lactobacillus gasseri. Results 43 (32.3%) infants were breastfed and 90 (67.7%) were formula-fed with either a standard formula (43 out of 90) or formula supplemented with a milk fat globule membrane (MFGM) fraction (47 out of 90). Lactobacilli were cultured from saliva of 34.1% breastfed infants, but only in 4.7% of the standard and 9.3% of the MFGM supplemented formula-fed infants. L. gasseri was the most prevalent (88% of Lactobacillus positive infants) of six Lactobacillus species detected. L. gasseri isolates inhibited Streptococcus mutans binding to saliva-coated hydroxyapatite, and inhibited growth of S. mutans, Streptococcus sobrinus, Actinomyces naeslundii, Actinomyces oris, Candida albicans and Fusobacterium nucleatum in a concentration dependent fashion. L. gasseri isolates bound to parotid and submandibular saliva, salivary gp340 and MUC7, and purified MFGM, and adhered to epithelial cells. L. gasseri was detected by qPCR in 29.7% of the oral swabs. Breastfed infants had significantly higher mean DNA levels of L. gasseri (2.14 pg/uL) than infants fed the standard (0.363 pg/uL) or MFGM (0.697 pg/uL) formula. Conclusions Lactobacilli

  13. [Aortic and cerebral trombosis caused by hypernatremic dehydration in an exclusively breast-fed infant].

    Science.gov (United States)

    Iglesias Fernández, C; Chimenti Camacho, P; Vázquez López, P; Guerrero Soler, M; Blanco Bravo, D

    2006-10-01

    Complete aortic thrombosis is rare in neonates. Because it carries high morbidity and mortality, this entity requires aggressive and early treatment. This report describes an 8-day-old healthy and exclusively breast-fed infant, without specific coagulopathy, who developed complete aortic and cerebral venous thrombosis, which was attributed to inadequate breast-feeding and severe hypernatremic dehydration. Early systemic anticoagulation and thrombolytic therapy allowed complete resolution of the problem.

  14. In Vitro Fermentation of caprine milk oligosaccharides by bifidobacteria isolated from breast-fed infants

    OpenAIRE

    Thum, Caroline; Roy, Nicole C; McNabb, Warren C; Otter, Don E; Cookson, Adrian L

    2015-01-01

    This study was conducted to investigate the catabolism and fermentation of caprine milk oligosaccharides (CMO) by selected bifidobacteria isolated from 4 breast-fed infants. Seventeen bifidobacterial isolates consisting of 3 different species (Bifidobacterium breve, Bifidobacterium longum subsp. longum and Bifidobacterium bifidum) were investigated. A CMO-enriched fraction (CMOF) (50% oligosaccharides, 10% galacto-oligosaccharides (GOS), 20% lactose, 10% glucose and 10% galactose) from caprin...

  15. [Severe vitamin B12 deficiency in infants breastfed by vegans].

    Science.gov (United States)

    Roed, Casper; Skovby, Flemming; Lund, Allan Meldgaard

    2009-10-19

    Weight loss and reduction of motor skills resulted in paediatric evaluation of a 10-month-old girl and a 12-month-old boy. Both children suffered form anaemia and delayed development due to vitamin B12 deficiency caused by strict maternal vegan diet during pregnancy and nursing. Therapy with cyanocobalamin was instituted with remission of symptoms. Since infants risk irreversible neurologic damage following severe vitamin B12 deficiency, early diagnosis and treatment are mandatory. Vegan and vegetarian women should take vitamin B12 supplementation during the pregnancy and nursing period.

  16. Aggravation of atopic dermatitis in breast-fed infants by tree nut-related foods and fermented foods in breast milk.

    Science.gov (United States)

    Uenishi, Toshiaki; Sugiura, Hisashi; Tanaka, Toshihiro; Uehara, Masami

    2011-02-01

    Ninety-two exclusively breast-fed Japanese infants with atopic dermatitis were studied to see whether tree nut-related foods (chocolate and coffee) and fermented foods (cheese, yogurt, bread, soy sauce, miso soup and fermented soy beans) eaten by their mothers affected their skin condition. Of the 92 infants, 67 (73%) showed improvement of skin lesions when their mothers avoided these foods and showed aggravation of skin lesions when these foods were reintroduced. The predominant offending foods were chocolate, yogurt, soy sauce and miso soup. A long-term maternal exclusion of the trigger foods brought about progressive improvement of skin lesions in the majority of the infants. These findings suggest that tree nut-related foods and fermented foods are important offending foods of atopic dermatitis in breast-fed infants. © 2010 Japanese Dermatological Association.

  17. Water requirements of breast-fed infants in a hot climate.

    Science.gov (United States)

    Almroth, S G

    1978-07-01

    To estimate the water requirements of exclusively breast-fed infants in a hot climate, theoretical calculations of water requirements were made and a field study was carried out in Jamaica. Three urine samples were collected from each of 16 infants. The specific gravity of individual urine samples ranged from 1.005 through 1.015, with a mean of 1.009 (SD +/- 0.002). Corresponding values for osmolality were calculated to be 103 through 468 mOsmole/liter with a mean of 258 mOsmole/liter. The mean specific gravity for an infant ranged from 1.006 through 1.012, or 139 through 358 mOsmole/liter. The mean outdoor temperature was 27.6 C and the humidity 76%. Because the values for specific gravity were universally low it was concluded that healthy, exclusively breast-fed infants living in a hot humid climate will manage well without additional water. Additional water may be desirable during illness.

  18. Fecal microbiota composition of breast-fed infants is correlated with human milk oligosaccharides consumed.

    Science.gov (United States)

    Wang, Mei; Li, Min; Wu, Shuai; Lebrilla, Carlito B; Chapkin, Robert S; Ivanov, Ivan; Donovan, Sharon M

    2015-06-01

    This study tested the hypothesis that the fecal bacterial genera of breast-fed (BF) and formula-fed (FF) infants differ and that human milk oligosaccharides (HMOs) modulate the microbiota of BF infants. Fecal samples were obtained from BF (n = 16) or FF (n = 6) infants at 3-month postpartum. Human milk samples were collected on the same day when feces were collected. The microbiota was assessed by pyrosequencing of bacterial 16S ribosomal RNA genes. HMOs were measured by high-performance liquid chromatography-chip time-of-flight mass spectrometry. The overall microbiota of BF differed from that of FF (P = 0.005). Compared with FF, BF had higher relative abundances of Bacteroides, lower proportions of Clostridium XVIII, Lachnospiraceae incertae sedis, Streptococcus, Enterococcus, and Veillonella (P milk HMO. Future studies are needed to validate these findings and determine whether the supplementation of formula with defined HMO could selectively modify the gut microbiota.

  19. Prevention and Management of Cow's Milk Allergy in Non-Exclusively Breastfed Infants.

    Science.gov (United States)

    Vandenplas, Yvan

    2017-07-10

    Introduction: The prevention and management of cow milk allergy (CMA) is still debated. Since CMA is much less frequent in breastfed infants, breastfeeding should be stimulated. Method: Literature was searched using databases to find original papers and reviews on this topic. Results: Hydrolysates with a clinical proof of efficacy are recommended in the prevention and treatment of CMA. However, not all meta-analyses conclude that hydrolysates do prevent CMA or other atopic manifestations such as atopic dermatitis. There are pros and cons to consider partially hydrolysed protein as an option for starter infant formula for each non-exclusively breastfed infant. A challenge test is still recommended as the most specific and sensitive diagnostic test, although a positive challenge test does not proof that the immune system is involved. The Cow Milk Symptom Score (CoMiSS™) is an awareness tool that enables healthcare professionals to better recognize symptoms related to the ingestion of cow milk, but it still needs validation as diagnostic tool. The current recommended elimination diet is a cow milk based extensive hydrolysate, although rice hydrolysates or soy infant formula can be considered in some cases. About 10 to 15% of infants allergic to cow milk will also react to soy. Mainly because of the higher cost, amino acid based formula is reserved for severe cases. There is no place for infant formula with intact protein from other animals as cross-over allergenicity is high. During recent years, attention focused also on the bifidogenic effect of prebiotics and more recently also on human milk oligosaccharides. A bifidogenic gastrointestinal microbiome may decrease the risk to develop allergic disease. The addition of probiotics and prebiotics to the elimination diet in treatment may enhance the development of tolerance development. Conclusion: Breastfeeding is the best way to feed infants. Cow milk based extensive hydrolysates remain the first option for the

  20. Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation

    Directory of Open Access Journals (Sweden)

    Frediani Simone

    2011-07-01

    Full Text Available Abstract Background Allergic proctocolitis (APC in exclusively breast-fed infants is caused by food proteins, deriving from maternal diet, transferred through lactation. In most cases a maternal cow milk-free diet leads to a prompt resolution of rectal bleeding, while in some patients a multiple food allergy can occur. The aim of this study was to assess whether the atopy patch test (APT could be helpful to identify this subgroup of patients requiring to discontinue breast-feeding due to polisensitization. Additionally, we assessed the efficacy of an amino acid-based formula (AAF when multiple food allergy is suspected. amino acid-based formula Methods We have prospectively enrolled 14 exclusively breast-fed infants with APC refractory to maternal allergen avoidance. The diagnosis was confirmed by endoscopy with biopsies. Skin prick tests and serum specific IgE for common foods, together with APTs for common foods plus breast milk, were performed. After a 1 month therapy of an AAF all patients underwent a follow-up rectosigmoidoscopy. Results Prick tests and serum specific IgE were negative. APTs were positive in 100% infants, with a multiple positivity in 50%. Sensitization was found for breast milk in 100%, cow's milk (50%, soy (28%, egg (21%, rice (14%, wheat (7%. Follow-up rectosigmoidoscopy confirmed the remission of APC in all infants. Conclusions These data suggest that APT might become a useful tool to identify subgroups of infants with multiple gastrointestinal food allergy involving a delayed immunogenic mechanism, with the aim to avoid unnecessary maternal dietary restrictions before discontinuing breast-feeding.

  1. Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation.

    Science.gov (United States)

    Lucarelli, Sandra; Di Nardo, Giovanni; Lastrucci, Ginevra; D'Alfonso, Ylenia; Marcheggiano, Adriana; Federici, Tatiana; Frediani, Simone; Frediani, Tullio; Cucchiara, Salvatore

    2011-07-16

    Allergic proctocolitis (APC) in exclusively breast-fed infants is caused by food proteins, deriving from maternal diet, transferred through lactation. In most cases a maternal cow milk-free diet leads to a prompt resolution of rectal bleeding, while in some patients a multiple food allergy can occur. The aim of this study was to assess whether the atopy patch test (APT) could be helpful to identify this subgroup of patients requiring to discontinue breast-feeding due to polisensitization. Additionally, we assessed the efficacy of an amino acid-based formula (AAF) when multiple food allergy is suspected. amino acid-based formula We have prospectively enrolled 14 exclusively breast-fed infants with APC refractory to maternal allergen avoidance. The diagnosis was confirmed by endoscopy with biopsies. Skin prick tests and serum specific IgE for common foods, together with APTs for common foods plus breast milk, were performed. After a 1 month therapy of an AAF all patients underwent a follow-up rectosigmoidoscopy. Prick tests and serum specific IgE were negative. APTs were positive in 100% infants, with a multiple positivity in 50%. Sensitization was found for breast milk in 100%, cow's milk (50%), soy (28%), egg (21%), rice (14%), wheat (7%). Follow-up rectosigmoidoscopy confirmed the remission of APC in all infants. These data suggest that APT might become a useful tool to identify subgroups of infants with multiple gastrointestinal food allergy involving a delayed immunogenic mechanism, with the aim to avoid unnecessary maternal dietary restrictions before discontinuing breast-feeding.

  2. Timing of Etonogestrel-Releasing Implants and Growth of Breastfed Infants: A Randomized Controlled Trial.

    Science.gov (United States)

    Carmo, Lilian Sheila de Melo Pereira; Braga, Giordana Campos; Ferriani, Rui Alberto; Quintana, Silvana Maria; Vieira, Carolina Sales

    2017-07-01

    To evaluate the growth of breastfed infants whose mothers had inserted an etonogestrel-releasing implant in the immediate postpartum period. An open, randomized controlled, and parallel trial of postpartum women who were block-randomized to early (up to 48 hours postpartum before discharge) or conventional (at 6 weeks postpartum) insertion of an etonogestrel implant. The primary outcome was average infant weight at 12 months (360 days) and a difference of equal to or greater than 10% between groups was considered clinically significant. The secondary outcomes were infant's height and head and arm circumferences. These variables were measured at baseline and at 14, 40, 90, 180, 270, and 360 days postpartum. The mixed-effects linear regression model was used to evaluate the outcomes with a power of 80% and a significance level of 1% for the primary outcome and 0.3% for secondary outcomes as a result of correction for multiple hypothesis testing. From June to August 2015, a total of 100 women were randomized: 50 to early and 50 to conventional postpartum etonogestrel insertion. Sociodemographic characteristics were similar between the groups, except for educational attainment. The conventional insertion group included a higher proportion of women with 8 or more years of formal education than the early insertion group (88% [44/50] compared with 70% [35/50], P=.02). There was no difference in infant weight at 360 days between the groups (early [mean±standard deviation] 10.1±1.2 kg compared with conventional 9.8±1.3 kg, mean difference estimate 0.3 kg, 95% confidence interval 0-0.7 kg). Growth curves, height, and head and arm circumferences did not differ between the groups. There is no difference in growth at 12 months among breastfed infants whose mothers underwent early compared with conventional postpartum insertion of the etonogestrel implant. ClinicalTrials.gov, NCT02469454.

  3. In Vitro Fermentation of caprine milk oligosaccharides by bifidobacteria isolated from breast-fed infants.

    Science.gov (United States)

    Thum, Caroline; Roy, Nicole C; McNabb, Warren C; Otter, Don E; Cookson, Adrian L

    2015-01-01

    This study was conducted to investigate the catabolism and fermentation of caprine milk oligosaccharides (CMO) by selected bifidobacteria isolated from 4 breast-fed infants. Seventeen bifidobacterial isolates consisting of 3 different species (Bifidobacterium breve, Bifidobacterium longum subsp. longum and Bifidobacterium bifidum) were investigated. A CMO-enriched fraction (CMOF) (50% oligosaccharides, 10% galacto-oligosaccharides (GOS), 20% lactose, 10% glucose and 10% galactose) from caprine cheese whey was added to a growth medium as a sole source of fermentable carbohydrate. The inclusion of the CMOF was associated with increased bifidobacterial growth for all strains compared to glucose, lactose, GOS, inulin, oligofructose, 3'-sialyl-lactose and 6'-sialyl-lactose. Only one B. bifidum strain (AGR2166) was able to utilize the sialyl-CMO, 3'-sialyl-lactose and 6'-sialyl-lactose, as carbohydrate sources. The inclusion of CMOF increased the production of acetic and lactic acid (P lactose present in the CMOF. These findings indicate that the dietary consumption of CMO may stimulate the growth and metabolism of intestinal Bifidobacteria spp. including B. bifidum typically found in the large intestine of breast-fed infants.

  4. Iron Stores of Breastfed Infants during the First Year of Life

    Directory of Open Access Journals (Sweden)

    Ekhard E. Ziegler

    2014-05-01

    Full Text Available The birth iron endowment provides iron for growth in the first months of life. We describe the iron endowment under conditions of low dietary iron supply. Subjects were infants participating in a trial of Vitamin D supplementation from 1 to 9 months. Infants were exclusively breastfed at enrollment but could receive complementary foods from 4 months but not formula. Plasma ferritin (PF and transferrin receptor (TfR were determined at 1, 2, 4, 5.5, 7.5, 9 and 12 months. At 1 month PF ranged from 38 to 752 µg/L and was only weakly related to maternal PF. PF declined subsequently and flattened out at 5.5 months. PF of females was significantly higher than PF of males except at 12 months. TfR increased with age and was inversely correlated with PF. PF and TfR tracked strongly until 9 months. Iron deficiency (PF < 10 µg/L began to appear at 4 months and increased in frequency until 9 months. Infants with ID were born with low iron endowment. We concluded that the birth iron endowment is highly variable in size and a small endowment places infants at risk of iron deficiency before 6 months. Boys have smaller iron endowments and are at greater risk of iron deficiency than girls.

  5. [The influence of preventive iron supplementation to iron nutritional status in breastfed infants].

    Science.gov (United States)

    Wang, Yue-jiao; Wu, Qin; Yang, Li-chen; Zhang, Xiao-rui; Zeng, Chao-mei; Yang, Xiao-guang; Liu, Jie

    2012-04-01

    To analyze the effects to iron status who were given preventive iron supplements for two months from when they were breast-fed to four-month-old. A total of 123 infants in four-month-old age who were breast-fed were randomly divided into iron supplementation group (63 cases) and control group (60 cases), iron supplementation group was supplied with low-dose iron (1 mg×kg⁻¹×d⁻¹) for two months with no intervention for control group. Blood samples were collected to test C reactive protein and iron status indicators in six-month-old age group infants, and the growth indices were measured and compared on the gender difference of iron status at and 6 months. After 2 months of low-dose iron supplementation, the hemoglobin of iron supplementation group (26 cases) increased about 5.5 g/L while the control group (34 cases) increases about 0.0 g/L (median), 95% confidence intervals were -7.0 - 13.0 g/L and -9.0 - 15.0 g/L, respectively. The hemoglobin increase of iron supplementation group was higher than the control group, the difference was statistically significant (u = -2.326, P nutritional status and the growth did not show any significant difference between iron supplementation group and control group (P > 0.05). At age 6 month, the MCV of the boys were (75.89 ± 3.34) fl, while the girls were (77.20 ± 3.17) fl. The boys had lower values of MCV than the girls, and the gender difference was statistically significant (t = 4.73, P nutritional status did not show any significant gender difference (P > 0.05). Low-dose iron supplementation of breast-fed infants at 4-month-old can increase the hemoglobin level when they were 6-month-old, and had no measurable side effect on growth.

  6. Plasma total homocysteine increases from day 20 to 40 in breastfed but not formula-fed low-birthweight infants

    NARCIS (Netherlands)

    Fokkema, M R; Woltil, H A; van Beusekom, C M; Schaafsma, A; Dijck-Brouwer, D A J; Muskiet, F A J

    2002-01-01

    Homocysteine is an intermediate in the folate cycle and methionine metabolism. This study investigated whether formula-fed infants have different plasma total homocysteine to their breastfed counterparts, and during what period any difference developed. Plasma total homocysteine was determined in 53

  7. Serum lutein concentrations in healthy term infants fed human milk or infant formula with lutein

    OpenAIRE

    Bettler, Jodi; Zimmer, J. Paul; Neuringer, Martha; DeRusso, Patricia A.

    2009-01-01

    Background Lutein is a carotenoid that may play a role in eye health. Human milk typically contains higher concentrations of lutein than infant formula. Preliminary data suggest there are differences in serum lutein concentrations between breastfed and formula-fed infants. Aim of the study To measure the serum lutein concentrations among infants fed human milk or formulas with and without added lutein. Methods A prospective, double-masked trial was conducted in healthy term formula-fed infant...

  8. High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial.

    Science.gov (United States)

    Tang, Minghua; Krebs, Nancy F

    2014-11-01

    High intake of cow-milk protein in formula-fed infants is associated with higher weight gain and increased adiposity, which have led to recommendations to limit protein intake in later infancy. The impact of protein from meats for breastfed infants during complementary feeding may be different. We examined the effect of protein from meat as complementary foods on growth and metabolic profiles of breastfed infants. This was a secondary analysis from a trial in which exclusively breastfed infants (5-6 mo old from the Denver, CO, metro area) were randomly assigned to receive commercially available pureed meats (Meat group; n = 14) or infant cereal (Cereal group; n = 28) as their primary complementary feedings for ∼ 5 mo. Anthropometric measures and diet records were collected monthly from 5 to 9 mo of age; intakes from complementary feeding and breast milk were assessed at 9 mo of age. The Meat group had significantly higher protein intake, whereas energy, carbohydrate, and fat intakes from complementary feeding did not differ by group over time. At 9 mo of age, mean (± SEM) intakes of total (complementary feeding plus breast milk) protein were 2.9 ± 0.6 and 1.4 ± 0.4 g · kg(-1) · d(-1), ∼ 17% and ∼ 9% of daily energy intake, for Meat and Cereal groups, respectively (P Meat group (ΔWAZ: 0.24 ± 0.19; ΔLAZ: 0.14 ± 0.12) and decreased in the Cereal group (ΔWAZ: -0.07 ± 0.17; ΔLAZ: -0.27 ± 0.24) (P-group by time meats was associated with greater linear growth and weight gain but without excessive gain in adiposity, suggesting that potential risks of high protein intake may differ between breastfed and formula-fed infants and by the source of protein. © 2014 American Society for Nutrition.

  9. Clinical presentation and metabolic consequences in 40 breastfed infants with nutritional vitamin B12 deficiency--what have we learned?

    Science.gov (United States)

    Honzik, Tomas; Adamovicova, Miriam; Smolka, Vratislav; Magner, Martin; Hruba, Eva; Zeman, Jiri

    2010-11-01

    Maternal vitamin B(12) (Cbl) deficiency causes nutritional Cbl deficiency in breastfed infants. To analyse clinical presentation and metabolic consequences in 40 breastfed infants with Cbl deficiency. Cbl levels in serum and breast milk were determined by an electrochemiluminescence immunoassay, methylmalonic acid level by GC/MS, plasma homocysteine by HPLC and propionylcarnitine by MS/MS. Profound Cbl deficiency was found in 17 children (69 ± 17 ng/l, controls 200-900), and milder Cbl deficiency in 23 children (167 ± 40 ng/l). Maternal Cbl deficiency was mostly caused by insufficient Cbl absorption. Only six mothers were vegetarian. The average age at diagnosis was 4.4 ± 2.5 months. Clinical symptoms included failure to thrive (48% of children), hypotonia (40%), developmental delay (38%) and microcephaly (23%). 63% of children had anaemia (megaloblastic in 28% of all children). All but one patient had methylmalonic aciduria, 80% of patients had hyperhomocysteinemia and 87% had increased aminotransferases. Propionylcarnitine was elevated in two out of 25 infants. Comparing groups with severe and mild Cbl deficiency, a marked difference was found in severity of clinical and laboratory changes. Maternal Cbl status and diagnostic delay are the major factors influencing severity and progression of Cbl deficiency in breastfed infants. In our cohort, propionylcarnitine was not sufficiently sensitive marker of Cbl deficiency. Although symptoms are reversible on Cbl substitution, permanent neurological damage can result. Selective screening for Cbl deficiency is indicated in all breastfed infants with failure to thrive, hypotonia, developmental delay, microcephaly or megaloblastic anaemia. The best prevention in future could be the screening of all pregnant women. Copyright © 2009 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  10. Skin prick testing to food allergens in breast-fed young infants with moderate to severe atopic dermatitis.

    Science.gov (United States)

    Rennick, Gordon J; Moore, Elizabeth; Orchard, David C

    2006-02-01

    SUMMARY The role of food allergy in atopic dermatitis is controversial. This study presents results of skin prick tests to 31 different food allergens in a selected population of predominantly breast-fed young infants who had moderate to severe generalized atopic dermatitis. Of the 59 infants (22 female, mean age 26.5 weeks) tested, 54 infants (91.5%) had positive responses to one or more foods, 53 infants (90%) were positive to one or more of the five common food allergens (egg white, cow's milk, peanuts, wheat or soy) and 80% were positive to egg white, which was by far the most common positive test. A total of 37 infants had strongly positive responses to one or more foods, with 33 of these 37 having strongly positive responses to egg white. The significance of these responses is discussed. It is concluded that positive skin prick tests to foods, particularly to egg white, are very common in this selected population of breast-fed infants with moderate to severe atopic dermatitis.

  11. Association of neonatal hyperbilirubinemia in breast-fed infants with UGT1A1 or SLCOs polymorphisms.

    Science.gov (United States)

    Sato, Hiroko; Uchida, Toshihiko; Toyota, Kentaro; Nakamura, Tomohiro; Tamiya, Gen; Kanno, Miyako; Hashimoto, Taeko; Watanabe, Masashi; Aoki, Kuraaki; Hayasaka, Kiyoshi

    2015-01-01

    Neonates have physiologically increased bilirubin production and immature bilirubin metabolism, and present hyperbilirubinemia in association with genetic and or epigenetic factors. We previously reported that maximal body weight loss (inadequate feeding) is an independent risk factor for the development of hyperbilirubinemia in breast-fed Japanese neonates, and the UGT1A1 211G>A genotype becomes a risk factor under conditions of inadequate feeding. We extended the study to the association of other genetic factors, the UGT1A1 (TA)7 and solute-carrier organic anion transporters (SLCOs) polymorphisms with neonatal hyperbilirubinemia. We enrolled 401 full-term Japanese infants who were exclusively breastfeeding and classified them into two groups based on the degree of maximal body weight loss. We analyzed the clinical characteristics and UGT1A1 and SLCOs genotypes. Statistical analysis revealed that maximal body weight loss is the only independent risk factor for the development of neonatal hyperbilirubinemia. UGT1A1, SLCO1B1 and SLCO1B3 polymorphisms become risk factors in neonates showing 10% or greater body weight loss during the neonatal period. Inadequate feeding may increase the bilirubin burden and cause apparent hyperbilirubinemia in neonates, who have a polymorphic change in the genes involved in the transport and/or metabolism of bilirubin.

  12. Taxonomic composition of microbiota of colon in breastfed infants with acute colienteritis

    Directory of Open Access Journals (Sweden)

    L. I. Sydorchuk

    2017-02-01

    Full Text Available Introduction: In recent years, paradoxical situation has been created, that testifies adverse evolution of modern acute intestinal infections, especially in infants and vital prognosis for patients by measure of deep study of this disease in patients, which number is significant and continues to grow, and the prognosis is getting worse. Aim: To define the etiology of colienteritis in infants (1–6 months old, the taxonomic composition of pathogenic and conditionally pathogenic microorganisms. Materials and methods: Content of colon of 48 children (one to six months old with colienteritis underwent bacterial and mycological examination (control group – 35 samples of colon content of practically healthy infants. Results: Etiological structure was determined in 28 (58,33 % of investigations. Consistency index, frequency of occurrence, Margalef species richness, Whittaker species diversity, Simpson and Berger–Parker species dominance indices of bacteria of genera Bifidobacterium, Lactobacillus, Bacteroides and Escherichia did not differ in patients and healthy children. These indices grow in Peptostreptococci: constancy index – by 78,26 %, frequency of occurrence – by 60,00 %, Margalef species richness index – by 2 times, Whittaker species diversity index – by 97,32 %, Simpson species dominance index – by 3 times and Berger - Parker index – by 65,31 %. These indices also grew in conditionally pathogenic Enterobacteria (Proteus by 82,24 %, by 2 times, by 2,03 times, by 68,18 % respectively. Study of taxonomic composition of colon microbiota in children with acute colienteritis showed widespread contamination of biotope (cavity by pathogenic (E. coli Hly +, enteropathogenic E. coli and conditionally pathogenic (C. diversus, Proteus ssp. Enterobacteria, Staphylococci, Peptococcus. This is accompanied with elimination of bacteria of genus Eubacterium from colon cavity. Conclusions: Acute colienteritis in one to six months old breastfed

  13. Thiamine responsive acute life threatening metabolic acidosis in exclusively breast-fed infants.

    Science.gov (United States)

    Qureshi, Umar Amin; Sami, Abdus; Altaf, Uruj; Ahmad, Kaisar; Iqbal, Javeed; Wani, Nisar Ahmad; Mir, Zahid; Ali, Iram

    2016-02-01

    Acute life threatening metabolic acidosis in exclusively breast fed infants due to thiamine deficiency is not described. Kashmir valley, a north Indian state has a population that largely consumes polished rice. A six months prospective descriptive study of infants who presented with acute life threatening metabolic acidosis (Blood pH ≤ 7.0) due to thiamine deficiency. Twenty three infants (Eleven male; Twelve female) in the age range of 32 days to 4 months had a pH of ≤7 at admission. Onset of moaning was immediate (2-24 hours). Blood lactate levels were more than 15mmol/L. Blood thiamine levels of six infants in whom it was done ranged from 11-69 nmol/L (control 78-185 nmol/L). All infants were exclusively breast fed. Maternal staple diet consisted of polished rice. All mothers consumed rice after washing it thrice. Twelve lactating mothers were on customary dietary restrictions. Practice of straining rice after cooking was observed in thirteen. The commonest symptoms were irritability (82%) and reflux (56%). Commonest signs were tachycardia (100%) and moaning (73%). At presentation 52% were in cardiogenic shock. Response to thiamine was dramatic with moaning and irritability subsiding in two hours and tachycardia in four hours. Adequate perfusion was achieved in one hour. Eighteen patients seen at six months follow up had normal neurodevelopment. Thiamine deficiency in an infant can present as sudden onset metabolic acidosis. If treated early, metabolic acidosis due to thiamine deficiency is associated with good immediate and long term prognosis even if pH is less than 7 at presentation. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Does supplementation of formula with evening primrose and fish oils augment long chain polyunsaturated fatty acid status of low birthweight infants to that of breast-fed counterparts?

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Schaafsma, A; Okken, A; Muskiet, FAJ

    We investigated whether formulae with evening primrose and fish oils raise long chain polyunsaturated fatty acids (LCPUFA) in plasma cholesterol esters (CE), erythrocytes (RSC) and platelets (PLT) to levels encountered in breast-fed infants. Low birthweight infants (less than or equal to 2500 g)

  15. Outcome Differences between Breast-Fed and Bottle-Fed Infants.

    Science.gov (United States)

    Larson, Sandra K.; And Others

    DiPietro, Larson, and Porges (1987) found behavioral and physiological differences between breast-fed and bottle-fed newborns. It was suggested that breast-feeding is associated with more optimal physiological organization and with increased irritable reactivity early in the neonatal period. The present study investigated whether breast-fed…

  16. HIV-free survival at 12-24 months in breastfed infants of HIV-infected women on antiretroviral treatment.

    Science.gov (United States)

    Chikhungu, Lana Clara; Bispo, Stephanie; Rollins, Nigel; Siegfried, Nandi; Newell, Marie-Louise

    2016-07-01

    To provide estimates of HIV-free survival at 12-24 months in breastfed children by maternal ART (6 months or lifelong) to inform WHO HIV and Infant Feeding guidelines. Eighteen studies published 2005-2015 were included in a systematic literature review (1295 papers identified, 156 abstracts screened, 55 full texts); papers were analysed by narrative synthesis and meta-analysis of HIV-free survival by maternal ART regimen in a random effects model. We also grouped studies by feeding modality. Study quality was assessed using a modified Newcastle-Ottawa Scale (NOS) and GRADE. The pooled estimates for 12-month HIV-free survival were 89.8% (95% confidence interval, CI: 86.5%, 93.2%) for infants of mothers on ART for 6 months post-natally (six studies) and 91.4% (95% CI 87.5%, 95.4%) for infants of mothers on lifelong ART (three studies). Eighteen-month HIV-free survival estimates were 89.0% (95% CI 83.9%, 94.2%) with 6 months ART (five studies) and 96.1% (95% CI 92.8%, 99.0%) with lifelong ART (three studies). Twenty-four-month HIV-free survival for infants whose mothers were on ART to 6 months post-natally (two studies) was 89.2% (95% CI 79.9%, 98.5%). Heterogeneity was considerable throughout. In four studies, HIV-free survival in breastfed infants ranged from 87% (95% CI 78%, 92%) to 96% (95% CI 91%, 98%) and in formula-fed infants from 67% (95% CI 35.5%, 87.9%) to 97.6% (95% CI 93.0%, 98.2%). Our results highlight the importance of breastfeeding for infant survival and of ART in reducing the risk of mother-to-child HIV transmission and support the WHO recommendation to initiate ART for life immediately after HIV diagnosis. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  17. [Nuclear techniques in nutrition: assessment of body fat and intake of human milk in breast-fed infants].

    Science.gov (United States)

    Pallaro, Anabel; Tarducci, Gabriel

    2014-12-01

    The application of nuclear techniques in the area of nutrition is safe because they use stable isotopes. The deuterium dilution method is used in body composition and human milk intake analysis. It is a reference method for body fat and validates inexpensive tools because of its accuracy, simplicity of application in individuals and population and the background of its usefulness in adults and children as an evaluation tool in clinical and health programs. It is a non-invasive technique as it uses saliva, which facilitates the assessment in pediatric populations. Changes in body fat are associated with non-communicable diseases; moreover, normal weight individuals with high fat deposition were reported. Furthermore, this technique is the only accurate way to determine whether infants are exclusively breast-fed and validate conventional methods based on surveys to mothers.

  18. (H2O)-H-2 turnover method as a means to detect bias in estimations of intake of nonbreast milk liquids in breast-fed infants

    NARCIS (Netherlands)

    Haisma, H; Coward, WA; Albernaz, E; Barros, A; Victora, CG; Wright, A; Visser, GH

    Objective: Firstly, to compare food, and macronutrient intake as obtained from a single 24-h recall and a frequency questionnaire (FQ) covering a 14-day period in breast-fed infants aged 4 months of age. Secondly, nonbreast milk water intake (NB-WI, ml/day) was used as an estimation of energy and

  19. A nationwide study on hospital admissions due to dehydration in exclusively breastfed infants in the Netherlands : Its incidence, clinical characteristics, treatment and outcome

    NARCIS (Netherlands)

    Pelleboer, R.A.A.; Bontemps, S.T.H.; Verkerk, P.H.; Dommelen, P. van; Pereira, R.R.; Wouwe, J.P. van

    2009-01-01

    Aims: To estimate the incidence and clinical characteristics in hospital admissions due to dehydration or undernutrition and their laboratory evaluation and treatment outcome in exclusively breastfed infants. Methods: All hospital admissions during the first 3 months of life assessed by the Dutch

  20. Energy utilization and growth in breast-fed and formula-fed infants measured prospectively during the first year of life

    NARCIS (Netherlands)

    N.C. de Bruin (Niels); H.J. Degenhart (Herman); S. Gal; K.R. Westerterp (Klaas); Th. Stijnen (Theo); H.K.A. Visser (Henk)

    1998-01-01

    textabstractThis study is the first to report approximations of energy requirements for male and female breast-fed and formula-fed infants based on individual estimates of total daily energy expenditure (TDEE) and energy deposition derived from total body fat (TBF) and

  1. Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods

    NARCIS (Netherlands)

    Harmsen, HJM; Wildeboer-Veloo, ACM; Raangs, GC; Wagendorp, AA; Klijn, N; Bindels, JG; Welling, GW

    Background: An obvious difference between breast-fed and formula-fed newborn infants is the development of the intestinal flora, considered to be of importance for protection against harmful micro-organisms and for the maturation of the intestinal immune system. In this study, novel molecular

  2. 13C-labeled oligosaccharides in breastfed infants' urine: individual-, structure- and time-dependent differences in the excretion.

    Science.gov (United States)

    Dotz, Viktoria; Rudloff, Silvia; Blank, Dennis; Lochnit, Günter; Geyer, Rudolf; Kunz, Clemens

    2014-02-01

    Human milk oligosaccharides (HMOs) have been paid much attention due to their beneficial effects observed in vitro, e.g., prebiotic, anti-infective and anti-inflammatory properties. However, in vivo investigations with regard to HMO metabolism and functions are rare. The few data available indicate that HMOs are absorbed to a low extent and excreted via urine without noteworthy modifications, whereas the major proportion reaches infant's colon undigested. Via intrinsic (13)C-labeling of HMOs during their biosynthesis in the mammary gland of 10 lactating women, we were able to follow the fate of (13)C-labeled oligosaccharides (OSs) from their secretion in milk to the excretion in the urine of their breastfed infants. To a certain extent, we could therefore discriminate between original HMOs and non-labeled OSs derived from degradation of HMOs or endogenous glycoconjugates. By means of our novel, rapid, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)-based approach, we found a homogeneous time pattern of isotopomer enrichment in milk among all subjects and between single OS species. In contrast, the time curves from infants' urine varied strongly between individuals and OS species, though the overall MALDI-TOF MS profile resembled those of the mothers' milk. Our data suggest that neutral HMOs might be processed and/or utilized differentially after or upon absorption from the gut, as deduced from their structure-dependent variation in the extent of tracer enrichment and in the retention times in infant's organism. This sheds new light on the role of HMOs within infant's body, beyond the intestine and its microbiota alone.

  3. Evaluation of the daily iron intake by non-breastfed Egyptian infants ...

    African Journals Online (AJOL)

    Iron deficiency is frequently associated with anaemia. The prevalence of anaemia among Egyptian infants and young children is 25%. Fortification of infant and followup milk-based formulae remains a valuable method for delivering iron to reduce the incidence of iron deficiency anaemia. Percentage of Egyptian ...

  4. Passage of food antigens into circulation of breast-fed infants with atopic dermatitis.

    Science.gov (United States)

    Cavagni, G; Paganelli, R; Caffarelli, C; D'Offizi, G P; Bertolini, P; Aiuti, F; Giovannelli, G

    1988-11-01

    We have selected 13 babies presenting with atopic dermatitis during exclusive breast feeding. After evaluation of reaginic reaction, we detected beta-lactoglobulin (BLG) in breast milk and babies sera before and after maternal elimination diet and after maternal challenge. beta-Lactoglobulin was present only in the sera of infants ingesting breast milk containing BLG. We have seen reaginic reactions to cow's milk in seven babies. The maternal elimination diet improved eczema in 11/13 infants, maternal challenge worsened atopic dermatitis in 9/9 children. We demonstrated the transport of food antigen via breast milk into infants' circulation.

  5. ‘Dose-to-Mother’ Deuterium Oxide Dilution Technique: An Accurate Strategy to Measure Vitamin A Intake in Breastfed Infants

    Directory of Open Access Journals (Sweden)

    Veronica Lopez-Teros

    2017-02-01

    Full Text Available In Mexico, infants (0–2 years old show the highest prevalence of vitamin A deficiency (VAD, measured by serum retinol concentrations. Thus, we consider that low vitamin A (VA intake through breast milk (BM combined with poor weaning practices are the main factors that contribute to VAD in this group. We combined the assessment of VA status in lactating women using BM retinol and a stable isotope ‘dose-to-mother’ technique to measure BM production in women from urban and agricultural areas. Infants’ mean BM intake was 758 ± 185 mL, and no difference was observed between both areas (p = 0.067. Mean BM retinol concentration was 1.09 μmol/L, which was significantly lower for the agricultural area (p = 0.028. Based on BM retinol concentration, 57% of women were VAD; although this prevalence fell to 16% when based on fat content. Regardless of the VA biomarker used here, infants from the urban and agricultural areas cover only 66% and 49% of their dietary adequate intake from BM, respectively (p = 0.054. Our data indicate that VAD is still a public health concern in Mexico. Adopting both methods to assess VA transfer from the mother to the breastfed child offers an innovative approach towards the nutritional assessment of vulnerable groups.

  6. Nutrition for healthy term infants

    OpenAIRE

    1998-01-01

    Nutrition for Healthy Term Infants is the new national statement on nutrition for infants from birth to 24 months, developed collaboratively by the Canadian Paediatric Society, Dietitians of Canada and Health Canada.

  7. Complementary feeding with cow's milk alters sleeping metabolic rate in breast-fed infants

    NARCIS (Netherlands)

    Haisma, H; Wells, JCK; Coward, WA; Duro, D; Victora, CG; Vonk, RJ; Wright, A; Visser, GH

    Although it is widely accepted that energy expenditure in infants is a function of feeding pattern, the mechanism behind this is not well understood. The objectives of this observational study were as follows: 1) to compare minimal observable energy expenditure (MOEE) between 2 subgroups of

  8. Growth of Czech Breastfed Infants in Comparison with the World Health Organization Standards

    Czech Academy of Sciences Publication Activity Database

    Vignerová, J.; Shriver, L.; Paulová, M.; Brabec, Marek; Schneidrová, D.; Růžková, R.; Procházka, B.; Riedlová, J.

    2015-01-01

    Roč. 23, č. 1 (2015), s. 32-38 ISSN 1210-7778 Grant - others:GA MZd(CZ) NS9974; Pedagogická fakulta UK(CZ) PRVOUK P02 Institutional support: RVO:67985807 Keywords : breastfeeding * Czech * growth standards * infants * national references * WHO standards Subject RIV: FG - Pediatrics Impact factor: 0.525, year: 2015

  9. Socio-economic and environmental factors influence energy utilization in Brazilian breast-fed infants

    NARCIS (Netherlands)

    Haisma, Hinke; Coward, W. Andrew; Visser, G. Henk; Vonk, Roel; Wells, Jonathan C. K.; Wright, A.; Victora, Cesar G.

    2006-01-01

    Energy intake recommendations for infants are based on data from industrialized countries. FAO/WHO/UNU expressed the need for studies on total energy expenditure (TEE) and basal metabolic rate from developing countries covering current and changing lifestyles. For this observational study, 65

  10. [Growth of exclusively breast-fed Chilean infants in relation to new 1994 WHO Reference Charts].

    Science.gov (United States)

    Atalah Samur, E; Castillo Lancelloti, C

    1997-03-01

    The aim of this study was to evaluate the growth of Chilean infants from medium-to-low socioeconomic status fed according to the current WHO guidelines. Growth pattern was compared to a recent reference chart published by WHO for infants, and the NCHS/WHO growth standards. The source of information was a nation-wide infant feeding survey conducted in 1993. From this database, infants aged 1-12 month +/- 5 days, with exclusive breast feeding until the fourth or sixth month were selected (939 males, 940 females). The weight-for-age z-score (WAZ), and the height-for-age z-score (HAZ) were calculated using both the NCHS/ WHO and the new WHO reference growth charts. At each month of age, WHZ and HAZ results were grouped in the following categories: = 2.0. Observed WAZ at the first month of age was below the new WHO reference chart (0.32 z-score), increasing up to 1.29 z-score at the tenth month. The HAZ results were lower the WHO reference chart throughout the period studied, although a trend to improved values was noted during the second semester (F = 6.01 p < 0.001). Growth pattern of the studied group was more similar to the NCHS/WHO chart than the new chart proposed by WHO. As a consequence, the new WHO reference chart identifies a higher proportion of the infants as having a subnormal nutritional status during the first semester of life, compared to those classified in this category by the NCHS/WHO standards (p < 0.001). This can be a factor for the introduction of complementary foods early in life. The relative homogeneity of the population used as source of the WHO reference chart may limit it use in developing countries.

  11. The study of breast milk IGF-1, leptin, ghrelin and adiponectin levels as possible reasons of high weight gain in breast-fed infants.

    Science.gov (United States)

    Kon, Igor Ya; Shilina, Natalia M; Gmoshinskaya, Maria V; Ivanushkina, Tatiana A

    2014-01-01

    Excessive consumption of protein that leads to increased blood levels of insulin-like growth factor-1 (IGF-1) is an important risk factor for high growth velocity and obesity in formula-fed infants. However, it is not clear whether these factors can explain the high growth velocity in breast-fed infants. To study the possible links between the growth velocity in breast-fed infants and the levels of protein, IGF-1 and other hormones, which regulate energy homeostasis, in mothers' breast milk. We studied 103 mother-infant pairs. Their daily breast milk intake and level of IGF-1, leptin, ghrelin, adiponectin, protein and fat in breast milk were measured at 1, 2 and 3 months of lactation. The infant group was divided into three subgroups of low, normal and high weight gain tertiles. The breast milk consumed by the infants with high weight gain contained higher levels of IGF-1 than that consumed by those with low weight gain at all periods studied (p = 0.032 at 3 months of lactation), and ghrelin levels were higher at 1 and 2 months and leptin levels at 2 and 3 months of lactation (p milk IGF-1 level and infant weight gain (r = 0.294, p = 0.043). Total daily breast milk, fat and hormone intake was also higher in the high weight gain group compared to the low weight gain group. One of the reasons for the high growth velocity in breast-fed infants may be the enhanced levels of the studied hormones in breast milk.

  12. Maternal fish oil supplementation in lactation: effect on developmental outcome in breast-fed infants

    DEFF Research Database (Denmark)

    Lauritzen, L.; Jørgensen, M.H.; Olsen, S.F.

    2005-01-01

    vocabulary at one year was lower in the children of the FO-compared with the OO-group ( P ... with a habitual fish intake below the population median were randomized to 4.5 g center dot d(-1) of FO or olive oil (OO) for the first four months of lactation. Fifty-three mothers with habitual fish intake in the highest quartile were included as reference group. The effect of the resulting increase in infant...... DHA-intake and RBC-DHA level was assessed on problem solving ability at nine months and language at one and two years of age. Infants in the three groups performed equally well on the problem test and no association was observed between problem solving and erythrocyte-DHA at four months. Passive...

  13. Identification of Oligosaccharides in Feces of Breast-fed Infants and Their Correlation with the Gut Microbial Community *

    Science.gov (United States)

    Davis, Jasmine C. C.; Totten, Sarah M.; Huang, Julie O.; Nagshbandi, Sadaf; Kirmiz, Nina; Garrido, Daniel A.; Lewis, Zachery T.; Wu, Lauren D.; Smilowitz, Jennifer T.; German, J. Bruce; Mills, David A.; Lebrilla, Carlito B.

    2016-01-01

    Glycans in breast milk are abundant and found as either free oligosaccharides or conjugated to proteins and lipids. Free human milk oligosaccharides (HMOs) function as prebiotics by stimulating the growth of beneficial bacteria while preventing the binding of harmful bacteria to intestinal epithelial cells. Bacteria have adapted to the glycan-rich environment of the gut by developing enzymes that catabolize glycans. The decrease in HMOs and the increase in glycan digestion products give indications of the active enzymes in the microbial population. In this study, we quantitated the disappearance of intact HMOs and characterized the glycan digestion products in the gut that are produced by the action of microbial enzymes on HMOs and glycoconjugates from breast milk. Oligosaccharides from fecal samples of exclusively breast-fed infants were extracted and profiled using nanoLC-MS. Intact HMOs were found in the fecal samples, additionally, other oligosaccharides were found corresponding to degraded HMOs and non-HMO based compounds. The latter compounds were fragments of N-glycans released through the cleavage of the linkage to the asparagine residue and through cleavage of the chitobiose core of the N-glycan. Marker gene sequencing of the fecal samples revealed bifidobacteria as the dominant inhabitants of the infant gastrointestinal tracts. A glycosidase from Bifidobacterium longum subsp. longum was then expressed to digest HMOs in vitro, which showed that the digested oligosaccharides in feces corresponded to the action of glycosidases on HMOs. Similar expression of endoglycosidases also showed that N-glycans were released by bacterial enzymes. Although bifidobacteria may dominate the gut, it is possible that specific minority species are also responsible for the major products observed in feces. Nonetheless, the enzymatic activity correlated well with the known glycosidases in the respective bacteria, suggesting a direct relationship between microbial abundances and

  14. Identification of Oligosaccharides in Feces of Breast-fed Infants and Their Correlation with the Gut Microbial Community.

    Science.gov (United States)

    Davis, Jasmine C C; Totten, Sarah M; Huang, Julie O; Nagshbandi, Sadaf; Kirmiz, Nina; Garrido, Daniel A; Lewis, Zachery T; Wu, Lauren D; Smilowitz, Jennifer T; German, J Bruce; Mills, David A; Lebrilla, Carlito B

    2016-09-01

    Glycans in breast milk are abundant and found as either free oligosaccharides or conjugated to proteins and lipids. Free human milk oligosaccharides (HMOs) function as prebiotics by stimulating the growth of beneficial bacteria while preventing the binding of harmful bacteria to intestinal epithelial cells. Bacteria have adapted to the glycan-rich environment of the gut by developing enzymes that catabolize glycans. The decrease in HMOs and the increase in glycan digestion products give indications of the active enzymes in the microbial population. In this study, we quantitated the disappearance of intact HMOs and characterized the glycan digestion products in the gut that are produced by the action of microbial enzymes on HMOs and glycoconjugates from breast milk. Oligosaccharides from fecal samples of exclusively breast-fed infants were extracted and profiled using nanoLC-MS. Intact HMOs were found in the fecal samples, additionally, other oligosaccharides were found corresponding to degraded HMOs and non-HMO based compounds. The latter compounds were fragments of N-glycans released through the cleavage of the linkage to the asparagine residue and through cleavage of the chitobiose core of the N-glycan. Marker gene sequencing of the fecal samples revealed bifidobacteria as the dominant inhabitants of the infant gastrointestinal tracts. A glycosidase from Bifidobacterium longum subsp. longum was then expressed to digest HMOs in vitro, which showed that the digested oligosaccharides in feces corresponded to the action of glycosidases on HMOs. Similar expression of endoglycosidases also showed that N-glycans were released by bacterial enzymes. Although bifidobacteria may dominate the gut, it is possible that specific minority species are also responsible for the major products observed in feces. Nonetheless, the enzymatic activity correlated well with the known glycosidases in the respective bacteria, suggesting a direct relationship between microbial abundances and

  15. Identification of Probiotic Strains from Human Milk in Breastfed Infants with Respiratory Infections

    Directory of Open Access Journals (Sweden)

    Neamtu Bogdan

    2014-12-01

    Full Text Available Isolation and industrial exploitation of probiotics from human milk is a goal for worldwide milk biotechnology centres because of their modulation effect on the immune system in infants and adults. In the proposed study we have analysed fermentation patterns of Lactobacilli isolated from human milk, the reliability of API 50 CH carbohydrate fermentation system and a possible link between lactose concentrations and fermentation profiles on carbohydrates. We had succesfully identified three species of Lactobacillus (paracasei ssp paracasei, fermentum, acidophilus and one unsatisfactory identification of Lactoccocus lactis ssp lactis. These strains had different carbohydrate fermentation patterns but with common characteristics and showed no statistically significant correlations between their carbohydrate metabolic trends and lactose concentrations in the milk samples.

  16. Characterization of Lactobacillus gasseri isolates from a breast-fed infant.

    Science.gov (United States)

    Rodrigues da Cunha, Luciana; Fortes Ferreira, Célia L L; Durmaz, Evelyn; Goh, Yong Jun; Sanozky-Dawes, Rosemary; Klaenhammer, Todd

    2012-01-01

    The potential health benefits of probiotic bacteria have led to the isolation of new microbial strains for incorporation into food products. However, newly isolated candidate probiotic organisms do not automatically share the "generally recognized as safe" (GRAS) status of traditional lactic acid bacteria (LAB). Before their introduction into food products, the safety of new isolates has to be evaluated. The objective of this study was to characterize LAB isolates from the stool of a newborn infant, and evaluate their safety and probiotic potential, in vitro. Thirty colonies were identified as Lactobacillus gasseri through sequencing of 16S rDNA. Pulsed Field Gel Electrophoresis using restriction enzymes SmaI and Apa I revealed that 29 of the L. gasseri were nearly identical, however one isolate exhibited a distinctive DNA fingerprint. All 30 L. gasseri were evaluated for resistance to antibiotics, bile tolerance, hemolytic activity and antagonism toward selected pathogens. All 30 strains harbored three plasmids, with one strain that showed strong tolerance to 0.5% of bile and harbored a unique fourth plasmid encoding a putative multidrug resistance transporter protein (LmrB). No hemolytic activity or antagonism, beyond acid inhibition was observed. Three selected strains UFVCC1083, 1091 and 1112 showed strong resistance to simulated small intestinal and gastric juices and adhered in vitro to mucin and two intestinal epithelial cell lines, Caco-2 and HT-29. This study identified and characterized recently isolated L. gasseri strains from faeces of a breast fed infant as potential probiotic candidates for use in the human milk banks in Brazil.

  17. [The anatomical features of the middle ear exerting the influence on the formation of exudative otitis media in the breast-fed infants of different gestational age].

    Science.gov (United States)

    Matroskin, A G; Rakhmanova, I V; Dreval', A A; Kislyakov, A N; Vladimirov, A I

    The objective of the present study was to elucidate the anatomical features of the structure of the middle ear and eustachian tube in the breast-fed infants of different gestational age that may be responsible for the formation of exudates (fluids). We have examined 150 temporal bones obtained from the children's cadavers that were allocated to three groups as follows: 50 temporal bones obtained at weeks 26-30 weeks of gestation (group 1), 44 bones 31-36 weeks of gestation (group 2), and 37-40 weeks of gestation (full-term babies, group 3),The analysis of the data obtained on an individual bases revealed either increase or decreases in the selected characteristics of the eustachian tube in comparison with the respective average values as well as the well apparent predominance of a single change or a combination of alteration of several parameters in one case in 26-30 weeks and 31-36 weeks groups. No significant changes were found in group 1. It is concluded that the presence of a single change or a combination of two or three abnormal changes in the parameters of the bone structures of the eustachian tube can affect the development of the secretory process in the middle ear especially in the children born after 36 weeks of pregnancy.

  18. Metabolisable energy consumption in the exclusively breast-fed infant aged 3--6 months from the developed world: a systematic review.

    Science.gov (United States)

    Reilly, John J; Ashworth, Susan; Wells, Jonathan C K

    2005-07-01

    The present study aimed to evaluate evidence on metabolisable energy consumption and pattern of consumption with age in infants in the developed world who were exclusively breast-fed, at around the time of introducing complementary feeding. We carried out a systematic review aimed at answering three questions: how much milk is transferred from mother to infant?; does transfer increase with the age of the infant?; and what is the metabolisable energy content of breast milk? Thirty-three eligible studies of 1041 mother--infant pairs reported transfer at 3--4 months of age, the weighted mean transfer being 779 (SD 40) g/d. Six studies (99 pairs) measured transfer at 5 months, with a weighted mean transfer of 827 (SD 39) g/d. Five studies (72 pairs) measured milk transfer at 6 months, reporting a weighted mean transfer of 894 (SD 87) g/d. Nine longitudinal studies reported no significant increases in milk transfer after 2--4 months. Twenty-five studies on breast-milk energy content were based on 777 mother--infant pairs. The weighted mean metabolisable energy content was 2.6 (SD 0.2) kJ/g. Breast-milk metabolisable energy content is probably lower, and breast-milk transfer slightly higher, than is usually assumed. Longitudinal studies do not support the hypothesis that breast-milk transfer increases markedly with age. More research on energy intake in 5--6-month-old exclusively breast-fed infants is necessary, and information on the metabolisability of breast milk in mid-infancy is desirable. This evidence should inform future recommendations on infant feeding and help to identify research needs in infant energy balance.

  19. A sustainable food support for non-breastfed infants: implementation and acceptability within a WHO mother-to-child HIV transmission prevention trial in Burkina Faso.

    Science.gov (United States)

    Cames, Cécile; Mouquet-Rivier, Claire; Traoré, Tahirou; Ayassou, Kossiwavi A; Kabore, Claire; Bruyeron, Olivier; Simondon, Kirsten B

    2010-06-01

    To provide HIV-positive mothers who opted for exclusive breastfeeding or formula feeding from birth to 6 months postpartum as a means of prevention of mother-to-child transmission (PMTCT) of HIV with a sustainable infant food support programme (FSP) from 6 to 12 months postpartum. We describe the implementation and assessment of this pilot initiative. The FSP included a 6-month provision of locally produced infant fortified mix (IFM; 418 kJ/100 g of gruel) for non-breastfed infants coupled with infant-feeding and psychosocial counselling and support. Acceptability and feasibility were assessed in a subsample of sixty-eight mother-infant pairs. The FSP was developed in collaboration with local partners to support participants in a PMTCT prevention study. Formula was provided for free from 0 to 6 months postpartum. Cessation by 6 months was recommended for breastfeeding mothers. The FSP was positively received and greatly encouraged breastfeeding mothers to cease by 6 months. As recommended, most infants were given milk as an additional replacement food, mainly formula subsidised by safety networks. Among daily IFM consumers, feeding practices were satisfactory overall; however, the IFM was shared within the family by more than one-third of the mothers. Cessation of IFM consumption was observed among twenty-two infants, seventeen of whom were fed milk and five neither of these. Without any food support most mothers would have been unable to provide appropriate replacement feeding. The food security of non-breastfed infants urgently needs to be addressed in HIV PMTCT programmes. Our findings on a simple cost-effective pioneer intervention provide an important foundation for this process.

  20. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy.

    Science.gov (United States)

    Guez, Sophie; Chiarelli, Gabriella; Menni, Francesca; Salera, Simona; Principi, Nicola; Esposito, Susanna

    2012-06-24

    In infants, vitamin B12 deficiency may be due to an inborn error of absorption and metabolism, or nutritional problems. An exclusively breastfed 5-month-old Italian male infant, who was born after a normal full-term pregnancy to a vegan mother who was apparently daily treated with a multivitamin oral preparation during the second and third trimester, was hospitalised because of poor weight gain, feeding difficulties, severe pallor, muscle hypotonia and somnolence. Upon admission, his weight, length and head circumference were below the third percentile, he had an enlarged liver and spleen, and showed a significant delay in developmental milestones and communicative reactions. He had a hemoglobin level of 4.7 g/dL with an MCV of 84.2 fL, a white blood cell count of 4,680/mm3, and a platelet count of 45,000/mm3. His serum vitamin B12 level was 57 pg/mL (normal value 180-500 pg/mL) and serum folate level 12.8 ng/mL (normal value >3 ng/mL). The results of metabolic examinations excluded a cobalamin C disorder, whereas nutritional screening showed a serum iron concentration of 9 μg/dL and serum ferritin of 4 ng/mL. Magnetic resonance imaging of the brain showed mild dilatation of the lateral ventricles with diffuse delayed myelination. The child was diagnosed as having vitamin B12 and iron deficiency due to nutritional inadequacy and was immediately treated with packed red blood cells, intramuscular vitamin B12 injections, and iron supplementation. A few days after the start of therapy, his hemoglobin levels and other hematological parameters rapidly improved, and a clinical improvement was observed within few weeks. There was an increase in his achievement of developmental milestones, but his development was still retarded seven months after the start of therapy. This case underlines the importance of adequately controlling maternal vitamin B12 intake during pregnancy by means of supplementation which, in the case of vegan mothers, should be significantly greater than

  1. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy

    Directory of Open Access Journals (Sweden)

    Guez Sophie

    2012-06-01

    Full Text Available Abstract Background In infants, vitamin B12 deficiency may be due to an inborn error of absorption and metabolism, or nutritional problems. Case presentation An exclusively breastfed 5-month-old Italian male infant, who was born after a normal full-term pregnancy to a vegan mother who was apparently daily treated with a multivitamin oral preparation during the second and third trimester, was hospitalised because of poor weight gain, feeding difficulties, severe pallor, muscle hypotonia and somnolence. Upon admission, his weight, length and head circumference were below the third percentile, he had an enlarged liver and spleen, and showed a significant delay in developmental milestones and communicative reactions. He had a hemoglobin level of 4.7 g/dL with an MCV of 84.2 fL, a white blood cell count of 4,680/mm3, and a platelet count of 45,000/mm3. His serum vitamin B12 level was 57 pg/mL (normal value 180–500 pg/mL and serum folate level 12.8 ng/mL (normal value >3 ng/mL. The results of metabolic examinations excluded a cobalamin C disorder, whereas nutritional screening showed a serum iron concentration of 9 μg/dL and serum ferritin of 4 ng/mL. Magnetic resonance imaging of the brain showed mild dilatation of the lateral ventricles with diffuse delayed myelination. The child was diagnosed as having vitamin B12 and iron deficiency due to nutritional inadequacy and was immediately treated with packed red blood cells, intramuscular vitamin B12 injections, and iron supplementation. A few days after the start of therapy, his hemoglobin levels and other hematological parameters rapidly improved, and a clinical improvement was observed within few weeks. There was an increase in his achievement of developmental milestones, but his development was still retarded seven months after the start of therapy. Conclusion This case underlines the importance of adequately controlling maternal vitamin B12 intake during pregnancy by means of

  2. Anemia em lactentes de baixa renda em aleitamento materno exclusivo Anemia in low-income exclusively breastfed infants

    Directory of Open Access Journals (Sweden)

    Marco Antonio A. Torres

    2006-08-01

    Full Text Available OBJETIVO:Verificar o comportamento dos valores da hemoglobina e a prevalência de anemia entre lactentes de termo de 3 a 6 meses de idade em aleitamento materno exclusivo. MÉTODOS: Estudo transversal em 242 lactentes de 3 a 6 meses de idade com peso de nascimento superior a 2.500 g, em aleitamento materno exclusivo e em acompanhamento no Programa de Promoção do Crescimento e Desenvolvimento do Lactente do Programa Einstein na Comunidade de Paraisópolis. A dosagem de hemoglobina foi realizada por meio de punção digital entre o terceiro e o sexto meses de vida. Adotaram-se os valores de Hb OBJECTIVE: To verify the behavior of hemoglobin levels and anemia prevalence in full term infants, aged 3 to 6 months and on exclusive breastfeeding. METHODS: A cross-sectional study of 242 infants aged 3 to 6 months with birth weights of more than 2,500 g, on exclusive breastfeeding and monitored by the Program for the Promotion of Infant Growth and Development, part of the Paraisópolis Einstein Community Program. Hemoglobin was assayed by finger prick between the third and sixth months of life. Anemia was defined as Hb < 10.3 g/dL (Saarinen or Hb < 10 g/dL (Brault-Dubuc for infants aged 3 to 5 months and as Hb < 11.0 g/dL (WHO for infants aged 6 months. RESULTS: Mean hemoglobin concentration was 11.3 and 11.4 g/dL at 3 and 4 months and 11.2 and 11.1 g/dL at 5 and 6 months, respectively. The percentage of anemic infants varied depending on age and the cutoff adopted, being 11.8, 10.2 and 8.3% at 3, 4 and 5 months, respectively, according to the Brault-Dubuc criteria, and 20.6, 14.8 and 10.4% by the Saarinen criteria. Anemia prevalence at 6 months was 37.5%. CONCLUSIONS: Anemia prevalence rates observed among infants aged between 3 and 6 months varied from 8.3 to 37.5%, justifying increased attention on the part of pediatricians to the hemoglobin levels of infants who are on exclusive breastfeeding, come from low-income families and present risk factors

  3. Developmental Readiness of Normal Full Term Infants To Progress from Exclusive Breastfeeding to the Introduction of Complementary Foods: Reviews of the Relevant Literature Concerning Infant Immunologic, Gastrointestinal, Oral Motor and Maternal Reproductive and Lactational Development.

    Science.gov (United States)

    Naylor, Audrey J., Ed.; Morrow, Ardythe L., Ed.

    This review of the developmental readiness of normal, full-term infants to progress from exclusive breastfeeding to the introduction of complementary foods is the result of the international debate regarding the best age to introduce complementary foods into the diet of the breastfed human infant. After a list of definitions, four papers focus on:…

  4. Nutritional vitamin B12 deficiency in a breast-fed infant of a vegan-diet mother.

    Science.gov (United States)

    Sklar, R

    1986-04-01

    A 7-month-old male presented with lethargy and failure to thrive. The child was exclusively breast-fed from birth by a mother who was a strict vegetarian. Laboratory data revealed macrocytic anemia and methylmalonic acid in the urine, consistent with vitamin B12 deficient anemia. The patient responded well to supplementation with B12 alone and was developmentally normal by 11 months of age. This study emphasizes the need for assuring maternal dietary adequacy during pregnancy and after birth.

  5. Randomised controlled trial testing the effect of cotrimoxazole prophylaxis on morbidity and mortality outcomes in breastfed HIV-exposed uninfected infants: study protocol.

    Science.gov (United States)

    Coutsoudis, Anna; Daniels, Brodie; Moodley-Govender, Eshia; Ngomane, Noluthando; Zako, Linda; Spooner, Elizabeth; Kiepiela, Photini; Reddy, Shabashini; Kuhn, Louise; Ramjee, Gita

    2016-07-12

    No randomised controlled trial (RCT) has examined the efficacy of cotrimoxazole (CTX) prophylaxis in HIV-exposed uninfected (HEU) infants during the breastfeeding period, in this new era of effective prevention of mother-to-child transmission (PMTCT) prophylaxis. The efficacy of CTX prophylaxis has presently been demonstrated only in HIV-infected children. The absence of proven benefits in HEU breastfed infants associated with infectious diseases justifies an RCT as proposed. Herewith lies the rationale for conducting the proposed study. A partially blinded RCT is proposed to evaluate the efficacy of CTX prophylaxis administered from 6 weeks of age to HEU infants receiving a PMTCT regimen. A non-inferiority design will be used, randomising 1298 infants to receive CTX or not to receive CTX. Participants will be reviewed at the following time points: 6 weeks (enrolment and randomisation), 10 weeks, 14 weeks, 4 months and monthly thereafter until 12 months of age. They will be evaluated for anthropometric growth, interval illness, CTX adherence, signs and symptoms of study drug toxicity, concomitant medication use, breastfeeding status and HIV infection status. The study will compare the incidence of grade 3 and grade 4 common childhood illnesses (focusing on pneumonia and diarrhoea) and all-cause mortality until 12 months of age. In a subset of participants, we will compare grade 3 and grade 4 haemoglobin and alanine aminotransferase results as well as investigate gut integrity. The study has ethical approval from the University of KwaZulu-Natal Biomedical Research Ethics Committee (BFC212/13). PACTR201311000621110 and DOH-27-0614-4728; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Prevention of vitamin K deficiency bleeding in breastfed infants: lessons from the Dutch and Danish biliary atresia registries.

    NARCIS (Netherlands)

    Hasselt, PM van; Koning, TJ de; Kvist, N.; Vries, E. De; Lundin, C.R.; Berger, R.; Kimpen, J.L.; Houwen, R.H.; Jorgensen, M.H.; Verkade, H.J.; Aronsen, D.C.; Kindermann, A.; Kneepkens, C.M.; Heurn, L.W.E. van; Neucker, A.M.; Langen, Z.J. de; Peeters, P.M.; Madern, G.C.; Escher, J.H.; Zee, D.C. van der; Rieu, P.N.M.A.; Tolboom, J.J.M.

    2008-01-01

    OBJECTIVE: Newborns routinely receive vitamin K to prevent vitamin K deficiency bleeding. The efficacy of oral vitamin K administration may be compromised in infants with unrecognized cholestasis. We aimed to compare the risk of vitamin K deficiency bleeding under different prophylactic regimens in

  7. Long-chain polyunsaturated fatty acids in breast milk and early weight gain in breast-fed infants.

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A.H.; Smit, H.A.; Brunekreef, B.; de Jongste, J.C.; Gerritsen, J.; Seidell, J.C.

    2009-01-01

    The long-chain PUFA (LCPUFA) content of an infant's diet might affect early weight gain. In early trials on supplementation of formula feeding n-3 LCPUFA affected weight gain adversely. n-6 LCPUFA are thought to promote adipose tissue development and might be associated with higher weight gain. We

  8. Long-chain polyunsaturated fatty acids in breast milk and early weight gain in breast-fed infants

    NARCIS (Netherlands)

    Scholtens, Salome; Wijga, Alet H.; Smit, Henriette A.; Brunekreef, Bert; de Jongste, Johan C.; Gerritsen, Jorrit; Seidell, Jaap C.

    The long-chain PUFA (LCPUFA) content of an infant's diet might affect early weight gain. In early trials on supplementation of formula feeding n-3 LCPUFA affected weight gain adversely. n-6 LCPUFA are thought to promote adipose tissue development and might be associated with higher weight gain. We

  9. Long-chain polyunsaturated fatty acids in breast milk and early weight gain in breast-fed infants.

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A.H.; Smit, H.A.; Brunekreef, B.; de Jongste, J.C.; Gerritsen, J.; Seidell, J.C.

    2008-01-01

    The long-chain PUFA (LCPUFA) content of an infant's diet might affect early weight gain. In early trials on supplementation of formula feeding n-3 LCPUFA affected weight gain adversely. n-6 LCPUFA are thought to promote adipose tissue development and might be associated with higher weight gain. We

  10. Prevention of vitamin K deficiency bleeding in breastfed infants: lessons from the Dutch and Danish biliary atresia registries

    DEFF Research Database (Denmark)

    Hasselt, P.M. van; Koning, T.J. de; Vries, E. de

    2008-01-01

    OBJECTIVE: Newborns routinely receive vitamin K to prevent vitamin K deficiency bleeding. The efficacy of oral vitamin K administration may be compromised in infants with unrecognized cholestasis. We aimed to compare the risk of vitamin K deficiency bleeding under different prophylactic regimens ...... prophylaxis at birth. Our data underline the fact that event analysis in specific populations at risk can help to evaluate and improve nationwide prophylactic regimens Udgivelsesdato: 2008/4...

  11. Discharge timing, outpatient follow-up, and home care of late-preterm and early-term infants.

    Science.gov (United States)

    Hwang, Sunah S; Barfield, Wanda D; Smith, Ruben A; Morrow, Brian; Shapiro-Mendoza, Carrie K; Prince, Cheryl B; Smith, Vincent C; McCormick, Marie C

    2013-07-01

    To compare the timing of hospital discharge, time to outpatient follow-up, and home care practices (breastfeeding initiation and continuation, tobacco smoke exposure, supine sleep position) for late-preterm (LPT; 34 0/7-36 6/7 weeks) and early-term (ET; 37 0/7-38/6/7 weeks) infants with term infants. We analyzed 2000-2008 data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System. χ(2) Analyses were used to measure differences in maternal and infant characteristics, hospital discharge, outpatient care, and home care among LPT, ET, and term infants. We calculated adjusted risk ratios for the risk of adverse care outcomes among LPT and ET infants compared with term infants. In the adjusted analysis, LPT infants were less likely to be discharged early compared with term infants, whereas there was no difference for ET infants (risk ratio [RR; 95% confidence interval (CI)]: 0.65 [0.54-0.79]; 0.95 [0.88-1.02]). [corrected]. LPT and ET infants were more likely to have timely outpatient follow-up (1.07 [1.06-1.08]; 1.02 [1.02-1.03]), more likely to experience maternal tobacco smoke exposure (1.09 [1.05-1.14]; 1.08 [1.06-1.11]), less likely to be initially breastfed (0.95 [0.94-0.97]; 0.98 [0.97-0.98]), less likely to be breastfed for ≥10 weeks (0.88 [0.86-0.90]; 0.94 [0.93-0.96]), and less likely to be placed in a supine sleep position (0.95 [0.93-0.97]; 0.97 [0.96-0.98]). Given that LPT and ET infants bear an increased risk of morbidity and mortality, greater efforts are needed to ensure safe and healthy posthospitalization and home care practices for these vulnerable infants.

  12. Safety and immunomodulatory effects of three probiotic strains isolated from the feces of breast-fed infants in healthy adults: SETOPROB study.

    Directory of Open Access Journals (Sweden)

    Julio Plaza-Diaz

    Full Text Available We previously described the isolation and characterization of three probiotic strains from the feces of exclusively breast-fed newborn infants: Lactobacillus paracasei CNCM I-4034, Bifidobacterium breve CNCM I-4035 and Lactobacillus rhamnosus CNCM I-4036. These strains were shown to adhere to intestinal mucus in vitro, to be sensitive to antibiotics and to resist biliary salts and low pH. In the present study, a multicenter, randomized, double-blind, placebo-controlled trial with 100 healthy volunteers in three Spanish cities was carried out to evaluate the tolerance, safety, gut colonization and immunomodulatory effects of these three probiotics. Volunteers underwent a 15-day washout period, after which they were randomly divided into 5 groups that received daily a placebo, a capsule containing one of the 3 strains or a capsule containing a mixture of two strains for 30 days. The intervention was followed by another 15-day washout period. Patients did not consume fermented milk for the entire duration of the study. Gastrointestinal symptoms, defecation frequency and stool consistency were not altered by probiotic intake. No relevant changes in blood and serum, as well as no adverse events occurred during or after treatment. Probiotic administration slightly modified bacterial populations in the volunteers' feces. Intestinal persistence occurred in volunteers who received L. rhamnosus CNCM I-4036. Administration of B. breve CNCM I-4035 resulted in a significant increase in fecal secretory IgA content. IL-4 and IL-10 increased, whereas IL-12 decreased in the serum of volunteers treated with any of the three strains. These results demonstrate that the consumption of these three bacterial strains was safe and exerted varying degrees of immunomodulatory effects.ClinicalTrials.gov NCT01479543.

  13. Safety and Immunomodulatory Effects of Three Probiotic Strains Isolated from the Feces of Breast-Fed Infants in Healthy Adults: SETOPROB Study

    Science.gov (United States)

    Plaza-Diaz, Julio; Gomez-Llorente, Carolina; Campaña-Martin, Laura; Matencio, Esther; Ortuño, Inmaculada; Martínez-Silla, Rosario; Gomez-Gallego, Carlos; Periago, Maria Jesús; Ros, Gaspar; Chenoll, Empar; Genovés, Salvador; Casinos, Beatriz; Silva, Ángela; Corella, Dolores; Portolés, Olga; Romero, Fernando; Ramón, Daniel; Perez de la Cruz, Antonio; Gil, Angel; Fontana, Luis

    2013-01-01

    We previously described the isolation and characterization of three probiotic strains from the feces of exclusively breast-fed newborn infants: Lactobacillus paracasei CNCM I-4034, Bifidobacterium breve CNCM I-4035 and Lactobacillus rhamnosus CNCM I-4036. These strains were shown to adhere to intestinal mucus in vitro, to be sensitive to antibiotics and to resist biliary salts and low pH. In the present study, a multicenter, randomized, double-blind, placebo-controlled trial with 100 healthy volunteers in three Spanish cities was carried out to evaluate the tolerance, safety, gut colonization and immunomodulatory effects of these three probiotics. Volunteers underwent a 15-day washout period, after which they were randomly divided into 5 groups that received daily a placebo, a capsule containing one of the 3 strains or a capsule containing a mixture of two strains for 30 days. The intervention was followed by another 15-day washout period. Patients did not consume fermented milk for the entire duration of the study. Gastrointestinal symptoms, defecation frequency and stool consistency were not altered by probiotic intake. No relevant changes in blood and serum, as well as no adverse events occurred during or after treatment. Probiotic administration slightly modified bacterial populations in the volunteers’ feces. Intestinal persistence occurred in volunteers who received L. rhamnosus CNCM I-4036. Administration of B. breve CNCM I-4035 resulted in a significant increase in fecal secretory IgA content. IL-4 and IL-10 increased, whereas IL-12 decreased in the serum of volunteers treated with any of the three strains. These results demonstrate that the consumption of these three bacterial strains was safe and exerted varying degrees of immunomodulatory effects. Trial Registration ClinicalTrials.gov NCT01479543 PMID:24205115

  14. Cranial sonography in term and near-term infants

    Energy Technology Data Exchange (ETDEWEB)

    Yikilmaz, Ali [Gevher Nesibe Hospital and Erciyes Medical School, Department of Radiology, Talas, Kayseri (Turkey); Taylor, George A. [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2008-06-15

    Sonographic patterns of brain injury in the term and near-term infant are quite different from those in the premature infant. Although periventricular leukomalacia and germinal matrix hemorrhage are rarely seen in term infants, selective neuronal injury, parasagittal infarction, focal stroke, diffuse hypoxic-ischemic injury, and deep parenchymal hemorrhages are more common lesions. In addition, congenital brain tumors, hamartomatous lesions, such as hemimegalencephaly, and tuberous sclerosis can mimic ischemic and hemorrhagic injury. Sonography remains an important tool in the initial evaluation of intracranial abnormalities in critically ill term and near-term infants. An understanding of the differences in etiology, sonographic patterns, and limitations of sonography in the term infant is essential for accurate and effective diagnoses in this age group. (orig.)

  15. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding.

    Science.gov (United States)

    Jaafar, Sharifah Halimah; Jahanfar, Shayesteh; Angolkar, Mubashir; Ho, Jacqueline J

    2011-03-16

    To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast milk production and shorten duration of breastfeeding; however, this remains unclear. To assess the effect of pacifier use versus no pacifier use in healthy full-term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2010). Randomised and quasi-randomised controlled trials comparing pacifier use versus no pacifier use in healthy full-term newborns who have initiated breastfeeding regardless of whether they were born at home or in the hospital. Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We found three trials (involving 1915 babies) for inclusion in the review but have included only two trials (involving 1302 healthy full-term breastfeeding infants) in the analysis. Meta-analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.00; 95% confidence interval (CI) 0.95 to 1.06), and at four months of age (RR 0.99; 95% CI 0.92 to 1.06) and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.97 to 1.02), and at 4 months of age (RR 1.01; 95% CI 0.98 to 1.03). Pacifier use in healthy term breastfeeding infants, started from birth or after lactation is established, did not significantly affect the prevalence or duration of

  16. INDICATORS OF LONG-CHAIN POLYUNSATURATED FATTY-ACID STATUS OF EXCLUSIVELY BREAST-FED INFANTS AT DELIVERY AND AFTER 20-22 DAYS

    NARCIS (Netherlands)

    VANBEUSEKOM, CM; NIJEBOER, HJ; VANDERVEERE, CN; LUTEYN, AJ; OFFRINGA, PJ; MUSKIET, FAJ; BOERSMA, ER

    The fatty acid composition of plasma cholesterol esters (CE), erythrocytes (RBC) and mature milk from seven lactating /women and their exclusively breastfed newborns, living on Dominica, were studied. Blood samples were taken from umbilical cord and mother at birth. A sample of breastmilk was

  17. Respiratory distress of the term newborn infant.

    Science.gov (United States)

    Edwards, Martin O; Kotecha, Sarah J; Kotecha, Sailesh

    2013-03-01

    Respiratory distress is recognised as any signs of breathing difficulties in neonates. In the early neonatal period respiratory distress is common, occurring in up to 7% of newborn infants, resulting in significant numbers of term-born infants being admitted to neonatal units. Many risk factors are involved; the increasing number of term infants delivered by elective caesarean section has also increased the incidence. Additionally the risk decreases with each advancing week of gestation. At 37 weeks, the chances are three times greater than at 39-40 weeks gestation. Multiple conditions can present with features of respiratory distress. Common causes in term newborn infants include transient tachypnoea of the newborn, respiratory distress syndrome, pneumonia, meconium aspiration syndrome, persistent pulmonary hypertension of the neonate and pneumothorax. Early recognition of respiratory distress and initiation of appropriate treatment is important to ensure optimal outcomes. This review will discuss these common causes of respiratory distress in term-born infants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Prevalência do uso de chupeta em lactentes amamentados e não amamentados atendidos em um hospital universitário Prevalencia del uso de chupete en lactantes amamantados y no amamantados atendidos en un hospital universitario Prevalence of pacifier among breastfed and not breastfed infants attending a university hospital

    Directory of Open Access Journals (Sweden)

    Silvia Diez Castilho

    2012-06-01

    and the arguments for changing their minds about the pacifier used. METHODS: Cross sectional study comprising 642 mother-infant pairs (0-12months at a University Hospital, in Campinas, São Paulo, Brazil. The mother was questioned about her original intention regarding the pacifier, the current outcome and the explanation for changing or not her mind. After a descriptive analysis, the logistic regression was applied to verify the association between the pacifier and breastfeeding. RESULTS: The prevalence of pacifier use was 48% (95%CI 44-52, being greater among non-breastfeed infants (70% compared those breastfed (36%; p=0.029. Among the infants exclusively breastfed, 29% used pacifier (p<0.001. The chance to be breastfed was smaller when the infant used a pacifier (OR=0.22; 95%CI 0.15-0.33. Among the mothers, 60% changed their minds regarding their previous intention about pacifier use. The main reasons for changing plans were: infant rejection (95% - for those who wanted to use the pacifier, and to soothe the baby (72% - for those who initially did not want to use the pacifier. CONCLUSIONS: The prevalence of pacifier use is high. This habit is more frequent among non-breastfed infants; among the breastfed ones, it is less frequent for those exclusively-breastfed. The majority of mothers changed their minds regarding their initial plans about pacifier use. Few worried about the possibility that the pacifier could interfere on breastfeeding.

  19. Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding.

    Science.gov (United States)

    Jaafar, Sharifah Halimah; Ho, Jacqueline J; Jahanfar, Shayesteh; Angolkar, Mubashir

    2016-08-30

    To successfully initiate and maintain breastfeeding for a longer duration, the World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of artificial teats or pacifiers for breastfeeding infants. Concerns have been raised that offering the pacifier instead of the breast to calm the infant may lead to less frequent episodes of breastfeeding and as a consequence may reduce breast-milk production and shorten duration of breastfeeding. To assess the effect of restricted versus unrestricted pacifier use in healthy full-term newborns whose mothers have initiated breastfeeding and intend to exclusively breastfeed, on the duration of breastfeeding, other breastfeeding outcomes and infant health. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2016) and reference lists of retrieved studies. Randomised and quasi-randomised controlled trials comparing restricted versus unrestricted pacifier use in healthy full-term newborns who have initiated breastfeeding. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach. We found three trials (involving 1915 babies) for inclusion in the review, but have included only two trials (involving 1302 healthy full-term breastfeeding infants) in the analysis. Meta-analysis of the two combined studies showed that pacifier use in healthy breastfeeding infants had no significant effect on the proportion of infants exclusively breastfed at three months (risk ratio (RR) 1.01; 95% confidence interval (CI) 0.96 to 1.07, two studies, 1228 infants), and at four months of age (RR 1.01; 95% CI 0.94 to 1.09, one study, 970 infants, moderate-quality evidence), and also had no effect on the proportion of infants partially breastfed at three months (RR 1.00; 95% CI 0.98 to 1.02, two studies, 1228 infants), and at four months of age (RR 0.99; 95% CI 0

  20. Multicystic encephalomalacia in term infants.

    Science.gov (United States)

    Frigieri, G; Guidi, B; Costa Zaccarelli, S; Rossi, C; Muratori, G; Ferrari, F; Cavazzuti, G B

    1996-12-01

    The terms "multicystic encephalomalacia" and "subcortical leucomalacia" (SCL) are used to describe the presence of areas of necrosis that develop into cystic lesions inside the brain. These lesions are generally due to severe asphyxia and/or hypotension. The designation SCL can also be used to describe the extent and the seat of the lesion in the brain or to distinguish subcortical lesions from periventricular and/or combined ones. In this study we give an account of our experience with eight newborns admitted to our neonatal intensive care unit, who presented clinical-neurological alterations and encephalomalacic lesions whose presence was documented by ultrasonography.

  1. Adequacy and safety of an infant formula with a protein/energy ratio of 1.8 g/100 kcal and enhanced protein efficiency for term infants during the first 4 months of life.

    Science.gov (United States)

    Turck, Dominique; Grillon, Christophe; Lachambre, Emmanuelle; Robiliard, Patrick; Beck, Laurence; Maurin, Jean-Luc; Kempf, Christian; Bernet, Jean-Paul; Marx, Jacques; Lebrun, Françoise; Van Egroo, Louis-Dominique

    2006-09-01

    Excess protein in infant formula may lead to renal overload and play a role in later obesity. The objective of this controlled, prospective, randomized, double-blind study was to assess the suitability and safety of a modified protein content infant formula and its noninferiority as compared to a conventional formula. Healthy term infants age energy ratio: 2.6 g/100 kcal) or the isocaloric whey-predominant study formula (protein/energy ratio: 1.8 g/100 kcal) for 120 days. Primary outcome was daily weight gain between D0 and D120 (noninferiority criterion: difference in daily weight gain index at monthly intervals. Tolerance and safety were assessed at each visit. 162 infants were enrolled, 84% of the formula-fed infants and 36% of the breast-fed infants completing the study. Mean daily weight gain from D0 to D120 in the formula-fed groups differed by 0.38 g/day [95% CI: -2.59; 1.83] signifying the noninferiority of the study formula. Secondary outcomes did not differ between the 2 groups at any time and were comparable to outcomes in the breast-fed group. Tolerance was good and adverse events were not different between study groups. The whey-predominant study infant formula with a protein/energy ratio of 1.8 g/100 kcal and enhanced protein efficiency is safe and not inferior to a conventional formula in ensuring normal growth during the first four months of life.

  2. Changes in soluble transferrin receptor and hemoglobin concentrations in Malawian mothers are associated with those values in their exclusively breastfed, HIF-exposed infants

    Science.gov (United States)

    Background: Infant iron status at birth is influenced by maternal iron status during pregnancy; however there are few data on the extent to which maternal iron status is associated with infant iron status during exclusive breastfeeding. Objective: We evaluated how maternal and infant hemoglobin (Hb...

  3. Changes in soluble transferrin receptor and hemoglobin concentrations in Malawian mothers are associated with those values in their exclusively breastfed, HIV-exposed infants.

    Science.gov (United States)

    Infant iron status at birth is influenced bymaternal iron status during pregnancy; however, there are limited data on the extent to which maternal iron status is associated with infant iron status during exclusive breastfeeding. We evaluated how maternal and infant hemoglobin and iron status [solubl...

  4. The utility of alkaline phosphatase measurement as a screening test for rickets in breast-fed infants and toddlers: a study from the puget sound pediatric research network.

    Science.gov (United States)

    Taylor, James A; Richter, Monica; Done, Stephen; Feldman, Kenneth W

    2010-12-01

    To determine if alkaline phosphatase (AP) levels are a useful screening test for rickets, the authors measured serum AP levels in children 6 to 15 months old who were predominantly breast-fed for > 6 months without vitamin D supplementation. Radiographs were obtained on children with elevated AP levels to determine the presence of rickets. AP levels were obtained on 246 children; levels were elevated in 33 (13.4%). Rickets was present in 4 of 18 children with elevated levels on whom radiographs were obtained. The sensitivity and specificity of AP levels as a test for rickets was maximal at a cutoff value of 552 U/L. Using this cutoff value, the specificity of AP levels as a test for rickets was 97.4%, and the positive predictive value (PPV) was 40.0%. These results suggest that AP levels may be a useful screening test for rickets in children who are breast-fed for prolonged periods without vitamin D supplementation.

  5. Slight Hydronephrosis in Newborns and Breast-fed Infants: Can the Presence of Vesicoureteral Reflux Be Predicted?; Hidronefrosis leve en neonatos y lactantes: puede predecirse la presencia del reflujo vesicoureteral?

    Energy Technology Data Exchange (ETDEWEB)

    Berrocal, T.; Pablo, T. de; Gutierrez, J.; Prieto, C.; Hoyo, M. L. del [Hospital Universitario La Paz. Madrid (Spain)

    2003-07-01

    The purpose of this study was to determine the value of slight-to moderate echo graphically detected hydronephrosis in newborns and breast-fed infants that might serve as indicator for Vesicoureteral reflux (VUR), and to evaluate the necessity of performing micturating cystourethrougraphy (MCUG) in these patients. There were reviewed MCUG of 237 patients (174 boys and 63 girls between the ages of 0 and 18 months) with slight echo graphically detected hydronephrosis in order to evaluate the presence of primary VUR. Patients with secondary reflux or those that presented anomalies which made impossible an exact reflux gradind were excluded. However, normal kidneys with reflux which were contralateral to hydronephrotic kidneys were included in the study. For a statistical analysis of the data, each kidney was considered separately, thereby forming a total of 474 kidneys. Slight hydronephrosis was diagnosed when the renal pelvis anteroposterior diameter was observed to measure between 0.5 and 1.5 cm. The International Grading System was used to grade reflux during MCUG. Of the 474 kidneys evaluated, 306 showed slight hydromephrosis in the echography. Only 98 of these presented reflux (32%) (14 grade 1.50 grade II, 32 grade III and 2 grade IV). The echography was normal (i. e. hydronephrosis not present) in 52 kidneys with reflux (31%) which were contralateral to hydronephrotic kidneys, although 38 of these had reflux of grade II or higher. The echography showed slight hydronephrosis in 208 kidneys that did not have reflux during MCUG (68%). There were no significant differences in the incidence of VUR among normal or hydronephrotic kidneys. There is a poor correlation between slight hydronephrosis and presence or grade of reflux in newborns and breast-fed infants. The latter should not, therefore, be considered an indication for MCUC. (Author) 33 refs.

  6. Fatty acid composition in breast milk and serum phospholipids of healthy term Chinese infants during first 6 weeks of life.

    Science.gov (United States)

    Peng, Y M; Zhang, T Y; Wang, Q; Zetterström, R; Strandvik, B

    2007-11-01

    To compare the fatty acid (FA) pattern in early and mature breast milk with that in plasma phospholipids of cord blood and breast-fed infants. Forty-five mother-infant pairs from western Shanghai were studied. All infants, born at term with normal weight and length, were examined at birth and days 5 and 42. FA was analyzed by capillary gas-liquid chromatography. Cord blood showed higher concentration of long-chain polyunsaturated FA (LCPUFA) but lower saturated (SFA) and monounsaturated (MUFA) FA than postnatal infants' plasma. SFA decreased with age in the infants, but MUFA and linoleic acid (LA, 18:2omega6) increased. LCPUFA were lower in the plasma of 5-day-old infants than in cord blood, but LA was 80%, alpha-linolenic acid (ALA, 18:3omega3) 33% and the ratio omega-6/omega-3 42% higher. At day 42, LA increased further, LCPUFA remained similar, and was in breast milk lower than at day 5, while ALA and gamma-linolenic acid (18:3omega6) were higher. The activity index of desaturases indicated high Delta9 activity in breast milk and high activity of Delta5 desaturase in the infants. Breast milk FA composition changed markedly from day 5 to 42 with increasing correlation to infants' plasma. Calculation of desaturase activities suggested high capacity of LCPUFA synthesis.

  7. Excess weight loss in first-born breastfed newborns relates to maternal intrapartum fluid balance.

    Science.gov (United States)

    Chantry, Caroline J; Nommsen-Rivers, Laurie A; Peerson, Janet M; Cohen, Roberta J; Dewey, Kathryn G

    2011-01-01

    The objectives were to describe weight loss in a multiethnic population of first-born, predominantly breastfed, term infants and to identify potentially modifiable risk factors for excess weight loss (EWL). Data on prenatal breastfeeding intentions, demographic characteristics, labor and delivery interventions and outcomes, breastfeeding behaviors, formula and pacifier use, onset of lactogenesis, and nipple type and pain were collected prospectively. Logistic regression analyses identified independent predictors of EWL (≥10% of birth weight) by using a preplanned theoretical model. EWL occurred for 18% of infants who received no or minimal (≤60 mL total since birth) formula (n = 229), including 19% of exclusively breastfed infants (n = 134) and 16% of infants who received minimal formula (n = 95). In bivariate analyses, EWL was associated (P lactogenesis (>72 hours), fewer infant stools, and infant birth weight. In multivariate logistic regression analysis, only 2 variables predicted EWL significantly, namely, intrapartum fluid balance (adjusted relative risk for EWL of 3.18 [95% confidence interval [CI]: 1.35-13.29] and 2.80 [95% CI: 1.17-11.68] with net intrapartum fluid balance of >200 and 100-200 mL/hour, respectively, compared with lactogenesis (adjusted relative risk: 3.35 [95% CI: 1.74-8.10]). EWL was more common in this population than reported previously and was independently related to intrapartum fluid balance. This suggests that intrapartum fluid administration can cause fetal volume expansion and greater fluid loss after birth, although other mechanisms are possible.

  8. Maternal Intention to Breastfeed and Breastfeeding Outcomes in Term and Preterm Infants: PRAMS 2000–2003

    Science.gov (United States)

    Colaizy, Tarah T.; Saftlas, Audrey F.; Morriss, Frank H.

    2012-01-01

    Objective To determine the effect of intention to breastfeed on short-term breastfeeding outcomes in women delivering term and preterm infants Design Data from the CDC Pregnancy Risk Assessment Monitoring System (PRAMS) for three states, Ohio, Michigan and Arkansas during 2000–2003 were analyzed. SAS 9.1.3 and SUDAAN 10 were used for analyses. Results 16839 subjects were included, 9.7% delivered preterm. 52.5% expressed definite intention to breastfeed, 16.8% tentative intention, 4.3% were uncertain, 26.8% had no intention to breastfeed. 65.2% initiated breastfeeding, 45.2% breastfed ≥ 4weeks, 30% breastfed ≥ 10 weeks. Women with definite intention were more likely to initiate (OR 24.3, 95% CI 18.4, 32.1), to breastfeed ≥ 4 weeks (OR 7.12, 95% CI 5.95, 8.51), and to breastfeed ≥ 10 weeks (OR 2.75, 95% CI 2.2, 3.45) compared to tentative intention. Levels of intention did not differ between women delivering preterm and term. Women delivering at < 34 weeks were more likely to initiate breastfeeding (OR 2.24, 95% CI 1.64, 3.06), and to breastfeed ≥ 4 weeks (OR 2.58, 95% CI 1.96, 3.41), but less likely to breastfeed ≥ 10 weeks (OR 0.55, 95% CI 0.44, 0.68) compared to term. Women delivering between 34 and 36 weeks were less likely to breastfeed ≥ 10 weeks than those delivering at term (OR 0.63, 95% CI 0.49, 0.81). Conclusions Prenatal intention to breastfeed is a powerful predictor of short-term breastfeeding outcomes in women delivering both at term and prematurely. PMID:21936968

  9. Maternal fish consumption in the nutrition transition of the Amazon Basin: growth of exclusively breastfed infants during the first 5 years.

    Science.gov (United States)

    Marques, Rejane C; Dórea, José Garrofe; Bernardi, José V E; Bastos, Wanderley R; Malm, Olaf

    2008-01-01

    Changes in fish-eating habits due to rapid urbanization in Western Amazon was used as model to investigate whether maternal fish-intake rate impacts on children's weight and height during the first 5 years. The study examined the growth of 82 breastfed children, and maternal fish consumption (hair mercury concentrations, HHg) during pregnancy and lactation. Fish consumption in mothers and children was estimated through HHg. The children were measured and weighed at birth and at 6 (exclusive breastfeeding), 36 and 60 months. Fish consumption rate (HHg) had no significant impact on children's growth at the specified ages (p = 0.35). After 6 months of exclusive breastfeeding, children had the highest proportion of Z-scores -1 SD) for height-for-age (70/82), weight-for-age (74/82) and weight-for-height (74/82). At 5 years, all but one child attained Z-scores >-1. The apparently good nutritional status of subjects is more likely due to a well balanced diet composition than to only one dietary protein source--fish.

  10. Growth of exclusively breastfed and self-weaned children of Greece aged 0-36 months.

    Science.gov (United States)

    Patsourou, Anna; Konstantinides, Theodoros; Mantadakis, Elpis; Tsalkidis, Aggelos; Zarras, Charalambos; Balaska, Athena; Simopoulos, Konstantinos; Chatzimichael, Athanassios

    2012-12-01

    Breastfeeding is recognized as an important public health issue with substantial social and economic implications. Moreover, the growth of exclusively breastfed babies differs from that of their formula-fed counterparts. The purpose of this study was to evaluate the physical growth of exclusively breastfed and self-weaned boys and girls of Greece 0-36 months of age. The physical growth of children was monitored from birth up to 36 months of age. Body weight, length/height, and head circumference were recorded. The study population included 101 boys and 105 girls who were recruited consecutively from a private breastfeeding clinic in the second largest city of Greece and through La Leche League groups throughout the country during 2000 to 2005. All infants were exclusively breastfed for ≥ 6 months. Anthro software ( www.who.int/childgrowth/software/en/index.html ) was used to compare the data of our study population and the World Health Organization standards for weight, length/height, and head circumference for age. Male and female infants at 12 months had almost tripled their weight (192% and 190% increase, respectively) and had increased their length (height) by 48% and 47%, respectively, and head circumference had increased by 35% and 33%, respectively. In both sexes the relative length/height and the head circumference-for-age increase rates were higher from the first to the second month of life than at any other period. Long-term exclusively breastfed infants grow normally. Hence, no recommendations for the interruption of lactation and/or supplementation with formula are justified.

  11. Preterm Infants Exhibit Greater Variability in Cerebrovascular Control than Term Infants

    Science.gov (United States)

    Fyfe, Karinna L.; Odoi, Alexsandria; Yiallourou, Stephanie R.; Wong, Flora Y.; Walker, Adrian M.; Horne, Rosemary S.C.

    2015-01-01

    Study Objectives: Sudden infant death syndrome (SIDS) remains an important cause of infant death, particularly among infants born preterm. Prone sleeping is the major risk factor for SIDS and this has recently been shown to alter cerebrovascular control in term infants. As preterm infants are at greater risk for SIDS than those born at term, we hypothesized that their cerebrovascular control in the prone position would be reduced compared to term infants. Patients or Participants: There were 35 preterm (mean gestation 31.2 ± 0.4 w) and 17 term (mean gestation 40.1 ± 0.3 w) infants. Design: Infants underwent daytime polysomnography at 2–4 w, 2–3 mo, and 5–6 mo postterm age. Infants slept both prone and supine and were presented with cardiovascular challenges in the form of 15° head-up tilts (HUT). Measurements and Results: Cerebral tissue oxygenation index (TOI) was recorded using near-infrared spectroscopy (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and mean arterial pressure (MAP) was recorded using a Finometer cuff (Finapres Medical Systems, Amsterdam, The Netherlands). In the prone position TOI increased following the HUT (P < 0.05), whereas no change was seen in the supine position. The overall pattern of response was similar in both groups, but more variable in preterm than term infants (P < 0.05). Conclusions: Cerebrovascular control differs between the prone and supine positions in preterm infants. Although overall the responses to head-up tilts were similar between term and preterm infants, greater variability of responses in preterm infants suggests persisting immaturity of their cerebrovascular control in the first year of life, which may contribute to their increased risk of sudden infant death syndrome. Citation: Fyfe KL, Odoi A, Yiallourou SR, Wong FY, Walker AM, Horne RS. Preterm infants exhibit greater variability in cerebrovascular control than term infants. SLEEP 2015;38(9):1411–1421. PMID:25669192

  12. Early short-term infant food supplementation, maternal weight loss and duration of breast-feeding: a randomised controlled trial in rural Senegal.

    Science.gov (United States)

    Ly, C T; Diallo, A; Simondon, F; Simondon, K B

    2006-02-01

    Early supplementation of breastfed infants may have consequences both for the mother and the child. We hypothesised that it would result in decreased maternal weight loss and in shorter durations of breastfeeding and birth intervals. Controlled randomised population-based trial. Six villages in the Sine area of Senegal, West Africa. Healthy breastfed infants and their mothers, 68 controls and 66 supplemented infants at randomization. Supplementation with high-energy, nutrient dense food from 4 to 7 months of age, twice daily under supervision of field workers. Both controls and supplemented infants were free to eat other complementary foods. Maternal weight was measured monthly. Dates of breastfeeding cessation and of subsequent births were collected prospectively through weekly demographic surveillance, and were analysed using Cox's regression models and 'intent-to-supplement' approach. Mean maternal weight gain from 4 to 7 months postpartum tended to be greater in the supplemented group (+0.25 kg/months, 95% confidence interval (CI): -0.07, +0.57). Supplemented infants were breastfed for significantly longer durations than controls (medians: 24.9 and 23.7 months, respectively, P: 0.034). Their adjusted hazard ratio (HR) for breastfeeding cessation was 0.59 (95% CI: 0.40, 0.89). Their mothers had a lower risk of a new birth than mothers of controls (adjusted HR: 0.57, 95% CI: 0.36, 0.92). Early short-term infant supplementation tended to decrease maternal postpartum weight loss, but it increased, rather than shortened, the duration of breastfeeding and birth interval. This study was supported by a grant from the French Ministry of Research (Grant 92L0623).

  13. Lactation Support and Breastfeeding Duration in Jaundiced Infants: A Randomized Controlled Trial

    OpenAIRE

    Catherine M Pound; Katherine Moreau; Kristina Rohde; Nick Barrowman; Mary Aglipay; Farion, Ken J.; Plint, Amy C.

    2015-01-01

    Objectives Neonatal jaundice is the most common problem in full-term infants during the immediate post-natal period. We examined the effect of a lactation support intervention on breastfeeding duration in hospitalized jaundiced infants. Study Design We conducted a randomized controlled trial with a qualitative component involving mothers of hospitalized jaundiced breastfed infants

  14. Early short-term infant food supplementation, maternal weight loss and duration of breast-feeding : a randomised controlled trial in rural Senegal

    OpenAIRE

    Ly, C.T.; Diallo, A.; Simondon, François; Simondon, Kirsten

    2006-01-01

    Objective: Early supplementation of breastfed infants may have consequences both for the mother and the child. We hypothesised that it would result in decreased maternal weight loss and in shorter durations of breastfeeding and birth intervals. Design: Controlled randomised population-based trial. Setting: Six villages in the Sine area of Senegal, West Africa. Subjects: Healthy breastfed infants and their mothers, 68 controls and 66 supplemented infants at randomization. Intervention: Supplem...

  15. Early term birth: understanding the health risks to infants.

    Science.gov (United States)

    Craighead, Debra Vela

    2012-01-01

    Early term birth, which occurs at 37 to 38 weeks gestation, is often elective and can carry significant health risks to infants, including short-term and long-term health outcomes. Nurses and other health care providers involved in the care of pregnant women and infants need to be aware of these infants' physiologic vulnerability and potential short- term and long-term care requirements. Nurses can educate patients and raise awareness of the risks associated with early term birth. © 2012 AWHONN.

  16. Hematological and iron content evolution in exclusively breastfed late-preterm newborns

    Directory of Open Access Journals (Sweden)

    Renato Takeshi Yamada

    2014-01-01

    Full Text Available OBJECTIVES: To analyze and compare the evolution of hematological parameters and body iron content between exclusively breastfed late-preterm and term newborns during the first two months of life. METHODS: Cohort study. Weight, length, head circumference, body mass index, hemoglobin, hematocrit, reticulocytes, total iron-binding capacity, transferrin saturation, serum iron and ferritin were measured in 25 late-preterm and 21 term newborns (at birth and at one and two months of age who were exclusively breastfed. Statistical analysis: Kolmogorov-Smirnov test, one-way ANOVA or Kruskal-Wallis test; and Student's t-test or Mann-Whitney test. Significance: p<0.05. RESULTS: The corrected gestational ages of the late-preterm infants were 39.98 weeks at one month of life and 44.53 weeks at two months. Anthropometric measures and the body mass index increased over time (p<0.001 and hemoglobin, hematocrit, reticulocytes and body iron content decreased (p<0.001. Late-preterm infants at term corrected gestational age had reduced hemoglobin, hematocrit and reticulocyte concentrations, and reduced total iron-binding capacity (p<0.001 and serum iron (p = 0.0034 compared with values observed in term newborns at birth. Late-preterm newborns at a corrected gestational age of one month post-term had hemoglobin (p = 0.0002, hematocrit (p = 0.0008, iron (p<0.0001 and transferrin saturation (p<0.001 levels lower than those of term newborns at one month of age and a higher total iron-binding capacity (p = 0.0018. Ferritin did not differ between the groups. CONCLUSION: Exclusively breastfed late-preterm newborns presented greater reductions in hemoglobin/hematocrit and lower iron stores at a corrected gestational age of one month post-term than did term newborns, suggesting specific iron supplementation needs.

  17. Preterm Infants Exhibit Greater Variability in Cerebrovascular Control than Term Infants.

    Science.gov (United States)

    Fyfe, Karinna L; Odoi, Alexsandria; Yiallourou, Stephanie R; Wong, Flora Y; Walker, Adrian M; Horne, Rosemary S C

    2015-09-01

    Sudden infant death syndrome (SIDS) remains an important cause of infant death, particularly among infants born preterm. Prone sleeping is the major risk factor for SIDS and this has recently been shown to alter cerebrovascular control in term infants. As preterm infants are at greater risk for SIDS than those born at term, we hypothesized that their cerebrovascular control in the prone position would be reduced compared to term infants. There were 35 preterm (mean gestation 31.2 ± 0.4 w) and 17 term (mean gestation 40.1 ± 0.3 w) infants. Infants underwent daytime polysomnography at 2-4 w, 2-3 mo, and 5-6 mo postterm age. Infants slept both prone and supine and were presented with cardiovascular challenges in the form of 15° head-up tilts (HUT). Cerebral tissue oxygenation index (TOI) was recorded using near-infrared spectroscopy (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and mean arterial pressure (MAP) was recorded using a Finometer cuff (Finapres Medical Systems, Amsterdam, The Netherlands). In the prone position TOI increased following the HUT (P position. The overall pattern of response was similar in both groups, but more variable in preterm than term infants (P positions in preterm infants. Although overall the responses to head-up tilts were similar between term and preterm infants, greater variability of responses in preterm infants suggests persisting immaturity of their cerebrovascular control in the first year of life, which may contribute to their increased risk of sudden infant death syndrome. © 2015 Associated Professional Sleep Societies, LLC.

  18. Anemia and Red Blood Cell Abnormalities in HIV-Infected and HIV-Exposed Breastfed Infants: A Secondary Analysis of the Kisumu Breastfeeding Study.

    Directory of Open Access Journals (Sweden)

    Collins Odhiambo

    Full Text Available Anemia results in increased morbidity and mortality, underscoring the need to better understand its pathophysiology amongst HIV-exposed and infected children in sub-Saharan Africa, the region where most infant HIV exposure and infections occur.This analysis used samples obtained from children in the Kisumu Breastfeeding Study (KiBS. KiBS was a longitudinal phase IIB, open-label, one-arm clinical trial, designed to investigate the safety, tolerability and effectiveness of a maternal triple-antiretroviral (ARV regimen for prevention of mother-to-child transmission (PMTCT of HIV, during late pregnancy and early infancy while breastfeeding. Blood samples from 482 children were obtained at birth, 2, 6, 10 and 14 weeks and 6, 9, 12, 18 and 24 months. Severity of anemia was graded using the NIH Division of AIDS (DAIDS toxicity tables. We describe the proportion of children with anemia and anomalies in red blood cell parameters at various time points over 24 months and compare rates of anemia between HIV-infected and HIV-uninfected children and by mothers' ARV regimen and infant malaria infection.The proportion of children with anemia significantly increased after the breastfeeding period in both HIV-infected and HIV-uninfected children with higher proportion among HIV-infected children compared to HIV-uninfected children (RR: 1.72; CI: 1.22-2.44, p = 0.002. Maternal triple-antiretroviral regimen was not associated with infant anemia (p = 0.11. There was no significant difference in mean hemoglobin between HIV-uninfected children with and without malaria at each time point except at 24 months.A relatively lower proportion of children with severe anemia during the breastfeeding period suggest that exposure to mother's triple antiretroviral combinations through breast milk, posed minimal risk of hematologic toxicity.

  19. Serum activity of dipeptidyl peptidase IV (DPPIV; EC 3.4.14.5) in breast-fed infants with symptoms of allergy.

    Science.gov (United States)

    Jarmołowska, Beata; Bielikowicz, Krzysztof; Iwan, Małgorzata; Sidor, Katarzyna; Kostyra, Elzbieta; Kaczmarski, Maciej

    2007-03-01

    Beta-casomorphins, opioid peptides present in mother's milk, are a good substrate for DPPIV (EC 3.4.14.5) which is a major factor limiting the half-life of biologically active peptides. Serum DPPIV activity of two groups of infants (healthy and atopic dermatitis) and contents of beta-casomorphin-5 and -7 in their mothers' milk were determined in the study. We have found correlation between those two parameters in the group of children with atopic dermatitis syndromes, while no such a correlation was found in the control group.

  20. The cup-versus-bottle debate: a theme from an ethnographic study of the supplementation of breastfed infants in hospital in the United kingdom.

    Science.gov (United States)

    Cloherty, Michele; Alexander, Jo; Holloway, Immy; Galvin, Kate; Inch, Sally

    2005-05-01

    This article reports 1 theme from an ethnographic study that aimed to describe the experiences, expectations, and beliefs of mothers and health care professionals concerning supplementation in a UK maternity unit. Observation was conducted on the postnatal ward and the newborn infant unit, and 30 mothers, 17 midwives, 4 neonatal nurses, 3 health care assistants, 3 senior house officers, and 3 senior pediatricians gave in-depth interviews during a 9-month period in 2002. One of the major themes that emerged was the cup-versus-bottle debate. There were 3 categories strongly linked to this theme: difficulties returning to the breast, ease of use, and necessary skills and knowledge. It appears there is an urgent need to determine which is the best method of giving supplementary feeds, so that full, accurate information can be given to mothers, appropriate policies be devised, and the necessary resources and staff training be provided.

  1. Short-term outcomes of mothers and infants exposed to antenatal amphetamines.

    Science.gov (United States)

    Oei, J; Abdel-Latif, M E; Clark, R; Craig, F; Lui, K

    2010-01-01

    To determine the short-term outcomes of newborn infants and mothers exposed to antenatal amphetamines in the state of New South Wales and the Australian Capital Territory during 2004. Amphetamine exposure was determined retrospectively using ICD-10 AM morbidity code searches of hospital medical records and from records of local drug and alcohol services. Records were reviewed on site. All public hospitals (n = 101) with obstetric services were included. Amphetamines were used by 200 (22.9%) of the 871 identified drug-using mothers. Most women (182, 91%) injected amphetamines intravenously. Compared with the other 669 drug users, amphetamine-using mothers were significantly more likely to use multiple classes of drugs (45.0% vs 7.8%), be subject to domestic violence (32.1% vs 17.5%), be homeless (14.8% vs 4.9%) and be involved with correctional services (19.8% vs 9.7%). The incidence of comorbid psychiatric illnesses were significantly higher (57.4% vs 41.7%) and their infants were more likely to be preterm (29.5% vs 20.4%), notified as children at risk (67.0% vs 32.8%), fostered before hospital discharge (14.5% vs 5.5%) and less likely to be breastfed (27.0% vs 41.6%). Amphetamine-exposed mothers and infants in public hospitals of NSW and the ACT are at significantly higher risk of adverse social and perinatal outcomes even when compared with mothers and infants exposed to other drugs of dependency. Increased vigilance for amphetamine exposure is recommended due to a high prevalence of use, especially in Australia, as a recreational drug.

  2. Evolução histórica dos utensílios empregados para alimentar lactentes não amamentados Historical evolution of utensils used to feed non breastfed infants

    Directory of Open Access Journals (Sweden)

    Silvia Diez Castilho

    2010-06-01

    Full Text Available O objetivo desse artigo de revisão é descrever os utensílios empregados ao longo da história para alimentar lactentes não amamentados. O levantamento bibliográfico foi realizado nas bases de dados MEDLINE, LILACS e SciELO, de 1966 a 2007. Para a análise documental, foram processadas buscas na Internet, em enciclopédias, livros de arte, história e museus. Utensílios manufaturados com materiais e formas variadas, dependendo da disponibilidade, poder aquisitivo e cultura, foram empregados desde os primórdios da história para alimentar bebês que, por diferentes motivos, deixaram de ser amamentados. Muitos objetos coexistiram na mesma época e local, outros em tempos e pontos geográficos distantes. A aceitação de uma nova alternativa ocorria sem evidência que comprovasse ou apontasse para os benefícios da mudança. Alguns utensílios voltaram a ser empregados embora a mortalidade infantil fosse elevada à época em que foram utilizados. No início do século XX, as mamadeiras assumiram a forma cilíndrica cônica. A tecnologia trouxe avanços no sentido de melhorar a higienização e possibilitar o controle da contaminação. O vidro deu lugar ao plástico e os bicos de borracha, aos de silicone, mas a mamadeira, como a conhecemos hoje, é a mesma de cem anos atrás.The objective of this article is to describe the utensils used throughout history to feed non breastfed infants. The method used was article review, reference search on the MEDLINE, LILACS and SciELO databases from 1966 to 2007 and documental analysis based on data from the internet, encyclopedias, art and history books, and museums. Utensils manufactured in a variety of materials and shapes, depending on availability, purchasing power and culture have been used since early history to feed babies who for different reasons were not breastfed. Many objects coexisted at the same time and place, others at distant sites and times. New alternatives have been accepted without

  3. Isolation, identification and characterisation of three novel probiotic strains (Lactobacillus paracasei CNCM I-4034, Bifidobacterium breve CNCM I-4035 and Lactobacillus rhamnosus CNCM I-4036) from the faeces of exclusively breast-fed infants.

    Science.gov (United States)

    Muñoz-Quezada, Sergio; Chenoll, Empar; Vieites, José María; Genovés, Salvador; Maldonado, José; Bermúdez-Brito, Miriam; Gomez-Llorente, Carolina; Matencio, Esther; Bernal, María José; Romero, Fernando; Suárez, Antonio; Ramón, Daniel; Gil, Angel

    2013-01-01

    The aim of the present study was to isolate, identify and characterise novel strains of lactic acid bacteria and bifidobacteria with probiotic properties from the faeces of exclusively breast-fed infants. Of the 4680 isolated colonies, 758 exhibited resistance to low pH and tolerance to high concentrations of bile salts; of these, only forty-two exhibited a strong ability to adhere to enterocytes in vitro. The identities of the isolates were confirmed by 16S ribosomal RNA (rRNA) sequencing, which permitted the grouping of the forty-two bacteria into three different strains that showed more than 99 % sequence identity with Lactobacillus paracasei, Lactobacillus rhamnosus and Bifidobacterium breve, respectively. The strain identification was confirmed by sequencing the 16S-23S rRNA intergenic spacer regions. Strains were assayed for enzymatic activity and carbohydrate utilisation, and they were deposited in the Collection Nationale de Cultures de Microorganismes (CNCM) of the Institute Pasteur and named L. paracasei CNCM I-4034, B. breve CNCM I-4035 and L. rhamnosus CNCM I-4036. The strains were susceptible to antibiotics and did not produce undesirable metabolites, and their safety was assessed by acute ingestion in immunocompetent and immunosuppressed BALB/c mouse models. The three novel strains inhibited in vitro the meningitis aetiological agent Listeria monocytogenes and human rotavirus infections. B. breve CNCM I-4035 led to a higher IgA concentration in faeces and plasma of mice. Overall, these results suggest that L. paracasei CNCM I-4034, B. breve CNCM I-4035 and L. rhamnosus CNCM I-4036 should be considered as probiotic strains, and their human health benefits should be further evaluated.

  4. Exogenous Attention Influences Visual Short-Term Memory in Infants

    Science.gov (United States)

    Ross-Sheehy, Shannon; Oakes, Lisa M.; Luck, Steven J.

    2011-01-01

    Two experiments examined the hypothesis that developing visual attentional mechanisms influence infants' Visual Short-Term Memory (VSTM) in the context of multiple items. Five- and 10-month-old infants (N = 76) received a change detection task in which arrays of three differently colored squares appeared and disappeared. On each trial one square…

  5. Delay in Retinal Photoreceptor Development in Very Preterm Compared to Term Infants

    OpenAIRE

    Vajzovic, Lejla; Rothman, Adam L.; Tran-Viet, Du; Cabrera, Michelle T.; Freedman, Sharon F.; Toth, Cynthia A.

    2015-01-01

    Photoreceptor development in very preterm infants appears delayed when compared to term infants, suggesting photoreceptor immaturity in premature infants. Delayed maturation of photoreceptors could contribute to differences in visual function in some very preterm infants.

  6. Obstetric interventions and perinatal asphyxia in growth retarded term infants

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Lindmark, G

    1997-01-01

    -fold (6-8%) for growth retarded infants both in SGA infants in general and infants with asymmetric body proportions. The immediate perinatal outcome, however, was favorable with Apgar below 8 at 5 min in only 2% irrespective of the type of growth retardation, in spite of the fact that less than 25......% of the SGA pregnancies and 10% of those with asymmetric fetal growth had been eligible for close antenatal fetal monitoring. CONCLUSION: With a moderate increase in interventions at delivery, perinatal outcome was highly favorable for term infants with a weight for gestational age, weight for length...

  7. Short-term outcome for term and near-term singleton infants with intrapartum polyhydramnios.

    Science.gov (United States)

    Leibovitch, Leah; Schushan-Eisen, Irit; Kuint, Jacob; Weissmann-Brenner, Alina; Maayan-Metzger, Ayala

    2012-01-01

    To evaluate rates of early short-term neonatal complications among term and near-term newborn infants with polyhydramnios. Retrospective data were collected on 788 term infants with prenatal diagnosis of polyhydramnios and 1,576 matched controls, including information on maternal condition and on infant perinatal complications. The total rate of major congenital malformations among infants born to mothers with polyhydramnios was 2.3% compared to 0.13% for those with normal amniotic fluid index (p polyhydramnios, but no major congenital malformations, are at increased risk for minor congenital malformations (4.2%) as well as for postnatal complications, such as respiratory distress (5.7%), cardiovascular manifestations (mainly delayed closure of the ductus arteriosus; 3.1%) and hypoglycemia (7%) compared to controls. Multivariate logistic regression revealed that polyhydramnios was associated only with postnatal respiratory distress and hypoglycemia. The severity of polyhydramnios was not associated with an increased rate of neonatal complications. Although infants with polyhydramnios, but no major congenital malformations, were found to have increased rates of respiratory distress and hypoglycemia, these clinical manifestations were mild and had little effect on the babies' well-being and length of hospital stay. Copyright © 2011 S. Karger AG, Basel.

  8. Meningitis por estreptococo ß-hemolítico del grupo B en lactantes Meningitis in breast-fed infants caused by Group B ß-hemolytic streptococcus

    Directory of Open Access Journals (Sweden)

    Félix Orlando Dickinson Meneses

    2013-03-01

    2010. The risk was estimated according to the year of occurrence, the age, the province and the municipality as well as the fatality rate and the association of delay in medical diagnosis and in admission to the hospital and death. Results: the incidence rate of the whole period was 0.03 per 1 000 livebirths and the fatality rate amounted to 31.58 %. The propo9rtion of cases between males and females was very similar (50.9 % and 49.1 % respectively. The infants aged younger than 3 months were more affected by the disease (38 cases and they accounted for 100 % of those children who died (18 cases. The most risky provinces were Pinar del Rio (9.09 per 1 000 livebirths and Santiago de Cuba (0.08 per 1 000 livebirths. The municipality with the highest risk index was San Luis in Santiago de Cuba (0.31 per 1 000 livebirhts. The average length of time for medical diagnosis was 17 hours and for admission to the hospital was 5 hours. No association was found between delay in medical diagnosis (RR= 0.66 and in admission to the hospital (RR= 1.22 and death occurrence. Conclusions: Group B ß-hemolytic streptococcus is a significant preventable cause of meningitis and neonatal death.

  9. A retrospective evaluation of term infants treated with surfactant therapy

    Directory of Open Access Journals (Sweden)

    Özge Sürmeli-Onay

    2015-04-01

    Full Text Available Aim: To investigate the clinical and therapeutic characteristics and outcomes of term infants who received surfactant therapy (ST for severe respiratory failure in our neonatal intensive care unit (NICU. Methods: The medical records of term infants (gestational age ≥ 370/7 weeks who received ST between 2003-2012 in NICU of Hacettepe University Ihsan Dogramaci Children’s Hospital were evaluated retrospectively. Results: During ten years period, 32 term infants received ST; the mean gestational age was 38.1 ± 0.88 wk and the mean birth weight was 2,936 ± 665 g. The underlying lung diseases were severe congenital pneumonia (CP in 13 (40.6%, acute respiratory distress syndrome (ARDS in 5 (15.6%, meconium aspiration syndrome (MAS in 5 (15.6%, congenital diaphragmatic hernia (CDH in 4 (12.5%, respiratory distress syndrome in 3 (9.4% and pulmonary hemorrhage in 2 (6.3% infants. The median time of the first dose of ST was 7.75 (0.5-216 hours. Pulmonary hypertension accompanied the primary lung disease in 9 (28.1% infants. Mortality rate was 25%. Conclusion: In term infants, CP, ARDS and MAS were the main causes of respiratory failure requiring ST. However, further prospective studies are needed for defining optimal strategies of ST in term infants with respiratory failure.

  10. Kernicterus in late preterm infants cared for as term healthy infants.

    Science.gov (United States)

    Bhutani, Vinod K; Johnson, Lois

    2006-04-01

    To compare the clinical profile and health care experiences related to management of newborn jaundice and hyperbilirubinemia in preterm infants ( or =37(0/7) weeks) and develop acute and/or chronic posticteric sequelae. Retrospective study of a convenient sample of term and near term infants voluntarily reported to the Pilot Kernicterus Registry (1992-2003). Study infants were required to meet the clinical definitions for acute bilirubin encephalopathy (moderate or advanced severity) and/or the classical signs of kernicterus. Main outcome measures were the comparison of etiology, severity and duration of extreme hyperbilirubinemia (TSB levels >20 mg/dL), response to interventions of intensive phototherapy and exchange transfusion, and health care delivery experiences in preterm as compared with term infants. No targeted attention was accorded to preterm infants during their neonatal health care experiences as related to predischarge risk assessment, feeding, discharge follow-up instructions, or breastfeeding, regardless of the known vulnerability of preterm infants to safely transition during the first week after birth. The TSB levels, age at re-hospitalization, and birth weight distribution were similar for late preterm and term infants. Large for gestational age and late preterm infants disproportionately developed kernicterus as compared with those who were appropriate for gestational age and term. Clinical management of extreme of hyperbilirubinemia, by the attending clinical providers, was not impacted or influenced by the gestational age, clinical signs, or risk assessment. This resulted in severe posticteric sequelae which was more severe and frequent in late preterm infants. Late prematurity (34(0/7) to 36(6/7) weeks) of healthy infants was not recognized as a risk factor for hazardous hyperbilirubinemia by clinical practitioners. Unsuccessful lactation experience was the most frequent experience; being large for gestational age as well as the other known

  11. Breast-feeding among Mothers of Low Birth Weight Infants

    OpenAIRE

    Lefebvre, Francine

    1990-01-01

    The physical and emotional condition of the mother delivering a premature or low birth weight infant may be quite different than that of the mother of a healthy term infant when initiating breast-feeding. Despite this difference, incidence and duration of lactation among mothers of pre-term or low birth weight infants was found to be quite good compared with that of mothers of term infants. Considerable problems, however, are encountered by premature or low birth weight infants when breast-fe...

  12. Infants long-term memory for complex music

    Science.gov (United States)

    Ilari, Beatriz; Polka, Linda; Costa-Giomi, Eugenia

    2002-05-01

    In this study we examined infants' long-term memory for two complex pieces of music. A group of thirty 7.5 month-old infants was exposed daily to one short piano piece (i.e., either the Prelude or the Forlane by Maurice Ravel) for ten consecutive days. Following the 10-day exposure period there was a two-week retention period in which no exposure to the piece occurred. After the retention period, infants were tested on the Headturn Preference Procedure. At test, 8 different excerpts of the familiar piece were mixed with 8 different foil excerpts of the unfamiliar one. Infants showed a significant preference for the familiar piece of music. A control group of fifteen nonexposed infants was also tested and showed no preferences for either piece of music. These results suggest that infants in the exposure group retained the familiar music in their long-term memory. This was demonstrated by their ability to discriminate between the different excerpts of both the familiar and the unfamiliar pieces of music, and by their preference for the familiar piece. Confirming previous findings (Jusczyk and Hohne, 1993; Saffran et al., 2000), in this study we suggest that infants can retain complex pieces of music in their long-term memory for two weeks.

  13. Leukocyte recruitment in preterm and term infants.

    Science.gov (United States)

    Karenberg, Katinka; Hudalla, Hannes; Frommhold, David

    2016-12-01

    Impaired cellular innate immune defense accounts for susceptibility to sepsis and its high morbidity and mortality in preterm infants. Leukocyte recruitment is an integral part of the cellular immune response and follows a well-defined cascade of events from rolling of leukocytes along the endothelium to firm adhesion and finally transmigration which is concerted by a variety of adhesion molecules. Recent analytical advances such as fetal intravital microscopy have granted new insights into ontogenetic regulation and maturation of fetal immune cell recruitment. Understanding the fetal innate immune system is essential for targeted prevention and therapy of premature infants with severe infections or disorders of the immune system. This review gives an overview of the basic principles of leukocyte recruitment, particularly neutrophil trafficking, and its development during early life and highlights technical limitations to our current knowledge.

  14. Lutein-fortified infant formula fed to healthy term infants: evaluation of growth effects and safety

    Directory of Open Access Journals (Sweden)

    Davis Anne M

    2010-05-01

    Full Text Available Abstract Background/Objectives Breast milk contains lutein derived from the mother's diet. This carotenoid is currently not added to infant formula, which has a small and variable lutein content from innate ingredients. This study was conducted to compare the growth of infants fed lutein-fortified infant formula with that of infants fed infant formula without lutein fortification. Subjects/Methods This 16-week study was prospective, randomized, controlled, and double-blind with parallel groups of healthy term infants fed either control formula (Wyeth S-26 Gold, designated as Gold or experimental formula (Wyeth S-26 Gold fortified with lutein at 200 mcg/l, designated as Gold + Lutein. Two hundred thirty-two (232 infants ≤ 14 days postnatal age were randomized and 220 (94.8% completed the study. Weight (g, head circumference (cm, and length (cm were measured at Weeks 4, 8, 12, and 16. The primary endpoint was weight gain (g/day from baseline to Week 16. Safety was assessed through monitoring of study events (SEs throughout the study and evaluation of selected blood chemistry tests performed at Week 16. Results Infants in both treatment groups demonstrated appropriate growth. No differences between treatment groups were found in any of the measures of growth at any of the measurement time points. Both study formulas were well tolerated. The mean values of all measured blood chemistry parameters fell within the modified normal ranges for infants, and the values for both groups for any measured parameter were similar. Conclusions Infants fed lutein-fortified S-26 Gold demonstrated growth equivalent to that of infants fed unfortified lutein formula.

  15. Neonatal jaundice and stool production in breast- or formula-fed term infants

    NARCIS (Netherlands)

    Buiter, Hannah D.; Dijkstra, Sebastiaan S. P.; Elferink, Rob F. M. Oude; Bijster, Peter; Woltil, Henk A.; Verkade, Henkjan J.

    It has remained unclear whether the amount of fecal fat excreted in the stool and stool production influences the severity of neonatal jaundice. We determined the relationship between stool production, fecal fat excretion and jaundice in healthy breast-fed (BF) or formula-fed (FF) (near-)term

  16. [Low Apgar score in term newborn infants and delivery pattern].

    Science.gov (United States)

    Atanasova, V; Slavkova, N; Yonov, M; Valkova, A

    2012-01-01

    Examine the influence of delivery pattern over neonatal condition in the first minutes of life. We have studied 3624 term newborns of single pregnancies for period of 2 years in the city of Pleven. The patients were divided in 4 groups by the delivery pattern: vaginal delivery with head presentation (2497 infants), vaginal delivery with instrumental assist (45 infants), per vias naturales in breech presentation (44 infants), delivery via Caesarean section (1038 infants). According to our results the Apgar score differs itself from the pathology of a given newborn. Neonatal deaths are significantly higher in the newborns with low Apgar score than deaths in the general population. From all cases of low Apgar score without other clinical problems the highest is the percentage in the infants delivered via Caesarean section. The goal of the Apgar score is to focus attention on the infant's condition in the first few minutes of its life and the need of resuscitation. Low Apgar score is an important predictor of the newborn morbidity and death rate. The Apgar score alone is not a proof for intrapartal asphyxia and is not associated with long-term neurological damage.

  17. Obstetric interventions and perinatal asphyxia in growth retarded term infants

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Lindmark, G

    1997-01-01

    neonatal outcome at term have been studied in relation to different types of fetal growth retardation, including sub-groups with low ponderal index or low amount of subcutaneous fat. RESULTS: The need for obstetric intervention indicated by suspected fetal asphyxia before or during labor was increased 3......BACKGROUND: The monitoring of fetal growth during pregnancy is usually justified because of the increased perinatal risk of these babies. METHODS: In 1552 infants from the Scandinavian Small for Gestational Age Study the need for obstetric interventions, risk of fetal asphyxia and immediate......-fold (6-8%) for growth retarded infants both in SGA infants in general and infants with asymmetric body proportions. The immediate perinatal outcome, however, was favorable with Apgar below 8 at 5 min in only 2% irrespective of the type of growth retardation, in spite of the fact that less than 25...

  18. Synbiotics, probiotics or prebiotics in infant formula for full term infants: a systematic review

    Directory of Open Access Journals (Sweden)

    Mugambi Mary N

    2012-10-01

    Full Text Available Abstract Background Synbiotics, probiotics or prebiotics are being added to infant formula to promote growth and development in infants. Previous reviews (2007 to 2011 on term infants given probiotics or prebiotics focused on prevention of allergic disease and food hypersensitivity. This review focused on growth and clinical outcomes in term infants fed only infant formula containing synbiotics, probiotics or prebiotics. Methods Cochrane methodology was followed using randomized controlled trials (RCTs which compared term infant formula containing probiotics, prebiotics or synbiotics to conventional infant formula with / without placebo among healthy full term infants. The mean difference (MD and corresponding 95% confidence intervals (CI were reported for continuous outcomes, risk ratio (RR and corresponding 95% CI for dichotomous outcomes. Where appropriate, meta-analysis was performed; heterogeneity was explored using subgroup and sensitivity analyses. If studies were too diverse a narrative synthesis was provided. Results Three synbiotic studies (N = 475, 10 probiotics studies (N = 933 and 12 prebiotics studies (N = 1563 were included. Synbiotics failed to significantly increase growth in boys and girls. Use of synbiotics increased stool frequency, had no impact on stool consistency, colic, spitting up / regurgitation, crying, restlessness or vomiting. Probiotics in formula also failed to have any significant effect on growth, stool frequency or consistency. Probiotics did not lower the incidence of diarrhoea, colic, spitting up / regurgitation, crying, restlessness or vomiting. Prebiotics in formula did increase weight gain but had no impact on length or head circumference gain. Prebiotics increased stool frequency but had no impact on stool consistency, the incidence of colic, spitting up / regurgitation, crying, restlessness or vomiting. There was no impact of prebiotics on the volume of formula tolerated, infections and gastrointestinal

  19. Benign "setting sun" phenomenon in full-term infants.

    Science.gov (United States)

    Yoshikawa, Hideto

    2003-06-01

    I report two normally developed infants showing benign" setting sun" phenomenon. A 2(2-12)-year-old boy and a 7-year-old boy, who were born without any complications at full term, developed brief episodes of downward gazing during sucking and crying after birth However, there were no other clinical or laboratory findings, and they developed normally. The phenomenon was not visible until 6 months and 7 months, respectively. The "setting sun" phenomenon usually indicates underlying severe brain damage and can also be seen, although rarely, in healthy full-term infants until 1 to 5 months. However, the benign "setting sun" phenomenon might exist until 6 or 7 months of age in normal infants.

  20. Improvement of conventional transcutaneous bilirubinometry results in term newborn infants.

    Science.gov (United States)

    Felc, Zlata

    2005-05-01

    This prospective study was performed to determine a way to improve conventional transcutaneous bilirubinometry results in healthy term newborn infants. In 118 infants during phototherapy (group A), and in 118 infants without phototherapy (group B), bilirubin determinations were done in duplicate using the Minolta AirShields Jaundice Meter type 101 (transcutaneous bilirubin index [TcB]), and the diazometric method on the Hitachi 717 Automated Analyzer (total reacting serum bilirubin [SeB]). In 112 infants (group C), bilirubin determinations were done in triplicate, using simple direct-reading photometry on the Moltronic Bilirubinometer (direct serum bilirubin [BiB]). A close correlation between TcB and SeB values was observed in group A ( r = 0.69; p < 0.001) and in group B ( r = 0.59; p < 0.001). The 95% confidence intervals of TcB readings corresponding to SeB were +/- 80.7 micromol/L in group A and +/- 76.9 micromol/L in group B, respectively. In group C, using a correctly calibrated BiB with adult sera containing bilirubin concentration in the range 271 to 344 micromol/L, the 95% confidence intervals of parallel TcB and BiB readings corresponding to SeB were +/- 28 micromol/L. Parallel determinations of the TcB and the BiB in healthy term newborn infants give results almost identical to those of bilirubin determination by the laboratory method.

  1. Delivery room management of term and preterm newly born infants.

    Science.gov (United States)

    Saugstad, Ola Didrik

    2015-01-01

    Delivery room management, especially in the first 'golden' minute, is of the utmost importance. An exact and universal definition of when a baby is born is needed to obtain agreement on what is meant by the first minute of life. Education of young girls is a basic requirement to optimize the health of the mother and baby. Interventions in pregnancy should as far as possible be evidence based. Antenatal care, the selection of birth mode and antenatal steroid therapy when indicated also contribute to obtaining the best outcome. Delayed cord clamping is recommended for both preterm and term infants. However, more data are needed regarding the most immature infants. Routine suctioning of the mouth and airways is not required. Thermal control is important - keep the temperature in the delivery room at 26°C and wrap infants plastic. However, this procedure does not reduce mortality. Since delayed cord clamping increases mean birth weight by approximately 30 g/kg, the present birth weight charts based on early clamping need to be corrected. Preterm infants in need of ventilatory support should start with CPAP from the first breath. A T-piece device seems to have some advantages compared to self-inflating bags. Surfactant instillation is often not needed prophylactically provided the mother has received antenatal steroids. Less invasive methods for administering surfactant may be useful. If ventilatory support is needed, start with air in term and near-term infants. For babies of 29-33 weeks of gestation start with 21-30% oxygen and for infants <29 weeks start with 30% oxygen and adjust according to the response obtained. © 2015 S. Karger AG, Basel.

  2. Bowel Habits of Preterm Infants 1'11 1101131

    African Journals Online (AJOL)

    Conclusion: The average frequency of stools/ day in exclusively breastfed infants increases with gestational age. Most preterm and term neonates fed on breast milk produce predominantly soft stool during the first 10 days of life. It is hoped that the data produced from this study will serve as a reference for comparison with ...

  3. Free amino acids in full-term and pre-term human milk and infant formula.

    Science.gov (United States)

    Chuang, Chih-Kuang; Lin, Shuan-Pei; Lee, Hung-Chang; Wang, Tuen-Jen; Shih, Yu-Shu; Huang, Fu-Yuan; Yeung, Chun-Yan

    2005-04-01

    Although the nutritional value of human milk has been thoroughly studied, few reports describing its free amino acid (FAA) content have been published. Although infant formulas are designed to approximate the nutrient composition of human milk, the content and concentration of free amino acids are unknown. We compared the FAA concentrations of milk from mothers of preterm and full-term infants with those in several infant formulas. Human milk was obtained during three different stages of lactation (colostral, transitional and mature milk). Sixty-seven samples were collected from 44 healthy mothers of term infants and 23 mothers of premature infants 29 to 36 weeks gestation (mean 33 weeks). Two brands of powdered term formula (TF-A and TF-B) and two brands designed for preterm infants (PTF-A and PTF-B )were also studied. Ion exchange chromatography was used for free amino acid analysis. The mean concentration of total FAA in human milk was significantly higher than any of the infant formulas (8139 micromol/L for pre-term human milk; 3462 micromol/L for full term human milk; TF-A, 720 micromol/L; TF-B, 697 micromol/L; PTF-A, 820 micromol/L; PTF-B, 789 micromol/L) (P milk was significantly higher than in human transitional and mature milks (P milk and preterm milk except for phosphoethanolamine, hydroxyproline, asparagine, and alpha-amino-eta-butyric acid. There were significant differences in all FAA concentrations between all human milks and infant formulas (P milk and decreases through the transitional and mature milk stages. FAA is higher in all human milks than in infant formulas.

  4. Prematurity, Immune Function and Infant Feeding Practices

    OpenAIRE

    Hampton, Shelagh M

    1999-01-01

    Recently, there has been much interest in the literature in the role of early nutrition and the health of the individual in adulthood. A majority of infants in the UK are born full term, while pretem infants account for 4-6 % of the total births. Milk feeding practices are divided into three groups: breast, combination (breast-fed with formula as ‘top-up’) and bottle (formula). In studies conducted by our group and other researchers immune function in full-term and preterm infants has been...

  5. Icterus Neonatorum in Near-Term and Term Infants; An overview

    Directory of Open Access Journals (Sweden)

    Rehan Ali

    2012-05-01

    Full Text Available Neonatal jaundice is the yellowish discoloration of the skin and/or sclerae of newborn infants caused by tissue deposition of bilirubin. Physiological jaundice is mild, unconjugated (indirect-reacting bilirubinaemia, and affects nearly all newborns. Physiological jaundice levels typically peak at 5 to 6 mg/dL (86 to 103 μmol/L at 72 to 96 hours of age, and do not exceed 17 to 18 mg/dL (291–308 μmol/L. Levels may not peak until seven days of age in Asian infants, or in infants born at 35 to 37 weeks’ gestation. Higher levels of unconjugated hyperbilirubinaemia are considered pathological and occur in a variety of conditions. The clinical features and management of unconjugated hyperbilirubinaemia in healthy near-term and term infants, as well as bilirubin toxicity and the prevention of kernicterus, are reviewed here. The pathogenesis and aetiology of this disorder are discussed separately.

  6. Efficacy and Safety of Acupuncture in Preterm and Term Infants

    OpenAIRE

    Wolfgang Raith; Berndt Urlesberger; Georg M Schmölzer

    2013-01-01

    The aim of the paper was to review the literature about safety and efficiency of acupuncture therapy in term and preterm infants. We searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials using a predefined algorithm, reviewed abstracts from the Pediatric Academic Society annual meetings (2000–2012), and performed a manual search of references in narrative and systematic reviews. A total of 26 studies identified met our search criteria. Only 6 of these studies met our in...

  7. Efficacy and Safety of Acupuncture in Preterm and Term Infants

    Directory of Open Access Journals (Sweden)

    Wolfgang Raith

    2013-01-01

    Full Text Available The aim of the paper was to review the literature about safety and efficiency of acupuncture therapy in term and preterm infants. We searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials using a predefined algorithm, reviewed abstracts from the Pediatric Academic Society annual meetings (2000–2012, and performed a manual search of references in narrative and systematic reviews. A total of 26 studies identified met our search criteria. Only 6 of these studies met our inclusion criteria; however, two studies had to be excluded because the manuscripts were published in Chinese. Hence, only four studies were included in our analysis. Three of the four studies evaluated the effects of acupuncture on infantile colic, and one assessed pain reduction during minor painful procedures in preterm babies. The limited data available suggests that acupuncture could be a safe nonpharmacologic treatment option for pain reduction in term and preterm infants and could also be a non-pharmacologic treatment option to treat infantile colic. Currently acupuncture in infants should be limited to clinical trials and studies evaluating short- and long-term effects and should be performed only by practitioners with adequate training and experience in neonatal/pediatric acupuncture.

  8. Efficacy and safety of acupuncture in preterm and term infants.

    Science.gov (United States)

    Raith, Wolfgang; Urlesberger, Berndt; Schmölzer, Georg M

    2013-01-01

    The aim of the paper was to review the literature about safety and efficiency of acupuncture therapy in term and preterm infants. We searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials using a predefined algorithm, reviewed abstracts from the Pediatric Academic Society annual meetings (2000-2012), and performed a manual search of references in narrative and systematic reviews. A total of 26 studies identified met our search criteria. Only 6 of these studies met our inclusion criteria; however, two studies had to be excluded because the manuscripts were published in Chinese. Hence, only four studies were included in our analysis. Three of the four studies evaluated the effects of acupuncture on infantile colic, and one assessed pain reduction during minor painful procedures in preterm babies. The limited data available suggests that acupuncture could be a safe nonpharmacologic treatment option for pain reduction in term and preterm infants and could also be a non-pharmacologic treatment option to treat infantile colic. Currently acupuncture in infants should be limited to clinical trials and studies evaluating short- and long-term effects and should be performed only by practitioners with adequate training and experience in neonatal/pediatric acupuncture.

  9. Long-term oral sensitivity and feeding skills of low-risk pre-term infants.

    Science.gov (United States)

    Dodrill, Pamela; McMahon, Sandra; Ward, Elizabeth; Weir, Kelly; Donovan, Tim; Riddle, Bena

    2004-01-01

    This study examined the oral sensitivity and feeding skills of low-risk pre-term infants at 11-17 months corrected age. Twenty pre-term infants (PT) born between 32 and 37 weeks at birth without any medical comorbidities were assessed. All of this PT group received supplemental nasogastric (NG) tube feeds during their birth-stay in hospital. A matched control group of 10 healthy full-term infants (FT) was also assessed. Oral sensitivity and feeding skills were assessed during a typical mealtime using the Royal Children's Hospital Oral Sensitivity Checklist (OSC) and the Pre-Speech Assessment Scale (PSAS). Results demonstrated that, at 11-17 months corrected age, the PT group displayed significantly more behaviours suggestive of altered oral sensitivity and facial defensiveness, and a trend of more delayed feeding development than the FT group. Further, results demonstrated that, relative to the FT group, pre-term infants who received greater than 3 weeks of NG feeding (PT>3NG) displayed significantly more facial defensive behaviour, and displayed significant delays across more aspects of their feeding development than pre-term infants who received less than 2 weeks of NG feeding (PToral sensitivity and facial defensiveness, as well as feeding delays. These observations warrant further investigation on this topic.

  10. Food and Nutrient Intake and Nutrient Sources in 1-Year-Old Infants in Finland: A Cross-Sectional Analysis

    Directory of Open Access Journals (Sweden)

    Helena H. Hauta-alus

    2017-12-01

    Full Text Available The infant diet has short- and long-term health consequences. Updated data regarding the dietary intake of Finnish infants are lacking. The objectives of this study were to describe infant food and nutrient intake and to identify food sources of the nutrients. Altogether, 739 healthy infants were studied. Dietary intake and breastfeeding frequency were assessed with a three-day food record at 1 year of age. Dietary intake was calculated separately for non-breastfed and breastfed infants. One-third (36% of the infants were partially breastfed and 95% consumed mass-produced baby foods. The infants’ diet consisted mainly of infant formula, dairy milk, porridges, fruit and berry foods, and meat dishes. The mean vegetable, fruit and berry consumption was 199 g/day. Most nutrient intakes were adequate except for fat, linoleic acid, vitamin D and iron from food. Mean sucrose intake, as a percentage of total energy intake (E%, was 5–6 E%. High protein intake (>20 E% was observed in 19% of non-breastfed infants. Overall, the infants’ diet was favorable since vegetable and fruit consumption was reasonably high and nutrient intake was mostly adequate. However, the fat intake was lower, and protein intake higher than recommended. Increasing the consumption of vegetable oils and reducing the intake of red meat and dairy milk may further improve the diet of 1-year-olds.

  11. Soy infant formula: is it that bad?

    Science.gov (United States)

    Vandenplas, Yvan; De Greef, Elisabeth; Devreker, Thierry; Hauser, Bruno

    2011-02-01

    The objective of this study is to review the indications of soy infant formula (SIF). Structured review of publications is made available through standard search engines (Pubmed,…). The medical indications for SIF are limited to galactosaemia and hereditary lactase deficiency. In the treatment of cow's milk allergy, SIF is used for economic reasons, as extensive hydrolysates are expensive. SIF is dissuaded mainly because of its phytooestrogen content. Isoflavone serum levels are much higher in SIF-fed infants than in breastfed or cow milk formula-fed infants. Administration of pure isoflavones to animals causes decreased fertility, but clinically relevant adverse effects of SIF in infants are not reported.   Soy infant formula remains an option for feeding of term born infants if breastfeeding is not possible and if standard infant formula is not tolerated. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

  12. Electrophysiological assessment of the brain function in term SGA infants.

    Science.gov (United States)

    Ozdemir, Ozmert M A; Ergin, Hacer; Sahiner, Türker

    2009-05-13

    Small for gestational age (SGA) infants are defined as babies having a birth weight below the 10th percentile for gestational age. A great number of studies have shown that children with SGA have an increased risk of impaired neurodevelopment. Electroencephalography (EEG) is an excellent method for measuring brain maturation in newborns. In this study, the effect of SGA on the maturation of cerebrocortical electrographic activity was investigated by the EEG and also analyzed with power spectral analysis. Serial EEGs were performed in 40 term SGAs, and 20 term appropriate for gestational age (AGA) infants in 1st week, 1st and 3rd month. Power spectral analysis was performed quantitatively in five channels (Fp1-C3, C3-O1, Fp2-C4, C4-O2, and Cz-C4 channels). Amplitude levels of the SGA group were significantly lower than the AGA group in all records. Delta frequency was the major frequency component in the groups. Delta frequency activities in the midline vertex region were decreased in the AGA group with increasing postconceptual age while the activities of the SGA group were increased. Contrarily, beta frequency activities in the midline vertex region were increased in the AGA group with increasing postconceptual age while these activities of the SGA group were decreased. Theta frequency activities in the fronto-central regions were lower in the SGA group. In terms of the vertex, k-complex, and sleep spindle, there was no difference between the two groups. We conclude that cerebrocortical electrophysiological maturation has been delayed in term SGA infants during the first three months of postnatal life.

  13. Disparities in mortality rates among US infants born late preterm or early term, 2003-2005.

    Science.gov (United States)

    King, Jennifer P; Gazmararian, Julie A; Shapiro-Mendoza, Carrie K

    2014-01-01

    The purpose of this study was to identify disparities in neonatal, post-neonatal, and overall infant mortality rates among infants born late preterm (34-36 weeks gestation) and early term (37-38 weeks gestation) by race/ethnicity, maternal age, and plurality. In analyses of 2003-2005 data from US period linked birth/infant death datasets, we compared infant mortality rates by race/ethnicity, maternal age, and plurality among infants born late preterm or early term and also determined the leading causes of death among these infants. Among infants born late preterm, infants born to American Indian/Alaskan Native, non-Hispanic black, or teenage mothers had the highest infant mortality rates per 1,000 live births (14.85, 9.90, and 11.88 respectively). Among infants born early term, corresponding mortality rates were 5.69, 4.49, and 4.82, respectively. Among infants born late preterm, singletons had a higher infant mortality rate than twins (8.59 vs. 5.62), whereas among infants born early term, the rate was higher among twins (3.67 vs. 3.15). Congenital malformations and sudden infant death syndrome were the leading causes of death among both late preterm and early term infants. Infant mortality rates among infants born late preterm or early term varied substantially by maternal race/ethnicity, maternal age, and plurality. Information about these disparities may help in the development of clinical practice and prevention strategies targeting infants at highest risk.

  14. Disparities in Mortality Rates Among US Infants Born Late Preterm or Early Term, 2003–2005

    Science.gov (United States)

    Gazmararian, Julie A.; Shapiro-Mendoza, Carrie K.

    2015-01-01

    The purpose of this study was to identify disparities in neonatal, post-neonatal, and overall infant mortality rates among infants born late preterm (34–36 weeks gestation) and early term (37–38 weeks gestation) by race/ethnicity, maternal age, and plurality. In analyses of 2003–2005 data from US period linked birth/infant death datasets, we compared infant mortality rates by race/ethnicity, maternal age, and plurality among infants born late preterm or early term and also determined the leading causes of death among these infants. Among infants born late preterm, infants born to American Indian/Alaskan Native, non-Hispanic black, or teenage mothers had the highest infant mortality rates per 1,000 live births (14.85,9.90, and 11.88 respectively). Among infants born early term, corresponding mortality rates were 5.69, 4.49, and 4.82, respectively. Among infants born late preterm, singletons had a higher infant mortality rate than twins (8.59 vs. 5.62), whereas among infants born early term, the rate was higher among twins (3.67 vs. 3.15). Congenital malformations and sudden infant death syndrome were the leading causes of death among both late preterm and early term infants. Infant mortality rates among infants born late preterm or early term varied substantially by maternal race/ ethnicity, maternal age, and plurality. Information about these disparities may help in the development of clinical practice and prevention strategies targeting infants at highest risk. PMID:23519825

  15. Effects of employment and education on preterm and full-term infant mortality in Korea.

    Science.gov (United States)

    Ko, Y-J; Shin, S-H; Park, S M; Kim, H-S; Lee, J-Y; Kim, K H; Cho, B

    2014-03-01

    The infant mortality rate is a sensitive and commonly used indicator of the socio-economic status of a population. Generally, studies investigating the relationship between infant mortality and socio-economic status have focused on full-term infants in Western populations. This study examined the effects of education level and employment status on full-term and preterm infant mortality in Korea. Data were collected from the National Birth Registration Database and merged with data from the National Death Certification Database. Prospective cohort study. In total, 1,316,184 singleton births registered in Korea's National Birth Registration Database between January 2004 and December 2006 were included in the study. Multivariate logistic regression analysis was performed. Paternal and maternal education levels were inversely related to infant mortality in preterm and full-term infants following multivariate adjusted logistic models. Parental employment status was not associated with infant mortality in full-term infants, but was associated with infant mortality in preterm infants, after adjusting for place of birth, gender, marital status, paternal age, maternal age and parity. Low paternal and maternal education levels were found to be associated with infant mortality in both full-term and preterm infants. Low parental employment status was found to be associated with infant mortality in preterm infants but not in full-term infants. In order to reduce inequalities in infant mortality, public health interventions should focus on providing equal access to education. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  16. Spontaneous movements in the supine position of healthy term infants and preterm infants with or without periventricular leukomalacia.

    Science.gov (United States)

    Kouwaki, Masanori; Yokochi, Mitsuko; Togawa, Yasuko; Kamiya, Takeshi; Yokochi, Kenji

    2013-04-01

    The individual motor elements presumed to be essential for motor development were determined from spontaneous movements involving the entire body of normal term and preterm infants. Then, diagnostic items for motor abnormality in infants with periventricular leukomalacia (PVL) were investigated. Video recordings of 24 healthy term infants, 21 normal preterm infants (8 males, 13 females; median gestational age 30 weeks; median birth weight 1216g) and 14 preterm infants with PVL (6 males, 8 females; median gestational age 30 weeks; median birth weight 1360g) were analyzed. In healthy term infants, predominant shoulder rotation was noticed until 1 month of age. After 2 months of age, isolated movements of the shoulder, elbow, hip, knee, and ankle frequently emerged. In preterm infants with PVL at the corrected age of 2 months, startle response and predominant shoulder rotation were more frequently seen and isolated neck, shoulder, elbow, hip, knee, and ankle movements were less frequently seen than in the normal preterm infants (Fisher's exact test, p<0.025). At 2 months of age, isolated movements evolve, and their failure to occur is suggested to be a useful sign for the diagnosis of cerebral motor disorders. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  17. Prognostic correlative values of the late-infancy MRI pattern in term infants with perinatal asphyxia.

    Science.gov (United States)

    Tekgul, Hasan; Serdaroglu, Gul; Yalman, Osman; Tutuncuoglu, Sarenur

    2004-07-01

    The aim of this study was to define the risk ratios of the late-infancy magnetic resonance imaging pattern for long-term outcome in term infants with perinatal asphyxia. We evaluated 65 term infants with perinatal asphyxia and performed magnetic resonance imaging examinations between 4-12 months of age. Magnetic resonance imaging scans were classified as follows: (1) periventricular leukomalacia in 21 (32%) infants, (2) marked cortical atrophy in 17 (26%) infants, (3) multicystic encephalomalacia in 10 (15%) infants, (4) deep gray matter involvement in 8 (12%) infants, (5) focal cortical involvement in 6 (9%) infants, (6) myelination delay in 3 (5%) infants. The overall outcome was favorable in 19 (29%) of 65 infants. Infants with diffuse cortical involvement (multicystic encephalomalacia and marked cortical atrophy) are four times (odds ratio: 4.4 and 4.1 respectively) more likely to attain the unfavorable outcome than the infants with other patterns of magnetic resonance imaging. Infants with focal cortical involvement had relatively favorable outcome in 60% of the cases. In conclusion, it appears that the overall outcome of infants with perinatal asphyxia correlated well with the magnetic resonance imaging patterns obtained between 4 and 12 months of age.

  18. Visual Short-Term Memory for Complex Objects in 6- and 8-Month-Old Infants

    Science.gov (United States)

    Kwon, Mee-Kyoung; Luck, Steven J.; Oakes, Lisa M.

    2014-01-01

    Infants' visual short-term memory (VSTM) for simple objects undergoes dramatic development: Six-month-old infants can store in VSTM information about only a simple object presented in isolation, whereas 8-month-old infants can store information about simple objects presented in multiple-item arrays. This study extended this work to examine…

  19. An experimental study on mother-infant skin-to-skin contact in full-terms

    NARCIS (Netherlands)

    Beijers, R.; Cillessen, L.J.G.; Zijlmans, M.A.C.

    2016-01-01

    In premature infants, daily skin-to-skin contact (SSC) has various beneficial effects on the health of the infant and the mother. These beneficial effects might extend to full-term infants. This experimental within-subject study examines the immediate effects of SSC on full-terms’ cortisol

  20. Improvement in long-term breastfeeding for very preterm infants.

    Science.gov (United States)

    Sharp, Mary; Campbell, Catherine; Chiffings, Debbie; Simmer, Karen; French, Noel

    2015-04-01

    The extensive health benefits of breastfeeding preterm infants for both mother and infant have been widely reported. However, establishing and maintaining breastfeeding for very preterm (VP) infants remain challenging. The aim of this study was to examine changes in breastfeeding of VP infants over time. Breastfeeding questionnaires were administered to two cohorts of parents of VP infants (breastfeeding in C2 compared with those in C1 (65.6%) (pbenefits of breastfeeding were endorsed by more women in C2 (45.8%) compared with C1 (11.4%) (pbreastfeeding of the VP infant over time. This improvement was associated with attitudinal shifts in mothers about the benefits of breastfeeding.

  1. Home care practices for preterm and term infants after hospital discharge in Massachusetts, 2007 to 2010.

    Science.gov (United States)

    Hwang, S S; Lu, E; Cui, X; Diop, H; Barfield, W D; Manning, S E

    2015-10-01

    The objective of this study was to compare the prevalence of home care practices in very to moderately preterm (VPT), late preterm (LPT) and term infants born in Massachusetts. Using 2007 to 2010 Massachusetts Pregnancy Risk Assessment Monitoring System data, births were categorized by gestational age (VPT: 23 to 33 weeks; LPT: 34 to 36 weeks; term: 37 to 42 weeks). Home care practices included breastfeeding initiation and continuation, and infant sleep practices (supine sleep position, sleeping in a crib, cosleeping in an adult bed). We developed multivariate models to examine the association of infant sleep practices and breastfeeding with preterm status, controlling for maternal sociodemographic characteristics. Supine sleep position was more prevalent among term infants compared with VPT and LPT infants (77.1%, 71.5%, 64.4%; P=0.02). In the adjusted model, LPT infants were less likely to be placed in supine sleep position compared with term infants (adjusted prevalence ratio=0.86; 95% confidence interval: 0.75 to 0.97). Breastfeeding initiation and continuation did not differ among preterm and term groups. Nearly 16% of VPT and 18% of LPT and term infants were not sleeping in cribs and 14% of LPT and term infants were cosleeping on an adult bed. Compared with term infants, LPT infants were less likely to be placed in supine sleep position after hospital discharge. A significant percent of preterm and term infants were cosleeping on an adult bed. Hospitals may consider improving their safe sleep education, particularly to mothers of LPT infants.

  2. Craniocerebral birth injuries in term newborn infants: a retrospective series.

    Science.gov (United States)

    Nachtergaele, Pieter; Van Calenbergh, Frank; Lagae, Lieven

    2017-11-01

    In an attempt to further define the spectrum of cranial birth injuries, we analyzed 21 consecutive cranial birth injuries in term neonates presenting to the neurosurgical department of our institution over the period 1994-2015. We performed a retrospective chart review from the medical records of the University Hospitals of the KU Leuven, from 1994 to 2015. We included 21 infants of 36-week gestational age or older with a diagnosis of cranial birth injury. The types and locations of injuries, the presenting signs, symptoms and their timing, and the required treatment(s) were recorded. Various maternal and neonatal factors and the mode of delivery were recorded. We recorded the different modes of delivery rates at our institution in the year 2013 and the rates in the Flemish community between 1995 and 2013, in order to compare the mode of delivery rates in the study group with current practice at our institution and with general practice over the years in the Flemish community. The most common clinical presentations were swelling (43% of cases) and seizures (19% of cases). Average Apgar scores were 6.57 at 1 min and 8.43 at 5 min; 48% of children had abnormally low Apgar scores at 1 min and 9.5% had abnormally low scores at 5 min. The most common intracranial lesion was skull fractures (33%). Operative treatment was required in 11 infants (52%). One infant died. Assisted mechanical delivery by either forceps and/or vacuum extraction occurred in 43% of infants. In comparison, in the year 2013, only 13.97% of deliveries at our institution were mechanically assisted. Over the period 1995-2013, the highest mechanically assisted delivery rates in the Flemish community were 14.1% in 1996. Although our series is too small to make firm conclusions, it is remarkable that the rates of assisted mechanical deliveries in our series far exceeded the assisted mechanical delivery rates at our institution in the year 2013 and even the highest vacuum and forceps delivery rates in

  3. Supine sleep positioning in preterm and term infants after hospital discharge from 2000 to 2011.

    Science.gov (United States)

    Hwang, S S; Smith, R A; Barfield, W D; Smith, V C; McCormick, M C; Williams, M A

    2016-09-01

    Supine sleep positioning (SSP) has been shown to reduce the risk of sudden infant death syndrome (SIDS) and preterm infants are at higher risk for SIDS. Population-based estimates of SSP are lacking for the preterm population. The objectives of this study are: (1) compare the prevalence of SSP after hospital discharge for preterm and term infants in the United States; and (2) assess racial/ethnic disparities in SSP for preterm and term infants. We analyzed the 2000 to 2011 data from the Pregnancy Risk Assessment Monitoring System of Centers for Disease Control and Prevention from 35 states. We measured prevalence of SSP by preterm and term gestational age (GA) categories. We calculated adjusted prevalence ratios (APR) to evaluate the likelihood of SSP for each GA category compared with term infants and the likelihood of SSP for non-Hispanic black (NHB) and Hispanic infants compared with non-Hispanic white (NHW) infants. Prevalence of SSP varied by GA: ⩽27, 59.7%; 28 0/7 to 33 6/7, 63.7%; 34 0/7 to 36 6/7 (late preterm), 63.6%; and 37 0/7 to 42 6/7 (term) weeks, 66.8% (Ppreterm infants were slightly less likely to be placed in SSP compared with term infants (APR: 0.96, confidence interval: 0.95 to 0.98). There were racial/ethnic disparities in SSP for all GA categories when NHB and Hispanic infants were compared with NHW infants. All infants had suboptimal adherence to SSP indicating a continued need to better engage families about SSP. Parents of late preterm infants and families of NHB and Hispanic infants will also require greater attention given their decreased likelihood of SSP.

  4. A prospective study of cow's milk allergy in exclusively breast-fed infants. Incidence, pathogenetic role of early inadvertent exposure to cow's milk formula, and characterization of bovine milk protein in human milk

    DEFF Research Database (Denmark)

    Høst, A; Husby, S; Osterballe, O

    1988-01-01

    A cohort of 1,749 newborns in the municipality of Odense were followed prospectively for the development of cow's milk allergy (CMA) during their first year of life. Altogether 39 fulfilled the criteria for CMA (2.2%). Out of the 39 infants, 17 developed symptoms of CMA during breast-feeding, in ...

  5. A prospective study of cow's milk allergy in exclusively breast-fed infants. Incidence, pathogenetic role of early inadvertent exposure to cow's milk formula, and characterization of bovine milk protein in human milk

    DEFF Research Database (Denmark)

    Høst, A; Husby, S; Osterballe, O

    1988-01-01

    had signs of CMA in the neonatal period. Review of records from the newborn nursery revealed that all 9 infants had been exposed to cow's milk formula in amounts corresponding to approximately 0.4-3.0 g of beta-lactoglobulin (BLG) during the first three days of life. Human milk samples were analyzed...

  6. Maternal intention to breast-feed and breast-feeding outcomes in term and preterm infants: Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2003.

    Science.gov (United States)

    Colaizy, Tarah T; Saftlas, Audrey F; Morriss, Frank H

    2012-04-01

    To determine the effect of intention to breast-feed on short-term breast-feeding outcomes in women delivering term and preterm infants. Data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) for three states, Ohio, Michigan and Arkansas, during 2000-2003 were analysed. SAS 9·1·3 and SUDAAN 10 statistical software packages were used for analyses. Arkansas, Michigan and Ohio, USA. Mothers of recently delivered infants, selected by birth certificate sampling. Of 16,839 mothers included, 9·7% delivered preterm. Some 52·2% expressed definite intention to breast-feed, 16·8% expressed tentative intention, 4·3% were uncertain and 26·8% had no intention to breast-feed. Overall 65·2% initiated breast-feeding, 52·0% breast-fed for ≥4 weeks and 30·8% breast-fed for ≥10 weeks. Women with definite intention were more likely to initiate (OR = 24·3, 95% CI 18·4, 32·1), to breast-feed for ≥4 weeks (OR = 7·12, 95% CI 5·95, 8·51) and to breast-feed for ≥10 weeks (OR = 2·75, 95% CI 2·20, 3·45) compared with women with tentative intention. Levels of intention did not differ between women delivering preterm and term. Women delivering at breast-feeding (OR = 2·24, 95% CI 1·64, 3·06) and to breast-feed for ≥4 weeks (OR = 2·58, 95% CI 1·96, 3·41), but less likely to breast-feed for ≥10 weeks (OR = 0·55, 95% CI 0·44, 0·68), compared with those delivering at term. Women delivering between 34 and 36 weeks were less likely to breast-feed for ≥10 weeks than those delivering at term (OR = 0·63, 95% CI 0·49, 0·81). Prenatal intention to breast-feed is a powerful predictor of short-term breast-feeding outcomes in women delivering both at term and prematurely.

  7. Long-term exposure to indoor air pollution and wheezing symptoms in infants

    DEFF Research Database (Denmark)

    Raaschou-Nielsen, O.; Hermansen, M.N.; Loland, L.

    2010-01-01

    of an association between long-term exposure to indoor air pollution and wheezing symptoms in infants, suggesting that indoor air pollution is not causally related to the underlying disease. Practical Implications Nitrogen oxides, formaldehyde and fine particles were measured in the air in infants' bedrooms......Long-term exposure to air pollution is suspected to cause recurrent wheeze in infants. The few previous studies have had ambiguous results. The objective of this study was to estimate the impact of measured long-term exposure to indoor air pollution on wheezing symptoms in infants. We monitored...... wheezing symptoms in diaries for a birth cohort of 411 infants. We measured long-term exposure to nitrogen oxides (NO(x)), NO(2), formaldehyde, PM(2.5) and black smoke in the infants' bedrooms and analyzed risk associations during the first 18 months of life by logistic regression with the dichotomous end...

  8. Respiratory syncytial virus hospitalization outcomes and costs of full-term and preterm infants.

    Science.gov (United States)

    McLaurin, K K; Farr, A M; Wade, S W; Diakun, D R; Stewart, D L

    2016-11-01

    Infection with respiratory syncytial virus (RSV), which causes lower respiratory tract infections, is the leading cause of hospitalization among children preterm and full-term infants without chronic lung disease or other high-risk conditions. This analysis used Truven Health Market Scan Multi-State Medicaid and Commercial Claims and Encounters databases, which contain a combined 4 million births from 2003 to 2013. Infants with comorbid conditions associated with increased risk for RSV infection were excluded. Infants were classified as preterm (position. Costs of RSV hospitalizations were captured and reported in 2014 USD. Inpatient claims for RSV hospitalizations were evaluated for the presence of codes indicating admission to the intensive care unit (ICU), use of mechanical ventilation (MV) and length of stay. These three measures were used to describe hospital severity. Chronologic age at the time of RSV hospitalization was also captured. Data were summarized and no statistical comparisons were conducted. There were 1 683 188 infants insured through Medicaid and 1 663 832 infants insured through commercial plans born from 1 July 2003 to 30 June 2013. Of those, 10.8 and 8.8% in each database, respectively, were born prematurely. There were 29 967 Medicaid-insured infants and 16 310 commercially insured infants with an RSV hospitalization during their first year of life. Mean first-year RSV hospitalization costs were higher for preterm infants, ranging from $8324 and $10 570 for full-term infants to $15 839 and $19 931 for preterm infants 33-34 wGA, and to $39 354 and $40 813 for preterm infants preterm infants, with longer lengths of stay, a higher proportion of infants admitted to the intensive care unit (ICU) and increased use of MV compared with full-term infants. Mean costs of RSV hospitalizations with a PICU admission ranged from approximately $35 000 to $89 000. In both Medicaid and commercial groups, costs were greater for

  9. Thyroid Function among Breastfed Children with Chronically Excessive Iodine Intakes

    Directory of Open Access Journals (Sweden)

    Inger Aakre

    2016-06-01

    Full Text Available Iodine excess may impair thyroid function and trigger adverse health consequences for children. This study aims to describe iodine status among breastfed infants with high iodine exposure in the Saharawi refugee camps Algeria, and further assess thyroid function and iodine status among the children three years later. In 2010, a cross-sectional study among 111 breastfed children aged 0–6 months was performed (baseline study. In 2013, a second cross-sectional study (follow-up study was conducted among 289 children; 213 newly selected and 76 children retrieved from baseline. Urinary iodine concentration (UIC and breast milk iodine concentration (BMIC were measured at baseline. UIC, thyroid hormones and serum thyroglobulin (Tg were measured at follow-up. At baseline and follow-up, 88% and 72% had excessive iodine intakes (UIC ≥ 300 µg/L, respectively. At follow-up, 24% had a thyroid hormone disturbance and/or elevated serum Tg, including 9% with subclinical hypothyroidism (SCH, 4% with elevated fT3 and 14% with elevated Tg. Children with SCH had poorer linear growth and were more likely to be underweight than the children without SCH. Excessive iodine intakes and thyroid disturbances were common among children below four years of age in our study. Further, SCH seemed to be associated with poor growth and weight.

  10. Evaluation of the Sodium Serum Level in Infants with Jaundice

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi

    2015-05-01

    Full Text Available Background: Inadequate milk intake during the first year of neonate’s life can result in weight loss, severe hyperbilirubinemia, and sometimes hypernatremia. In this study, we aimed to determine the relationship between neonatal weight loss and hypernatremia in term breastfed infants with idiopathic jaundice, as well as the necessity of sodium concentration measurement in newborns with idiopathic jaundice via weight loss measurement. Methods: In this cross-sectional study, we examined 273 infants with jaundice of unknown etiology at Ghaem Hospital, Mashhad, in years 2008-2012. The study sample consisted of 226 infants in the control group (serum sodium concentration

  11. Tolerance of a standard intact protein formula versus a partially hydrolyzed formula in healthy, term infants

    Directory of Open Access Journals (Sweden)

    Marunycz John D

    2009-06-01

    Full Text Available Abstract Background Parents who perceive common infant behaviors as formula intolerance-related often switch formulas without consulting a health professional. Up to one-half of formula-fed infants experience a formula change during the first six months of life. Methods The objective of this study was to assess discontinuance due to study physician-assessed formula intolerance in healthy, term infants. Infants (335 were randomized to receive either a standard intact cow milk protein formula (INTACT or a partially hydrolyzed cow milk protein formula (PH in a 60 day non-inferiority trial. Discontinuance due to study physician-assessed formula intolerance was the primary outcome. Secondary outcomes included number of infants who discontinued for any reason, including parent-assessed. Results Formula intolerance between groups (INTACT, 12.3% vs. PH, 13.7% was similar for infants who completed the study or discontinued due to study physician-assessed formula intolerance. Overall study discontinuance based on parent- vs. study physician-assessed intolerance for all infants (14.4 vs.11.1% was significantly different (P = 0.001. Conclusion This study demonstrated no difference in infant tolerance of intact vs. partially hydrolyzed cow milk protein formulas for healthy, term infants over a 60-day feeding trial, suggesting nonstandard partially hydrolyzed formulas are not necessary as a first-choice for healthy infants. Parents frequently perceived infant behavior as formula intolerance, paralleling previous reports of unnecessary formula changes. Trial Registration clinicaltrials.gov: NCT00666120

  12. Interrupter technique in infancy: Higher airway resistance and lower short-term variability in preterm versus term infants.

    Science.gov (United States)

    Usemann, Jakob; Demann, Désirée; Anagnostopoulou, Pinelopi; Korten, Insa; Gorlanova, Olga; Schulzke, Sven; Frey, Urs; Latzin, Philipp

    2017-10-01

    In preschool children, measurement of airway resistance using interrupter technique (Rint) is feasible to assess the degree of bronchial obstruction. Although some studies measured Rint in infancy, values of Rint and its variability in preterm infants are unknown. In this study, Rint and its variability was measured at infancy and compared between healthy term and preterm infants. High quality Rint measurements in term (n = 50) and preterm (n = 48) infants were obtained at postmenstrual age of 42-50 weeks in two study centers in Switzerland. Intra-measurement variability of Rint in one measurement and inter-measurement variability between two subsequent measurements was assessed by coefficient of variation (CV). Mean Rint in term infants was 4.2 ± (SD; 1.9) kPa · s · L -1 and in preterm infants was 5.6 ± (2.8) kPa · s · L -1 . Mean CV in term infants was 29.6 ± (14.9)% and in preterm infants was 20.2 ± (8.4)%. Rint was significantly lower (95%CI -2.31 to -0.38; P = 0.007) and CV significantly higher (95%CI 4.53-14.3; P preterm infants. There were no differences in mean Rint and mean CV between the first and the second measurement obtained in a subgroup of term (n = 24, 48%) and preterm (n = 22, 45%) infants. Our results suggest that differences in airway mechanics between term and preterm infants can be assessed with the interrupter technique during early infancy. Before clinical application of Rint measurements in this age group, reasons underlying the variability of measurements should be further investigated. © 2017 Wiley Periodicals, Inc.

  13. A population-based cohort study of breastfeeding according to gestational age at term delivery.

    Science.gov (United States)

    Lutsiv, Olha; Giglia, Lucia; Pullenayegum, Eleanor; Foster, Gary; Vera, Claudio; Chapman, Barbara; Fusch, Christoph; McDonald, Sarah D

    2013-11-01

    Because breastfeeding is the optimal form of infant feeding, this study was conducted to determine the effect of gestational age on breastfeeding in term infants. A retrospective population-based cohort study of singleton/twin hospital births was conducted in Ontario, Canada between April 1, 2009, and March 31, 2010. Multivariate logistic regression was used to determine the adjusted effect of gestational age on breastfeeding. Our study population comprised 92,364 infants, of whom 80,297 (86.9%) were exclusively or partially breastfed at the time of hospital discharge. Multivariate logistic regression analyses demonstrated that early-term infants had lower odds of being breastfed compared with infants born at 41 weeks gestation (40 weeks: aOR, 0.93; 95% CI, 0.86-0.99; 39 weeks: aOR, 0.87; 95% CI, 0.81-0.93; 38 weeks: aOR, 0.81; 95% CI, 0.75-0.88; 37 weeks: aOR, 0.74; 95% CI, 0.67-0.82). Using a population-based approach, we found that infants born at 40, 39, 38, and 37 weeks gestation had increasingly lower odds of being breastfed compared with infants born at 41 weeks. Clinicians need to be made aware of the differences in outcomes of infants delivered at early and late term, so that appropriate breastfeeding support can be provided to women at risk for not breastfeeding. Copyright © 2013 Mosby, Inc. All rights reserved.

  14. Long-term developmental outcome of infants with iron deficiency.

    Science.gov (United States)

    Lozoff, B; Jimenez, E; Wolf, A W

    1991-09-05

    Iron-deficiency anemia has been associated with lowered scores on tests of mental and motor development in infancy. However, the long-term developmental outcome of infants with iron deficiency is unknown, because developmental tests in infancy do not predict later intellectual functioning. This study is a follow-up evaluation of a group of Costa Rican children whose iron status and treatment were documented in infancy. Eighty-five percent (163) of the 191 children in the original group underwent comprehensive clinical, nutritional, and psychoeducational assessments at five years of age. The developmental test battery consisted of the Wechsler Preschool and Primary Scale of Intelligence, the Spanish version of the Woodcock-Johnson Psycho-Educational Battery, the Beery Developmental Test of Visual-Motor Integration, the Goodenough-Harris Draw-a-Man Test, and the Bruininks-Oseretsky Test of Motor Proficiency. All the children had excellent hematologic status and growth at five years of age. However, children who had moderately severe iron-deficiency anemia as infants, with hemoglobin levels less than or equal to 100 g per liter, had lower scores on tests of mental and motor functioning at school entry than the rest of the children. Although these children also came from less socioeconomically advantaged homes, their test scores remained significantly lower than those of the other children after we controlled for a comprehensive set of background factors. For example, the mean (+/- SD) adjusted Woodcock-Johnson preschool cluster score for the children who had moderate anemia in infancy (n = 30) was 448.6 +/- 9.7, as compared with 452.9 +/- 9.2 for the rest of the children (n = 133) (P less than 0.01); the adjusted visual-motor integration score was 5.9 +/- 2.1, as compared with 6.7 +/- 2.3 (P less than 0.05). Children who have iron-deficiency anemia in infancy are at risk for long-lasting developmental disadvantage as compared with their peers with better iron status.

  15. Nutrition for healthy term infants, birth to six months: An overview

    OpenAIRE

    Critch, Jeffrey N

    2013-01-01

    Nutrition for healthy term infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada that was most recently updated in September 2012 with recommendations from birth to six months of age. This practice point outlines the development process, principles of infant feeding, and recommendations for clinicians. Health professionals involved in counselling families about infant nutrition are advised to read the st...

  16. Goniometer Measurements of Oral Labial Angle and Evaluation of Oral Motor Reflexes in Preterm Infants: Comparison to Findings in Term Infants.

    Science.gov (United States)

    Ince, Deniz Anuk; Tugcu, Ali Ulas; Ecevit, Ayşe; Ciyiltepe, Muzeyyen; Kurt, Abdullah; Abbasoğlu, Aslıhan; Tekindal, Mustafa Agah; Tarcan, Aylin

    2015-10-01

    To date, no study has evaluated changes in oral labial angle as preterm infants mature. The main purpose of this study was to document goniometer measurements of the labial angle of the mouth in preterm infants, to assess changes with development, to compare to findings in healthy term infants, and also evaluate oral motor reflexes in these groups. Seventy-eight preterm infants and 45 healthy term infants were recruited for the prospective study. Labial angle was assessed via goniometer, and oral motor reflexes and the volume of milk ingested were evaluated. There was significant difference between term and preterm infants' labial angles (P Goniometer measurements of the oral labial angle may reveal oral motor performance in preterm infants and may be relevant for feeding skills assessment in this group of infants. © The Author(s) 2015.

  17. Lung volume, breathing pattern and ventilation inhomogeneity in preterm and term infants.

    Directory of Open Access Journals (Sweden)

    Philipp Latzin

    Full Text Available BACKGROUND: Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques. METHODOLOGY/PRINCIPAL FINDINGS: We studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg than preterm infants without BPD (23.4 mL/kg and term-born infants (22.6 mL/kg, though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t(PTEF/t(E than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity. CONCLUSIONS: Our results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.

  18. Impact of Parent Practices of Infant Positioning on Head Orientation Profile and Development of Positional Plagiocephaly in Healthy Term Infants.

    Science.gov (United States)

    Leung, Amy; Mandrusiak, Allison; Watter, Pauline; Gavranich, John; Johnston, Leanne M

    2017-04-04

    The influence of infant positioning on the development of head orientation and plagiocephaly is not clear. This study explored the relationship between infant body and head positioning, with the development of asymmetrical head orientation and/or positional plagiocephaly. Methods: Clinician measurement of head orientation profile and parent-reported infant positioning data were collected for 94 healthy term infants at 3, 6, and 9 weeks of age. Plagiocephaly was measured at 9 weeks with the modified Cranial Vault Asymmetry Index. More severe plagiocephaly was associated with longer supine-sleep-maximum (p = 0.001) and longer supine-lying-total (p = 0.014) at 6 weeks. Prone positioning was not associated with plagiocephaly. Parent-reported head asymmetry during awake and sleep time at 3 weeks identified infants with clinician-measured head asymmetry at 9 weeks. Better symmetry in head turning was associated with more side-lying-total time by 9 weeks (p = 0.013). Our results showed that infant positioning is associated with early head orientation and plagiocephaly development. Early parent-reported asymmetry during awake and sleep time is an important indicator for the need for professional assessment and advice. A Plagiocephaly Prevention Strategy and Plagiocephaly Screening Pathway are provided for clinicians and parents.

  19. Infant feeding bottle design, growth and behaviour: results from a randomised trial

    Directory of Open Access Journals (Sweden)

    Fewtrell MS

    2012-03-01

    Full Text Available Abstract Background Whether the design of an anti-vacuum infant feeding bottle influences infant milk intake, growth or behavior is unknown, and was the subject of this randomized trial. Methods Subjects 63 (36 male healthy, exclusively formula-fed term infants. Intervention Randomisation to use Bottle A (n = 31, one-way air valve: Philips Avent versus Bottle B (n = 32, internal venting system: Dr Browns. 74 breast-fed reference infants were recruited, with randomisation (n = 24 to bottle A (n = 11 or B (n = 13 if bottle-feeding was subsequently introduced. Randomisation stratified by gender and parity; computer-based telephone randomisation by independent clinical trials unit. Setting Infant home. Primary outcome measure infant weight gain to 4 weeks. Secondary outcomes (i milk intake (ii infant behaviour measured at 2 weeks (validated 3-day diary; (iii risk of infection; (iv continuation of breastfeeding following introduction of mixed feeding. Results Number analysed for primary outcome Bottle A n = 29, Bottle B n = 25. Primary outcome There was no significant difference in weight gain between randomised groups (0-4 weeks Bottle A 0.74 (SD 1.2 SDS versus bottle B 0.51 (0.39, mean difference 0.23 (95% CI -0.31 to 0.77. Secondary outcomes Infants using bottle A had significantly less reported fussing (mean 46 versus 74 minutes/day, p Breast-fed reference group There were no significant differences in primary or secondary outcomes between breast-fed and formula fed infants. The likelyhood of breastfeeding at 3 months was not significantly different in infants subsequently randomised to bottle A or B. Conclusion Bottle design may have short-term effects on infant behaviour which merit further investigation. No significant effects were seen on milk intake or growth; confidence in these findings is limited by the small sample size and this needs confirmation in a larger study. Trial registration Clinical Trials.gov NCT00325208.

  20. Infant feeding bottle design, growth and behaviour: results from a randomised trial.

    Science.gov (United States)

    Fewtrell, M S; Kennedy, K; Nicholl, R; Khakoo, A; Lucas, A

    2012-03-16

    Whether the design of an anti-vacuum infant feeding bottle influences infant milk intake, growth or behavior is unknown, and was the subject of this randomized trial. 63 (36 male) healthy, exclusively formula-fed term infants. Randomisation to use Bottle A (n = 31), one-way air valve: Philips Avent) versus Bottle B (n = 32), internal venting system: Dr Browns). 74 breast-fed reference infants were recruited, with randomisation (n = 24) to bottle A (n = 11) or B (n = 13) if bottle-feeding was subsequently introduced. Randomisation: stratified by gender and parity; computer-based telephone randomisation by independent clinical trials unit. Infant home. infant weight gain to 4 weeks. (i) milk intake (ii) infant behaviour measured at 2 weeks (validated 3-day diary); (iii) risk of infection; (iv) continuation of breastfeeding following introduction of mixed feeding. Number analysed for primary outcome: Bottle A n = 29, Bottle B n = 25. There was no significant difference in weight gain between randomised groups (0-4 weeks Bottle A 0.74 (SD 1.2) SDS versus bottle B 0.51 (0.39), mean difference 0.23 (95% CI -0.31 to 0.77). Infants using bottle A had significantly less reported fussing (mean 46 versus 74 minutes/day, p bottle B. There was no significant difference in any other outcome measure. Breast-fed reference group: There were no significant differences in primary or secondary outcomes between breast-fed and formula fed infants. The likelyhood of breastfeeding at 3 months was not significantly different in infants subsequently randomised to bottle A or B. Bottle design may have short-term effects on infant behaviour which merit further investigation. No significant effects were seen on milk intake or growth; confidence in these findings is limited by the small sample size and this needs confirmation in a larger study. Clinical Trials.gov NCT00325208.

  1. Long-Term Cognitive Outcomes of Infants Born Moderately and Late Preterm

    Science.gov (United States)

    Odd, David Edward; Emond, Alan; Whitelaw, Andrew

    2012-01-01

    Aim: To investigate whether infants born late preterm have poorer cognitive outcomes than term-born infants. Method: A cohort study based on the Avon Longitudinal Study of Parents and Children. Cognitive measures were assessed between the ages of 8 and 11 years. Exposure groups were defined as moderate/late preterm (32-36 weeks' gestation) or term…

  2. Early vs delayed clamping of the umbilical cord in full term, preterm and very preterm infants

    DEFF Research Database (Denmark)

    Moller, N.K.; Weber, T.

    2008-01-01

    Randomized studies from 2006 and two meta-analyses published in 2007 agree that clamping of the umbilical cord can be delayed. For the preterm and very preterm infant benefits include less need for blood transfusion and less morbidity, especially for the very preterm male infant. For the term...

  3. DEVELOPMENT OF MUSCLE POWER IN PRETERM INFANTS - INDIVIDUAL TRAJECTORIES AFTER TERM AGE

    NARCIS (Netherlands)

    DEGROOT, L; HOPKINS, B; TOUWEN, BCL; VANDERHOEK, AM

    In a longitudinal study individual trajectories were traced for the developing relationship between active and passive muscle power in preterm (n = 37) and fullterm (n = 20) infants from term to 24 weeks (corrected) age. Such trajectories should enable the identification of those infants at highest

  4. Effect of massage stimulation on weight gain in full term infants

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    Nyoman Nursari Dewi

    2011-08-01

    Full Text Available Background Massage is a tactile/kinesthetic stimulation with biochemical and physiological effects on the body. Newborn infant massage stimulation given by mothers may promote maternal-infant bonding and attachment, enhance infant weight gain and stimulate the production of breast milk. There have been few studies on the effect of massage stimulation on weight gain in full term infants, and this topic remains controversial. Objective To examine the effect of massage stimulation on weight gain in full term infants. Methods This quasi-experimental study was held in Sanglah Hospital and Bunda Setia Maternity Clinic. Massage stimulation was performed by mothers once daily for a four week period. Massage stimulation was given to 30 full term infants and their weight gain was compared to 31 control infants who did not receive massages. Results There were no differences in subject characteristics between the massage and control groups. Median weight gain in the massage group was 1230 grams, while that in the control group was 830 grams (P=0.028. Conclusion Weight gain in full term infants in the massage group was significantly greater than that in the control group after 4 weeks.

  5. Reliability of Neurobehavioral Assessments from Birth to Term Equivalent Age in Preterm and Term Born Infants.

    Science.gov (United States)

    Eeles, Abbey L; Olsen, Joy E; Walsh, Jennifer M; McInnes, Emma K; Molesworth, Charlotte M L; Cheong, Jeanie L Y; Doyle, Lex W; Spittle, Alicia J

    2017-02-01

    Neurobehavioral assessments provide insight into the functional integrity of the developing brain and help guide early intervention for preterm (term equivalent age. Few neurobehavioral assessments used in the preterm period have established interrater reliability. To evaluate the interrater reliability of the Hammersmith Neonatal Neurological Examination (HNNE) and the NICU Network Neurobehavioral Scale (NNNS), when used both preterm and at term (>36 weeks). Thirty-five preterm infants and 11 term controls were recruited. Five assessors double-scored the HNNE and NNNS administered either preterm or at term. A one-way random effects, absolute, single-measures interclass correlation coefficient (ICC) was calculated to determine interrater reliability. Interrater reliability for the HNNE was excellent (ICC > 0.74) for optimality scores, and good (ICC 0.60-0.74) to excellent for subtotal scores, except for 'Tone Patterns' (ICC 0.54). On the NNNS, interrater reliability was predominantly excellent for all items. Interrater agreement was generally excellent at both time points. Overall, the HNNE and NNNS neurobehavioral assessments demonstrated mostly excellent interrater reliability when used prior to term and at term.

  6. Pre-exposure Prophylaxis Use by Breastfeeding HIV-Uninfected Women: A Prospective Short-Term Study of Antiretroviral Excretion in Breast Milk and Infant Absorption.

    Directory of Open Access Journals (Sweden)

    Kenneth K Mugwanya

    2016-09-01

    Full Text Available As pre-exposure prophylaxis (PrEP becomes more widely used in heterosexual populations, an important consideration is its safety in infants who are breastfed by women taking PrEP. We investigated whether tenofovir and emtricitabine are excreted into breast milk and then absorbed by the breastfeeding infant in clinically significant concentrations when used as PrEP by lactating women.We conducted a prospective short-term, open-label study of daily oral emtricitabine-tenofovir disoproxil fumarate PrEP among 50 HIV-uninfected breastfeeding African mother-infant pairs between 1-24 wk postpartum (ClinicalTrials.gov Identifier: NCT02776748. The primary goal was to quantify the steady-state concentrations of tenofovir and emtricitabine in infant plasma ingested via breastfeeding. PrEP was administered to women through daily directly observed therapy (DOT for ten consecutive days and then discontinued thereafter. Non-fasting peak and trough samples of maternal plasma and breast milk were obtained at drug concentration steady states on days 7 and 10, and a single infant plasma sample was obtained on day 7. Peak blood and breast milk samples were obtained 1-2 h after the maternal DOT PrEP dose, while maternal trough samples were obtained at the end of the PrEP dosing interval (i.e., 23 to 24 h after maternal DOT PrEP dose. Tenofovir and emtricitabine concentrations were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS assays. Of the 50 mother-infant pairs enrolled, 48% were ≤12 wk and 52% were 13-24 wk postpartum, and median maternal age was 25 y (interquartile range [IQR] 22-28. During study follow-up, the median (IQR daily reported frequency of infant breastfeeding was 15 times (12 to 18 overall, 16 (14 to 19 for the ≤12 weeks, and 14 (12 to 17 for the 13-24 wk infant age groups. Overall, median (IQR time-averaged peak concentrations in breast milk were 3.2 ng/mL (2.3 to 4.7 for tenofovir and 212.5 ng/mL (140.0 to 405.0 for

  7. Time course study of blood pressure in term and preterm infants immediately after birth.

    Directory of Open Access Journals (Sweden)

    Gerhard Pichler

    Full Text Available To describe temporal changes in systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively in term and preterm infants immediately after birth.Prospective observational two-center study. In term infants SBP, DBP, and MBP were assessed non-invasively every minute for the first 15 minutes, and in preterm infants every minute for the first 15 minutes, as well as at 20, 25, 30, 45, and 60 minutes after birth. Regression analyses were performed by gender and respiratory support in all neonates; and by mode of delivery, cord clamping time, and development of ultrasound-detected brain injury in preterm neonates.Term infants (n = 54 had a mean (SD birth weight of 3298 (442 g and gestational age of 38 (1 weeks, and preterm infants (n = 94 weighed 1340 (672 g and were 30 (3 weeks gestation. Term infants' SBP, DBP and MBP within the first 15 minutes after birth were independent of gender or respiratory support. Linear mixed regression analysis showed that preterm infants, who were female, born vaginally, had delayed cord clamping and did not require positive pressure ventilation nor develop periventricular injury or ventriculomegaly, had significantly higher SBP, DBP, and MBP at some measurement points within the first hour after birth.We present novel reference ranges of BP immediately after birth in a cohort of term and preterm neonates. They may aid in optimization of cardiovascular support during early transition at all gestations.

  8. Growth and neurodevelopment outcome in symmetric versus asymmetric small for gestational age term infants.

    Science.gov (United States)

    Maciejewski, E; Hamon, I; Fresson, J; Hascoet, J-M

    2016-08-01

    Few studies compared growth and neurodevelopment outcome between asymmetric (aSYM) and symmetric (SYM) small for gestational age (SGA) term infants. We aimed at evaluating their respective outcome at 9 months postnatal age. A cohort study including infants born in 2010 to 2011 with a birth weight Lezine test items. Of 6586 infants, 194 were SGA: 38.7% SYM and 61.3% aSYM. The aSYM group showed better catch-up growth (85% versus 70%, P=0.03) with larger HC (44.9±1.6 versus 43.7±1.2 cm, P<0.0001). No difference in neurodevelopmental screening was observed between SGA groups, but infants without any catch-up growth were at higher risk of delayed outcome. Term SGA infants must be closely followed, regardless of their characteristics, to improve their outcome.

  9. Voxel-based morphometry and fMRI revealed differences in brain gray matter in breastfed and milk formula–fed children

    Science.gov (United States)

    Background and Purpose: Infant diets may have significant impact on brain development in children. The aim of this study was to evaluate brain grey matter structure and function in 8-year-old children who were predominantly breastfed (BF) or fed cow’s milk formula (MF) as infants. Materials and Me...

  10. Development of Sucking Patterns in Pre-Term Infants with Bronchopulmonary Dysplasia

    NARCIS (Netherlands)

    da Costa, Saakje P.; van der Schans, Cees P.; Zweens, Mar J.; Boelema, Sarai R.; van der Meij, Eva; Boerman, Mieke A.; Bos, Arend F.

    2010-01-01

    Background: Pre-term infants with bronchopulmonary dysplasia (BPD) are at risk of acquiring brain abnormalities. Combined with ongoing breathing difficulties, this may influence the development of their sucking patterns. Objective: To determine the longitudinal development of sucking patterns from

  11. Prognostic Factors of Developmental Outcome in Neonatal Seizures in Term Infants

    Directory of Open Access Journals (Sweden)

    Yin-Hsuan Lai

    2013-06-01

    Conclusion: In term infants with neonatal seizures, several risk factors related to adverse outcome were recognized. Physicians should pay more attention to these factors when handling patients with neonatal seizures.

  12. Causes and short-term outcomes of preterm infants

    Directory of Open Access Journals (Sweden)

    Xu Aiqun

    2017-01-01

    Full Text Available Introduction/Objective. Preterm birth (PB is the most important reason of neonatal mortality, and the second most common direct cause of death for children under the age of five years. The aim of this study was to analyze the clinical features and outcomes of preterm infants. Methods. The clinical data of 307 preterm infants delivered in the Qingdao University hospital from January 1, 2012 to December 31, 2012 were retrospectively analyzed. Results. The incidence of PB was 6.52%. There were 143 cases of preterm prelabour rupture of membranes (PPROM (46.58%, 66 cases of spontaneous PB (21.5%, and 98 cases of therapeutic PB (31.92%. Deliveries with gestational weeks (GW < 32 were mainly vaginal (60.72%, but deliveries with GW ≥ 32 exhibited higher C-section rate (60.99% than the vaginal delivery rate (p < 0.05. The birth weight was 2,340.46 ± 606.26 g, and the Z-score at birth was -0.15 ± 1.08. The Z-score in the group with GW within 28 to 31+6 weeks was less than that in the group with GW within 32 to 33+6 and with GW ≥ 34 (р < 0.05. The average hospital stay of preterm infants was 15.17 ± 12.35 days, and the most common complication in these preterm infants was respiratory distress syndrome with 13.92%. Conclusion. PB could cause a variety of serious complications in infants. The main causes of PB, such ас PPROM, should be actively prevented and treated; meanwhile, preterm infants should also be actively treated so as to improve their outcomes.

  13. Preterm and Term Infants' Perception of Temporally Coordinated Syllable-Object Pairings: Implications for Lexical Development

    Science.gov (United States)

    Gogate, Lakshmi; Maganti, Madhavilatha; Perenyi, Agnes

    2014-01-01

    Purpose: This experimental study examined term infants (n = 34) and low-risk near-term preterm infants (gestational age 32-36 weeks) at 2 months chronological age (n = 34) and corrected age (n = 16). The study investigated whether the preterm infants presented with a delay in their sensitivity to synchronous syllable-object pairings when compared…

  14. Optimizing Nutrition in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Bai-Horng Su

    2014-02-01

    Full Text Available Extrauterine growth restriction is common in very preterm infants. The incidence in very-low-birth-weight infants ranges between 43% and 97% in various centers, with a wide variability due to the use of different reference growth charts and nonstandard nutritional strategies. Extrauterine growth restriction is associated with an increased risk of poor neurodevelopmental outcome. Inadequate postnatal nutrition is an important factor contributing to growth failure, as most very preterm infants experience major protein and energy deficits during neonatal intensive care unit hospitalization. First-week protein and energy intake are associated with 18-month developmental outcomes in very preterm infants. Early aggressive nutrition, including parenteral and enteral, is well tolerated in the very preterm infant and is effective in improving growth. Continued provision of appropriate nutrition (fortified human milk or premature formula is important throughout the growing care during the hospitalization. After discharge, exclusively breast-fed infants require additional supplementation. If formula-fed, nutrient-enriched postdischarge formula should be continued for approximately 9 months corrected age. Supplementation of the preterm formulas with protein would increase the protein/energy ratio (3 g/100 kcal, leading to increased lean mass with relatively decreased fat deposition. Further research is required to optimize the nutritional needs of preterm infants and to evaluate the effects of nutritional interventions on long-term growth, neurodevelopment, and other health outcomes.

  15. Long-Term Effects of a Home-Visiting Intervention for Depressed Mothers and Their Infants

    Science.gov (United States)

    Kersten-Alvarez, Laura E.; Hosman, Clemens M. H.; Riksen-Walraven, J. Marianne; Van Doesum, Karin T. M.; Hoefnagels, Cees

    2010-01-01

    Background: Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term effects of an intervention for mothers with postpartum…

  16. Long-term effects of a home-visiting intervention for depressed mothers and their infants

    NARCIS (Netherlands)

    Kersten-Alvarez, L.E.; Hosman, C.M.H.; Riksen-Walraven, J.M.A.; Doesum, K.T.M. van; Hoefnagels, C.C.J.

    2010-01-01

    Background - Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term

  17. Does Human Milk Modulate Body Composition in Late Preterm Infants at Term-Corrected Age?

    Science.gov (United States)

    Giannì, Maria Lorella; Consonni, Dario; Liotto, Nadia; Roggero, Paola; Morlacchi, Laura; Piemontese, Pasqua; Menis, Camilla; Mosca, Fabio

    2016-10-23

    (1) Background: Late preterm infants account for the majority of preterm births and are at risk of altered body composition. Because body composition modulates later health outcomes and human milk is recommended as the normal method for infant feeding, we sought to investigate whether human milk feeding in early life can modulate body composition development in late preterm infants; (2) Methods: Neonatal, anthropometric and feeding data of 284 late preterm infants were collected. Body composition was evaluated at term-corrected age by air displacement plethysmography. The effect of human milk feeding on fat-free mass and fat mass content was evaluated using multiple linear regression analysis; (3) Results: Human milk was fed to 68% of the infants. According to multiple regression analysis, being fed any human milk at discharge and at  term-corrected and being fed exclusively human milk at term-corrected age were positively associated with fat-free mass content(β = -47.9, 95% confidence interval (CI) = -95.7; -0.18; p = 0.049; β = -89.6, 95% CI = -131.5; -47.7; p Human milk feeding appears to be associated with fat-free mass deposition in late preterm infants. Healthcare professionals should direct efforts toward promoting and supporting breastfeeding in these vulnerable infants.

  18. Comparison of the phospholipid classes in human milk in Japanese mothers of term and preterm infants.

    Science.gov (United States)

    Shoji, Hiromichi; Shimizu, Toshiaki; Kaneko, Noritsugu; Shinohara, Koichi; Shiga, Seigo; Saito, Masami; Oshida, Kyoichi; Shimizu, Takashi; Takase, Mitsunori; Yamashiro, Yuichiro

    2006-08-01

    Phospholipids (PLs) play an essential role in the growth and brain development of infants. To investigate PL composition in human milk (HM), including lysophosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, phosphatidylserine, phosphatidylcholine (PC) and sphingomyelin (SM), from healthy Japanese mothers. Analyses were performed on colostrum, transitional milk and mature milk from mothers of preterm and term infants. HM samples were collected from mothers of 15 term infants (term group) and of 19 preterm infants (preterm group). PL composition was determined by two-dimensional thin-layer chromatography in conjunction with phosphorus analysis. In both groups, the PL content (% of total lipid) of mature milk was significantly lower than in colostrum. SM and PC were the main PLs in HM, but in the preterm group, the percentage of SM in mature milk was significantly higher and PC in mature milk was significantly lower than in the term group. The transition from colostrum to mature milk leads to an increase in SM and a decrease in PC in the HM of preterm infants, along with a decrease in PL content. This is the first report to demonstrate the differences in PL composition in HM between mothers of preterm and term infants.

  19. Lung function at term in extremely preterm-born infants: a regional prospective cohort study.

    Science.gov (United States)

    Bentsen, Mariann Haavik; Markestad, Trond; Øymar, Knut; Halvorsen, Thomas

    2017-10-25

    To compare lung function of extremely preterm (EP)-born infants with and without bronchopulmonary dysplasia (BPD) with that of healthy term-born infants, and to determine which perinatal characteristics were associated with lung function at term and how predictive these measurements were for later respiratory health in EP-born infants. Perinatal variables were recorded prospectively, and tidal breathing parameters were measured at term-equivalent age using electromagnetic inductance plethysmography. Respiratory morbidity was defined by hospital readmissions and/or treatment with asthma medications during the first year of life. Fifty-two EP-born infants (mean gestational age 261, range 226-276 weeks) and 45 term-born infants were included. There was evidence of significant airway obstruction, higher tidal volumes and increased minute ventilation in the EP-born infants with and without BPD, although generally more pronounced for those with BPD. Male gender, antenatal steroids and number of days on continuous positive airway pressure were associated with lung function outcomes at term. A prediction model incorporating two unrelated tidal breathing parameters, BPD, birth weight z-score and gender, predicted respiratory morbidity in the first year of life with good accuracy (area under the curve 0.818, sensitivity and specificity 81.8% and 75.0%, respectively). Lung function measured at term-equivalent age was strikingly abnormal in EP-born infants, irrespective of BPD. Tidal breathing parameters may be of value in predicting future pulmonary health in infants born premature. NCT01150396; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Nutrition for healthy term infants, six to 24 months: An overview.

    Science.gov (United States)

    Critch, Jeffrey N

    2014-12-01

    Nutrition for Healthy Term Infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada. It was republished in September 2012, with recommendations on infant feeding from birth to six months of age. The statement was most recently updated in April 2014, with recommendations for feeding older infants and young children from six to 24 months of age. The present practice point outlines the statement development process and principles of feeding, with specific recommendations for clinicians. Health professionals who counsel families on nutrition in infants and young children are advised to read the statement in its entirety because discussion in the longer document expands on and clarifies advice summarized in the principles and recommendations given here. The complete statement is available on Health Canada's website: www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/index-eng.php.

  1. Differences in walking attainment ages between low-risk preterm and healthy full-term infants

    Directory of Open Access Journals (Sweden)

    Ana P. Restiffe

    2012-08-01

    Full Text Available OBJECTIVE: To compare gross motor development of preterm infants (PT without cerebral palsy with healthy full-term (FT infants, according to Alberta Infant Motor Scale (AIMS; to compare the age of walking between PT and FT; and whether the age of walking in PT is affected by neonatal variables. METHODS: Prospective study compared monthly 101 PT and 52 FT, from the first visit, until all AIMS items had been observed. Results: Mean scores were similarity in their progression, except from the eighth to tenth months. FT infants were faster in walking attainment than PT. Birth weight and length and duration of neonatal nursery stay were related to walking delay. CONCLUSION: Gross motor development between PT and FT were similar, except from the eighth to tenth months of age. PT walked later than FT infants and predictive variables were birth weight and length, and duration of neonatal intensive unit stay.

  2. Respiratory muscle activity related to flow and lung volume in preterm infants compared with term infants

    NARCIS (Netherlands)

    Hutten, Gerard J.; van Eykern, Leo A.; Latzin, Philipp; Thamrin, Cindy; van Aalderen, Wim M.; Frey, Urs

    2010-01-01

    Infants with chronic lung disease (CLD) have a capacity to maintain functional lung volume despite alterations to their lung mechanics. We hypothesize that they achieve this by altering breathing patterns and dynamic elevation of lung volume, leading to differences in the relationship between

  3. Is it correct to correct? Developmental milestones in 555 "normal" preterm infants compared with term infants.

    NARCIS (Netherlands)

    Ouden, L. den; Rijken, M.; Brand, R.; Verloove-Vanhorick, S.P.; Ruys, J.H.

    1991-01-01

    To determine whether correction for preterm birth should be applied during developmental assessment, we conducted a prospective national survey of very premature infants (born at less than 32 weeks of gestation); neurodevelopment in the first 2 years was studied with the Dutch child health care

  4. Formula milk versus term human milk for feeding preterm or low birth weight infants.

    Science.gov (United States)

    McGuire, W; Anthony, M Y

    2001-01-01

    Term (mature) human breast milk, compared with artificial formula milks, may provide insufficient nutrition for growth and development in preterm or low birth weight infants. However, human milk may confer advantages to infants in terms of a decreased incidence of adverse outcomes. To determine if formula milk compared with term human breast milk leads to improved growth and development without significant adverse effects in low birth weight or preterm infants. The standard search strategy of the Cochrane Neonatal Review Group was used. This included electronic searches of the Cochrane Controlled Trials Register, MEDLINE, EMBASE and previous reviews including cross references. Randomised controlled trials comparing feeding with formula milk versus term human milk in low birth weight or preterm infants. Data were extracted using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author and synthesis of data using relative risk, risk difference and weighted mean difference. Six trials, all initiated more than 20 years ago, fulfilled the pre-specified inclusion criteria. Four small trials compared feeding with standard calorie formula milk versus unfortified term human milk. Two trials compared feeding with calorie-enriched formula milk versus unfortified term human milk. No trials comparing feeding with formula milk versus nutrient-fortified term human milk were found. Only one trial reported longer term follow up of growth and development. In preterm and low birth weight infants, enteral feeding with formula milk compared with unfortified term human milk resulted in a greater rate of growth in the short term. We did not find a statistically significant difference in the incidence of necrotising enterocolitis, but this was evaluated as a pre-defined outcome in only one trial. The single trial that evaluated longer-term outcomes did not find evidence of an effect on longer-term growth and

  5. Randomised clinical trial of parenteral selenium supplementation in preterm infants.

    OpenAIRE

    Daniels, L; Gibson, R.; Simmer, K.

    1996-01-01

    AIM: To determine whether selenium supplementation of parenteral nutrition with 3 micrograms/kg/day of selenious acid is safe and effective in improving the selenium status of preterm infants. METHODS: Thirty eight preterm infants with mean (SEM) birthweight of 1171 (38) g and gestational age 29 (0.3) weeks were randomly allocated to a non-supplemented (PN-selenium, n = 19) or supplemented (PN+selenium, n = 19) group. The study began at 2.8 (0.2) (range 1-5) days of age. Term breastfed (n = 2...

  6. Transient Hypothyroidism in Premature Infants After Short-term Topical Iodine Exposure: An Avoidable Risk?

    Directory of Open Access Journals (Sweden)

    Jordan E. Pinsker

    2013-04-01

    Full Text Available Studies in preterm infants have shown that prolonged treatment with topical iodine (multiple doses, often over multiple days can transiently suppress thyroid function. However, it is uncertain if topical iodine exposure for very short periods of time can cause significant changes in thyroid function. We report two cases of transient hypothyroidism in preterm infants after short-term exposure to topical iodine during surgical preparation, and review their clinical and laboratory findings before and after iodine exposure. We conclude that premature infants are at risk of developing transient hypothyroidism in response to a single, short-term exposure to topical iodine, even in iodine-sufficient geographical areas. We advise monitoring of thyroid function in these infants after iodine exposure, as treatment with levothyroxine may be needed for a limited duration to prevent the sequelae of untreated hypothyroidism. Consideration of using alternative cleansing agents is also advised.

  7. Long-term follow-up of benign positional vertical opsoclonus in infants: retrospective cohort.

    Science.gov (United States)

    Sternfeld, Amir; Lobel, Daniella; Leiba, Hana; Luckman, Judith; Michowiz, Shalom; Goldenberg-Cohen, Nitza

    2017-09-13

    Benign positional vertical opsoclonus in infants, also described as paroxysmal tonic downgaze, is an unsettling phenomenon that leads to extensive work-up, although benign course has been reported in sporadic cases. We describe long-term follow-up of a series of infants with the phenomenon. This retrospective cohort included all infants diagnosed with rapid downgaze eye movement in 2012-2015 and followed until 2016. The databases of two medical centres were retrospectively reviewed. Benign positional vertical opsoclonus was diagnosed based on clinical findings of experienced neuro-ophthalmologists. Data were collected on demographics, symptoms and signs, neuro-ophthalmological and neurological evaluations, and outcome. Imaging studies were reviewed. Main outcome measures were long-term outcome and findings of the thorough investigation. The cohort included six infants. All infants were born at term. Age at presentation was several days to 12 weeks. Episodes lasted a few seconds and varied in frequency from <10 to dozens per day. In five infants, symptoms occurred in the supine position. There was a wide variability in the work-up without any pathological findings. Follow-up ranged from 1 to 2.5 years. Ocular symptoms gradually decreased until resolution. Infants reached normal developmental milestones. Our identification of six patients in only 3 years suggests benign positional vertical opsoclonus may be more prevalent than previously described. In our experience, it affects otherwise healthy infants and resolves spontaneously. In view of the good long-term outcome, a comprehensive clinical investigation may not be necessary. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. "The effect of fluid supplementation on serum bilirubin level during phototerapy in term infants "

    OpenAIRE

    Torkaman M; Afsharpeyman SH; Khalili Matinzadeh Z; Amirsalary S; Kavehmanesh Z; Hashemi S.A

    2007-01-01

    Background: Jaundice is a common and benign problem in neonatal period. Several therapeutic procedures for decreasing of serum bilirubin level has been recommended. phototherapy is most common them. Our goal Form this study is the evaluation of serum therapy effects in decreasing of serum bilirubin concentration in icteric infants that are treated with phototherapy. Methods: This is a prospective clinical trial in Najmeih Hospital in 2002. In this study 80 term icteric infants with bilirubin ...

  9. Cortisol, contingency learning, and memory in preterm and full-term infants

    Science.gov (United States)

    Haley, David W.; Weinberg, Joanne; Grunau, Ruth E.

    2005-01-01

    Summary Cortisol plays an important role in learning and memory. An inverted-U shaped function has been proposed to account for the positive and negative effects of cortisol on cognitive performance and memory in adults, such that too little or too much impair but moderate amounts facilitate performance. Whether such relationships between cortisol and mental function apply to early infancy, when cortisol secretion, learning, and memory undergo rapid developmental changes, is unknown. We compared relationships between learning/memory and cortisol in preterm and full-term infants and examined whether a greater risk for adrenal insufficiency associated with prematurity produces differential cortisol–memory relationships. Learning in three-month old (corrected for gestational age) preterm and full-term infants was evaluated using a conjugate reinforcement mobile task. Memory was tested by repeating the same task 24 h later. Salivary cortisol samples were collected before and 20 min after the presentation of the mobile. We found that preterm infants had lower cortisol levels and smaller cortisol responses than full-term infants. This is consistent with relative adrenal insufficiency reported in the neonatal period. Infants who showed increased cortisol levels from 0 to 20 min on Day 1 had significantly better memory, regardless of prematurity, than infants who showed decreased cortisol levels. PMID:16122876

  10. Cardiac arrest in infants, children, and adolescents: long-term emotional and behavioral functioning

    NARCIS (Netherlands)

    L. van Zellem (Lennart); E.M.W.J. Utens (Elisabeth); M.J. Madderom (Marlous); J.S. Legerstee (Jeroen); F.K. Aarsen (Femke); D. Tibboel (Dick); C.M.P. Buysse (Corinne)

    2016-01-01

    textabstractVery little is known about the psychological consequences of a cardiac arrest (CA) during childhood. Our aim was to assess long-term emotional and behavioral functioning, and its predictors, in survivors of CA in childhood. This long-term follow-up study involved all consecutive infants,

  11. Changes in quantitative ultrasound in preterm and term infants during the first year of life

    Energy Technology Data Exchange (ETDEWEB)

    Tansug, Nermin, E-mail: ntansug@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Yildirim, Sule Aslan, E-mail: sulesln@yahoo.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Canda, Ebru, E-mail: ebruerbass@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Ozalp, Deniz, E-mail: bluexxdeniz@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Yilmaz, Ozge, E-mail: oyilmaz_76@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey); Taneli, Fatma, E-mail: fatma.taneli@bayar.edu.tr [Celal Bayar University, Faculty of Medicine, Department of Biochemistry, 45020 Manisa (Turkey); Ersoy, Betuel, E-mail: betul_e@hotmail.com [Celal Bayar University, Faculty of Medicine, Department of Pediatrics, 45020 Manisa (Turkey)

    2011-09-15

    Since most of in utero bone mass accretion occurs during the third trimester and postnatal need for bone nutrients is increased, preterm infants have an increased risk of low bone mass. Early identification of the risk is of crucial importance. Quantitative ultrasound, which is a relatively inexpensive, portable, noninvasive, and radiation-free method, gives information about bone density, cortical thickness, elasticity and microarchitecture. The aim of this study was to obtain quantitative ultrasound measurements of tibial speed of sound of preterm and term infants and to assess clinical factors associated with these measurements during the first year of life. Seventy-eight preterm and 48 term infants were enrolled in this study. Measurements were made on the 10th day of life in both groups, and were repeated on the 2nd, 6th and 12th months for preterm infants and on the12th month for the term infants. Speed of sound on preterm infants was significantly decreased on the 2nd month but significantly increased on the 12th month (P = 0.00). Comparing speed of sound of term and preterm infants, 10th day measurements were significantly different (P = 0.00), but there was not any significant difference between the 12th month values (P = 0.26). There was not any relation between biochemical parameters and speed of sound. The technique has potential clinical value for assessment of bone status. Further studies with long term follow up are needed to evaluate the value of quantitative ultrasound with other bone markers to predict the risk of fracture.

  12. Association between breastfeeding support and breastfeeding rates in the UK: a comparison of late preterm and term infants

    Science.gov (United States)

    Rayfield, Sarah; Oakley, Laura; Quigley, Maria A

    2015-01-01

    Objective To explore the association between breastfeeding support and breastfeeding among late preterm (gestation 34–36 weeks) and term (gestation ≥37 weeks) infants. Methods Secondary analysis of the UK 2010 Infant Feeding Survey. Logistic regression was used to determine the association of breastfeeding support with breastfeeding at 10 days and 6 weeks in late preterm and term infants. Results The study included 14 525 term and 579 late preterm infants. A total of 11 729 infants initiated breastfeeding (11 292 (81.1%) term, 437 (79.4%) late preterm infants, p=0.425). Of these, 9230 (84.3%) term and 365 (85.6%) late preterm infants were breastfeeding at 10 days (p=0.586); of these 7547 (82.0%) term and 281 (75.4%) late preterm infants were still breastfeeding at 6 weeks (p=0.012). Mothers who reported receiving contact details for breastfeeding support groups had a higher likelihood of breastfeeding late preterm (adjusted ORs, aOR 3.14, 95% CI 1.40 to 7.04) and term infants (aOR 2.24, 95% CI 1.86 to 2.68) at 10 days and term infants at 6 weeks (aOR 1.83, 95% CI 1.51 to 2.22). Those who reported that they did not receive enough help with breastfeeding in hospital had a lower likelihood of breastfeeding late preterm at 10 days and term infants at 10 days and 6 weeks, compared to those who reported having enough help. Conclusions Receiving sufficient help with breastfeeding in hospital and the contact details for breastfeeding support groups is associated with breastfeeding term infants up to 6 weeks and late preterm infants at 10 days. PMID:26567257

  13. Sleep-wake cycle of the healthy term newborn infant in the immediate postnatal period.

    Science.gov (United States)

    Korotchikova, Irina; Stevenson, Nathan J; Livingstone, Vicki; Ryan, C Anthony; Boylan, Geraldine B

    2016-04-01

    To examine sleep-wake cycle (SWC) composition of healthy term infants in the immediate postnatal period using EEG, and investigate factors that might influence it. Multichannel video-EEG was recorded for a median of 61.9 min (IQR: 60.0-69.3). The absolute and relative scores of sleep states were calculated for each infant's recording. Parametric/non-parametric statistical tests and multiple linear regression analysis were used to investigate the influence of perinatal factors on SWC composition. Eighty healthy term infants aged 1-36 h were studied. A well-developed SWC was evident as early as within the first 6h after birth. The mean (SD) percentage of active sleep (AS) was 52.1% (12.9) and quiet sleep (QS) was 38.6% (12.5). AS was longer and QS shorter in infants delivered by elective caesarean section (CS) compared to infants delivered by vaginal delivery or emergency CS. This is the first large cohort EEG study that has quantified neonatal sleep. SWC is clearly present immediately after birth, it is dominated by AS, and is influenced by mode of delivery. This knowledge of the early neonatal EEG/SWC can be used as reference data for EEG studies of neurologically compromised infants. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  14. The influence of a formula supplemented with dairy lipids and plant oils on the erythrocyte membrane omega-3 fatty acid profile in healthy full-term infants: a double-blind randomized controlled trial.

    Science.gov (United States)

    Giannì, Maria Lorella; Roggero, Paola; Baudry, Charlotte; Ligneul, Amandine; Morniroli, Daniela; Garbarino, Francesca; le Ruyet, Pascale; Mosca, Fabio

    2012-10-17

    Human milk is the optimal nutrition for infants. When breastfeeding is not possible, supplementation of infant formula with long chain polyunsaturated fatty acids appears to promote neurodevelopmental outcome and visual function. Plant oils, that are the only source of fat in most of infant formulas, do not contain specific fatty acids that are present in human and cow milk and do not encounter milk fat triglyceride structure. Experimental data suggest that a mix of dairy lipids and plant oils can potentiate endogenous synthesis of n-3 long chain polyunsaturated fatty acids. This trial aims to determine the effect of an infant formula supplemented with a mixture of dairy lipids and plant oils on the erythrocyte membrane omega-3 fatty acid profile in full-term infants (primary outcome). Erythrocyte membrane long chain polyunsaturated fatty acids and fatty acids content, the plasma lipid profile and the insulin-growth factor 1 level, the gastrointestinal tolerance, the changes throughout the study in blood fatty acids content, in growth and body composition are evaluated as secondary outcomes. In a double-blind controlled randomized trial, 75 healthy full-term infants are randomly allocated to receive for four months a formula supplemented with a mixture of dairy lipids and plant oils or a formula containing only plant oils or a formula containing plant oils supplemented with arachidonic acid and docosahexaenoic acid. Twenty-five breast-fed infants constitute the reference group. Erythrocyte membrane omega-3 fatty acid profile, long chain polyunsaturated fatty acids and the other fatty acids content, the plasma lipid profile and the insulin-growth factor 1 level are measured after four months of intervention. Gastrointestinal tolerance, the changes in blood fatty acids content, in growth and body composition, assessed by means of an air displacement plethysmography system, are also evaluated throughout the study. The achievement of an appropriate long chain

  15. Nutrition for healthy term infants, birth to six months: An overview.

    Science.gov (United States)

    Critch, Jeffrey N

    2013-04-01

    Nutrition for healthy term infants is a joint statement by Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada that was most recently updated in September 2012 with recommendations from birth to six months of age. This practice point outlines the development process, principles of infant feeding, and recommendations for clinicians. Health professionals involved in counselling families about infant nutrition are advised to read the statement in its entirety, because the underlying discussions expand upon and clarify the advice summarized in the principles and recommendations. The complete statement is available on Health Canada's website (www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/index-eng.php).

  16. Infant formula and infant nutrition: bioactive proteins of human milk and implications for composition of infant formulas.

    Science.gov (United States)

    Lönnerdal, Bo

    2014-03-01

    Human milk contains an abundance of biologically active components that are highly likely to contribute to the short- and long-term benefits of breastfeeding. Many of these components are proteins; this article describes some of these proteins, such as α-lactalbumin, lactoferrin, osteopontin, and milk fat globule membrane proteins. The possibility of adding their bovine counterparts to infant formula is discussed as well as the implications for infant health and development. An important consideration when adding bioactive proteins to infant formula is that the total protein content of formula needs to be reduced, because formula-fed infants have significantly higher concentrations of serum amino acids, insulin, and blood urea nitrogen than do breastfed infants. When reducing the protein content of formula, the amino acid composition of the formula protein becomes important because serum concentrations of the essential amino acids should not be lower than those in breastfed infants. Both the supply of essential amino acids and the bioactivities of milk proteins are dependent on their digestibility: some proteins act only in intact form, others act in the form of larger or small peptides formed during digestion, and some are completely digested and serve as a source of amino acids. The purity of the proteins or protein fractions, potential contaminants of the proteins (such as lipopolysaccharide), as well as the degree of heat processing used during their isolation also need to be considered. It is likely that there will be more bioactive components added to infant formulas in the near future, but guidelines on how to assess their bioactivities in vitro, in animal models, and in clinical studies need to be established. The extent of testing needed is likely going to depend on the degree of complexity of the components and their bioequivalence with the human compounds whose effects they are intended to mimic.

  17. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 2: The palate of the preterm/low birthweight infant

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-10-01

    Full Text Available Abstract Background Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1. The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. Methods An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. Results Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. Conclusion There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and

  18. Worth the Wait? The Effect of Early Term Birth on Maternal and Infant Health.

    Science.gov (United States)

    Buckles, Kasey; Guldi, Melanie

    2017-01-01

    Early term birth is defined as birth at 37 or 38 weeks gestation. While infants born early term are not considered premature, the medical literature suggests that they have an increased risk of serious adverse health outcomes compared to infants born at term (39 or 40 weeks). Despite these known harms, we document a rise in early term births in the United States from 1989 to the mid-2000s, followed by a decline in recent years. We posit that the recent decline in early term births has been driven by changes in medical practice advocated by the American College of Obstetricians and Gynecologists, programs such as the March of Dimes’ "Worth the Wait" campaign, and by Medicaid policy. We first show that this pattern cannot be attributed to changes in the demographic composition of mothers, and provide some evidence that efforts to reduce early term elective deliveries (EEDs) through Medicaid policy were effective. We next exploit county-level variation in the timing of these changes in medical practice to examine the effect of early term inductions (our proxy for EEDs) on infant and maternal health. We find that early term inductions lower birth weights and increase the risks of precipitous labor, birth injury, and required ventilation. Our results suggest that reductions in early term inductions can explain about one-third of the overall increase in birth weights between 2010 and 2013 for births at 37 weeks gestation and above.

  19. Weight loss percentage prediction of subsequent neonatal hyperbilirubinemia in exclusively breastfed neonates.

    Science.gov (United States)

    Chang, Rui-Jane; Chou, Hung-Chieh; Chang, Yu-Hsun; Chen, Mei-Huei; Chen, Chien-Yi; Hsieh, Wu-Shiun; Tsao, Po-Nien

    2012-02-01

    The incidence of neonatal hyperbilirubinemia in our hospital has increased since the implementation of breastfeeding promotion. Inadequate breastfeeding results in reduced calorie intake, weight loss and neonatal hyperbilirubinemia. Supplementary feeding is required if breastfeeding proves inadequate. However, the optimal weight loss cut-off value for supplementary feeding is unknown. We collected records for all healthy neonates with a gestational age ≥35 weeks and birth body weight (BBW) above 2500 g, born between March 2002 and July 2005, from our nursery. A total of 1979 neonates were reviewed, 874 of whom were exclusively breastfed and subsequently enrolled in this study. Only infants who were breastfed exclusively were enrolled; 219 of these infants (25.1%) presented significant hyperbilirubinemia after 72 hours of age. Infants with early-onset (BBW after 48 hours and weight loss ≥11% of BBW after 72 hours as the cut-off values for the prediction of subsequent hyperbilirubinemia, negative predictive values were 77.7% and 76.8%, respectively. This study documented the relationship between weight loss percentage and subsequent hyperbilirubinemia incidence. Our data provide a basis for determination of an optimal weight loss percentage cut-off value that indicates supplementary feeding. Copyright © 2012. Published by Elsevier B.V.

  20. Cardioventilatory coupling in preterm and term infants: effect of position and sleep state.

    Science.gov (United States)

    Elder, Dawn E; Larsen, Peter D; Galletly, Duncan C; Campbell, Angela J

    2010-11-30

    This study documented the effect of position on cardioventilatory coupling (CVC), the triggering of inspiratory onset by a preceding heartbeat, in infants. Cardiorespiratory signals and corresponding oxygen saturation (SpO(2)) were downloaded from Quiet Sleep (QS) and Active Sleep (AS) in prone and supine from preterm (PT) and term (T) infants. Inspiratory onsets (I) and timing of the corresponding ECG R wave were determined and R-R and R-I intervals calculated. The RI(-1) interval (time between inspiration and the preceding R wave) dispersion was measured using proportional Shannon Entropy of the RI(-1) interval (SH(α)), to provide a quantitative measure of CVC. CVC was more frequently seen in QS in PT (p=0.002) and T (p=0.02) infants but not influenced by position (p=0.71, p=0.46). CVC correlated with SpO(2) in PT (r=-0.230, p=0.03) but not T infants (r=0.085, p=0.34). These data imply an augmentation of cardiac influence on ventilatory rhythm in infants in QS. In preterm infants CVC may have a role in supporting oxygenation. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. A cross-sectional study of plasma and urinary aluminum levels in term and preterm infants.

    Science.gov (United States)

    Bougle, D; Bureau, F; Voirin, J; Neuville, D; Duhamel, J F

    1992-01-01

    High aluminum levels have been reported in sick and intravenously fed premature infants; however, aluminum is a ubiquitous pollutant of food. This study compares the usual aluminum levels of healthy newborns from birth to the third month of life with those of enterally fed premature infants free of renal failure. Plasma and urine concentrations were determined 66 times in full-term newborns (n = 58), 56 times in a group of preterm infants whose gestational age at birth was 28 to 32 weeks (n = 36) and 54 times in another group of preterm infants whose gestational age at birth was 33 to 36 weeks (n = 50). Daily aluminum intakes (+/- SE) of the full-term infants and the two groups of preterm infants were 0.42 +/- 0.05, 0.64 +/- 0.03, and 0.52 +/- 0.03 mumol/kg per day, respectively (p = .05). Plasma aluminum levels were 0.29 +/- 0.05, 0.49 +/- 0.06, and 0.39 +/- 0.05 mumol/L (p = .007); urine excretion levels were 0.80 +/- 0.12, 0.77 +/- 0.21, and 0.78 +/- 0.2 mumol of aluminum/mmol of creatinine (p value not significant). Although the metabolic consequences of the high aluminum intakes and blood levels we have observed in very low birth weight infants remain to be assessed, these results suggest that more attention should be paid to the aluminum status and intake of healthy premature babies.

  2. Peripherally inserted central catheters for long-term parenteral nutrition in infants with intestinal failure.

    Science.gov (United States)

    Piper, Hannah G; de Silva, Nicole T; Amaral, Joao G; Avitzur, Yaron; Wales, Paul W

    2013-05-01

    Infants with intestinal failure often require long-term central access for delivery of parenteral nutrition (PN). Traditionally, surgically placed central venous catheters (CVCs) have been used; however, the complications associated with these catheters can lead to significant morbidity. Peripherally inserted central catheters (PICCs) are potentially superior to CVCs because they tend to be smaller, and can be placed without general anesthesia. The purpose of the study is to report the use of PICCs for long-term administration of PN in infants with intestinal failure and compare with previously published catheter infection and venous thrombosis rates. A 4-year review of infants younger than 12 months with intestinal failure and a PICC for PN delivery was performed to determine the incidence of catheter-related bloodstream infections (CRBSIs) and PICC-associated venous thrombosis. The complication rates were compared with those reported for CVCs and PICCs in the pediatric literature. A total of 45 infants with intestinal failure, receiving PN through a PICC were included in the study. Data from 95 PICCs accounting for 10,189 catheter days were collected. The overall incidence of CRBSI was 5.3/1000 catheter days and the incidence of venous thrombosis was 2.0/1000 catheter days. PICCs offer an advantage over CVCs in that they can often be inserted without a general anesthesia and do not require manipulation of the vein. Given the low rate of CRBSI and venous thrombosis, we recommend PICCs for infants with intestinal failure requiring PN.

  3. Evolving Understanding of Hypoxic-Ischemic Encephalopathy in the Term Infant

    NARCIS (Netherlands)

    de Vries, Linda S.; Cowan, Frances M.

    2009-01-01

    Our aim was to document changes in the evaluation and prognosis of term-born infants with neonatal encephalopathy of hypoxic-ischemic origin, with particular reference to our own experiences and influences, and to summarize the debate on causation and the relative importance of antenatal and

  4. The qualitative assessment of general movements in preterm, term and young infants - Review of the methodology

    NARCIS (Netherlands)

    Einspieler, C; Prechtl, HFR; Ferrari, F; Cioni, G; Bos, AF

    1997-01-01

    We describe the state of the art of Prechtl's method for the qualitative assessment of general movements as a diagnostic tool for early detection of brain dysfunction, After discussing the optimal technique for video recording general movements in preterm, term and young infants, attention is

  5. Fractured long bones in a term infant delivered by cesarian section

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, M.; Dollberg, M.; Wajntraub, G.; Itzchaki, M.

    1987-03-01

    A term infant was delivered uneventfully by repeat cesarian section. At the age of 1 week there was clinical and radiographic evidence of fractures of the left tibia and right radius. The fractures most likely occurred during the cesarian section. Birth trauma should not be excluded on the basis of cesarian section delivery.

  6. Long-Term Memory for Music: Infants Remember Tempo and Timbre

    Science.gov (United States)

    Trainor, Laurel J.; Wu, Luann; Tsang, Christine D.

    2004-01-01

    We show that infants' long-term memory representations for melodies are not just reduced to the structural features of relative pitches and durations, but contain surface or performance tempo- and timbre-specific information. Using a head turn preference procedure, we found that after a one week exposure to an old English folk song, infants…

  7. Magnetic resonance imaging at term and neuromotor outcome in preterm infants

    Energy Technology Data Exchange (ETDEWEB)

    Valkama, A.M.; Paeaekkoe, E.L.E.; Vainionpaeae, L.K.; Lanning, F.P.; Ilkko, E.A.; Koivisto, M.E

    2000-07-01

    In order to evaluate the value of neonatal brain magnetic resonance imaging (MRI) for prediction neuro motor outcome in very low birthweight (VLBW) preterm infants, 51 such infants with gestational age less than 34 wk underwent brain MRI at term age. Myelination, parenchymal lesions (haemorrhage, leukomalacia, infarction, reduction of white matter), parenchymal lesions without subependymal haemorrhage, ventricular/brain ratios and widths of the extra cerebral spaces were assessed. The MRI findings were compared with cranial ultrasound (US) performed at term. Infants' neuro motor development was followed up until 18 mo corrected age. Parenchymal lesions seen in MRI at term predicted cerebral palsy (CP) with 100 % sensitivity and 79 % specificity, the corresponding figures for US being 67 % and 85 %, respectively. Parenchymal lesions in MRI, excluding subependymal haemorrhages, predicted CP with a sensitivity of 82 % and specificity of 97 %, the corresponding figures for US being 58 % and 100 % respectively. Delayed myelination, ventricular/brain ratios and widths of the extra cerebral spaces failed to predict CP. Term age is a good time for neuroradiological examinations in prematurely born high-risk infants. Parenchymal lesions seen in MRI are reliable predictors for CP.

  8. Crescimento do perímetro cefálico nos primeiros seis meses em crianças em aleitamento materno exclusivo Crecimiento del perímetro cefálico en los primeros 6 meses en niños en lactancia materna exclusiva Head circumference growth of exclusively breastfed infants during the first six months of life

    Directory of Open Access Journals (Sweden)

    Maria da Graça M Jaldin

    2011-12-01

    crecimiento satisfactorio del perímetro cefálico, en conformidad con el percentil 50 del estándar WHO/2006 y de la referencia NCHS/1977.OBJECTIVE: To analyze the head circumference growth of exclusively breastfed children from birth to the sixth month of life using, as references, the National Center for Health Statistics (NCHS/1977 as well as the World Health Organization/2006 international standard (WHO/2006. METHODS: A longitudinal research carried out at the Mother and Child University Hospital of the Federal University of Maranhão (Northeast Brazil, from October 2007 to November 2008. A non-probabilistic sample of 328 singleton full term neonates, with birthweight >2500g and <4000g was enrolled, being all neonates exclusively breastfed from birth to the sixth month of life; 181 children (95 females and 86 males completed the follow-up. The head circumference was estimated by average, standard deviation and percentiles 5, 50 and 95. Percentile results were compared taking as references the NCHS/1977 and the WHO/2006 standards. RESULTS: There was an average of 1.5cm in head circumference growth for males and 1.4cm for females per month during the first six months of life. Head circumference followed the 50th percentile of the WHO/2006 standard for both genders. Regarding the NCHS/1977 standard, males presented head circumference following the 50th percentile throughout the six months, except at birth, and females followed the 50th percentile from birth until six months of life. CONCLUSIONS: Exclusively breastfed children presented a satisfactory head circumference growth up to the sixth month of life, in accordance with the 50th percentile of WHO/2006 and NCHS/1977 standards.

  9. Postmortem lung volume/body weight standards for term and preterm infants.

    Science.gov (United States)

    De Paepe, Monique E; Shapiro, Svetlana; Hansen, Katrine; Gündoğan, Füsun

    2014-01-01

    Assessment of lung growth is a critical component of the perinatal autopsy. Increased lung liquid content may lead to overestimation of lung growth based on (wet) lung weight. In contrast, lung volume is not influenced by intraalveolar lung liquid. Our aim was to establish age-specific reference values for postmortem lung volume/BW in preterm and term infants. We performed a retrospective analysis of fetuses/infants (16-41 weeks' gestation) without (N = 134) or with (N = 79) risk factors for pulmonary hypoplasia. Lungs were inflated at standardized pressure and volumes determined by water immersion method. Lung volume increased 11-fold between 16 and 41 weeks' gestation, concomitant with a 16-fold increase in BW. Mean lung volume/BW remained constant at 33-34 ml/kg between 16 and 31 weeks' gestation and decreased to 23.4 ml/kg at term. Lung volume/BW of infants with severe risk factors (renal anomalies, diaphragmatic hernia) was significantly lower than age-matched standards. In this group, all fetuses/infants diagnosed as having lung hypoplasia by lung volume/BW also had lung hypoplasia LW/BW standards. However, in infants with "softer" risk factors (rupture of membranes, chromosomal anomalies), 5/26 cases diagnosed with lung hypoplasia based on lung volume/BW had normal LW/BW ratios. In these discrepant cases, lung sections showed significant inflammation and edema, likely accounting for increased wet lung weight. In conclusion, we determined age-specific lung volume/BW reference values for preterm and term infants. In selected situations assessment of lung volume/BW may represent a useful complementary tool to LW/BW for postmortem evaluation of lung size. Copyright © 2013 Wiley Periodicals, Inc.

  10. Long-term experience with ZENPEP in infants with exocrine pancreatic insufficiency associated with cystic fibrosis.

    Science.gov (United States)

    Wooldridge, Jamie L; Schaeffer, David; Jacobs, David; Thieroff-Ekerdt, Ruth

    2014-11-01

    The objective of our study was to determine whether infants with cystic fibrosis who developed exocrine pancreatic insufficiency in early infancy would tolerate long-term treatment with ZENPEP (pancrelipase) delayed-release capsules, containing 3000 US Pharmacopeia units of lipase/capsule, and demonstrate consistent long-term growth. The most common treatment-emergent adverse events were diarrhea, vomiting, and constipation (mild or moderate). At study completion, median weight-for-age percentiles increased from 22nd to 49th, median length-for-age percentiles increased from 36.5th to 42nd, and median weight-for-length percentiles increased from 41.5th to 55.5th. Long-term treatment (up to 12 months) of infants with exocrine pancreatic insufficiency owing to cystic fibrosis with ZENPEP was well tolerated and associated with improved growth parameters. This is the first long-term study of pancreatic enzyme replacement therapy conducted in this patient population.

  11. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 1: The palate of the term newborn

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-10-01

    Full Text Available Abstract Background The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinical studies are needed. The objective of this review is to provide a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development. One focus of this review is the analysis of studies on the palate of the term newborn, since knowing what is 'normal' is a precondition of being able to assess abnormalities. Methods A search profile based on Cochrane search strategies applied to 10 medical databases was used to identify existing studies. Articles, mainly those published before 1960, were identified from hand searches in textbooks, encyclopedias, reference lists and bibliographies. Sources in English, German, and French of more than a century were included. Data for term infants were recalculated if particular information about weight, length, or maturity was given. The extracted values, especially those from non-English paper sources, were provided unfiltered for comparison. Results The search strategy yielded 182 articles, of which 155 articles remained for final analysis. Morphology of the term newborn's palate was of great interest in the first half of the last century. Two general methodologies were used to assess palatal morphology: visual and metrical descriptions. Most of the studies on term infants suffer from lack of reliability tests. The groove system was recognized as the distinctive feature of the infant palate. The shape of the palate of the term infant may vary considerably, both visually and metrically. Gender, race, mode of delivery, and nasal deformities were identified as causes contributing to altered palatal morphology. Until today, anatomical features of the newborn's palate are subject to a non-uniform nomenclature. Conclusion Today's knowledge of a newborn's 'normal' palatal

  12. Postpartum CT examination of the heads of full term infants

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, B.; Brand, M.; Brockerhoff, P.

    1980-11-01

    Intracranial hemorrhage and decreased density of the cerebral parenchyma were the major findings on CT of 150 full term newborns in the first week of life. Clinically silent hemorrhage was rare. All neonates with severe intracranial bleeding had neurological abnormalities. A correlation was not found between hemorrhage and the mode of delivery. The site of hemorrhage has an important bearing on brain development. Periventricular hypodensity is an ambiguous finding which should be interpreted in conjunction with the clinical findings.

  13. Neonatal Pneumopericardium in a Nonventilated Term Infant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Smita Roychoudhury

    2017-01-01

    Full Text Available Neonatal pneumopericardium (PPC is a rare form of neonatal air leak syndrome with high morbidity and mortality. Air leak syndrome in the newborn is usually associated with active resuscitation, respiratory distress syndrome, meconium aspiration syndrome, mechanical ventilation, or trauma associated with labour. Neonatal PPC can be associated with other air leak syndromes such as pneumomediastinum, pneumothorax, pneumoperitoneum, and subcutaneous and interstitial emphysema. Spontaneous PPC is a rare event in the neonatal period. We report a case of PPC in association with pneumothorax in a nonventilated term infant. The infant responded to thoracocentesis without the need for pericardiocentesis.

  14. Long-chain polyunsaturated fatty acid supplementation in infants born at term.

    Science.gov (United States)

    Simmer, Karen; Patole, Sanjay K; Rao, Shripada C

    2011-12-07

    The n-3 and n-6 fatty acids linolenic acid and linoleic acid are precursors of the n-3 and n-6 long chain fatty acids (LCPUFA). Infant formula has historically only contained the precursor fatty acids. Over the last few years, some manufacturers have added LCPUFA to formulae and marketed them as providing an advantage for the development of term infants. To assess whether supplementation of formula with LCPUFA is safe and of benefit to term infants. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, April, 2011), MEDLINE (1966 to April 2011), EMBASE (1980 to April 2011), CINAHL (December 1982 to April 2011) and abstracts of the Society for Pediatric Research (1980 to 2010). No language restrictions were applied. Randomised and quasi randomised trials comparing LCPUFA supplemented vs. non-supplemented formula milk and with clinical endpoints were reviewed. Methodological quality of studies was assessed using the guidelines of Cochrane neonatal review group. Data were sought regarding effects on visual acuity, neurodevelopmental outcomes and physical growth. When appropriate, meta-analysis was conducted to provide a pooled estimate of effect. Twenty-five randomised studies were identified; fifteen were included (n = 1889) and ten excluded.Visual acuity was assessed by nine studies. Visual evoked potential was used in six studies, two used Teller cards and one used both. Four studies reported beneficial effects while the remaining five did not.Neurodevelopmental outcome was measured by eleven studies. Bayley scales of infant development (BSID) was used in nine studies; only two showed beneficial effects. Meta-analysis did not show significant benefits of supplementation. One study followed the infants up to nine years of age and did not find benefit of supplementation. One study reported better novelty preference measured by Fagan Infant test at nine months. Another study reported better problem solving at 10 months. One study used

  15. Inhaled Nitric Oxide Therapy for Pulmonary Disorders of the Term and Preterm Infant

    OpenAIRE

    Sokol, Gregory M.; Konduri, G. Ganesh; Van Meurs, Krisa P.

    2016-01-01

    The 21st century began with the FDA approval of inhaled nitric oxide therapy for the treatment of neonatal hypoxic respiratory failure associated with pulmonary hypertension in recognition of the two randomized clinical trials demostrating a significant reduction in the need for extracorporeal support in the term and near-term infant. Inhaled nitric oxide is one of only a few therapeutic agents approved for use through clinical investigations primarily in the neonate. This article provides an...

  16. Health Services Use by Late Preterm and Term Infants From Infancy to Adulthood: A Meta-analysis.

    Science.gov (United States)

    Isayama, Tetsuya; Lewis-Mikhael, Anne-Mary; O'Reilly, Daria; Beyene, Joseph; McDonald, Sarah D

    2017-07-01

    Late-preterm infants born at 34 to 36 weeks' gestation have increased risks of various health problems. Health service utilization (HSU) of late-preterm infants has not been systematically summarized before. To summarize the published literature on short- and long-term HSU by late-preterm infants versus term infants from infancy to adulthood after initial discharge from the hospital. We searched Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Cohort and case-control studies that compared HSU (admissions, emergency department visits, etc) between late-preterm infants and term infants were included. Data extracted included study design, setting, population, HSU, covariates, and effect estimates. Fifty-two articles were included (50 cohort and 2 case-control studies). Meta-analyses with random effect models that used the inverse-variance method found that late-preterm infants had higher chances of all-cause admissions than term infants during all the time periods. The magnitude of the differences decreased with age from the neonatal period through adolescence, with adjusted odds ratios from 2.34 (95% confidence intervals 1.19-4.61) to 1.09 (1.05-1.13) and adjusted incidence rate ratios from 2.62 (2.52-2.72) to 1.14 (1.11-1.18). Late-preterm infants had higher rates of various cause-specific HSU than term infants for jaundice, infection, respiratory problems, asthma, and neurologic and/or mental health problems during certain periods, including adulthood. Considerable heterogeneity existed and was partially explained by the variations in the adjustment for multiple births and gestational age ranges of the term infants. Late-preterm infants had higher risks for all-cause admissions as well as for various cause-specific HSU during the neonatal period through adolescence. Copyright © 2017 by the American Academy of Pediatrics.

  17. Long-Term Outcome of Catheter-Related Arterial Thrombosis in Infants with Congenital Heart Disease.

    Science.gov (United States)

    Rizzi, Mattia; Kroiss, Sabine; Kretschmar, Oliver; Forster, Ishilde; Brotschi, Barbara; Albisetti, Manuela

    2016-03-01

    To investigate the long-term outcome of catheter-related arterial thrombosis in children. Data from clinical and radiologic long-term follow-up of infants with congenital heart disease developing arterial thrombosis following femoral catheterization are presented. Ninety-five infants with radiologically proven arterial thrombosis because of cardiac catheter (n = 52; 55%) or indwelling arterial catheter (n = 43; 45%) were followed for a median time of 23.5 months (IQR 13.3-47.3). Overall, radiologic complete thrombus resolution was observed in 64 (67%), partial resolution in 8 (9%), and no resolution in 23 (24%) infants. Complete resolution was significantly more frequent in infants with indwelling arterial catheter-related thrombosis compared with cardiac catheter-related thrombosis (P = .001). Patients with complete resolution had a significantly lower blood pressure difference and increased ankle-ankle index compared with patients with partial or no resolution (P < .0001). However, symptoms of claudication were present only in 1 case and clinical significant legs growth retardation (≥ 15 mm) was present in 1%. A significant percentage of persistent occlusion is present in children with arterial catheter-related thrombosis on long-term follow-up. In these children, the magnitude of leg growth retardation is small and possibly not clinically relevant. However, in children with congenital heart disease, the high prevalence of persistent arterial occlusion may hamper future diagnostic and/or interventional catheterization. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Association of breast-fed neonatal hyperbilirubinemia with UGT1A1 polymorphisms: 211G>A (G71R) mutation becomes a risk factor under inadequate feeding.

    Science.gov (United States)

    Sato, Hiroko; Uchida, Toshihiko; Toyota, Kentaro; Kanno, Miyako; Hashimoto, Taeko; Watanabe, Masashi; Nakamura, Tomohiro; Tamiya, Gen; Aoki, Kuraaki; Hayasaka, Kiyoshi

    2013-01-01

    Breastfeeding jaundice is a well-known phenomenon, but its pathogenesis is still unclear. Increased production of bilirubin, impaired hepatic uptake and metabolism of bilirubin, and increased enterohepatic circulation of bilirubin account for most cases of pathological neonatal hyperbilirubinemia. We previously reported that 211G>A (G71R) mutation of the UGT1A1 gene is prevalent in East Asians and is associated with the development of neonatal hyperbilirubinemia. Recently, significant association of G71R mutation with hyperbilirubinemia in breast-fed neonates was reported. We enrolled 401 full-term Japanese infants, who were exclusively breast-fed without supplementation of formula before developing hyperbilirubinemia, and classified them into two groups based on the degree of maximal body weight loss during the neonatal period. We analyzed the sex, gestational age, delivery mode, body weight at birth, maximal body weight loss and genotypes of G71R and (TA)(7) polymorphic mutations of UGT1A1. Statistical analysis revealed that maximal body weight loss during the neonatal period is the only independent risk factor for the development of neonatal hyperbilirubinemia. The effect of G71R mutation on neonatal hyperbilirubinemia is significant in neonates with 5% or greater maximal body weight loss and its influence increases in parallel with the degree of maximal body weight loss. Our study indicates that G71R mutation is a risk factor for neonatal hyperbilirubinemia only in infants with inadequate breastfeeding and suggests that adequate breastfeeding may overcome the genetic predisposing factor, G71R mutation, for the development of neonatal hyperbilirubinemia.

  19. Vitamin D supplementation is associated with higher serum 25OHD in Asian and White infants living in Vancouver, Canada.

    Science.gov (United States)

    Green, Tim J; Li, Wangyang; Barr, Susan I; Jahani, Mitra; Chapman, Gwen E

    2015-04-01

    To prevent rickets, the Health Canada and the American Academy of Pediatrics recommend that breastfed infants receive a daily vitamin D supplement of 10 μg d(-1) . Compliance with this recommendation is variable and its effect on infant vitamin D status is unclear. We measured serum 25-hydroxyvitamin D (25OHD) in Asian immigrant (n=28) and White (n=37) mothers and their infants aged 2-4 months living in Vancouver (49°N). Mothers completed health and demographic questionnaires. All subjects were term infants who were primarily breastfed. Analysis of variance, χ(2) , multiple regression and logistic regression analysis were performed as appropriate. Mean 25OHD of the infants was 31 (95% confidence interval 28-34) ng mL(-1) . Only two infants had a 25OHD concentration indicative of deficiency, colour or ethnicity (Asian vs. White) did not influence infant 25OHD. The infants in our study, most of whom received vitamin D supplements, were generally protected against low 25OHD. The study was limited by sample size and the nature of the cross-sectional study design. © 2012 Blackwell Publishing Ltd.

  20. Development of resting cardiovascular activity during the first 2 years of life differs in breastfed and formula-fed boys and girls

    Science.gov (United States)

    To investigate whether early infant diet influences cardiovascular development we recorded resting heart-rate (HR) at 3, 6, 9, 12, and 24 mo in awake healthy children who were breastfed (BF) or fed milk formula (MF) or soy formula (SF) during infancy (n = 83-146/group/age). HR, and indices of autono...

  1. Iron status at birth and at 4 weeks in preterm-SGA infants in comparison with preterm and term-AGA infants.

    Science.gov (United States)

    Mukhopadhyay, Kanya; Yadav, Ramesh Kumar; Kishore, Sai Sunil; Garewal, Gurjeevan; Jain, Vanita; Narang, Anil

    2012-08-01

    To determine the iron status at birth in preterm small for gestational age (SGA) in comparison with preterm appropriate for gestation (AGA) and term-AGA infants. Mother-infant pairs with gestation of SGA, and preterm-AGA and term-AGA as control were enrolled. Maternal, cord blood and infant blood samples at 4 weeks were obtained for various iron indices - cord serum ferritin, proportion of infants with "low" serum ferritin, serum ferritin at 4 weeks and correlation among maternal and neonatal iron indices - hemoglobin,serum ferritin and total iron-binding capacity. There were 50 mother-infant pairs in each group. Cord serum ferritin levels were less in preterm-SGA group as compared to preterm-AGA group (median [interquartile range]: 68 [30 113] vs. 120 [73 127], p = 0.002) and preterm-AGA had less cord ferritin than term-AGA (141 [63 259], p = 0.006). The proportion of the infants with "low" serum ferritin was more in preterm-SGA than in preterm-AGA (16 [32%] vs. 5 [10%], p = 0.01). The serum ferritin levels at follow-up were also less in preterm-SGA as compared to preterm-AGA (143.5 ± 101 vs. 235.1 ± 160, p = 0.004). Other cord blood iron indices and follow-up serum ferritin levels were similar. There was no correlation among various maternal and neonatal cord iron parameters. Preterm-SGA infants have lesser total iron stores as compared to gestation-matched AGA infants, which is again lesser than term infants. Future studies can be planned to look at iron status at 12 months as well as their neurodevelopmental outcome.

  2. Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review.

    Science.gov (United States)

    Johns, Helene M; Forster, Della A; Amir, Lisa H; McLachlan, Helen L

    2013-11-19

    Expressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing. Databases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression. A total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded by imprecise definitions of

  3. Prevalence and outcomes of breast milk expressing in women with healthy term infants: a systematic review

    Science.gov (United States)

    2013-01-01

    Background Expressing breast milk has become increasingly prevalent, particularly in some developed countries. Concurrently, breast pumps have evolved to be more sophisticated and aesthetically appealing, adapted for domestic use, and have become more readily available. In the past, expressed breast milk feeding was predominantly for those infants who were premature, small or unwell; however it has become increasingly common for healthy term infants. The aim of this paper is to systematically explore the literature related to breast milk expressing by women who have healthy term infants, including the prevalence of breast milk expressing, reported reasons for, methods of, and outcomes related to, expressing. Methods Databases (Medline, CINAHL, JSTOR, ProQuest Central, PsycINFO, PubMed and the Cochrane library) were searched using the keywords milk expression, breast milk expression, breast milk pumping, prevalence, outcomes, statistics and data, with no limit on year of publication. Reference lists of identified papers were also examined. A hand-search was conducted at the Australian Breastfeeding Association Lactation Resource Centre. Only English language papers were included. All papers about expressing breast milk for healthy term infants were considered for inclusion, with a focus on the prevalence, methods, reasons for and outcomes of breast milk expression. Results A total of twenty two papers were relevant to breast milk expression, but only seven papers reported the prevalence and/or outcomes of expressing amongst mothers of well term infants; all of the identified papers were published between 1999 and 2012. Many were descriptive rather than analytical and some were commentaries which included calls for more research, more dialogue and clearer definitions of breastfeeding. While some studies found an association between expressing and the success and duration of breastfeeding, others found the opposite. In some cases these inconsistencies were compounded

  4. Infant auditory short-term memory for non-linguistic sounds.

    Science.gov (United States)

    Ross-Sheehy, Shannon; Newman, Rochelle S

    2015-04-01

    This research explores auditory short-term memory (STM) capacity for non-linguistic sounds in 10-month-old infants. Infants were presented with auditory streams composed of repeating sequences of either 2 or 4 unique instruments (e.g., flute, piano, cello; 350 or 700 ms in duration) followed by a 500-ms retention interval. These instrument sequences either stayed the same for every repetition (Constant) or changed by 1 instrument per sequence (Varying). Using the head-turn preference procedure, infant listening durations were recorded for each stream type (2- or 4-instrument sequences composed of 350- or 700-ms notes). Preference for the Varying stream was taken as evidence of auditory STM because detection of the novel instrument required memory for all of the instruments in a given sequence. Results demonstrate that infants listened longer to Varying streams for 2-instrument sequences, but not 4-instrument sequences, composed of 350-ms notes (Experiment 1), although this effect did not hold when note durations were increased to 700 ms (Experiment 2). Experiment 3 replicates and extends results from Experiments 1 and 2 and provides support for a duration account of capacity limits in infant auditory STM. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants.

    Directory of Open Access Journals (Sweden)

    Katrin Ivars

    Full Text Available Cortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life.130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30, noon (10:00-12:00 and evening (19:30-21:30, each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist.A significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life.Cortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.

  6. Correlation between echocardiographic superior vena cava flow and short-term outcome in infants with asphyxia.

    Science.gov (United States)

    Kumagai, Takeshi; Higuchi, Ryuzo; Higa, Asumi; Tsuno, Yoshinobu; Hiramatsu, Chisako; Sugimoto, Takuya; Booka, Mina; Okutani, Takahiro; Yoshikawa, Norishige

    2013-05-01

    To assess the relationship between superior vena cava (SVC) flow and short-term outcome in infants with perinatal asphyxia. Infants in sequence born after more than 35 weeks of gestation who had been hospitalized at the NICU and normal neonatal wards of Wakayama Medical University between May 2005 and September 2010 were recruited for this observational cohort study. The study eligibility criterion was the presence of perinatal asphyxia, as evidenced by abnormal fetal heart rate monitoring and an Apgar score of 7 or less at 1 min or need for resuscitation using positive pressure ventilation. SVC flow was measured in the first three days of life by Doppler echocardiography as described by Kluckow and Evans. Short-term outcome was defined as poor if MRI demonstrated bilateral lesions of the basal ganglia and thalamus and/or multicystic encephalomalacia due to hypoxic ischemia. In the head cooling group, SVC flow in infants with a good outcome was lower than that in infants with a poor outcome at 12h (36.9±7.7 vs. 113.4±42.4 ml/kg/min (p=0.01)), 24h (75.2±25.3 vs. 155.6±45.7 ml/kg/min (p=0.03)), and 48 h (92.5±34.2 vs. 161.1±46.7 ml/kg/min (p=0.04)) after birth. SVC flow decreased promptly after introduction of head cooling in infants who had a good outcome, whereas it increased gradually after head cooling in those who had a poor outcome. We speculate that regulation of brain circulation is disrupted in infants with asphyxia who show a poor outcome. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

    Directory of Open Access Journals (Sweden)

    Cristiane M. Silva

    2017-11-01

    Conclusions: Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency.

  8. Circulating insulin-like growth factor I levels in newborn premature and full-term infants followed longitudinally.

    Science.gov (United States)

    Lineham, J D; Smith, R M; Dahlenburg, G W; King, R A; Haslam, R R; Stuart, M C; Faull, L

    1986-02-01

    Longitudinal circulating levels of insulin-like growth factor I (IGF-I) were measured by radioimmunoassay after acid/ethanol extraction of serum or plasma in 44 appropriate-for-gestational age (AGA) premature infants, 7 small-for-gestational age (SGA) premature infants and 9 AGA full-term infants. The subjects were divided into cohorts with gestational age at birth 26-29 weeks, 30-33 weeks, 34-37 weeks and 38-42 weeks (full-term). The premature infants in this study exhibited diminished growth as compared with normal intrauterine growth. In all but the earliest premature infant cohort there was an immediate fall from the mean fetal IGF-I level, as reflected by the cord value, to a basal postnatal circulating level of IGF-I. The basal level of circulating IGF-I in premature infants was related only to gestational age. It increased slowly from 25 weeks gestation until four weeks after full-term equivalent and was independent of time of birth. Full-term infants were distinguished from early premature infants by the occurrence of a prominent postnatal surge in circulating IGF-I levels that was characterised by a significant (P less than 0.02) increase between day 1 and days 10-15. The SGA and AGA infants in the 34-37 week cohort showed similar profiles of circulating IGF-I with no significant difference in cord values between the two groups.

  9. Short-Term Effects of Pacifier Texture on NNS in Neurotypical Infants

    Directory of Open Access Journals (Sweden)

    Austin L. Oder

    2013-01-01

    Full Text Available The dense representation of trigeminal mechanosensitive afferents in the lip vermilion, anterior tongue, intraoral mucosa, and temporomandibular joint allows the infant’s orofacial system to encode a wide range of somatosensory experiences during the critical period associated with feed development. Our understanding of how this complex sensorium processes texture is very limited in adults, and the putative role of texture encoding in the infant is unknown. The purpose of this study was to examine the short-term effects of a novel textured pacifier experience in healthy term infants (N=28. Nonnutritive suck (NNS compression pressure waveforms were digitized in real time using a variety of custom-molded textured pacifiers varying in spatial array density of touch domes. MANCOVA, adjusted for postmenstrual age at test and sex, revealed that infants exhibited an increase in NNS burst attempts at the expense of a degraded suck burst structure with the textured pacifiers, suggesting that the suck central pattern generator (sCPG is significantly disrupted and reorganized by this novel orocutaneous experience. The current findings provide new insight into oromotor control as a function of the oral somatosensory environment in neurotypically developing infants.

  10. The Relationship Between Infant Feeding Outcomes and Maternal Emotional Well-Being Among Mothers of Late Preterm and Term Infants. A Secondary, Exploratory Analysis

    Science.gov (United States)

    Tully, Kristin P.; Holditch-Davis, Diane; Silva, Susan; Brandon, Debra

    2016-01-01

    Background Late preterm birth is associated with lower rates of breastfeeding and earlier breastfeeding cessation than term birth. Purpose The objectives of this secondary analysis were to compare the incidence of exclusive breastfeeding after late preterm and term childbirth and to examine the association between infant feeding outcomes and maternal emotional well-being. Methods Participants were 105 mother-infant dyads (54 late preterm and 51 term) at a southeastern U.S. medical center. Face-to-face data collection and telephone follow up occurred during 2009-2012. Results Late preterm mothers were less likely to exclusively provide their milk than were term mothers during hospitalization. Feeding at one month did not differ between late preterm and term infants. Among late preterm mothers, (1) formula supplementation during hospitalization was associated with greater severity of anxiety compared to those exclusively providing formula and (2) exclusive provision of human milk at one month was associated with less severe depressive symptoms relative to those supplementing or exclusively formula feeding. Among term mothers, feeding outcome was not related to emotional well-being measures at either time point. Implications for Practice Mothers of late preterm infants may particularly benefit from anticipatory guidance and early mental health screening, with integrated, multidisciplinary lactation teams to support these interrelated health care needs Implications for Research Prospective research is critical to document women’s intentions for infant feeding and how experiences with childbirth and the early postpartum period impact achievement of their breastfeeding plans. PMID:27533332

  11. The Relationship Between Infant Feeding Outcomes and Maternal Emotional Well-being Among Mothers of Late Preterm and Term Infants: A Secondary, Exploratory Analysis.

    Science.gov (United States)

    Tully, Kristin P; Holditch-Davis, Diane; Silva, Susan; Brandon, Debra

    2017-02-01

    Late preterm birth is associated with lower rates of breastfeeding and earlier breastfeeding cessation than term birth. The objectives of this secondary analysis were to compare the incidence of exclusive breastfeeding after late preterm and term childbirth and to examine the association between infant feeding outcomes and maternal emotional well-being. Participants were 105 mother-infant dyads (54 late preterm and 51 term) at a southeastern US medical center. Face-to-face data collection and telephone follow-up occurred during 2009-2012. Late preterm mothers were less likely to exclusively provide their milk than were term mothers during hospitalization. Feeding at 1 month did not differ between late preterm and term infants. Among late preterm mothers, (1) formula supplementation during hospitalization was associated with greater severity of anxiety than among those exclusively providing formula and (2) exclusive provision of human milk at 1 month was associated with less severe depressive symptoms than among those supplementing or exclusively formula feeding. Among term mothers, feeding outcome was not related to emotional well-being measures at either time point. Mothers of late preterm infants may particularly benefit from anticipatory guidance and early mental health screening, with integrated, multidisciplinary lactation teams to support these interrelated healthcare needs. Prospective research is critical to document women's intentions for infant feeding and how experiences with childbirth and the early postpartum period impact achievement of their breastfeeding goals.

  12. Trunk position in supine of infants born preterm and at term: an assessment using a computerized pressure mat.

    Science.gov (United States)

    Dusing, Stacey; Mercer, Vicki; Yu, Bing; Reilly, Marie; Thorpe, Deborah

    2005-01-01

    Trunk position may influence motor, cognitive, and social development during infancy and early childhood and has not been quantitatively assessed. The purpose of this study was to assess the trunk positions of infants born at term and preterm in supine using a computerized pressure mat. Trunk position was represented as a ratio of head and pelvis to trunk pressure. Eighteen healthy infants born preterm with a mean gestational age of 31.9 weeks (25.0-34.6) and fifteen healthy infants born at term with a mean gestational age of 38.9 weeks (37.3-40.6) were assessed at 38 to 43 weeks gestational age. Infants born at term spent more than two-thirds of the time in either flexed or neutral trunk positions. No significant differences were found between infants born preterm and those born at term in total duration of flexion or extension or in flexion event duration. This study provides evidence that infants born preterm may not exhibit greater trunk extension tendencies in supine than infants born at term. Results should be interpreted with caution, however, because of the small sample size and large variability observed within the subject groups. Infants born at less than 30 weeks of gestation may demonstrate greater extension tendencies than those born at more than 30 weeks of gestation.

  13. Transcutaneous bilirubin nomogram for predicting neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants.

    Science.gov (United States)

    Yu, Zhang-Bin; Dong, Xiao-Yue; Han, Shu-Ping; Chen, Yu-Lin; Qiu, Yu-Fang; Sha, Li; Sun, Qing; Guo, Xi-Rong

    2011-02-01

    Identifying infants that will develop significant hyperbilirubinemia with the risk of kernicterus, and planning appropriate follow-up strategies, is particularly challenging. In this study, 36,921 transcutaneous bilirubin (TcB) measurements were obtained from 6,035 healthy neonates (gestational age ≥ 35 weeks and birth weight ≥ 2,000 g) between January 1 and December 31, 2009. All measurements were performed with the JM-103 bilirubinometer at designated times between 0 and 168 postnatal hours. TcB percentiles were calculated and used to develop an hour-specific nomogram. The rate of increase in TcB was higher during the first 72 h of age, after which levels declined to a plateau by 72-108 h of age. We constructed a TcB nomogram by using the 40th, 75th, and 95th percentile values of TcB for every 12 h of the studied interval. The 75th percentile curve of the nomogram may be an ideal cutoff point for intensive follow-up of the neonate for hyperbilirubinemia as it carries very high sensitivity (78.7%) and negative predictive value (98.5%). The specificity (45.7%) and positive predictive value (15.5%) decreased to reach their lowest levels at the 40th percentile. Of the neonates in the high-risk zone, 167 (48.8%) infants had persistent subsequent hyperbilirubinemia post-discharge, compared with 292 (27.0%) infants in the high-intermediate-risk zone at discharge. One-hundred and seventeen (5.5%) infants in the low-intermediate-risk zone moved into the high-risk zone during follow-up. No newborn infants in the low-risk zone became high-risk during follow-up. We provide an hour-specific TcB nomogram to predict neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants.

  14. Milk- and solid-feeding practices and daycare attendance are associated with differences in bacterial diversity, predominant communities, and metabolic and immune function of the infant gut microbiome

    Science.gov (United States)

    Thompson, Amanda L.; Monteagudo-Mera, Andrea; Cadenas, Maria B.; Lampl, Michelle L.; Azcarate-Peril, M. A.

    2015-01-01

    The development of the infant intestinal microbiome in response to dietary and other exposures may shape long-term metabolic and immune function. We examined differences in the community structure and function of the intestinal microbiome between four feeding groups, exclusively breastfed infants before introduction of solid foods (EBF), non-exclusively breastfed infants before introduction of solid foods (non-EBF), EBF infants after introduction of solid foods (EBF+S), and non-EBF infants after introduction of solid foods (non-EBF+S), and tested whether out-of-home daycare attendance was associated with differences in relative abundance of gut bacteria. Bacterial 16S rRNA amplicon sequencing was performed on 49 stool samples collected longitudinally from a cohort of 9 infants (5 male, 4 female). PICRUSt metabolic inference analysis was used to identify metabolic impacts of feeding practices on the infant gut microbiome. Sequencing data identified significant differences across groups defined by feeding and daycare attendance. Non-EBF and daycare-attending infants had higher diversity and species richness than EBF and non-daycare attending infants. The gut microbiome of EBF infants showed increased proportions of Bifidobacterium and lower abundance of Bacteroidetes and Clostridiales than non-EBF infants. PICRUSt analysis indicated that introduction of solid foods had a marginal impact on the microbiome of EBF infants (24 enzymes overrepresented in EBF+S infants). In contrast, over 200 bacterial gene categories were overrepresented in non-EBF+S compared to non-EBF infants including several bacterial methyl-accepting chemotaxis proteins (MCP) involved in signal transduction. The identified differences between EBF and non-EBF infants suggest that breast milk may provide the gut microbiome with a greater plasticity (despite having a lower phylogenetic diversity) that eases the transition into solid foods. PMID:25705611

  15. Milk- and solid-feeding practices and daycare attendance are associated with differences in bacterial diversity, predominant communities, and metabolic and immune function of the infant gut microbiome.

    Science.gov (United States)

    Thompson, Amanda L; Monteagudo-Mera, Andrea; Cadenas, Maria B; Lampl, Michelle L; Azcarate-Peril, M A

    2015-01-01

    The development of the infant intestinal microbiome in response to dietary and other exposures may shape long-term metabolic and immune function. We examined differences in the community structure and function of the intestinal microbiome between four feeding groups, exclusively breastfed infants before introduction of solid foods (EBF), non-exclusively breastfed infants before introduction of solid foods (non-EBF), EBF infants after introduction of solid foods (EBF+S), and non-EBF infants after introduction of solid foods (non-EBF+S), and tested whether out-of-home daycare attendance was associated with differences in relative abundance of gut bacteria. Bacterial 16S rRNA amplicon sequencing was performed on 49 stool samples collected longitudinally from a cohort of 9 infants (5 male, 4 female). PICRUSt metabolic inference analysis was used to identify metabolic impacts of feeding practices on the infant gut microbiome. Sequencing data identified significant differences across groups defined by feeding and daycare attendance. Non-EBF and daycare-attending infants had higher diversity and species richness than EBF and non-daycare attending infants. The gut microbiome of EBF infants showed increased proportions of Bifidobacterium and lower abundance of Bacteroidetes and Clostridiales than non-EBF infants. PICRUSt analysis indicated that introduction of solid foods had a marginal impact on the microbiome of EBF infants (24 enzymes overrepresented in EBF+S infants). In contrast, over 200 bacterial gene categories were overrepresented in non-EBF+S compared to non-EBF infants including several bacterial methyl-accepting chemotaxis proteins (MCP) involved in signal transduction. The identified differences between EBF and non-EBF infants suggest that breast milk may provide the gut microbiome with a greater plasticity (despite having a lower phylogenetic diversity) that eases the transition into solid foods.

  16. IgG transmitted from allergic mothers decreases allergic sensitization in breastfed offspring

    Directory of Open Access Journals (Sweden)

    Rafti Ektor

    2010-07-01

    Full Text Available Abstract Background The mechanism(s responsible for the reduced risk of allergic disease in breastfed infants are not fully understood. Using an established murine model of asthma, we demonstrated previously that resistance to allergic airway disease transmitted from allergic mothers to breastfed offspring requires maternal B cell-derived factors. Objective The aim of this study was to investigate the role of offspring neonatal Fc receptor for IgG uptake by intestinal epithelial cells (FcRn in this breast milk transferred protection from allergy. Methods Allergic airway disease was induced during pregnancy in C57BL/6 female mice. These allergic mothers foster nursed naive FcRn+/- or FcRn-/- progeny born to FcRn+/- females that were mated to C57BL/6J-FcRn-/- male mice. In offspring deficient in FcRn, we expected reduced levels of systemic allergen-specific IgG1, a consequence of decreased absorption of maternal IgG from the lumen of the neonatal gastrointestinal tract. Using this model, we were able to investigate how breast milk IgG affected offspring responses to allergic sensitization. Results Levels of maternal antibodies absorbed from the breast milk of allergic foster mothers were determined in weanling FcRn-sufficient or -deficient mice. Maternal transmission of allergen-specific IgG1 to breastfed FcRn-/- offspring was at levels 103-104 lower than observed in FcRn+/- or FcRn+/+ mice. Five weeks after weaning, when offspring were 8 wk old, mice were sensitized and challenged to evaluate their susceptibility to develop allergic airway disease. Protection, indicated by reduced parameters of disease (allergen-specific IgE in serum, eosinophilic inflammation in the airways and lung were evident in FcRn-sufficient mice nursed as neonates by allergic mothers. In contrast, FcRn-deficient mice breastfed by the same mothers acquired limited, if any, protection from development of allergen-specific IgE and associated pathology. Conclusions Fc

  17. Short-term, early intensive power mobility training: case report of an infant at risk for cerebral palsy.

    Science.gov (United States)

    Ragonesi, Christina B; Galloway, James Cole

    2012-01-01

    This case report describes the feasibility of quantifying short-term, intensive power mobility training for an infant soon after a diagnosis of cerebral palsy. An 11-month-old infant with significant mobility impairments and her parents were filmed during 14 consecutive daily training sessions. The infant moved the power chair with hand-over-hand assistance and performed open exploration of the joystick and toys. Mobility measures, coded from video, were compared across training. Frequency and combination of looking at and interacting with the joystick, percentage of time of moving independently, and average percentage of success in moving when prompted, all increased across the training. Quantifying short-term, intensive power mobility training for infants is feasible and may have yielded positive short-term effects for this infant. The "who," "when," and "how" of early power mobility training, as well as the critical need for paradigm shifts in power mobility training, are discussed.

  18. Benefits of Lactoferrin, Osteopontin and Milk Fat Globule Membranes for Infants

    Science.gov (United States)

    Prell, Christine; Timby, Niklas; Lönnerdal, Bo

    2017-01-01

    The provision of essential and non-essential amino acids for breast-fed infants is the major function of milk proteins. In addition, breast-fed infants might benefit from bioactivities of milk proteins, which are exhibited in the intestine during the digestive phase and by absorption of intact proteins or derived peptides. For lactoferrin, osteopontin and milk fat globule membrane proteins/lipids, which have not until recently been included in substantial amounts in infant formulas, in vitro experiments and animal models provide a convincing base of evidence for bioactivities, which contribute to the protection of the infant from pathogens, improve nutrient absorption, support the development of the immune system and provide components for optimal neurodevelopment. Technologies have become available to obtain these compounds from cow´s milk and the bovine compounds also exhibit bioactivities in humans. Randomized clinical trials with experimental infant formulas incorporating lactoferrin, osteopontin, or milk fat globule membranes have already provided some evidence for clinical benefits. This review aims to compare findings from laboratory and animal experiments with outcomes of clinical studies. There is good justification from basic science and there are promising results from clinical studies for beneficial effects of lactoferrin, osteopontin and the milk fat globule membrane complex of proteins and lipids. Further studies should ideally be adequately powered to investigate effects on clinically relevant endpoints in healthy term infants. PMID:28788066

  19. IGF-I and relation to growth in infancy and early childhood in very-low-birth-weight infants and term born infants.

    Science.gov (United States)

    de Jong, Miranda; Cranendonk, Anneke; Twisk, Jos W R; van Weissenbruch, Mirjam M

    2017-01-01

    In very-low-birth-weight infants IGF-I plays an important role in postnatal growth restriction and is probably also involved in growth restriction in childhood. We compared IGF-I and its relation to growth in early childhood in very-low-birth-weight infants and term appropriate for gestational age born infants. We included 41 very-low-birth-weight and 64 term infants. Anthropometry was performed at all visits to the outpatient clinic. IGF-I and insulin were measured in blood samples taken at 6 months and 2 years corrected age (very-low-birth-weight children) and at 3 months, 1 and 2 years (term children). Over the first 2 years of life growth parameters are lower in very-low-birth-weight children compared to term children, but the difference in length decreases significantly. During the first 2 years of life IGF-I is higher in very-low-birth-weight children compared to term children. In both groups there is a significant relationship between IGF-I and (change in) length and weight over the first 2 years of life and between insulin and change in total body fat. Considering the relation of IGF-I to growth and the decrease in difference in length, higher IGF-I levels in very-low-birth-weight infants in early childhood probably have an important role in catch-up growth in length.

  20. Intermediate-term results of the Ross procedure in neonates and infants.

    Science.gov (United States)

    Shinkawa, Takeshi; Bove, Edward L; Hirsch, Jennifer C; Devaney, Eric J; Ohye, Richard G

    2010-06-01

    Although good intermediate-term results for the Ross procedure in adults and older children have been reported, only short-term outcomes of this procedure in neonates and infants have been published. The objective of this study was to review our intermediate-term results of the Ross procedure for neonates and infants. The records of all 31 neonates and infants undergoing a Ross procedure between March 1993 and June 2008 were reviewed. Major study outcomes included patient survival, autograft function, and need for reoperation. The median age at the time of operation was 18 days, and median weight was 3.95 kg. Fifteen patients had aortic stenosis with or without insufficiency, 2 patients had isolated severe aortic insufficiency, and 14 patients had aortic stenosis with other left-side heart lesions, such as arch obstruction or mitral valve disease. Twenty-five patients required aortic annular enlargement (Ross-Konno procedure), and 14 required concomitant arch or mitral valve surgery. There were 5 early and 2 late deaths at a median follow-up of 6.0 years (range, 1.1 to 15.4 years). All early deaths were in patients requiring concomitant arch or mitral valve repair. Actuarial survival rate was 76.7% at 5, 10, and 15 years. There were 19 reinterventions, including 2 procedures on the autograft. Overall freedom from reoperation was 59.1% at 5 years and 50.6% at 10 years. Freedom from autograft reoperation was 95.2% at 5 and 10 years and 63.5% at 15 years. The Ross procedure for neonates and infants has good intermediate-term results with low mortality and acceptable rates of reintervention. The patients requiring concomitant arch or mitral valve surgery have higher initial operative risks although conditional survival remains good. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Inadvertent intramuscular administration of high dose bacillus Calmette Guerin vaccine in a pre-term infant

    Directory of Open Access Journals (Sweden)

    Asima Banu

    2013-01-01

    Full Text Available This case report examined the natural course of reaction after accidental intramuscular administration of high dose Bacille Calmette-Guιrin (BCG vaccine into the anterolateral aspect of thigh of a pre-term infant as a part of routine vaccination instead of intra-dermal injection into the arm. There is no consensus on the best management of this complication, although in this case healing was prolonged but was spontaneous without anti-tubercular chemotherapy.

  2. Postural adjustments in preterm infants at 4 and 6 months post-term during voluntary reaching in supine position

    NARCIS (Netherlands)

    Fallang, B; Saugstad, OD; Hadders-Algra, M

    2003-01-01

    Gradually it is getting clear that motor development - in particular balance control - in so-called "low-risk" preterm infants often differs from that in full-term infants. However, little is known on the etiology and pathophysiology of these problems. The aim of this study was to evaluate postural

  3. Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment.

    Science.gov (United States)

    Rothman, Adam L; Sevilla, Monica B; Mangalesh, Shwetha; Gustafson, Kathryn E; Edwards, Laura; Cotten, C Michael; Shimony, Joshua S; Pizoli, Carolyn E; El-Dairi, Mays A; Freedman, Sharon F; Toth, Cynthia A

    2015-12-01

    To assess retinal nerve fiber layer (RNFL) thickness at term-equivalent age in very preterm (compare very preterm infant RNFL thickness with brain anatomy and neurodevelopment. Cohort study. RNFL was semi-automatically segmented (1 eye per infant) in 57 very preterm and 50 term infants with adequate images from bedside portable, handheld spectral-domain optical coherence tomography imaging at 37-42 weeks postmenstrual age. Mean RNFL thickness was calculated for the papillomacular bundle (-15 degrees to +15 degrees) and temporal quadrant (-45 degrees to +45 degrees) relative to the fovea-optic nerve axis. Brain magnetic resonance imaging (MRI) scans clinically obtained in 26 very preterm infants were scored for global structural abnormalities by an expert masked to data except for age. Cognitive, language, and motor skills were assessed in 33 of the very preterm infants at 18-24 months corrected age. RNFL was thinner for very preterm vs term infants at the papillomacular bundle ([mean ± standard deviation] 61 ± 17 vs 72 ± 13 μm, P brain MRI lesion burden index (R(2) = 0.35, P = .001) and lower cognitive (R(2) = 0.18, P = .01) and motor (R(2) = 0.17, P = .02) scores. Relationships were similar for temporal quadrant. Thinner RNFL in very preterm infants relative to term-born infants may relate to brain structure and neurodevelopment. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Lidocaine response rate in aEEG-confirmed neonatal seizures : Retrospective study of 413 full-term and preterm infants

    NARCIS (Netherlands)

    Weeke, Lauren C.|info:eu-repo/dai/nl/413986446; Toet, Mona C.|info:eu-repo/dai/nl/28827024X; Van Rooij, Linda G M; Groenendaal, Floris|info:eu-repo/dai/nl/073282596; Boylan, Geraldine B.; Pressler, Ronit M.; Hellström-Westas, Lena; Van Den Broek, Marcel P H; De Vries, Linda S.|info:eu-repo/dai/nl/072995408

    2016-01-01

    OBJECTIVE: To investigate the seizure response rate to lidocaine in a large cohort of infants who received lidocaine as second- or third-line antiepileptic drug (AED) for neonatal seizures. METHODS: Full-term (n = 319) and preterm (n = 94) infants, who received lidocaine for neonatal seizures

  5. Long-chain polyunsaturated fatty acids and neurological developmental outcome at 18 months in healthy term infants

    NARCIS (Netherlands)

    Bouwstra, H; Dijck-Brouwer, DAJ; Boehm, G; Boersma, ER; Muskiet, FAJ; Hadders-Algra, M

    Aim: Previously, we found a beneficial effect of 2 mo supplementation of infant formula with long-chain polyunsaturated fatty acids (LC-PUFA) on neurological condition at 3 mo in healthy term infants. The aim of the present follow-up study was to evaluate whether the effect on neurological condition

  6. The Structure of Memory in Infants and Toddlers: An SEM Study with Full-Terms and Preterms

    Science.gov (United States)

    Rose, Susan A.; Feldman, Judith F.; Jankowski, Jeffery J.; Van Rossem, Ronan

    2011-01-01

    There is considerable dispute about the nature of infant memory. Using SEM models, we examined whether popular characterizations of the structure of adult memory, including the two-process theory of recognition, are applicable in the infant and toddler years. The participants were a cohort of preterms and full-terms assessed longitudinally--at 1,…

  7. Brain Volumes at Term-Equivalent Age in Preterm Infants : Imaging Biomarkers for Neurodevelopmental Outcome through Early School Age

    NARCIS (Netherlands)

    Keunen, Kristin; Išgum, Ivana; van Kooij, Britt J M; Anbeek, Petronella; van Haastert, Ingrid C; Koopman-Esseboom, Corine; van Stam, Petronella C; Nievelstein, Rutger A J; Viergever, Max A; de Vries, Linda S; Groenendaal, Floris; Benders, Manon J N L

    OBJECTIVE: To evaluate the relationship between brain volumes at term and neurodevelopmental outcome through early school age in preterm infants. STUDY DESIGN: One hundred twelve preterm infants (born mean gestational age 28.6 ± 1.7 weeks) were studied prospectively with magnetic resonance imaging

  8. Olive oil enema in a pre-term infant with milk curd syndrome.

    Science.gov (United States)

    Watanabe, Toshihiko; Takahashi, Masataka; Amari, Shoichiro; Ohno, Michinobu; Sato, Kaori; Tanaka, Hideaki; Miyasaka, Mikiko; Fuchimoto, Yasushi; Ito, Yushi; Kanamori, Yutaka

    2013-08-01

    Milk curd syndrome was first reported in the 1960s, but was gradually forgotten because of its low incidence thereafter. This condition in pre-term infants has been reported over the last decade and has again attracted neonatologists' attention. The present report describes a pre-term infant with milk curd syndrome. Abdominal distension was evident 14 days after the start of feeding with fortified expressed milk. Abdominal X-ray showed multiple intraluminal masses surrounded by a halo of air, and ultrasound indicated hyperechoic masses. Along with that history and the appearance of fecal impaction, the diagnosis of milk curd syndrome was confirmed. This baby was treated with olive oil enemas and successive colonic lavage for 3 days, and the symptoms were relieved. Olive oil enema, which softens hard stools and induces smooth movement of these stools, may be an effective and safe first-line treatment in pre-term infants with milk curd syndrome. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  9. Differential associations between infant affective and cortisol responses during the still face paradigm among infants born very low birth weight versus full-term.

    Science.gov (United States)

    Erickson, Sarah J; Maclean, Peggy; Qualls, Clifford; Lowe, Jean R

    2013-06-01

    Psychological stress responses may have both emotional and cortisol reactivity correlates, but there are limited data addressing the association between generalized negative and positive emotional states and cortisol reactivity to a psychological stressor among infants born very low birth weight (VLBW; affect) and physiological (cortisol) responses may provide insight into the nature of regulation difficulties identified in infants born VLBW. The purpose of this study was to assess the association between infant affective and cortisol responses to the Still Face paradigm (SF) in a cohort of six- to eight-month old infants born VLBW compared with infants born full-term (N=53 total; N=29 and N=24, respectively). Infant affect was coded in 1-s intervals while mother-infant dyads participated in the SF paradigm, and percent positive affect and percent negative affect were calculated separately for each SF episode. We had hypothesized that because infants born VLBW are at increased risk for dysregulation, they would show, compared to full-term controls, greater dysregulation in the form of less synchrony (i.e., less correlated affective and cortisol responses) across the two SF stressors (episodes 2 and 4). This hypothesis was largely supported: the associations between affective and cortisol responses were different for the two groups across the two stressors for percent positive affect (both stressor episodes 2 and 4) and percent negative affect (episode 4 only). For the full-term group, follow up correlations revealed significant negative associations between percent positive affective and cortisol responses for both stressors. Mothers' responsiveness did not explain the term group association differences between infant affective and cortisol responses across stressors. The (lack of) association of stress reactivity systems may index dysregulation or dysregulation correlates in preterm children. Understanding how this lack of coordination among stress systems relates

  10. Prone sleeping impairs circulatory control during sleep in healthy term infants: implications for SIDS.

    Science.gov (United States)

    Yiallourou, Stephanie R; Walker, Adrian M; Horne, Rosemary S C

    2008-08-01

    To determine the effects of sleeping position on development of circulatory control in infants over the first 6 months of postnatal age (PNA). Effects of sleeping position, sleep state and PNA on beat-beat heart rate (HR) and mean arterial pressure (MAP) responses to a head-up tilt (HUT) were assessed during sleep in infants at 2-4 wks, 2-3 mo and 5-6 mo PNA. Daytime polysomnography was performed on 20 full-term infants (12 F/8 M) and MAP was recorded continuously and noninvasively (Finometer). HUTs of 15 degrees were performed during active sleep (AS) and quiet sleep (QS) in both the prone and supine sleeping positions. MAP and HR data were expressed as the percentage change from baseline, and responses were divided into initial, middle and late phases. In the supine position HUT usually resulted in an initial increase (P sleeping throughout the HUT. Prone sleeping alters MAP responses to a HUT during QS at 2-3 mo PNA. Decreased autonomic responsiveness may contribute to the increased risk for SIDS of infants sleeping in the prone position.

  11. High-density diffuse optical tomography of term infant visual cortex in the nursery

    Science.gov (United States)

    Liao, Steve M.; Ferradal, Silvina L.; White, Brian R.; Gregg, Nicholas; Inder, Terrie E.; Culver, Joseph P.

    2012-08-01

    Advancements in antenatal and neonatal medicine over the last few decades have led to significant improvement in the survival rates of sick newborn infants. However, this improvement in survival has not been matched by a reduction in neurodevelopmental morbidities with increasing recognition of the diverse cognitive and behavioral challenges that preterm infants face in childhood. Conventional neuroimaging modalities, such as cranial ultrasound and magnetic resonance imaging, provide an important definition of neuroanatomy with recognition of brain injury. However, they fail to define the functional integrity of the immature brain, particularly during this critical developmental period. Diffuse optical tomography methods have established success in imaging adult brain function; however, few studies exist to demonstrate their feasibility in the neonatal population. We demonstrate the feasibility of using recently developed high-density diffuse optical tomography (HD-DOT) to map functional activation of the visual cortex in healthy term-born infants. The functional images show high contrast-to-noise ratio obtained in seven neonates. These results illustrate the potential for HD-DOT and provide a foundation for investigations of brain function in more vulnerable newborns, such as preterm infants.

  12. Do early infant feeding patterns relate to breast-feeding continuation and weight gain? Data from a longitudinal cohort study.

    Science.gov (United States)

    Casiday, R E; Wright, C M; Panter-Brick, C; Parkinson, K N

    2004-09-01

    To describe the first-week feeding patterns for breast- vs bottle-fed babies, and their association with sustained breast-feeding and infant weight gain at 6 weeks. A longitudinal cohort study. Feeding diaries were completed by mothers in an urban UK community shortly after birth; follow-up weight and feeding data were collected at routine health checks. Mothers of 923 full-term infants born during the recruiting period agreed to join the study. In all, 502 usable diaries were returned from 54% of the cohort. Breast-fed infants were fed more frequently (2.71 h between feeds) than bottle-fed infants (3.25 h between feeds) and mixed-fed infants (3.14 h between feeds) (Pweight gain at 6 weeks for breast-feeders, but no analysed factors were associated with higher weight gain for bottle-feeders. This large-scale study of first-week feeding patterns sheds light on the important and complicated issues of breast-feeding continuation and infant weight gain, with implications for the feeding advice given to mothers. Supplementary bottle feeds were clearly associated with discontinued breast-feeding at 6 weeks. Over that period, higher weight gain was associated with more frequent feeding for breast-fed infants only. Henry Smith Charity, SPARKS, Child Growth Foundation. Copyright 2004 Nature Publishing Group

  13. Long-term neurodevelopmental outcomes of infants born late preterm: a systematic review

    Directory of Open Access Journals (Sweden)

    Tripathi T

    2015-11-01

    Full Text Available Tanya Tripathi,1 Stacey C Dusing2,3 1Rehabilitation and Movement Science Program, Department of Physical Therapy, 2Department of Physical Therapy, 3Department of Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA, USA Purpose: Late preterm (LPT births constitute a large proportion of the preterm births in the USA. Over the last few decades, there has been an increase in research focusing on the neurodevelopment of infants born LPT. The purpose of this research was to systematically review the long-term neurodevelopmental outcomes in LPT infants. Materials and methods: We identified studies by using PubMed, ERIC, CINAHL, and PsycINFO databases. The references of included papers were reviewed for additional papers that met the inclusion criteria. Included papers compared motor, cognitive, language development, or academic performance outcomes between individuals born LPT and a term control group assessed between 12 months and 18 years of age. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards for systematic reviews were utilized including a two-step, two-investigator review process. Results: Of the 4,720 studies found in the initial search, 20 studies met the inclusion criteria. Approximately 75% of the 16 studies that assessed cognitive outcomes reported cognitive delay in the LPT group when compared to their full-term counterparts. More than 50% of the seven studies that assessed motor outcomes suggested a delay in motor development in the LPT group in comparison to full-term. Fewer papers assessed academic performance and language in children born LPT; however, the majority identified borderline differences when LPT infants were compared to those born full-term. Conclusion: Evidence suggests that infants born LPT are at an increased risk of neurodevelopmental delay between 1 and 18 years of life when compared to those born at term. The delay is most evident in the cognitive

  14. A first step towards a consensus static in vitro model for simulating full-term infant digestion.

    Science.gov (United States)

    Ménard, O; Bourlieu, C; De Oliveira, S C; Dellarosa, N; Laghi, L; Carrière, F; Capozzi, F; Dupont, D; Deglaire, A

    2018-02-01

    In vitro alternatives to clinical trials are used for studying human food digestion. For simulating infant digestion, only a few models, lacking physiological relevance, are available. Thanks to an extensive literature review of the in vivo infant digestive conditions, a gastrointestinal static in vitro model was developed for infants born at term and aged 28days. The model was applied to the digestion of a commercial infant formula. Kinetics of digestion, as well as the structural evolution, were compared with those obtained while submitting the same formula to the adult international consensus protocol of in vitro static digestion. The kinetics of proteolysis and lipolysis differed according to the physiological stage resulting mainly from the reduced level of enzymes and bile salts, as well as the higher gastric pH in the infant model. This in vitro static model of infant digestion is of interest for scientists, food or pharmaceutical manufacturers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. [Fatty acid composition of human milk from mothers of preterm and full-term infants].

    Science.gov (United States)

    Marín, María C; Sanjurjo, Adriana L; Sager, Gustavo; Margheritis, César; de Alaniz, María J T

    2009-08-01

    Human milk is an essential food for newborns and affects life in the long or short terms. Its composition is modified by nutritional status and maternal diet as well as by gestational age of the newborn. It provides human milk-fed infants with the medium-chain fatty acids which are a source of energy, and essential fatty acids and their metabolic derivatives which have been involved in the neural maturation. Due to the fact that there is little local data concerning the fatty acid composition in human milk of pre-term and full-term newborns, the present study was carried out in women living in the urban area of the Buenos Aires Province. Samples were provided by the Bank of Human Milk, H.I.G.A. San Martín Hospital. They corresponded to mothers who had delivered preterm infants (28-36 weeks of gestational age) or full-term infants (37-42 weeks of gestational ages). Total lipids were extracted, and the fatty acid composition was determined by gas-liquid chromatography. Results showed increases in saturated fatty acids up to 14 carbon atoms and in polyunsaturated fatty acids in mothers of preterm newborns compared with those of full-term newborns. It can be concluded that gestational age affects human milk fatty acid composition. This food is essential for pre-term newborns as it is the source of energetic compounds (saturated fatty acids) as well as plastic compounds, (polyunsaturated fatty acids) which are essential for the synthesis of structural lipids and neural development.

  16. Neonatal Pain in Very Preterm Infants: Long-Term Effects on Brain, Neurodevelopment and Pain Reactivity

    Directory of Open Access Journals (Sweden)

    Ruth Eckstein Grunau

    2013-10-01

    Full Text Available Effects of early life psychosocial adversity have received a great deal of attention, such as maternal separation in experimental animal models and abuse/neglect in young humans. More recently, long-term effects of the physical stress of repetitive procedural pain have begun to be addressed in infants hospitalized in neonatal intensive care. Preterm infants are more sensitive to pain and stress, which cannot be distinguished in neonates. The focus of this review is clinical studies of long-term effects of repeated procedural pain-related stress in the neonatal intensive care unit (NICU in relation to brain development, neurodevelopment, programming of stress systems, and later pain sensitivity in infants born very preterm (24–32 weeks’ gestational age. Neonatal pain exposure has been quantified as the number of invasive and/or skin-breaking procedures during hospitalization in the NICU. Emerging studies provide convincing clinical evidence for an adverse impact of neonatal pain/stress in infants at a time of physiological immaturity, rapidly developing brain microstructure and networks, as well as programming of the hypothalamic-pituitary-adrenal axis. Currently it appears that early pain/stress may influence the developing brain and thereby neurodevelopment and stress-sensitive behaviors, particularly in the most immature neonates. However, there is no evidence for greater prevalence of pain syndromes compared to children and adults born healthy at full term. In addressing associations between pain/stress and outcomes, careful consideration of confounding clinical factors related to prematurity is essential. The need for pain management for humanitarian care is widely advocated. Non-pharmacological interventions to help parents reduce their infant’s stress may be brain-protective.

  17. Respiratory variability in preterm and term infants: Effect of sleep state, position and age.

    Science.gov (United States)

    Elder, Dawn E; Campbell, Angela J; Larsen, Peter D; Galletly, Duncan

    2011-02-15

    The influence of sleep state and position on respiratory variability (RV) was studied in 13 preterm infants (PTIs) and 19 term infants (TIs). Temporally matched epochs of nasal pressure and oxygen saturation (Spo₂) data were extracted from nap polysomnography. Inspiratory onset times (I) were determined, and variability measures of the I-I interval compared in quiet sleep and active sleep, prone and supine and with age. Sleep state influenced respiratory variability (RV) in PTI and TI but Spo₂ only varied with sleep state in PTI (p=0.03). Position had no effect on RV in TI but influenced the standard deviation of ventilatory frequency (SDf) in PTI (p=0.04). Age did not influence RV in PTI but SDf and the coefficient of variation of ventilatory frequency (CVf) decreased in TI from birth to 3 months. These data confirm sleep state as the predominant influence on RV in healthy term and convalescent preterm infants, with horizontal prone positioning having little effect when sleep state is controlled for. Copyright © 2010 Elsevier B.V. All rights reserved.

  18. Radiologic differences in white matter maturation between preterm and full-term infants: TBSS study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ah Young; Jang, Sung Ho; Ahn, Sang Ho; Cho, Hee Kyung; Jo, Hae Min; Son, Su Min [Yeungnam University, Department of Physical Medicine and Rehabilitation, College of Medicine, Taegu (Korea, Republic of); Lee, Eunsil [Yeungnam University, Department of Pediatrics, College of Medicine, Taegu (Korea, Republic of)

    2013-03-15

    Widespread white matter (WM) pathology in preterm children has been proposed. The purpose of this study was to investigate maturational differences of WM between preterm infants with thinning of the corpus callosum and full-term infants. A total of 18 preterm children and 18 full-term children were divided into three subgroups according to the corrected age at the time of diffusion tensor imaging scanning. Tract-based spatial statistics was used for assessing differences in fractional anisotropy (FA) between preterm and full-term children, and between each age-related subgroup in preterm and in full-term children. In the preterm group, FA values of overall WM showed an increase with age. This trend indicates that WM maturation is a gradual occurrence during a child's first 2 years. In the full-term group, most WM structures had reached maturation at around 1 year of age; however, centrum semiovale level showed sustained maturation during the first 2 years. Results of our study demonstrate radiologic maturational differences of WM and provide evidence of the need for therapeutic intervention within 2 years of birth to prevent specific functional impairment and to improve clinical outcome in preterm children. (orig.)

  19. Leptin determination in colostrum and early human milk from mothers of preterm and term infants.

    Science.gov (United States)

    Eilers, Elisabeth; Ziska, Thomas; Harder, Thomas; Plagemann, Andreas; Obladen, Michael; Loui, Andrea

    2011-06-01

    Leptin is involved in the regulation of food intake and energy expenditure and is therefore important for growth and brain development. Analytical methods used for leptin measurement in human milk differ widely in the literature and yield varying results. To compare different preparation methods for the analysis of leptin in human milk and to investigate the leptin levels in colostrum and mature human milk from mothers of preterm or term infants. Mothers delivering a preterm (n=37) or a term infant (n=40) were recruited for a prospective study and were ask to collect breast milk on the 3rd and 28th day of lactation. Leptin, protein and fat concentrations were analysed. Clinical data of mother and child were recorded prospectively. Skim milk was most appropriate for leptin analysis. Human milk leptin concentrations did not differ between preterm and term human milk. In term milk, leptin concentration on day 28 was lower than on day 3 (pMilk leptin levels on the 3rd and 28th day were positively correlated with mothers' body mass index, but not with fat content in milk. Skim milk was the most stabile preparation for leptin analysis. Preterm and term human milk contain leptin in equal concentrations. Human milk leptin depends on mothers' body mass index. Copyright © 2011. Published by Elsevier Ireland Ltd.

  20. Decreased arousals among healthy infants after short-term sleep deprivation.

    Science.gov (United States)

    Franco, Patricia; Seret, Nicole; Van Hees, Jean Noël; Scaillet, Sonia; Vermeulen, Françoise; Groswasser, José; Kahn, André

    2004-08-01

    arousal. After the induced arousal, the infants were allowed to return to sleep to complete their naps. Sleep deprivation lasted a median of 120 minutes (range: 90-272 min). Most sleep characteristics were similar for the normal and sleep-deprived conditions, including sleep efficiency, time awake, percentages of REM sleep and non-REM sleep, frequency and duration of central apnea and of periodic breathing, duration of obstructive apnea, mean heart rate and variability, and mean breathing rates during REM sleep and non-REM sleep. After sleep deprivation, the duration of the naps increased, whereas there were decreases in the latency of REM sleep and in the density of body movements. More-intense auditory stimuli were needed for arousal when the infants were sleep-deprived, compared with normal nap sleep. Sleep deprivation was associated with a significant increase in the frequency of obstructive sleep apnea episodes, especially during REM sleep. No significant differences were noted when the effects of morning and afternoon sleep deprivation were compared. No correlation was found between the duration of sleep deprivation and either the frequency of obstructive apnea or the changes in arousal thresholds, although the infants who were more sleep-deprived exhibited tendencies toward higher auditory arousal thresholds and shorter REM sleep latencies, compared with less sleep-deprived infants. There were tendencies for a negative correlation between the auditory arousal thresholds and REM sleep latencies and for a positive correlation between the auditory arousal thresholds and the frequencies of obstructive apnea during REM sleep. Short-term sleep deprivation among infants is associated with the development of obstructive sleep apnea and significant increases in arousal thresholds. As already reported, sleep deprivation may induce effects on respiratory control mechanisms, leading to impairment of ventilatory and arousal responses to chemical stimulation and decreases in

  1. Use of probiotics and prebiotics in infant feeding.

    Science.gov (United States)

    Bertelsen, Randi J; Jensen, Elizabeth T; Ringel-Kulka, Tamar

    2016-02-01

    Gut colonization by beneficial bacteria in early life is necessary for establishing the gut mucosal barrier, maturation of the immune system and preventing infections with enteric pathogens. Mode of delivery, prematurity, breastfeeding, and use of antibiotics are some of many factors that have been described to influence early life colonization. Dysbiosis, the absence of normal colonization, is associated with many disease conditions. Pre- and probiotics are commonly used as supplementation in infant formula, such as prebiotic oligosaccharides for stimulation of Bifidobacterium growth aiming to mimic the high levels of these commensal bacteria in the gut of breastfed infants. Studies suggest that probiotic supplementation may be beneficial in prevention and management of disease (e.g., reducing the risk of necrotizing enterocolitis in preterm infants and treatment of acute gastroenteritis in children). Although these studies show promising beneficial effects, the long-term risks or health benefits of pre- and probiotic supplementation are not clear. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Health care utilization in the first year of life among small- and large- for-gestational age term infants.

    Science.gov (United States)

    Dietz, Patricia M; Rizzo, Joanne H; England, Lucinda J; Callaghan, William M; Vesco, Kimberly K; Bruce, F Carol; Bulkley, Joanna E; Sharma, Andrea J; Hornbrook, Mark C

    2013-08-01

    The objective of the study was to assess if small- and large-for gestational age term infants have greater health care utilization during the first year of life. The sample included 28,215 singleton term infants (37-42 weeks) without major birth defects delivered from 1998 through 2007 and continuously enrolled at Kaiser Permanente Northwest for 12 months after delivery. Birth weight for gestational age was categorized into 3 levels: 90th percentile (LGA). Length of delivery hospitalization, re-hospitalizations and sick/emergency room visits were obtained from electronic records. Logistic regression models estimated associations between birth weight category and re-hospitalization. Generalized linear models estimated adjusted mean number of sick/emergency visits. Among term infants, 6.2 % were SGA and 13.9 % were LGA. Of infants born by cesarean section, SGA infants had 2.7 higher odds [95 % 1.9, 3.8] than AGA infants of staying ≥5 nights during the delivery hospitalization; of those born vaginally, SGA infants had 1.5 higher adjusted odds [95 % 1.1, 2.1] of staying ≥4 nights. LGA compared to AGA infants had higher odds of re-hospitalization within 2 weeks of delivery [OR 1.25, 95 % CI 0.99, 1.58] and of a length of stay ≥4 days during that hospitalization [OR 2.6, 95 % CI 1.3, 5.0]. The adjusted mean number of sick/emergency room visits was slightly higher in SGA (7.8) than AGA (7.5) infants (P < .05). Term infants born SGA or LGA had greater health care utilization than their counterparts, although the increase in utilization beyond the initial delivery hospitalization was small.

  3. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study

    DEFF Research Database (Denmark)

    Hansen, Anne Kirkeby; Wisborg, Kirsten; Uldbjerg, Niels

    2007-01-01

    of the newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn) and serious respiratory morbidity (oxygen therapy for more than two days, nasal continuous positive airway pressure, or need for mechanical ventilation). RESULTS: 2687 infants were delivered by elective caesarean...... section. Compared with newborns intended for vaginal delivery, an increased risk of respiratory morbidity was found for infants delivered by elective caesarean section at 37 weeks' gestation (odds ratio 3.9, 95% confidence interval 2.4 to 6.5), 38 weeks' gestation (3.0, 2.1 to 4.3), and 39 weeks......-eclampsia, and intrauterine growth retardation, or by breech presentation. CONCLUSION: Compared with newborns delivered vaginally or by emergency caesarean sections, those delivered by elective caesarean section around term have an increased risk of overall and serious respiratory morbidity. The relative risk increased...

  4. Effect of Mother's Characteristics and Infant Feeding Practices on the ...

    African Journals Online (AJOL)

    46.4%). It was found that none of the exclusively breastfed babies were stunted, malnourished or wasted. Mothers who earned higher income had less stunted malnourished and wasted infants than those who earned lower income. Education ...

  5. A systematic review of controlled trials of lower-protein or energy-containing infant formulas for use by healthy full-term infants.

    Science.gov (United States)

    Abrams, Steven A; Hawthorne, Keli M; Pammi, Mohan

    2015-03-01

    Infant formulas have historically been developed based on providing macronutrients at intake concentrations approximately matching the composition of human milk. In most countries, targets of 1.4-1.5 g of protein/dL and 20 kcal/oz (67-68 kcal/dL) have been set as the protein and energy concentrations for formulas during the first year of life, although this may be an overestimation of these contents. Recent introduction of lower-protein and -energy formulas in full-term infants led us to systematically review the literature for its effects on growth. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, our inclusion criteria were studies that enrolled healthy full-term infants and evaluated lower-protein or lower-energy formula, reported anthropometric outcomes including weight and length, and followed infants for at least 6 mo. Six studies were eligible for inclusion. These studies varied in the content of nutrients provided in the intervention and control groups, by additional dietary components in the study groups, and the timing and length of the intervention, which limit their usefulness for interpreting newly introduced lower-protein and -energy formulas in the United States. These studies suggest adequate growth during infancy and early childhood with infant formulas with concentrations of protein and energy slightly below historical standards in the United States. Further long-term research is needed to assess the impact of the use of lower-protein and/or lower-energy products, especially for nutritionally at-risk populations such as preterm infants and infants who are born small for gestational age. © 2015 American Society for Nutrition.

  6. Impact on parents of bronchiolitis hospitalization of full-term, preterm and congenital heart disease infants

    Directory of Open Access Journals (Sweden)

    Lapillonne Alexandre

    2012-10-01

    Full Text Available Abstract Background The objective of this work was to explore the impact on parents of the bronchiolitis hospitalization of their infant using the Impact of Bronchiolitis Hospitalization Questionnaire (IBHQ©. Methods Four hundred sixty-three infants aged less than 1 year and hospitalized for bronchiolitis were included in a French observational study during the 2008–2009 season. Parents were asked to complete the IBHQ at hospital discharge and 3 months later. IBHQ scores, ranging from 0 (no impact to 100 (highest impact, were compared according to gestational age (full-term, 33–36 wGA, ≤ 32 wGA and the presence of congenital heart disease (CHD. The potential drivers of impact were explored using multivariate linear regressions. Results The study included 332 full-terms, 71 infants born at 33–36 wGA, and 60 at ≤ 32 wGA; 28 infants had a CHD. At hospital discharge, 9 of the 12 IBHQ mean scores were above 40, indicating a marked impact on parents. Three months later, all mean scores were lower but 5 were still greater than 40. At discharge, the length of hospitalization had a significant effect on IBHQ worries and distress, fear for future, guilt and impact on daily organization scores (p Conclusions Bronchiolitis hospitalization has conspicuous emotional, physical and organizational consequences on parents and siblings, which persist 3 months after hospital discharge. The main drivers of the impact were length of hospital stay and parents’ educational level, while infants’ gestational age or the presence of a CHD had little influence.

  7. Impact on parents of bronchiolitis hospitalization of full-term, preterm and congenital heart disease infants

    Science.gov (United States)

    2012-01-01

    Background The objective of this work was to explore the impact on parents of the bronchiolitis hospitalization of their infant using the Impact of Bronchiolitis Hospitalization Questionnaire (IBHQ©). Methods Four hundred sixty-three infants aged less than 1 year and hospitalized for bronchiolitis were included in a French observational study during the 2008–2009 season. Parents were asked to complete the IBHQ at hospital discharge and 3 months later. IBHQ scores, ranging from 0 (no impact) to 100 (highest impact), were compared according to gestational age (full-term, 33–36 wGA, ≤ 32 wGA) and the presence of congenital heart disease (CHD). The potential drivers of impact were explored using multivariate linear regressions. Results The study included 332 full-terms, 71 infants born at 33–36 wGA, and 60 at ≤ 32 wGA; 28 infants had a CHD. At hospital discharge, 9 of the 12 IBHQ mean scores were above 40, indicating a marked impact on parents. Three months later, all mean scores were lower but 5 were still greater than 40. At discharge, the length of hospitalization had a significant effect on IBHQ worries and distress, fear for future, guilt and impact on daily organization scores (pinfants was for the physical impact score at discharge (p=0.004). Conclusions Bronchiolitis hospitalization has conspicuous emotional, physical and organizational consequences on parents and siblings, which persist 3 months after hospital discharge. The main drivers of the impact were length of hospital stay and parents’ educational level, while infants’ gestational age or the presence of a CHD had little influence. PMID:23114197

  8. Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants.

    Science.gov (United States)

    Bai, Dorothy Li; Fong, Daniel Yee Tak; Lok, Kris Yuet Wan; Wong, Janet Yuen Ha; Tarrant, Marie

    2017-02-01

    To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. A total of 2450 mother-infant pairs were recruited in 2006-2007 and 2011-2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped. Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006-2007 and from 18·0 to 19·8 % in 2011-2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months. Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers' reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.

  9. Resistin and leptin in breast milk and infants in early life.

    Science.gov (United States)

    Savino, Francesco; Sorrenti, Miriam; Benetti, Stefania; Lupica, Maria Maddalena; Liguori, Stefania Alfonsina; Oggero, Roberto

    2012-10-01

    The role of adipokines in early life is considered an emerging topic issue in nutritional researches. To evaluate serum resistin and leptin concentrations and their relations in infants and in breast milk. We enrolled 41 term, AGA, healthy infants, of which 23 exclusively breast-fed (BF) and 18 formula-fed (FF), aged less than 6 months. Breast milk (BM) samples were collected from 23 breastfeeding mothers of the infants enrolled. Resistin concentration in serum and BM was determined by ELISA test (Human-Resistin-ELISA, Mediagnost, Reutlingen, Germany). Leptin concentration was determined by Radioimmunoassay method (LEP-R40, Mediagnost, Reutlingen, Germany). Infants weight, length and body mass index were measured. We used Mann-Whitney test. Spearman correlation was applied. Statistical significance was set at pmilk resistin concentration (n=23) was 0.18 (0.44) ng/ml. Leptin concentration was 3.04 (3.68) ng/ml in infants serum and in BM was 2.34 (5.73) ng/ml. Serum resistin concentrations in BF infants correlated positively with BM resistin (r=0.636, p=0.035). We have shown a positive correlation between resistin and leptin in total group of infants (r=0.44, p=0.05), confirmed in breastfed subjects (r=0.65, p=0.02). No correlations were found between serum hormones and anthropometric parameters of infants. Our findings show interestingly a positive correlation between resistin concentrations in BF infants serum and in BM and between resistin and leptin in infants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Radionuclide scintigraphy in the evaluation of gastroesophageal reflux in symptomatic and asymptomatic pre-term infants

    Energy Technology Data Exchange (ETDEWEB)

    Morigeri, C.; Mukhopadhyay, K.; Narang, A. [Postgraduate Institute of Medical Education and Research (PGIMER), Division of Neonatology, Department of Paediatrics, Chandigarh (India); Bhattacharya, A.; Mittal, B.R. [Postgraduate Institute of Medical Education and Research (PGIMER), Department of Nuclear Medicine, Chandigarh (India)

    2008-09-15

    Gastroesophageal reflux (GER) is very common in pre-term infants. The diagnosis based on symptoms is always questionable. The incidence of GER in symptomatic babies varies from 22% to 85%, but literature regarding the incidence of reflux in asymptomatic pre-term infants is lacking. We used radionuclide scintigraphy to evaluate the incidence of GER in symptomatic as well as asymptomatic pre-term neonates and to assess whether symptoms have any relation with positive scintigraphy. We studied 106 pre-term infants (52 symptomatic, 54 asymptomatic) of less than 34 weeks of gestation, who fulfilled the eligibility criteria. Babies were considered symptomatic in the presence of vomiting, regurgitation, apnea, de-saturations, unexplained bradycardia and recurrent lung collapses. Radionuclide scintigraphy was conducted at post-conceptional age of 32-34 weeks when they were clinically stable for 72 h. Feeding was avoided for 2 h preceding the study. {sup 99m}Tc sulphur colloid was administered in a dose of 1.85 MBq (0.05 mCi) in 1 ml, followed by milk (full feed) through an orogastric tube, prior to imaging under a gamma camera. Reflux was graded as low or high, and reflux episodes during the study were counted. The incidence of GER in the symptomatic group was 71.2% and in asymptomatic babies 61.1% (p=0.275). High-grade reflux was more common (71.4%) than low-grade (28.6%) in both groups (p=0.449). Mean number of reflux episodes in 20 min was 4.4{+-}2.4 in symptomatic babies and 4.9 {+-}2.2 in asymptomatic babies (p=0.321). Babies with positive scintigraphy were similar in birth weight, gestation, time to achieve full feeds, weight and age at discharge to those with negative scintigraphy. GER is common in pre-term infants of less than 34 weeks gestation. The incidence of positive scintigraphy and grade of reflux is not significantly different in symptomatic vs. asymptomatic babies. Though radionuclide scintigraphy is a simple, quick and non-invasive investigation in

  11. Associations between respiratory arrhythmia and fundamental frequency of spontaneous crying in preterm and term infants at term‐equivalent age

    Science.gov (United States)

    Shinya, Yuta; Kawai, Masahiko; Niwa, Fusako

    2016-01-01

    ABSTRACT This study investigated whether lower vagal function in preterm infants is associated with increased fundamental frequency (F 0; frequency of vocal fold vibration) of their spontaneous cries. We assessed respiratory sinus arrhythmia (RSA) during quiet sleep as a measure of vagal function, and its relationship with the F 0 of spontaneous cries in healthy preterm and term infants at term‐equivalent age. The results showed that preterm infants have significantly lower RSA, and higher overall F 0 than term infants. Moreover, lower RSA was associated with higher overall F 0 in preterm infants, whereas higher RSA was positively associated with mean and maximum F 0, and a larger F 0 range in term infants. These results suggest that individual differences in vagal function may be associated with the F 0 of spontaneous cries via modulation of vocal fold tension in infants at an early developmental stage. © 2016 The Authors. Developmental Psychobiology Published by Wiley Periodicals, Inc. Dev Psychobiol 58:724–733, 2016. PMID:27037599

  12. Neurodevelopmental outcomes in preterm infants: comparison of infants with and without diffuse excessive high signal intensity on MR images at near-term-equivalent age.

    Science.gov (United States)

    Jeon, Tae Yeon; Kim, Ji Hye; Yoo, So-Young; Eo, Hong; Kwon, Jeong-Yi; Lee, Jeehun; Lee, Munhyang; Chang, Yun Sil; Park, Won Soon

    2012-05-01

    To compare the neurodevelopmental outcomes between preterm infants with diffuse excessive high signal intensity (DEHSI) and those without DEHSI on magnetic resonance (MR) images, in association with other white matter lesions. This retrospective study was approved by the institutional review board, and requirement to obtain informed consent was waived. High-risk preterm infants (n = 126) who underwent screening brain MR imaging at near-term-equivalent age were classified into two groups according to the presence of DEHSI. Bayley Scales of Infant Development-II, presence of cerebral palsy, and neurosensory impairment between 18 and 24 months of age were compared between the two groups. The associations of MR findings of other white matter lesions (cystic encephalomalacia, punctate lesions, loss of volume, ventricular dilatation, and delayed myelination) and subsequent outcomes were also analyzed. Outcome data were evaluated by using exact logistic regression analyses and Fisher exact test. DEHSI was present in 75% (95 of 126) of infants. Subsequent neurodevelopmental outcomes did not differ significantly between the two groups. Severe motor delay and cerebral palsy were more common in infants with both DEHSI and other white matter lesions as compared with infants with normal white matter (P = .001 and P cystic encephalomalacia (odds ratio, 19.6; 95% confidence interval: 1.3, 333.3) and punctate lesions (odds ratio, 90.9; 95% confidence interval: 6.4, 1000) were significant predictors of cerebral palsy. Although the incidence of DEHSI was high (75%) in preterm infants at near-term-equivalent age MR imaging, DEHSI was not predictive of following adverse outcomes. Cystic encephalomalacia and punctate lesions were more significant predictors of cerebral palsy.

  13. Posture and movement in very preterm infants at term age in and outside the nest.

    Science.gov (United States)

    Zahed, M; Berbis, J; Brevaut-Malaty, V; Busuttil, M; Tosello, B; Gire, C

    2015-12-01

    The objective of this study is to evaluate the use of nests on general movements (GM) and posture in very preterm infants at term age. Seventeen high-risk preterm infants-less than 30 weeks of gestation (GA)-underwent a video recording, lying in supine position, with or without nest. Posture, GM quality, and movements made around the child's midline, as well as abrupt movements and frozen postures-in extension or flexion of the four limbs-were analyzed. Nest did not modify quality of GM. Children significantly adopted a curled-up position. The nest system was associated with an increase in movements toward or across the midline, as well as reduction of the hyperextension posture and head rotation movements. Frozen postures in flexion or extension, as well as abrupt movements of the four limbs, were reduced but not significantly. Nest helps very preterm infants to adopt semi-flexed posture and facilitates movements across the midline and reduces movements of spine hyperextension, without GM global quality modifications.

  14. Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 3: Discussion and Conclusion

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2005-11-01

    Full Text Available Abstract Background It has been hypothesized that prematurity and adjunctive neonatal care is 'a priori' a risk for disturbances of palatal and orofacial development which increases the need for later orthodontic or orthognathic treatment. As results on late consequences of prematurity are consistently contradictory, the necessity exists for a fundamental analysis of existing methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. Method A search of the literature was conducted based on Cochrane search strategies including sources in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered in tables for comparison (Parts 1 and 2. Results Morphology assessment of the infant palate is subject to non-standardized visual and metrical measurements. Most methodologies are inadequate for measuring a three-dimensional shape. Several confounding factors were identified as causes contributing to disturbances of palatal and orofacial development. Conclusion Taking into account the abovementioned shortcomings, the following conclusions may be drawn for practitioners and prospective investigators of clinical studies. 1 The lack of uniformity in the anatomical nomenclature of the infant's palate underlines the need for a uniform definition. 2 Metrically, non-intubated preterm infants do not exhibit different palatal width or height compared to matched term infants up to the corrected age of three months. Beyond that age, no data on the subject are currently available. 3 Oral intubation does not invariably alter palatal morphology of preterm and low birthweight infants. 4 The findings on palatal grooving, height, and asymmetry as a consequence of orotracheal intubation up to the age of 11 years are inconsistent. 5 Metrically

  15. Metabolic fate of milk glycosaminoglycans in breastfed and formula fed newborns.

    Science.gov (United States)

    Maccari, Francesca; Mantovani, Veronica; Gabrielli, Orazio; Carlucci, Antonio; Zampini, Lucia; Galeazzi, Tiziana; Galeotti, Fabio; Coppa, Giovanni V; Volpi, Nicola

    2016-04-01

    In this study, the content, structure and residual percentages of glycosaminoglycans (GAGs) in the feces of seven breastfed newborns after ingesting a known amount of milk were studied. A comparison was made with five newborns fed with formula milk. Characterization of GAGs from milk and feces samples was performed according to previous methodology. Compared to the ingested GAGs present in milk, residual feces GAGs of breastfed newborns were 99 % of human milk GAGs are utilized as opposed to ~96 % of formula milk. Hyaluronic acid utilization was found to be fairly similar contrary to chondroitin sulfate/dermatan sulfate and heparan sulfate, which were found to be ~10-18 times lower in formula milk fed children. Our new results further demonstrate that the elevated content of human milk GAGs passes undigested through the entire digestive system of newborns, possibly protecting the infant from infections. In the distal gastrointestinal tract, these complex macromolecules are catabolized by a cohort of bacterial enzymes and constituent monosaccharides/oligosaccharides utilized for further metabolic purposes potentially useful for bacteria metabolism or internalized by intestinal cells. Thanks to their elevated structural heterogeneity, milk GAGs are used differently depending on their distinct primary structure. Finally, a different utilization and availability was observed for human milk GAGs compared to formula milk due to their various composition and structural heterogeneity.

  16. Inhaled Nitric Oxide Therapy for Pulmonary Disorders of the Term and Preterm Infant

    Science.gov (United States)

    Sokol, Gregory M.; Konduri, G. Ganesh; Van Meurs, Krisa P.

    2016-01-01

    The 21st century began with the FDA approval of inhaled nitric oxide therapy for the treatment of neonatal hypoxic respiratory failure associated with pulmonary hypertension in recognition of the two randomized clinical trials demostrating a significant reduction in the need for extracorporeal support in the term and near-term infant. Inhaled nitric oxide is one of only a few therapeutic agents approved for use through clinical investigations primarily in the neonate. This article provides an overview of the pertinent biology and chemistry of nitric oxide, discusses potential toxicities, and reviews the results of pertinent clinical investigations and large randomized clinical trials including neurodevelopmental follow-up in term and preterm neonates. The clinical investigations conducted by the Eunice Kennedy Shriver NICHD Neonatal Research Network will be discussed and placed in context with other pertinent clinical investigations exploring the efficacy of inhaled nitric oxide therapy in neonatal hypoxic respiratory failure. PMID:27480246

  17. Infants with complex congenital heart diseases show poor short-term memory in the mobile paradigm at 3 months of age.

    Science.gov (United States)

    Chen, Chao-Ying; Harrison, Tondi; Heathcock, Jill

    2015-08-01

    The purpose of this study was to examine learning, short-term memory and general development including cognitive, motor, and language domains in infants with Complex Congenital Heart Defects (CCDH). Ten infants with CCHD (4 males, 6 females) and 14 infants with typical development (TD) were examined at 3 months of age. The mobile paradigm, where an infant's leg is tethered to an overhead mobile, was used to evaluate learning and short-term memory. The Bayley Scales of Infant Development 3rd edition (Bayley-III) was used to evaluate general development in cognitive, motor, and language domains. Infants with CCHD and infants with TD both showed learning with significant increase in kicking rate (pparadigm, but only infants with TD demonstrated short-term memory (p=0.017) in the mobile paradigm. There were no differences on cognitive, motor, and language development between infants with CCHD and infants with TD on the Bayley-III. Early assessment is necessary to guide targeted treatment in infants with CCHD. One-time assessment may fail to detect potential cognitive impairments during early infancy in infants with CCHD. Supportive intervention programs for infants with CCHD that focuses on enhancing short-term memory are recommended. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Ambient Air Pollution and Birth Weight in Full-Term Infants in Atlanta, 1994–2004

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    Darrow, Lyndsey A.; Klein, Mitchel; Strickland, Matthew J.; Mulholland, James A.; Tolbert, Paige E.

    2011-01-01

    Background An emerging body of evidence suggests that ambient levels of air pollution during pregnancy are associated with fetal growth. Objectives We examined relationships between birth weight and temporal variation in ambient levels of carbon monoxide, nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone, particulate matter ≤ 10 μm in diameter (PM10), ≤ 2.5 μm (PM2.5), 2.5 to 10 μm (PM2.5–10), and PM2.5 chemical component measurements for 406,627 full-term births occurring between 1994 and 2004 in five central counties of metropolitan Atlanta. Methods We assessed relationships between birth weight and pollutant concentrations during each infant’s first month of gestation and third trimester, as well as in each month of pregnancy using distributed lag models. We also conducted capture-area analyses limited to mothers residing within 4 miles (6.4 km) of each air quality monitoring station. Results In the five-county analysis, ambient levels of NO2, SO2, PM2.5 elemental carbon, and PM2.5 water-soluble metals during the third trimester were significantly associated with small reductions in birth weight (−4 to −16 g per interquartile range increase in pollutant concentrations). Third-trimester estimates were generally higher in Hispanic and non-Hispanic black infants relative to non-Hispanic white infants. Distributed lag models were also suggestive of associations between air pollutant concentrations in late pregnancy and reduced birth weight. The capture-area analyses provided little support for the associations observed in the five-county analysis. Conclusions Results provide some support for an effect of ambient air pollution in late pregnancy on birth weight in full-term infants. PMID:21156397

  19. Urinary tract infection in full-term newborn infants: risk factor analysis

    Directory of Open Access Journals (Sweden)

    Falcão Mário Cícero

    2000-01-01

    Full Text Available OBJECTIVE: To analyze the correlation of risk factors to the occurrence of urinary tract infection in full-term newborn infants. PATIENTS AND METHODS: Retrospective study (1997 including full-term infants having a positive urine culture by bag specimen. Urine collection was based on: fever, weight loss > 10% of birth weight, nonspecific symptoms (feeding intolerance, failure to thrive, hypoactivity, debilitate suction, irritability, or renal and urinary tract malformations. In these cases, another urine culture by suprapubic bladder aspiration was collected to confirm the diagnosis. To compare and validate the risk factors in each group, the selected cases were divided into two groups: Group I - positive urine culture by bag specimen collection and negative urine culture by suprapubic aspiration, and Group II - positive urine culture by bag specimen collection and positive urine culture by suprapubic aspiration . RESULTS: Sixty one infants were studied, Group I, n = 42 (68.9% and Group II, n = 19 (31.1%. The selected risk factors (associated infectious diseases, use of broad-spectrum antibiotics, renal and urinary tract malformations, mechanical ventilation, parenteral nutrition and intravascular catheter were more frequent in Group II (p<0.05. Through relative risk analysis, risk factors were, in decreasing importance: parenteral nutrition, intravascular catheter, associated infectious diseases, use of broad-spectrum antibiotics, mechanical ventilation, and renal and urinary tract malformations. CONCLUSION: The results showed that parenteral nutrition, intravascular catheter, and associated infectious diseases contributed to increase the frequency of neonatal urinary tract infection, and in the presence of more than one risk factor, the occurrence of urinary tract infection rose up to 11 times.

  20. 3D MR ventricle segmentation in pre-term infants with post-hemorrhagic ventricle dilation

    Science.gov (United States)

    Qiu, Wu; Yuan, Jing; Kishimoto, Jessica; Chen, Yimin; de Ribaupierre, Sandrine; Chiu, Bernard; Fenster, Aaron

    2015-03-01

    Intraventricular hemorrhage (IVH) or bleed within the brain is a common condition among pre-term infants that occurs in very low birth weight preterm neonates. The prognosis is further worsened by the development of progressive ventricular dilatation, i.e., post-hemorrhagic ventricle dilation (PHVD), which occurs in 10-30% of IVH patients. In practice, predicting PHVD accurately and determining if that specific patient with ventricular dilatation requires the ability to measure accurately ventricular volume. While monitoring of PHVD in infants is typically done by repeated US and not MRI, once the patient has been treated, the follow-up over the lifetime of the patient is done by MRI. While manual segmentation is still seen as a gold standard, it is extremely time consuming, and therefore not feasible in a clinical context, and it also has a large inter- and intra-observer variability. This paper proposes a segmentation algorithm to extract the cerebral ventricles from 3D T1- weighted MR images of pre-term infants with PHVD. The proposed segmentation algorithm makes use of the convex optimization technique combined with the learned priors of image intensities and label probabilistic map, which is built from a multi-atlas registration scheme. The leave-one-out cross validation using 7 PHVD patient T1 weighted MR images showed that the proposed method yielded a mean DSC of 89.7% +/- 4.2%, a MAD of 2.6 +/- 1.1 mm, a MAXD of 17.8 +/- 6.2 mm, and a VD of 11.6% +/- 5.9%, suggesting a good agreement with manual segmentations.

  1. Long chain polyunsaturated fatty acid supplementation in infants born at term.

    Science.gov (United States)

    Jasani, Bonny; Simmer, Karen; Patole, Sanjay K; Rao, Shripada C

    2017-03-10

    The long chain polyunsaturated fatty acids (LCPUFA) docosahexaenoic acid (DHA) and arachidonic acid (AA) are considered essential for maturation of the developing brain, retina and other organs in newborn infants. Standard infant milk formulae are not supplemented with LCPUFA; they contain only alpha-linolenic acid and linoleic acid, from which formula-fed infants must synthesise their own DHA and AA, respectively. Over the past few years, some manufacturers have added LCPUFA to formula milk and have marketed these products as providing an advantage for the overall development of full-term infants. To assess whether supplementation of formula milk with LCPUFA is both safe and beneficial for full-term infants, while focusing on effects on visual function, neurodevelopment and physical growth. Two review authors independently searched the Cochrane Central Register of Controlled Trials (CENTRAL; December 2016), MEDLINE (Ovid, 1966 to December 2016), Embase (Ovid, 1980 to December 2016), the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1980 to December 2016) and abstracts of the Pediatric Academic Societies (2000 to 2016). We applied no language restrictions. We reviewed all randomised controlled trials (RCTs) evaluating effects of LCPUFA supplemented versus non-supplemented formula milk on visual function, neurodevelopment and physical growth. We did not include trials reporting only biochemical outcomes. Two review authors extracted data independently. We assessed risk of bias of included studies using the guidelines of the Cochrane Neonatal Review Group. When appropriate, we conducted meta-analysis to determine a pooled estimate of effect. We identified 31 RCTs and included 15 of these in the review (N = 1889).Nine studies assessed visual acuity, six of which used visual evoked potentials (VEP), two Teller cards and one both. Four studies reported beneficial effects, and the remaining five did not. Meta-analysis of three RCTs showed significant

  2. Development of the forward parachute reaction and the age of walking in near term infants: a longitudinal observational study

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    Palermo Filippo

    2009-02-01

    Full Text Available Abstract Background Near term infants are a main part of preterms. They are at higher risk for mortality and morbidity than term infants and could show a quite different development of tone and reflexes from them. The aim of the present study was to describe longitudinally, in a large sample of healthy near term infants, the development of the forward parachute reaction (FPR and its correlation with the age of acquisition of independent walking. Methods The assessment of FPR (as absent, incomplete or complete was performed at 3, 6, 9, 12 months of corrected age in 484 infants, with a gestational age between 35.0 and 36.9 weeks. The age of acquisition of independent walking was monitored until its appearance. A correlation analysis was done between the age of walking and the acquisition of a complete or incomplete FPR, using the Spearman Rank correlation. The Mann-Withney U test was used to identify significant gestational age differences for the age of FPR appearance. Results Most of infants had a two-step development pattern. In fact, they showed at first an incomplete and then a complete FPR, which was observed more frequently at 9 months. An incomplete FPR only, without a successive maturation to a complete FPR, was present in the 21% of the whole sample. Infants with a complete FPR walked at a median age of 13 months, whereas those with an incomplete FPR only walked at a median age of 14 months. Conclusion We identified two groups within our sample of near term infants. The first group showed a progressive maturation of FPR, whereas the second one was characterised by the inability to get a complete pattern, within the one year observation's period. Furthermore, we observed a trend toward a delayed acquisition of independent walking in the latter group of infants.

  3. Middle latency auditory evoked responses in normal term infants: a longitudinal study.

    Science.gov (United States)

    Rogers, S H; Edwards, D A; Henderson-Smart, D J; Pettigrew, A G

    1989-05-01

    Middle latency auditory evoked responses (MLAERs) were measured in 21 normal term infants, three to five days after birth and then at 6 weeks, 7 months and 1 year of age. A polyphasic waveform was elicited during natural sleep in all infants at each recording session by monaural click stimulation at a rate of 9 per second. A 70 dBHL stimulus was found to be optimal as the MLAER became less well defined when the stimulus intensity approached the threshold hearing level. The first 60 to 70 msec of the waveform was found to be most stable, with decreasing detectability of peaks at longer latencies. There was no change in wave latency or reproducibility of MLAERs recorded during different sleep states. Waves Po and Na showed a significant decrease in latency with increasing stimulus intensity at term and/or 6 weeks of age. This was not evident for the remainder of the waveform. Waves Po, Na, Pa, Nb, Pb and Nc exhibited significant decreases in latency with age, attaining values indistinguishable from adults by 7 months of age.

  4. Breast-fed low-birth-weight premature neonates: developmental assessment and nutritional intake in the first 6 months of life.

    Science.gov (United States)

    Zukowsky, Ksenia

    2007-01-01

    A secondary analysis of a randomized clinical trial in which the control group received routine breast-feeding care, consisted of women planning to breast-feed their low-birth-weight (LBW) premature infants, was conducted. The purpose of this secondary analysis was to examine the nutrition of healthy premature LBW infants and its impact on their development. A longitudinal prospective descriptive design was implemented measuring the same group of 50 healthy breast-feeding LBW premature infants from birth to 6 months corrected age. Developmental screening was performed at 6 months corrected age using the Bayley Scales of Infant Development to assess development in Mental scale, Motor scale, and Infant Behavioral record. Repeated measures analyses of variance were performed between the 3 gestational age groups and between the breast-fed and non-breast-fed groups. Bayley Scales of Infant Development Mental and Motor scales showed significant differences between the breast-fed and non-breast-fed groups at 6 months corrected age (P premature LBW infants over time was recorded and described. Nutritional assessment indicated that human milk intake in some quantity decreased from 40 weeks corrected age to 6 months corrected age: 70% to 26%. These findings can be utilized in anticipatory guidance when caring for neonates and mothers in the neonatal intensive care unit to encourage mothers to provide their own milk and strive to breast-feed.

  5. The Relationship Between Thyroxine Level and Short Term Clinical Outcome Among Sick Newborn Infants

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    Maliheh Kadivar

    2011-02-01

    Full Text Available Premature and critically sick infants frequently experience several interventions, including blood transfusions, parentral nutrition, and prescriptions during hospitalization that could affect the result of thyroid function test. This study aims to investigate the correlation between thyroxine level and clinical short term outcome among the newborn infants in the neonatal intensive care unit (NICU. We assessed serum levels of thyroxine and thyroid stimulating hormone of 99 neonates who were admitted in the NICU from September 1st 2004 to March 30th 2005. Number of patients with low thyroxin level (less than 6.5 µg/dl was determined and the relation between serum total thyroxine level and birth weight, gestational age, duration of hospitalization, clinical diagnosis, and final outcome was investigated. Short term outcome was considered as duration of hospitalization and discharge alive from hospital. Prevalence of hypothyroxinemia was 26 percent. Later assessment of thyroxine level within 3 weeks revealed normal level of this parameter (8.12 µg/dl ±1.36. Patients with lower gestational age and lower birth weight had lower thyroxine level (7.15 µg/dl ±2.56, and P=0.03, 6.72 µg/dl ±3.03, and P=0.08. Low thyroxine level was not associated with adverse short-term clinical outcome (mortality rates; 3(11% and 9(12%, and duration of hospitalization among 17.7±9.8 vs 16.7± 13.0 in patients with hypothyroxinemia and low thyroxine level respectively. Hypothyroxinemia has considerable prevalence in neonatal intensive care setting and is related with lower birth weight and gestational age. Whether thyroxin levels are a marker or mediator of short term clinical outcome remains to be determined by further studies.

  6. Gut dysbiosis following C-section instigates higher colonisation of toxigenic Clostridium perfringens in infants.

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    Nagpal, R; Tsuji, H; Takahashi, T; Nomoto, K; Kawashima, K; Nagata, S; Yamashiro, Y

    2017-05-30

    Herein we investigated the intestinal carriage of α-toxigenic and enterotoxigenic Clostridium perfringens during infancy, focusing on its association with other gut microbes and mode of delivery and feeding. Faecal samples from 89 healthy term infants were collected at age 7 days, 1 month, 3 months, 6 months and 3 years. C. perfringens was quantified by qPCR; other gut bacteria were quantified by reverse-transcription-qPCR. Alpha-toxigenic C. perfringens was detected in 3.4% infants at day 7 but was present in 35-40% infants at subsequent time-points, with counts ranging from 10 3 -10 7 cells/g faeces. Enterotoxigenic C. perfringens remained undetected at day 7 but was detected in 1.1, 4.5, 10.1 and 4.5% infants at 1 month, 3 months, 6 months and 3 years, respectively. Intriguingly, infants carrying α-toxigenic C. perfringens had lower levels of Bacteroides fragilis group, bifidobacteria, lactobacilli and organic acids as compared to non-carriers. Further analyses revealed that, compared to vaginally-born infants, caesarean-born infants had higher carriage of C. perfringens and lower levels of B. fragilis group, bifidobacteria, lactobacilli and faecal organic acids during first 6 months. Compared to formula-fed infants, breast-fed infants were slightly less often colonised with C. perfringens; and within caesarean-born infants, breast-fed infants had slightly lower levels of C. perfringens and higher levels of B. fragilis group, bifidobacteria, and lactobacilli than formula-fed infants. This study demonstrates the quantitative dynamics of toxigenic C. perfringens colonisation in infants during the early years of life. Caesarean-born infants acquire a somewhat perturbed microbiota, and breast-feeding might be helpful in ameliorating this dysbiosis. Higher carriage of toxigenic C. perfringens in healthy infants is intriguing and warrants further investigation of its sources and clinical significance in infants, particularly the caesarean-born who may represent a

  7. Postural adjustments in preterm infants at 4 and 6 months post-term during voluntary reaching in supine position.

    Science.gov (United States)

    Fallang, Bjorg; Saugstad, Ola Didrik; Hadders-Algra, Mijna

    2003-12-01

    Gradually it is getting clear that motor development - in particular balance control - in so-called "low-risk" preterm infants often differs from that in full-term infants. However, little is known on the etiology and pathophysiology of these problems. The aim of this study was to evaluate postural behavior during reaching by means of kinetic and kinematic measurements. Preterm infants (n = 32) without cerebral palsy were investigated longitudinally at the corrected ages of 4 and 6 mo. Thirteen age-matched full-term infants served as controls. Cognitive and motor development were assessed by means of the quality of General Movements (GMs) at 4 mo and Bayley scales at 6 and 12 mo. The infants were lying supine on a forceplate reaching for a toy and the kinetics of the total body's Center of Pressure (COP) was measured in cranial-caudal and medial-lateral direction. The analysis focused on COP displacement, Vmax and oscillatory changes of the COP displacement during reaching. The kinematic analysis of reaching focused on movement units, Vmax and a compound kinematic variable reflecting the quality of reaching. The results showed that preterm infants showed a remarkable "still" postural behavior, which differed significantly from the mobile COP behavior of the full-term infants. More "still" postural behavior at 6 mo was associated with a better quality of reaching movements and with normal GMs at 4 mo. We concluded that "still" postural behavior is an adequate postural strategy of preterm infants. But it might be that this postural behavior is an indicator of later dysfunction.

  8. Bioactive Proteins in Human Milk: Health, Nutrition, and Implications for Infant Formulas.

    Science.gov (United States)

    Lönnerdal, Bo

    2016-06-01

    Breast milk confers many benefits to the newborn and developing infant. There is substantial support for better long-term outcomes, such as less obesity, diabetes, and cardiovascular disease, in breastfed compared with formula-fed infants. More short-term outcomes, such as incidence and duration of illness, nutrient status, and cognitive development during the first year of life also demonstrate benefits of breastfeeding. Several proteins in breast milk, including lactoferrin, α-lactalbumin, milk fat globule membrane proteins, and osteopontin, have been shown to have bioactivities that range from involvement in the protection against infection to the acquisition of nutrients from breast milk. In some cases, bovine counterparts of these proteins exert similar bioactivities. It is possible by dairy technology to add protein fractions highly enriched in these proteins to infant formula. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Gaze Behaviors of Preterm and Full-Term Infants in Nonsocial and Social Contexts of Increasing Dynamics: Visual Recognition, Attention Regulation, and Gaze Synchrony

    Science.gov (United States)

    Harel, Hagar; Gordon, Ilanit; Geva, Ronny; Feldman, Ruth

    2011-01-01

    Although research has demonstrated poor visual skills in premature infants, few studies assessed infants' gaze behaviors across several domains of functioning in a single study. Thirty premature and 30 full-term 3-month-old infants were tested in three social and nonsocial tasks of increasing complexity and their gaze behavior was micro-coded. In…

  10. Infant feeding and idiopathic intussusception.

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    Pisacane, A; Caracciolo, G; de Luca, U; Grillo, G; Simeone, C; Impagliazzo, N; Mazzarella, G

    1993-10-01

    A case-control study showed that, compared with infants who had never been fed human milk, breast-fed infants had a relative risk of intussusception of 6.0 (95% confidence interval, 1.8 to 20.4) when breast-feeding at admission was exclusive and of 2.3 (95% confidence interval, 0.8 to 6.6) when it was partial. Exclusive breast-feeding may be a risk factor for intussusception in infancy.

  11. Adipokines in breast milk and preterm infants.

    Science.gov (United States)

    Savino, Francesco; Liguori, Stefania Alfonsina; Lupica, Maria Maddalena

    2010-07-01

    Studies have shown that the early life environment affects feeding behaviour, food intake and energy balance in later life, suggesting there is a link between foetal and infant growth and the risk of metabolic disorders in adulthood. Although there is an evident epidemiological association between low birth weight and adult-onset diseases, the incidence of metabolic diseases in adulthood among people who were born prematurely is still unknown. Considerable advances have been made during the last years in the scientific knowledge of the benefits of early nutrition, such as breastfeeding, on health and well-being later in life. Nutritional researchers have focussed their attention on the biological characteristics of human breast milk, which represents the main source of nutrients in the first months of life for breastfed infants. Recently, leptin and ghrelin have been detected in the breast milk of mothers of term and preterm infants. Adiponectin and resistin, present in term human milk, have not been investigated in the breast milk of mothers of preterm infants. These hormones are involved in the regulation of energy balance and may have a role in the regulation of growth and development in the neonatal period and infancy, as well as long-term effects on metabolic programming. Leptin, adiponectin and resistin have been found at lower levels in pre-term infants compared with term newborns, whereas there seems to be no difference in ghrelin levels. Future research is necessary to clarify the role of hormones present in breast milk for identifying potential short- and long-term effects of breastfeeding on the health of children born prematurely. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  12. Reduced Breastfeeding Rates in Firstborn Late Preterm and Early Term Infants

    Science.gov (United States)

    Alligood-Percoco, Natasha; Martin, Ashley; Zhu, Junjia; Kjerulff, Kristen H.

    2016-01-01

    Abstract Objectives: The primary objective was to determine the rate of breastfeeding by gestational age reported by new mothers 1 month postpartum, with particular focus on early term newborns (37–386/7 weeks). Materials and Methods: Three thousand six primiparous women aged 18–36 years were interviewed during their third trimester and again 1 month postpartum. Logistic regression analysis was used to model the association between gestational age and breastfeeding 1 month postpartum among those who reported that they planned to breastfeed, controlling for potentially confounding variables. Results: Two thousand seven hundred seventy-two women planned to breastfeed (92.2%), among whom 116 (4.2%) delivered late preterm (34–366/7 weeks), 519 (18.7%) early term (37–386/7 weeks), and 2,137 (77.1%) term or postterm (39+ weeks). Among those who delivered late preterm, 63.8% were breastfeeding 1 month postpartum, early term 72.6%, and term or postterm 76.5%. This relationship was verified by a multivariate logistic regression analysis; late preterm newborns were significantly less likely to be breastfeeding 1 month postpartum than the term or postterm newborns (odds ratio [OR] 0.44; 95% confidence interval [CI] 0.28–0.69; p ≤ 0.0001), as were early term newborns (OR 0.77; 95% CI 0.60–0.99; p = 0.038). Conclusions: In this large prospective study of first-time mothers and newborns, gestational age was significantly associated with breastfeeding 1 month postpartum; highlighting late preterm and early term infants as populations at risk for shortened breastfeeding duration and the need to create specific breastfeeding support and education. PMID:27007890

  13. Cardiac arrest in infants, children, and adolescents: long-term emotional and behavioral functioning.

    Science.gov (United States)

    van Zellem, Lennart; Utens, Elisabeth M; Madderom, Marlous; Legerstee, Jeroen S; Aarsen, Femke; Tibboel, Dick; Buysse, Corinne

    2016-07-01

    Very little is known about the psychological consequences of a cardiac arrest (CA) during childhood. Our aim was to assess long-term emotional and behavioral functioning, and its predictors, in survivors of CA in childhood. This long-term follow-up study involved all consecutive infants, children, and adolescents surviving CA in a tertiary-care university children's hospital between January 2002 and December 2011. Emotional and behavioral functioning was assessed with the Child Behavior Checklist (CBCL), Teacher's Report Form (TRF), and Youth Self-Report (YSR). Of the eligible 107 CA survivors, 52 patients, parents, and/or teachers filled out online questionnaires. Compared with normative data, parents and teachers reported significantly more attention and somatic problems (age range 6-18 years). Parents also reported more attention problems for age range 1.5-5 years. Twenty-eight percent of the children (n = 14) scored in the psychopathological range (i.e., for age range 1.5-18 years; p < 0.001) according to parent reports. Male gender, older age, and basic life support were significantly related to worse scores on the scales internalizing problems, externalizing problems, and total problems and subscale attention problems. Long-term deficits in attention and somatic complaints were reported. Attention problems after childhood CA can interfere with school performance. Long-term follow-up with neuropsychological assessment should be organized. • Critical illness has a significant influence on the presence of long-term emotional and behavioral problems. • Long-term emotional and behavioral problems have been described for various groups of critically ill children such as congenital heart disease, meningococcal septic shock, and neonatal asphyxia. What is new: • This is the first study that addresses long-term emotional and behavioral problems in a relatively large consecutive series of children and adolescents surviving cardiac arrest. • Long-term

  14. Incidence and predisposing factors for severe disease in previously healthy term infants experiencing their first episode of bronchiolitis.

    Science.gov (United States)

    Papoff, Paola; Moretti, Corrado; Cangiano, Giulia; Bonci, Enea; Roggini, Mario; Pierangeli, Alessandra; Scagnolari, Carolina; Antonelli, Guido; Midulla, Fabio

    2011-07-01

    To determine the incidence and predisposing factors for severe bronchiolitis in previously healthy term infants first episode of bronchiolitis. Epidemiological, clinical and virological data were prospectively collected. Severity was assessed by the need for ventilatory support. Of the 310 infants enrolled, 16 (5.1%) presented with severe bronchiolitis requiring ventilatory support (11 since admission). Compared with infants with less severe bronchiolitis, infants with severe disease presented with lower birth weight, gestational age, postnatal weight and postnatal age, and were more likely to be born by cesarian section. C-reactive protein positive results (>0.8 mg/dL) and pulmonary consolidation on chest X-ray were more common among infants with severe disease. Severity was independently associated with younger age on admission bronchiolitis is uncommon in previously healthy term infants <12 months of age and when present develops soon after disease onset. Severity is predicted by young age and RSV carriage, whereas epidemiologic variables seem less likely to intervene. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  15. Comparison of a new transcutaneous bilirubinometer (Bilimed®) with serum bilirubin measurements in preterm and full-term infants

    Science.gov (United States)

    2009-01-01

    Background The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Bilimed®, a new transcutaneous bilirubinometer, suggests more accuracy compared to the existing non-invasive bilirubinometers because of its new technology. It furthermore takes into account different skin colours. No contact with the skin is needed during measurement, no additional material costs occur. Our aim was to assess the agreement between the Bilimed® and serum bilirubin in preterm and term infants of different skin colours. Methods The transcutaneous bilirubin measurements were performed on the infant's sternum and serum bilirubin was determined simultaneously. The agreement between both methods was assessed by Pearson's correlation and by Bland-Altman analysis. Results A total of 117 measurement cycles were performed in 99 term infants (group1), further 47 measurements in 38 preterm infants born between 34 - 36 6/7 gestational weeks (group 2), and finally 21 measurements in 13 preterm infants born between 28 - 33 6/7 gestational weeks (group 3). The mean deviation and variability (+/- 2SD) of the transcutaneous from serum bilirubin were: -14 (+/- 144) μmol/l; -0.82 (+/- 8.4) mg/dl in group 1, +16 (+/- 91) μmol/l;+0.93(+/- 5.3) mg/dl in group 2 and -8 (+/- 76) μmol/l; -0.47 (+/- 4.4) mg/dl in group 3. These limits of agreement are too wide to be acceptable in a clinical setting. Moreover, there was to be a trend towards less good agreement with increasing bilirubin values. Conclusion Despite its new technology the Bilimed® has no advantages, and more specifically no better agreement not only in term and near-term Caucasian infants, but also in non-Caucasian and more premature infants. PMID:19909530

  16. Comparison of a new transcutaneous bilirubinometer (Bilimed) with serum bilirubin measurements in preterm and full-term infants.

    Science.gov (United States)

    Karen, Tanja; Bucher, Hans Ulrich; Fauchère, Jean-Claude

    2009-11-12

    The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Bilimed, a new transcutaneous bilirubinometer, suggests more accuracy compared to the existing non-invasive bilirubinometers because of its new technology. It furthermore takes into account different skin colours. No contact with the skin is needed during measurement, no additional material costs occur. Our aim was to assess the agreement between the Bilimed and serum bilirubin in preterm and term infants of different skin colours. The transcutaneous bilirubin measurements were performed on the infant's sternum and serum bilirubin was determined simultaneously. The agreement between both methods was assessed by Pearson's correlation and by Bland-Altman analysis. A total of 117 measurement cycles were performed in 99 term infants (group1), further 47 measurements in 38 preterm infants born between 34 - 36 6/7 gestational weeks (group 2), and finally 21 measurements in 13 preterm infants born between 28 - 33 6/7 gestational weeks (group 3). The mean deviation and variability (+/- 2SD) of the transcutaneous from serum bilirubin were: -14 (+/- 144) micromol/l; -0.82 (+/- 8.4) mg/dl in group 1, +16 (+/- 91) micromol/l;+0.93(+/- 5.3) mg/dl in group 2 and -8 (+/- 76) micromol/l; -0.47 (+/- 4.4) mg/dl in group 3. These limits of agreement are too wide to be acceptable in a clinical setting. Moreover, there was to be a trend towards less good agreement with increasing bilirubin values. Despite its new technology the Bilimed has no advantages, and more specifically no better agreement not only in term and near-term Caucasian infants, but also in non-Caucasian and more premature infants.

  17. Comparison of a new transcutaneous bilirubinometer (Bilimed® with serum bilirubin measurements in preterm and full-term infants

    Directory of Open Access Journals (Sweden)

    Bucher Hans

    2009-11-01

    Full Text Available Abstract Background The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Bilimed®, a new transcutaneous bilirubinometer, suggests more accuracy compared to the existing non-invasive bilirubinometers because of its new technology. It furthermore takes into account different skin colours. No contact with the skin is needed during measurement, no additional material costs occur. Our aim was to assess the agreement between the Bilimed® and serum bilirubin in preterm and term infants of different skin colours. Methods The transcutaneous bilirubin measurements were performed on the infant's sternum and serum bilirubin was determined simultaneously. The agreement between both methods was assessed by Pearson's correlation and by Bland-Altman analysis. Results A total of 117 measurement cycles were performed in 99 term infants (group1, further 47 measurements in 38 preterm infants born between 34 - 36 6/7 gestational weeks (group 2, and finally 21 measurements in 13 preterm infants born between 28 - 33 6/7 gestational weeks (group 3. The mean deviation and variability (+/- 2SD of the transcutaneous from serum bilirubin were: -14 (+/- 144 μmol/l; -0.82 (+/- 8.4 mg/dl in group 1, +16 (+/- 91 μmol/l;+0.93(+/- 5.3 mg/dl in group 2 and -8 (+/- 76 μmol/l; -0.47 (+/- 4.4 mg/dl in group 3. These limits of agreement are too wide to be acceptable in a clinical setting. Moreover, there was to be a trend towards less good agreement with increasing bilirubin values. Conclusion Despite its new technology the Bilimed® has no advantages, and more specifically no better agreement not only in term and near-term Caucasian infants, but also in non-Caucasian and more premature infants.

  18. Postnatal weight loss in term infants: what is normal and do growth charts allow for it?

    Science.gov (United States)

    Wright, C M; Parkinson, K N

    2004-05-01

    Although it is a well known phenomenon, limited normative data on neonatal weight loss and subsequent gain are available, making it hard to assess individual children with prolonged weight loss. To establish, using data from a large prospective population based cohort study, norms and limits for postnatal weight loss and its impact on current growth reference charts. A cohort of 961 term infants were recruited at birth and followed using parental questionnaires and community nursing returns. Routine weights were collected for half the cohort at 5 days and for all at 12 days and 6 weeks. Less weight loss was seen than the 3-6% suggested by previous studies, but one in five infants had not regained their birth weight by 12 days. Those lightest at birth showed least weight loss. Twenty six (3%) children had more than 10% weight loss, but none showed evidence of major organic disease. Actual weights in the first fortnight are half to one centile space lower than growth charts suggest, while birthweight centiles for children born at 37 weeks were two centile spaces lower. Neonatal weight loss is brief, with few children remaining more than 10% below birth weight after 5 days. Growth charts are misleading in the first 2 weeks, because they make no allowance for neonatal weight loss.

  19. Trends of abnormal birthweight among full-term infants in Newfoundland and Labrador.

    Science.gov (United States)

    Edwards, Nicole M; Audas, Richard P

    2010-01-01

    The objective of this study was to investigate whether any observed trends in birthweight are accompanied by changes in maternal sociodemographic characteristics, including age, marital status, and education. We conducted a population-based study of term singletons born in Newfoundland and Labrador, Canada, between 1992 and 2005 (N = 66,638). Large-sample significance tests for two population proportions were used to test whether differences in mean birthweight, the proportion of low and high birthweight infants, and differences in maternal socio-demographic characteristics between 1992-95 and 2002-05 were statistically significant. Chi-square tests were used to test for associations between birthweight group and maternal age, education and marital status. Multivariate logistic regression was used to examine the interaction of these effects across time periods. Of the 66,638 infants included in the study, 54,256 (81.4%) were born in the normal birthweight range (2500-4000 grams) while 11,305 (17.0%) were high birthweight (> 4000 grams) and 1,077 (1.6%) were low birthweight (Newfoundland and Labrador.

  20. "The effect of fluid supplementation on serum bilirubin level during phototerapy in term infants "

    Directory of Open Access Journals (Sweden)

    Torkaman M

    2007-04-01

    Full Text Available Background: Jaundice is a common and benign problem in neonatal period. Several therapeutic procedures for decreasing of serum bilirubin level has been recommended. phototherapy is most common them. Our goal Form this study is the evaluation of serum therapy effects in decreasing of serum bilirubin concentration in icteric infants that are treated with phototherapy. Methods: This is a prospective clinical trial in Najmeih Hospital in 2002. In this study 80 term icteric infants with bilirubin level greater than 17 mg/dl were randomized in two groups, both groups underwent phototherapy and in the case group intravenous fluid supplementation was added. There were no significant differences in the mean gestational age, birth weight, hemoglobin, and also in total serum bilirubin level at admission in the two groups. Results: There were no significant differences in the mean rate of of serum bilirubin level decline during first 24 and 48 hours of hospitalization and also the time of bilirubin decreasing to less than 15 mg/dl and the length of hospitalization in two groups. Conclution: Our study showed intravenous fluid supplementation could be limited to special cases of neonatal icter such as moderate to severe dehydration.

  1. Breast-Feeding and Diabetes: Long-Term Impact on Mothers and Their Infants

    Science.gov (United States)

    Gunderson, Erica P.

    2010-01-01

    In the general population, breast-feeding is associated with a reduced risk of the offspring being overweight later in life by 22% to 24% across the age spectrum, from preschool children to adults. There is a dose-response gradient with increasing duration of breast-feeding, and lowest risk with prolonged, exclusive breast-feeding. Breast-feeding has been shown to slow infant growth up to 2 years of age. By contrast, the scientific evidence is inconclusive about whether breast-feeding protects against the onset of overweight and subsequent development of type 2 diabetes among offspring whose mothers had diabetes during pregnancy. Moreover, evidence is insufficient to determine if lactation protects against development of type 2 diabetes later in life in women with a diabetes history during pregnancy. Given the paucity of the evidence and equivocal findings about the long-term effects of breast-feeding on future health of women with diabetes during pregnancy and their infants, further research is recommended. PMID:18631440

  2. Tolerance of natural baby skin-care products on healthy, full-term infants and toddlers

    Directory of Open Access Journals (Sweden)

    Coret CD

    2014-02-01

    Full Text Available Catherine D Coret, Michael B Suero, Neena K Tierney Johnson & Johnson Consumer Companies, Inc, Skillman, NJ, USA Purpose: To evaluate the tolerance of baby skin-care products with at least 95% naturally derived ingredients on infants and toddlers. Materials and methods: Healthy, full-term infants and toddlers aged 1–36 months were enrolled. In study 1, a lightly fragranced natural baby hair and body wash (n=30, a lightly fragranced natural baby shampoo (n=30, or a lightly fragranced natural baby lotion (n=32 were assessed over 2 weeks. In study 2, a lightly fragranced natural baby hair and body wash and a lightly fragranced natural baby lotion (n=33 were assessed as a regimen over 4 weeks. The wash and shampoo were used three or more times per week, but not more than once daily. Lotions were applied in the morning or after a bath. Clinicians assessed the arms, legs, torso, or scalp for erythema, dryness, peeling/flakiness (study 1 only, tactile roughness, edema (study 1 only, rash/irritation (study 2 only, and overall skin condition (study 2 only at baseline, week 1, and weeks 2 or 4. Parents completed skin assessment questionnaires. In study 2, stratum corneum hydration was measured. Subjects were monitored for adverse events. Results: No significant changes in clinical grading scores were observed, indicating that all products were well tolerated. By the end of each study, >90% of parents/caregivers believed each product was mild and gentle. In study 2, improvement in stratum corneum hydration was observed (+37% at week 1 and +48% at week 4, P<0.05 for both. In study 1, one baby experienced mild erythema on the neck and scalp after using the shampoo (possibly related to treatment. In study 2, there were no product-related adverse events. Conclusion: The natural baby skin-care products were well tolerated by infants and toddlers when used alone or as part of a skin-care regimen. Keywords: bath, cleanser, natural, infant, lotion, shampoo

  3. Parity and risk of low birth weight infant in full term pregnancy

    Directory of Open Access Journals (Sweden)

    Lelly Andayasari

    2016-07-01

    birth during the period of January 1 to December 31, 2011. Multivariat logistic regression model was used to analyze the risks of low birth weight. Results: From a total of 4191 sample size, 2242 met the inclusion criteria and used for analysis. The proportion of  low birth weight was 9.5% nulliparous increased 1.6 fold higher  risk  to have low birth weight baby compared to multiparous (P=0.010, meanwhile  primiparous and multiparous had the same risk to have a low birth weight baby (0.614. In term of sex of infant, male infant had 1.4 fold higher risk of having low birth weight than the female infant(P=0.017. Conclusion: Nulliparous women and female infant were at higher risk of  having low birth weight. Keyword: parity, sex of infant, low birth weight

  4. Lung Volume, Breathing Pattern and Ventilation Inhomogeneity in Preterm and Term Infants

    NARCIS (Netherlands)

    Latzin, Philipp; Roth, Stefan; Thamrin, Cindy; Hutten, Gerard J.; Pramana, Isabelle; Kuehni, Claudia E.; Casaulta, Carmen; Nelle, Matthias; Riedel, Thomas; Frey, Urs

    2009-01-01

    Background: Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants,

  5. Effect of Breast-Feeding and Maternal Holding in Relieving Painful Responses in Full-Term Neonates: A Randomized Clinical Trial.

    Science.gov (United States)

    Obeidat, Hala M; Shuriquie, Mona A

    2015-01-01

    This randomized clinical trial was conducted to determine the efficacy of breast-feeding with maternal holding as compared with maternal holding without breast-feeding in relieving painful responses during heel lance blood drawing in full-term neonates. A convenience sample of 128 full-term newborn infants, in their fourth to sixth days of life, undergoing heel lance blood drawing for screening of hypothyroidism were included in the study. The neonates were randomly assigned into 2 equivalent groups. During heel lance blood drawing for infants, they either breast-fed with maternal holding (group I) or were held in their mother's lap without breast-feeding (group II). The painful responses were assessed simultaneously by 2 neonatal nurses blinded to the purpose of the study. Outcome measures for painful responses of the full-term neonates were evaluated with the Premature Infant Pain Profile scale. Independent t test showed significant differences in Premature Infant Pain Profile scale scores among the 2 groups (t = -8.447, P = .000). Pain scores were significantly lower among infants who were breast-fed in addition to maternal holding. Evidence from this study indicates that the combination of breast-feeding with maternal holding reduces painful responses of full-term infants during heel lance blood drawing.

  6. Infant feeding and growth trajectory patterns in childhood and body composition in young adulthood.

    Science.gov (United States)

    Rzehak, Peter; Oddy, Wendy H; Mearin, M Luisa; Grote, Veit; Mori, Trevor A; Szajewska, Hania; Shamir, Raanan; Koletzko, Sibylle; Weber, Martina; Beilin, Lawrence J; Huang, Rae-Chi; Koletzko, Berthold

    2017-08-01

    Background: Growth patterns of breastfed and formula-fed infants may differ, with formula-fed infants growing more rapidly than breastfed infants into childhood and adulthood. Objective: Our objectives were to identify growth patterns and investigate early nutritional programming potential on growth patterns at 6 y and on body composition at 20 y. Design: The West Australian Pregnancy Cohort (Raine) Study and 3 European cohort studies (European Childhood Obesity Trial, Norwegian Human Milk Study, and Prevention of Coeliac Disease) that collaborate in the European Union-funded Early Nutrition project combined, harmonized, and pooled data on full breastfeeding, anthropometry, and body composition. Latent growth mixture modeling was applied to identify growth patterns among the 6708 individual growth trajectories. The association of full breastfeeding for composition at 20 y among the identified trajectory classes were tested by analysis of variance. Results: Three body mass index (BMI; in kg/m 2 ) trajectory patterns were identified and labeled as follows-class 1: persistent, accelerating, rapid growth (5%); class 2: early, nonpersistent, rapid growth (40%); and class 3: normative growth (55%). A shorter duration of full breastfeeding for composition at 20 y ( P composition in young adulthood. Rapid-growth patterns in early childhood could be a mediating link between infant feeding and long-term obesity risk. © 2017 American Society for Nutrition.

  7. Child-rearing history and emotional bonding in parents of preterm and full-term infants

    NARCIS (Netherlands)

    Hall, R.A.S.; Hoffenkamp, H.N.; Tooten, A.; Braeken, J.; Vingerhoets, A.J.J.M.; van Bakel, H.J.A.

    2015-01-01

    Some parents fail to develop strong emotional bonds with their newborn infants. As the quality of the parent–infant relationship contributes to the infant’s development, it is of great importance to identify protective and risk factors that facilitate or impede the development of the parent–infant

  8. Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire.

    Science.gov (United States)

    Becquet, Renaud; Leroy, Valériane; Ekouevi, Didier K; Viho, Ida; Castetbon, Katia; Fassinou, Patricia; Dabis, François; Timite-Konan, Marguerite

    2006-04-01

    In high HIV prevalence resource-constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status. A prospective cohort study in Abidjan, Côte d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated. Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly

  9. Human milk peptides differentiate between the preterm and term infant and across varying lactational stages.

    Science.gov (United States)

    Dingess, Kelly A; de Waard, Marita; Boeren, Sjef; Vervoort, Jacques; Lambers, Tim T; van Goudoever, Johannes B; Hettinga, Kasper

    2017-10-18

    Variations in endogenous peptide profiles, functionality, and the enzymes responsible for the formation of these peptides in human milk are understudied. Additionally, there is a lack of knowledge regarding peptides in donor human milk, which is used to feed preterm infants when mother's own milk is not (sufficiently) available. To assess this, 29 human milk samples from the Dutch Human Milk Bank were analyzed as three groups, preterm late lactation stage (LS) (n = 12), term early (n = 8) and term late LS (n = 9). Gestational age (GA) groups were defined as preterm (24-36 weeks) and term (≥37 weeks). LS was determined as days postpartum as early (16-36 days) or late (55-88 days). Peptides, analyzed by LC-MS/MS, and parent proteins (proteins from matched peptide sequences) were identified and quantified, after which peptide functionality and the enzymes responsible for protein cleavage were determined. A total of 16 different parent proteins were identified from human milk, with no differences by GA or LS. We identified 1104 endogenous peptides, of which, the majority were from the parent proteins β-casein, polymeric immunoglobulin receptor, αs1-casein, osteopontin, and κ-casein. The absolute number of peptides differed by GA and LS with 30 and 41 differing sequences respectively (p human milk peptides. These results explain some of the variation in endogenous peptides in human milk, leading to future targets that may be studied for functionality.

  10. Rates of and factors associated with delivery-related perinatal death among term infants in Scotland.

    Science.gov (United States)

    Pasupathy, Dharmintra; Wood, Angela M; Pell, Jill P; Fleming, Michael; Smith, Gordon C S

    2009-08-12

    Rates of obstetric intervention in labor, including cesarean delivery, have increased significantly in most developed countries. It is, however, unclear if this has been paralleled by decreased rates of perinatal and neonatal death associated with complications of labor at term. To determine whether rates of perinatal death at term, either during labor or in the neonatal period, have changed in Scotland during the last 20 years and whether this was associated with a reduction in deaths ascribed to intrapartum anoxia. A population-based, retrospective cohort study of linked data from a registry of births (Scottish Morbidity Record 02) and a registry of perinatal deaths (Scottish Stillbirth and Infant Death Survey) between 1988 and 2007. Participants included all births of a singleton infant in a cephalic presentation at term (N = 1,012,266), excluding those with perinatal death due to congenital anomaly or antepartum stillbirth. Delivery-related perinatal death, defined as intrapartum stillbirth or neonatal death unrelated to congenital abnormality. These events were also subdivided into those events ascribed to intrapartum anoxia and all other causes. The risk of death was modeled using logistic regression and analyses were adjusted for maternal age, height, parity, socioeconomic deprivation status, gestational age, birth weight percentile, fetal sex, onset of labor, and the annual number of births per hospital. During the study period, the risk of delivery-related perinatal death decreased from 8.8 to 5.5 per 10,000 births (unadjusted change, -38%; 95% confidence interval [CI], -51% to -21%). When analyzed by the cause of death, there was a significant decrease in the risk of death ascribed to intrapartum anoxia (5.7 to 3.0 per 10,000 births; unadjusted change, -48%; 95% CI, -62% to -29%), but no significant change in the risk of death ascribed to other causes. When deaths ascribed to intrapartum anoxia were analyzed by the time of death in relation to delivery

  11. Effect of infant and follow-on formulas containing B lactis and galacto- and fructo-oligosaccharides on infection in healthy term infants.

    Science.gov (United States)

    Bocquet, Alain; Lachambre, Emmanuelle; Kempf, Christian; Beck, Laurence

    2013-08-01

    The aim of the present study was to compare the effect of Bifidobacterium animalis subspecies lactis (B lactis) alone or with 90% galacto-oligosaccharide (GOS) and 10% fructo-oligosaccharide (FOS) on infections in infants. In a multicenter trial, healthy, term, newborn infants ages 42 days or younger whose mothers had decided not to breast-feed beyond this age received infant and follow-on formulas containing B lactis (10 colony-forming units/g) + GOS/FOS (0.4 g/100 mL, intention-to-treat, n = 261) or B lactis alone (10⁷ colony-forming units/g, intention-to-treat, n = 267). Investigators accessed computer-generated randomization sequences via a remote server. Infants were exclusively fed formulas until 4 to 6 months of age and along with complementary feeding thereafter up to 12 months. The primary outcome was the mean number of annual infections reported by the investigators. Secondary outcomes were mean gains in anthropometric measurements, frequency of antibiotic use, and occurrence of adverse events based on investigators' records at each visit and gastrointestinal tolerance (daily stool frequency and consistency) and volume of formula intake recorded in 6-day diaries by parents. Mean ± standard deviation infection rates in infants followed up to 12 months (full analysis set) were 4.9 ± 3.2 per infant per year in the B lactis + GOS/FOS group (n = 219) and 4.5 ± 3.0 per infant per year in the B lactis group (n = 220; analysis of variance, P = 0.18). Mean daily weight gain was slightly lower in the B lactis + GOS/FOS than the B lactis group (16.1 ± 2.9 vs 16.6 ± 2.6 g/day, P = 0.046), but was not clinically significant. Other outcomes were not significantly different between groups. Formulas containing B lactis + GOS/FOS did not reduce infection rates beyond those containing only B lactis.

  12. Very pre-term infants' behaviour at 1 and 2 years of age and parental stress following basic developmental care

    NARCIS (Netherlands)

    Pal, S.M. van der; Maguire, C.M.; Bruil, J.; Cessie, S. le; Zwieten, P. van; Veen, S.; Wit, J.M.; Walther, F.J.

    2008-01-01

    This study explored the effects of basic developmental care on the behaviour of very pre-term infants and parental stress at I and 2 years of corrected age. A randomized controlled trial was done to compare basic Developmental Care (standardized nests and incubator covers) and controls (standard

  13. Central cortico-subcortical involvement: a distinct pattern of brain damage caused by perinatal and postnatal asphyxia in term infants

    NARCIS (Netherlands)

    Rademakers, R. P.; van der Knaap, M. S.; Verbeeten, B.; Barth, P. G.; Valk, J.

    1995-01-01

    The MR findings in a characteristic pattern of hypoxic-ischemic brain damage in term infants are described. The MR images of seven patients with cerebral palsy and a specific pattern of central cortico-subcortical cerebral damage were studied retrospectively and correlated with clinical findings.

  14. [Risks factors associated with intra-partum foetal mortality in pre-term infants].

    Science.gov (United States)

    Zeballos Sarrato, Susana; Villar Castro, Sonia; Ramos Navarro, Cristina; Zeballos Sarrato, Gonzalo; Sánchez Luna, Manuel

    2017-03-01

    Pre-term delivery is one of the leading causes of foetal and perinatal mortality. However, perinatal risk factors associated with intra-partum foetal death in preterm deliveries have not been well studied. To analyse foetal mortality and perinatal risk factors associated with intra-partum foetal mortality in pregnancies of less than 32 weeks gestational age. The study included all preterm deliveries between 22 and 31 +1 weeks gestational age (WGA), born in a tertiary-referral hospital, over a period of 7 years (2008-2014). A logistic regression model was used to identify perinatal risk factors associated with intra-partum foetal mortality (foetal malformations and chromosomal abnormalities were excluded). During the study period, the overall foetal mortality was 63.1% (106/168) (≥22 weeks of gestation) occurred in pregnancies of less than 32 WGA. A total of 882 deliveries between 22 and 31+6 weeks of gestation were included for analysis. The rate of foetal mortality was 11.3% (100/882). The rate of intra-partum foetal death was 2.6% (23/882), with 78.2% (18/23) of these cases occurring in hospitalised pregnancies. It was found that Assisted Reproductive Techniques, abnormal foetal ultrasound, no administration of antenatal steroids, lower gestational age, and small for gestational age, were independent risk factors associated with intra-partum foetal mortality. This study showed that there is a significant percentage intra-partum foetal mortality in infants between 22 and 31+6 WGA. The analysis of intrapartum mortality and risk factors associated with this mortality is of clinical and epidemiological interest to optimise perinatal care and improve survival of preterm infants. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Normative Data for Bone Mass in Healthy Term Infants from Birth to 1 Year of Age

    Directory of Open Access Journals (Sweden)

    Sina Gallo

    2012-01-01

    Full Text Available For over 2 decades, dual-energy X-ray absorptiometry (DXA has been the gold standard for estimating bone mineral density (BMD and facture risk in adults. More recently DXA has been used to evaluate BMD in pediatrics. However, BMD is usually assessed against reference data for which none currently exists in infancy. A prospective study was conducted to assess bone mass of term infants (37 to 42 weeks of gestation, weight appropriate for gestational age, and born to healthy mothers. The group consisted of 33 boys and 26 girls recruited from the Winnipeg Health Sciences Center (Manitoba, Canada. Whole body (WB as well as regional sites of the lumbar spine (LS 1–4 and femur was measured using DXA (QDR 4500A, Hologic Inc. providing bone mineral content (BMC for all sites and BMD for spine. During the year, WB BMC increased by 200% (76.0±14.2 versus 227.0±29.7 g, spine BMC by 130% (2.35±0.42 versus 5.37±1.02 g, and femur BMC by 190% (2.94±0.54 versus 8.50±1.84 g. Spine BMD increased by 14% (0.266±0.044 versus 0.304±0.044 g/cm2 during the year. This data, representing the accretion of bone mass during the first year of life, is based on a representative sample of infants and will aid in the interpretation of diagnostic DXA scans by researchers and health professionals.

  16. Gender-related differences of inguinal hernia and asymptomatic patent processus vaginalis in term and preterm infants.

    Science.gov (United States)

    Burgmeier, Christine; Dreyhaupt, Jens; Schier, Felix

    2015-03-01

    The aim of this study was to analyze the gender-related differences of inguinal hernia (IH) and patent processus vaginalis (PPV) in term and preterm infants. Over a nine-year-period 411 infants underwent laparoscopic herniorrhaphy within the first six months of life. 246 term (191 male; 55 female) and 165 preterm (118 male; 47 female) infants were included in this retrospective study. Initial presentation of IH and intraoperative anatomical findings of PPV were reviewed. We found that term boys (58.6%) and girls (58.2%) predominantly presented with right-sided IH whereas preterm boys (36.4%) and girls (44.7%) mostly presented with bilateral IH. Female babies had a higher incidence of initial left-sided IH. Term and preterm girls with initial left-sided hernia were found to have highest incidence of PPV. Male term babies with initial left-sided IH were found to have the lowest incidence of PPV (25.0%). The highest incidence of PPV in male was found in preterm boys with either left- or right-sided IH. Incidence and laterality of IH and PPV differ between term and preterm girls and boys. In open hernia repair decision concerning contralateral groin exploration should consider term/preterm birth as well as gender. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Diet and the faecal microflora of infants, children and adults in rural Nigeria and urban U.K.

    OpenAIRE

    Tomkins, A. M.; Bradley, A. K.; Oswald, S.; Drasar, B. S.

    1981-01-01

    The faecal microflora of breast-fed infants, weaned children and adults has been examined in rural Nigeria and urban U.K. Breast-fed infants had a similar anaerobic flora dominated by bifidobacteria but bacteroides were isolated in less than a quarter of either community. Weaned children in both communities had greater numbers of bacteroides and clostridia than breast-fed infants. Even higher numbers of bacteroides and clostridia were present in U.K. adults but not in Nigerian adults. Numbers...

  18. Failure to Thrive in the Term and Preterm Infants of Mothers Depressed in the Postnatal Period: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Drewett, Robert; Blair, Peter; Emmett, Pauline; Emond, Alan

    2004-01-01

    Aims: To examine the relationship between failure to thrive in preterm and term infants and postnatal depression in their mothers. Method: In a whole population birth cohort of 12,391 infants (excluding those born after term or with major congenital abnormalities) failure to thrive over the first nine months was identified using a conditional…

  19. Early skin-to-skin contact for healthy full-term infants after vaginal and caesarean delivery : A qualitative study on clinician perspectives

    NARCIS (Netherlands)

    Koopman, Inez; Callaghan-Koru, Jennifer A.; Alaofin, Oluwatope; Argani, Cynthia H.; Farzin, Azadeh

    2016-01-01

    Aims and objectives: This study aims to provide insight into key factors from a clinician's perspective that influence uninterrupted early skin-to-skin contact after vaginal and caesarean delivery of healthy full-term infants. Background: Early skin-to-skin contact of healthy full-term infants

  20. Effects of Joint Attention on Long-Term Memory in 9-Month-Old Infants: An Event-Related Potentials Study

    Science.gov (United States)

    Kopp, Franziska; Lindenberger, Ulman

    2011-01-01

    Joint attention develops during the first year of life but little is known about its effects on long-term memory. We investigated whether joint attention modulates long-term memory in 9-month-old infants. Infants were familiarized with visually presented objects in either of two conditions that differed in the degree of joint attention (high…

  1. Etiology and Short-term Outcome of First Seizure in Hospitalized Infants.

    Science.gov (United States)

    Nikunj, Niraj Kumar; Mishra, Devendra; Juneja, Monica; Talukdar, Bibek

    2016-10-08

    We enrolled 75 consecutive infants presenting with history of first seizure at a tertiary care hospital in New Delhi, India. Clinical and biochemical work-up for etiology, and electroencephalography were performed in all infants. Developmental assessment was done 3-month after discharge. 72% had generalized seizures, and fever was the commonest co-morbidity (57.3%). 68% had provoked seizures, mainly due to hypocalcemia (34.3%) or neuro-infections (29.3%). Seven (9.3%) infants died during hospital stay; mostly those with neuro-infections. 13 (20.3%) infants had developmental delay.

  2. Effect of oronasopharyngeal suction on arterial oxygen saturation in normal, term infants delivered vaginally: a prospective randomised controlled trial.

    Science.gov (United States)

    Modarres Nejad, V; Hosseini, R; Sarrafi Nejad, A; Shafiee, G

    2014-07-01

    Oronasopharyngeal suction (ONPS) with a suction bulb at birth is a traditional practice in the initial management of healthy infants in Iran and many other countries. The purpose of this study was to compare the effects of oronasopharyngeal suction (ONPS) with those of no suction in normal, term newborns delivered vaginally. A total of 170 healthy term infants of first and single uncomplicated pregnancies, with clear amniotic fluid, vaginal delivery and cephalic presentation, enrolled in the trial during labour. Newborns were randomised into one of the two groups, according to the use of the ONPS procedure. Arterial oxygen saturation (SaO2) levels, heart rates, blood gases of umbilical cord and Apgar scores were determined. The mean SaO2 values over the first and fifth min of birth were similar in the two groups. The maximum time to reach SaO2 of ≥ 92% was shorter in the no suction group. There were no statistically significant differences in the mean of heart rates, respiratory rates and Apgar scores between the groups. Apgar scores at 5 and 10 min were between 8 and 10 for all infants, respectively. Newborns receiving suction showed a statistically significant, lower mean partial carbon dioxide pressure (PCO2) and a significantly higher partial oxygen pressure (PO2) of umbilical artery. Although the differences were statistically significant, these were not considered clinically significant because values remained within normal ranges. According to this study, ONPS is not recommended as a routine procedure in normal, term infants delivered vaginally.

  3. Factors associated with weaning practices in term infants: a prospective observational study in Ireland.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2010-11-01

    The WHO (2001) recommends exclusive breast-feeding and delaying the introduction of solid foods to an infant\\'s diet until 6 months postpartum. However, in many countries, this recommendation is followed by few mothers, and earlier weaning onto solids is a commonly reported global practice. Therefore, this prospective, observational study aimed to assess compliance with the WHO recommendation and examine weaning practices, including the timing of weaning of infants, and to investigate the factors that predict weaning at ≤ 12 weeks. From an initial sample of 539 pregnant women recruited from the Coombe Women and Infants University Hospital, Dublin, 401 eligible mothers were followed up at 6 weeks and 6 months postpartum. Quantitative data were obtained on mothers\\' weaning practices using semi-structured questionnaires and a short dietary history of the infant\\'s usual diet at 6 months. Only one mother (0.2%) complied with the WHO recommendation to exclusively breastfeed up to 6 months. Ninety-one (22.6%) infants were prematurely weaned onto solids at ≤ 12 weeks with predictive factors after adjustment, including mothers\\' antenatal reporting that infants should be weaned onto solids at ≤ 12 weeks, formula feeding at 12 weeks and mothers\\' reporting of the maternal grandmother as the principal source of advice on infant feeding. Mothers who weaned their infants at ≤ 12 weeks were more likely to engage in other sub-optimal weaning practices, including the addition of non-recommended condiments to their infants\\' foods. Provision of professional advice and exploring antenatal maternal misperceptions are potential areas for targeted interventions to improve compliance with the recommended weaning practices.

  4. The Long-Term Public Health Benefits of Breastfeeding.

    Science.gov (United States)

    Binns, Colin; Lee, MiKyung; Low, Wah Yun

    2016-01-01

    Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer. © 2015 APJPH.

  5. Short-term outcome of newborn infants: spinal versus general anesthesia for elective cesarean section. A prospective randomized study.

    Science.gov (United States)

    Kavak, Z N; Başgül, A; Ceyhan, N

    2001-12-10

    To compare general and spinal anesthesia with respect to the short-term outcome of newborns born by elective cesarean deliveries. Pregnant women admitted to our hospital from January 1999 to July 2000, for whom elective repeat cesareans were planned after 37 weeks gestation, were allocated randomly after their informed consent to spinal anesthesia or general anesthesia. Maternal age, gestational age, birth weight, Apgar's score, hospital stay duration, and duration of cesarean section time were all noted. The rate of the neonatal respiratory depression, perinatal asphyxia, and admittance to the neonatal intensive care unit of the infants were documented. We also studied arterial samples withdrawn from the cord for the pH, bicarbonate, PaO(2) (oxygen pressure, arterial), and PaCO(2) (carbon dioxide pressure, arterial). The serum levels of creatine kinase with myocardial-specific isoform, aspartate aminotransferase, alanine aminotransferase, and total cortisol levels of the newborns were measured and served in ruling out perinatal stress and in confirming the diagnosis of perinatal asphyxia (and of myocardial damage). Statistical analyses was performed with the use of an unpaired Student's t-test, Chi-square test, and a power calculation was done. From the randomly selected patients, we had 38 (45.2%) infants for general anesthesia and 46 (54.8%) for spinal anesthesia. None of our primary endpoints favored any of the study groups, and the clinical short-term outcome of the infants was similar in the neonates born both by spinal and general anesthesia (P>0.05). The biochemical assays did not rule out or confirm any differences in the occurrence of perinatal stress (P>0.05). Anesthesia type does not seem to influence the short-term outcome of the newborn infants for the elective cesarean deliveries. We believe that both spinal and general anesthesia could be performed in elective term cesarean deliveries without any risk to the newborn infants.

  6. Development of iron homeostasis in infants and young children.

    Science.gov (United States)

    Lönnerdal, Bo

    2017-12-01

    Healthy, term, breastfed infants usually have adequate iron stores that, together with the small amount of iron that is contributed by breast milk, make them iron sufficient until ≥6 mo of age. The appropriate concentration of iron in infant formula to achieve iron sufficiency is more controversial. Infants who are fed formula with varying concentrations of iron generally achieve sufficiency with iron concentrations of 2 mg/L (i.e., with iron status that is similar to that of breastfed infants at 6 mo of age). Regardless of the feeding choice, infants' capacity to regulate iron homeostasis is important but less well understood than the regulation of iron absorption in adults, which is inverse to iron status and strongly upregulated or downregulated. Infants who were given daily iron drops compared with a placebo from 4 to 6 mo of age had similar increases in hemoglobin concentrations. In addition, isotope studies have shown no difference in iron absorption between infants with high or low hemoglobin concentrations at 6 mo of age. Together, these findings suggest a lack of homeostatic regulation of iron homeostasis in young infants. However, at 9 mo of age, homeostatic regulatory capacity has developed although, to our knowledge, its extent is not known. Studies in suckling rat pups showed similar results with no capacity to regulate iron homeostasis at 10 d of age when fully nursing, but such capacity occurred at 20 d of age when pups were partially weaned. The major iron transporters in the small intestine divalent metal-ion transporter 1 (DMT1) and ferroportin were not affected by pup iron status at 10 d of age but were strongly affected by iron status at 20 d of age. Thus, mechanisms that regulate iron homeostasis are developed at the time of weaning. Overall, studies in human infants and experimental animals suggest that iron homeostasis is absent or limited early in infancy largely because of a lack of regulation of the iron transporters DMT1 and ferroportin

  7. Cochlear function in 1-year-old term infants born with hypoxia-ischaemia or low Apgar scores.

    Science.gov (United States)

    Jiang, Ze D; Zang, Zeng; Wilkinson, Andrew R

    2012-02-01

    To examine the influence of perinatal hypoxia-ischaemia (HI) or low Apgar scores on distortion product otoacoustic emissions (DPOAEs) in infants at 1 year and detect any postnatal changes. Eighty-eight term infants born with perinatal HI or low Apgar scores alone were recruited at 1 year of age. The ears with type A tympanogram (normal) were studied with DPOAEs at 10 frequencies between 0.5 kHz and 10 kHz. DPOAE pass rates were decreased at all frequencies 1-10 kHz, particularly 1 and 2 kHz in both infants born with HI and those with low Apgar scores (χ(2) = 3.80-15.09, P Apgar score. Compared with those recorded at 1 and 6 months, DPOAE pass rates at 1 year were increased slightly in infants born with HI, but showed no marked changes in those born with low Apgar scores. DPOAE pass rates, mainly at 1 and 2 kHz, were decreased at 1 year in infants born with perinatal HI and low Apgar scores, suggesting a relative poor cochlear function. Further studies are needed to ascertain the hearing acuity. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  8. Fiber tracking at term displays gender differences regarding cognitive and motor outcome at 2 years of age in preterm infants.

    Science.gov (United States)

    van Kooij, Britt J M; van Pul, Carola; Benders, Manon J N L; van Haastert, Ingrid C; de Vries, Linda S; Groenendaal, Floris

    2011-12-01

    White matter microstructural changes can be detected with diffusion tensor imaging. It was hypothesized that diffusion parameters in the posterior limb of the internal capsule (PLIC) and corpus callosum (CC) bundles in preterm infants at term equivalent age (TEA) were associated with neurodevelopment at 2 y corrected age. In 67 preterm infants, fiber tracking was performed at TEA for the CC and both PLIC bundles. Volume, length, fractional anisotropy (FA), mean diffusivity, axial diffusivity, and radial diffusivity were determined for the three bundles. These parameters were assessed in relation to outcome on the Bayley Scales of Infant and Toddler Development III. In girls, volume and length of the CC bundle and right PLIC bundle volume were associated with cognition. In boys, volume, FA, mean and radial diffusivity, and length of the left PLIC were associated with fine motor scores. Correction for GA, birth weight, intraventricular hemorrhage, white matter injury, and maternal education did not change the results. Fiber tracking parameters in the PLIC and CC bundles in preterm infants at TEA revealed different associations with neurodevelopment between boys and girls. This study suggested that fiber tracking is a useful method to predict neurodevelopment in preterm infants.

  9. Effectiveness of zinc supplementation to full term normal infants: a community based double blind, randomized, controlled, clinical trial.

    Directory of Open Access Journals (Sweden)

    K V Radhakrishna

    Full Text Available UNLABELLED: The study was aimed to test whether zinc supplementation, if initiated early, can prevent stunting and promote optimum body composition in full term infants. For this, full term pregnant women from low income urban community were enrolled and were followed-up for 24 months postpartum. Body mass index (BMI was calculated from maternal weight and height that were collected one month after delivery. Infants' weight, and length, head, chest and mid upper arm circumferences and skin fold thicknesses at triceps, biceps and subscapular area were collected at baseline (before randomization and once in three months up till 24 months. Three hundred and twenty four infants were randomized and allocated to zinc (163 or placebo (161 groups respectively. Supplementation of zinc was initiated from 4 months of age and continued till children attained 18 months. The control (placebo group of children received riboflavin 0.5 mg/day, whereas the intervention (zinc group received 5 mg zinc plus riboflavin 0.5 mg/day. When infants were 18 months old, dietary intakes (in 78 children were calculated by 24 hour diet recall method and hemoglobin, zinc, copper and vitamin A were quantified in blood samples collected from 70 children. The results showed prevalence of undernutrition (body mass index <18.5 in 37% of the mothers. Mean±SD calorie consumption and zinc intakes from diets in infants were 590±282.8 Kcal/day and 0.97±0.608 mg/day respectively. Multiple linear regression models demonstrated maternal weight as a strong predictor of infants' weight and length at 18 months of age. As expected, diarrhea duration impacted infants' linear growth and weight gain adversely. Zinc supplementation for a mean period of 190 days, starting from 4 months up to 18 months of age, in full term normal infants, consuming an average energy of 590 Kcal/day, had significant effect on the skin fold thicknesses, but not on their linear growth. TRIAL REGISTRATION: Clinical

  10. Regulatory competence and social communication in term and preterm infants at 12 months corrected age. Results from a randomized controlled trial.

    Science.gov (United States)

    Olafsen, Kåre S; Rønning, John A; Handegård, Bjørn Helge; Ulvund, Stein Erik; Dahl, Lauritz Bredrup; Kaaresen, Per Ivar

    2012-02-01

    Temperamental regulatory competence and social communication in term and preterm infants at 12 months corrected age was studied in a randomized controlled intervention trial aimed at enhancing maternal sensitive responsiveness. Surviving infants competence was measured with the Infant Behavior Questionnaire, and social communication with the Early Social Communication Scales. Preterm intervention infants with low regulatory competence had higher responding to joint attention than preterm control infants. A sensitizing intervention may moderate the association between temperament and social communication, and thus allow an alternative functional outlet for preterm infants low in regulatory competence. The finding may have implications for conceptualizations of the role of early sensitizing interventions in promoting important developmental outcomes for premature infants. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Music Cognition in Early Infancy: Infants' Preferences and Long-Term Memory for Ravel

    Science.gov (United States)

    Ilari, Beatriz; Polka, Linda

    2006-01-01

    Listening preferences for two pieces, Prelude and Forlane from "Le tombeau de Couperin" by Maurice Ravel (1875-1937), were assessed in two experiments conducted with 8-month-old infants, using the Headturn Preference Procedure (HPP). Experiment 1 showed that infants, who have never heard the pieces, could clearly make a distinction between the…

  12. Preserving Mother Nature's best food for preterm infants

    Science.gov (United States)

    The American Academy of Pediatrics, the European Society for Paediatric Gastroenterology Hepatology and Nutrition, and the World Health Organization recommend that infants should be breastfed the first 6 mo of life. In the case of high-risk, very-low-birth-weight (<1500 g) premature infants, this is...

  13. Vitamin d deficiency in breast-fed toddlers.

    Science.gov (United States)

    Biser-Rohrbaugh, A; Hadley-Miller, N

    2001-01-01

    The evaluation of genu varum and intoeing in young toddlers is a frequent problem seen by the primary care physician and the orthopaedic surgeon. This report describes six nonwhite breast-fed toddlers with extreme genu varum. Clinical and radiographic findings were consistent with vitamin D-deficiency rickets. Within 3 to 6 months of the initiation of ergocalciferol treatment, reparative processes were evident on both radiographic and clinical examinations. Laboratory studies also showed underlying correction. With the current emphasis on the benefits of breast-feeding and the limitation of sunlight, this diagnosis must remain on the differential in the evaluation of genu varum.

  14. Birthweight of term infants and maternal occupation in a prospective cohort of pregnant women. The ALSPAC Study Team.

    Science.gov (United States)

    Farrow, A; Shea, K M; Little, R E

    1998-01-01

    To study the relation between birthweight of term infants and maternal occupation. Information on job titles since the age of 16, and sociodemographic and other lifestyle factors were obtained by means of questionnaires as part of the Avon longitudinal study of pregnancy and childhood (ALSPAC), from a cohort of 14,000 pregnant women. The British 1990 standard occupational classification was used to code jobs within nine major job groups. For 9282 women who delivered term infants and reported a job for the relevant period, there was a significant difference in mean birthweight among the nine major job groups. A 148 g difference was found between the mean birthweight of infants born to women with professional occupations and those with plant and machine operative jobs. Multiple regression analysis adjusted for sex of infant, parity, maternal height, smoking, caffeine consumption, and race. After adjustment the maternal job was no longer significantly associated with birthweight. Despite the absence of a significant association between birthweight and job after adjustment, there were several findings which agreed with publications on maternal occupation and pregnancy outcome. The major job groups with the lowest birthweights included the following jobs; metal forming or welding, electric or electronic work, jobs in the textile trade, and assembling and working with equipment (mobile and stationary). The lack of an association may indicate that the study was of insufficient power to detect a small difference; it may indicate the presence of confounding variables that were not adjusted for or it may indicate that no association exists.

  15. Banked preterm versus banked term human milk to promote growth and development in very low birth weight infants.

    LENUS (Irish Health Repository)

    Dempsey, Eugene

    2012-01-31

    BACKGROUND: Human milk banking has been available in many countries for the last three decades. The milk provided from milk banking is predominantly term breast milk, but some milk banks provide preterm breast milk. There are a number of differences between donor term and donor preterm human milk. OBJECTIVES: To determine the effect of banked preterm milk compared with banked term milk regarding growth and developmental outcome in very low birth weight infants (infants weighing less than 1500 g). SEARCH STRATEGY: We used the standard methods of the Cochrane Neonatal Review Group, including a search of the Cochrane Neonatal Group specialized register and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, January 2010). We searched the computerised bibliographic databases MEDLINE (1966 to February 2010), EMBASE (1988 to February 2010) and Web of Science (1975 to February 2010). We searched reference lists of all selected articles, review articles and the Oxford Database of Perinatal Trials. We also searched abstracts from neonatal and pediatric meetings (PAS electronic version from 2000 to 2009, ESPR hand search from 2000 to 2009). We applied no language restrictions. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing banked donor preterm milk with banked donor term milk regarding growth and developmental outcomes in very low birth weight infants DATA COLLECTION AND ANALYSIS: We planned to perform assessment of methodology regarding blinding of randomisation, intervention and outcome measurements as well as completeness of follow-up. We planned to evaluate treatment effect using a fixed-effect model using relative risk (RR), relative risk reduction, risk difference (RD) and number needed to treat (NNT) for categorical data and using mean, standard deviation and weighted mean difference (WMD) for continuous data. We planned an evaluation of heterogeneity. MAIN RESULTS: No studies met the inclusion criteria. AUTHORS

  16. Breastfeeding stimulates total and cow's milk-specific salivary IgA in infants.

    Science.gov (United States)

    Piirainen, Laura; Pesola, Jouni; Pesola, Ilkka; Komulainen, Jorma; Vaarala, Outi

    2009-05-01

    Breastfeeding may increase the rate of mucosal maturation and IgA production. We sought to determine the effect of breastfeeding vs. formula-feeding on the maturation of oral mucosa by measuring the salivary total antibodies and cow's milk protein-specific IgA. Fifty-eight saliva samples were collected from 39 healthy, full term infants. At the age of 3 months (n = 25) eight infants received only breast milk and seventeen formula (cow's milk based n = 10, hydrolysed n = 7) and breast milk; and at the age of 6 months (n = 33) eleven received breast milk, seventeen formula and breast milk and five were not breastfed any more (cow's milk based n = 14, hydrolysed n = 8). Total IgA, IgG, IgM and protein, and beta-lactoglobulin specific IgA were measured from saliva with enzyme-linked immunoassay (ELISA). The antibody results were proportioned to total protein. No differences in antibody levels between the feeding groups were found at 3 months of age. At 6 months, total IgA, total IgM and beta-lactoglobulin-specific IgA were higher among the breastfed infants compared to those receiving formula as supplement to breast milk or not breastfed any more (breast milk vs. any formula p = 0.029, p = 0.015, p = 0.058; breast milk vs. cow's milk formula p = 0.025, p = 0.044, p = 0.038). To conclude, breastfeeding stimulated the mucosal immune system to produce IgA to saliva, which is a marker for immunological maturation and likely provides protection against environmental antigens.

  17. Decreased memory B cells and increased CD8 memory T cells in blood of breastfed children: the generation R study.

    Directory of Open Access Journals (Sweden)

    Michelle A E Jansen

    Full Text Available Breastfeeding provides a protective effect against infectious diseases in infancy. Still, immunological evidence for enhanced adaptive immunity in breastfed children remains inconclusive.To determine whether breastfeeding affects B- and T-cell memory in the first years of life.We performed immunophenotypic analysis on blood samples within a population-based prospective cohort study. Participants included children at 6 months (n=258, 14 months (n=166, 25 months (n=112 and 6 years of age (n=332 with both data on breastfeeding and blood lymphocytes. Total B- and T-cell numbers and their memory subsets were determined with 6-color flow cytometry. Mothers completed questionnaires on breastfeeding when their children were aged 2, 6, and 12 months. Multiple linear regression models with adjustments for potential confounders were performed.Per month continuation of breastfeeding, a 3% (95% CI -6, -1 decrease in CD27+IgM+, a 2% (95 CI % -5, -1 decrease in CD27+IgA+ and a 2% (95% CI -4, -1 decrease in CD27-IgG+ memory B cell numbers were observed at 6 months of age. CD8 T-cell numbers at 6 months of age were 20% (95% CI 3, 37 higher in breastfed than in non-breastfed infants. This was mainly found for central memory CD8 T cells and associated with exposure to breast milk, rather than duration. The same trend was observed at 14 months, but associations disappeared at older ages.Longer breastfeeding is associated with increased CD8 T-cell memory, but not B-cell memory numbers in the first 6 months of life. This transient skewing towards T cell memory might contribute to the protective effect against infectious diseases in infancy.

  18. [Magnetic resonance imaging of premature infants with punctate white matter damage and short-term neurodevelopmental outcome].

    Science.gov (United States)

    Niu, Ying; Fu, Jianhua; Xue, Xindong

    2014-01-01

    To investigate the early diagnosis with MRI changes, MRI types and short-term neurodevelopmental outcome of preterm infants with punctate white matter damage (PWMD). There were 44 preterm infants with PWMD (group A) from March 2009 to August 2010 at the neonatal ward of Shengjing Hospital of China Medical University, according to the number, shape and distribution of the lesions, group A was divided into dot injury group (A1), clusters group (A2) and linear group (A3), the first MRI and DWI scan of all cases were within 14 days after birth, and 17 subjects received re-examination with the MRI in the hospital. Twenty preterm infants with normal MRI (group B) received the follow-up, according to the age, 20 normal full-term infants were selected (group C) as the control group using paired design. Mental development index (MDI) and psychomotor development index (PDI) were determined using Bayley scales of infant development-II. First MRI scan:in 44 infants with PWMD, group A1, A2, A3 separately had, 10, and 9 infants. MRI follow up in 17 cases showed that in 4 cases of A1 group the dot lesions disappeared; in 3 of 4 cases in clusters group who received re-examination, the lesions disappeared, 1 case had periventricular leukomalacia (PVL); in 5 of the 9 cases who had re-examination in linear group the lesions disappeared, while in 4 cases the lesions evolved into PVL. MDI and PDI: Group A [MDI (102.9 ± 15.5) , PDI (107.7 ± 17.5) ] was lower than that of group B[MDI (114.0 ± 13.1) , PDI (120.8 ± 9.4) ], group C [MDI (114.2 ± 12.2) , PDI (119.5 ± 10.7) ] (P A2 [MDI (100.8 ± 12.5) , PDI (105.0 ± 12.1) ] showed significantly reduced values compared with group B, Group C, Group A1 (P A2 (P dot-like and clustered injury that are easy to be absorbed and disappear, but the linear lesions are likely to evolve into PVL. In addition, the cluster-like and linear injury have an influence on short-term cognition and motion development, especially the outcome of linear injury

  19. Long-term outcome in term breech infants with low Apgar score--a population-based follow-up

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Thorngren-Jerneck, K

    2001-01-01

    and 218 controls. RESULTS: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP...

  20. Breastfeeding in Depressed Mother-Infant Dyads.

    Science.gov (United States)

    Field, Tiffany; Hernandez-Reif, Maria; Feijo, Larissa

    2002-01-01

    Interviewed depressed and non-depressed mothers on their breastfeeding practices and perceptions of their infants' feeding behavior. Found that, compared to non-depressed mothers, depressed mothers breast fed less often, stopped breastfeeding earlier, and scored lower on a breastfeeding confidence scale. Mothers who breastfed rather than bottle…

  1. Prebiotics and probiotics in infant nutrition

    NARCIS (Netherlands)

    Bakker-Zierikzee, A.

    2005-01-01

    IntroductionIn general breast-fed infants suffer less from infection, which could be partly explained by the specificcompostionand metabolic activity of their intestinalmicroflora. During the last two decades, many

  2. Beneficial Effects of Long-Term Growth Hormone Treatment on Adaptive Functioning in Infants With Prader-Willi Syndrome.

    Science.gov (United States)

    Lo, Sin T; Festen, Dederieke A M; Tummers-de Lind van Wijngaarden, Roderick F A; Collin, Philippe J L; Hokken-Koelega, Anita C S

    2015-07-01

    The aim of this study was to investigate the effect of growth hormone treatment on adaptive functioning in children with Prader-Willi syndrome. Vineland Adaptive Behavior Scale (VABS) was assessed during a randomized controlled trial (RCT) and after 7 years of growth hormone treatment. In the RCT, 75 children (42 infants and 33 prepubertal children) with Prader-Willi syndrome were included. Subsequently, 53 children were treated with long-term growth hormone. Our study demonstrates a marked delay in adaptive functioning in infants and children with Prader-Willi syndrome, which was associated with older age and lower intelligence. Results of the repeated measurements show that the earlier growth hormone treatment was started during infancy, the better the adaptive skills were on the long-term.

  3. Does Human Milk Modulate Body Composition in Late Preterm Infants at Term-Corrected Age?

    National Research Council Canada - National Science Library

    Giannì, Maria; Consonni, Dario; Liotto, Nadia; Roggero, Paola; Morlacchi, Laura; Piemontese, Pasqua; Menis, Camilla; Mosca, Fabio

    2016-01-01

    .... Because body composition modulates later health outcomes and human milk is recommended as the normal method for infant feeding, we sought to investigate whether human milk feeding in early life...

  4. Intracranial haemorrhage: an incidental finding at magnetic resonance imaging in a cohort of late preterm and term infants

    Energy Technology Data Exchange (ETDEWEB)

    Sirgiovanni, Ida; Groppo, Michela; Bassi, Laura; Passera, Sofia; Schiavolin, Paola; Fumagalli, Monica; Mosca, Fabio [Universita degli Studi di Milano, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy); Avignone, Sabrina; Cinnante, Claudia; Triulzi, Fabio [Universita degli Studi di Milano, Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy); Lista, Gianluca [V. Buzzi Children' s Hospital, ICP, Neonatal Intensive Care Unit, Milan (Italy)

    2014-03-15

    Intracranial haemorrhage (ICH) in term newborns has been increasingly recognised but the occurrence in late preterm infants and the clinical presentation are still unclear. To investigate the appearance of intracranial haemorrhage at MRI in a cohort of infants born at 34 weeks' gestation or more and to correlate MRI findings with neonatal symptoms. We retrospectively reviewed neonatal brain MRI scans performed during a 3-year period. We included neonates ≥34 weeks' gestation with intracranial haemorrhage and compared findings with those in babies without intracranial haemorrhage. Babies were classified into three groups according to haemorrhage location: (1) infratentorial, (2) infra- and supratentorial, (3) infra- and supratentorial + parenchymal involvement. Intracranial haemorrhage was observed in 36/240 babies (15%). All of these 36 had subdural haemorrhage. Sixteen babies were included in group 1; 16 in group 2; 4 in group 3. All infants in groups 1 and 2 were asymptomatic except one who was affected by intraventricular haemorrhage grade 3. Among the infants in group 3, who had intracranial haemorrhage with parenchymal involvement, three of the four (75%) presented with acute neurological symptoms. Uncomplicated spontaneous vaginal delivery was reported in 20/36 neonates (56%), vacuum extraction in 4 (11%) and caesarean section in 12 (33%). Babies with intracranial haemorrhage had significantly higher gestational age (38 ± 2 weeks vs. 37 ± 2 weeks) and birth weight (3,097 ± 485 g vs. 2,803 ± 741 g) compared to babies without intracranial haemorrhage and were more likely to be delivered vaginally than by caesarian section. Mild intracranial haemorrhage (groups 1 and 2) is relatively common in late preterm and term infants, although it mostly represents an incidental finding in clinically asymptomatic babies; early neurological symptoms appear to be related to parenchymal involvement. (orig.)

  5. Long-term effects of presurgical infant orthopedics in patients with cleft lip and palate: a systematic review.

    Science.gov (United States)

    Uzel, Aslıhan; Alparslan, Z Nazan

    2011-09-01

    This study aimed to assess the scientific evidence on the efficiency of presurgical infant orthopedic appliances in patients with cleft lip and palate to shed light on a specific, contemporary discussion of whether the appliances have long-term advantages with respect to treatment outcomes. A systematic review. Two literature surveys from the five electronic databases were performed with a 1-month interval. Randomized controlled trials and controlled clinical trials (controls had no presurgical infant orthopedics) that had follow-up periods of a minimum of 6 years were included in the study. The exceptions to the follow-up limit were studies related to feeding and parent satisfaction. Of the 319 articles retrieved in the literature surveys, 12 were qualified for the final analysis. The level of evidence of these articles ranged from 1b to 4. Eight randomized controlled trials and four controlled clinical trials were available on eight treatment outcomes. The longest follow-up period of the randomized controlled trials was 6 years. No randomized controlled trials were found on active presurgical infant orthopedic appliances and on nasoalveolar molding appliances. Based on the results, presurgical infant orthopedic appliances have no long-term positive effects on seven of the eight studied treatment outcomes in patients with cleft lip and palate. More randomized controlled trials need to be done to have evidence regarding the effects of presurgical infant orthopedics in different surgical protocols. Also, the encouraging results about the effect of nasolaveolar molding appliances on nasal symmetry have to be supported by future randomized controlled trials.

  6. Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants.

    Science.gov (United States)

    Innis, Sheila M; Friesen, Russell W

    2008-03-01

    Docosahexaenoic acid (DHA) is important to neural development. Whether DHA intakes are low enough in some pregnant women to impair infant development is uncertain. We sought to determine whether DHA deficiency occurs in pregnant women and contributes to poor infant development. Biochemical cutoffs, dietary intakes, or developmental scores indicative of DHA deficiency are not defined. Infant development has a distribution in which an individual's potential development is unknown. This was a randomized intervention to establish a distribution of developmental scores for infants of women with DHA intakes considered to be above requirements against which to compare the development of infants of mothers consuming their usual diet. DHA (400 mg/d; n = 67) or a placebo (n = 68) was consumed by the women from 16 wk gestation until delivery. We determined maternal red blood cell ethanolamine phosphoglyceride fatty acids, dietary intakes at 16 and 36 wk gestation, and infant visual acuity at 60 d of age. We described an approach to identify DHA deficiency when biochemical and functional markers of deficiency are unknown. In multivariate analyses, infant visual acuity was related to sex (beta = 0.660, SE = 0.93, and odds ratio = 1.93) and maternal DHA intervention (beta = 1.215, SE = 1.64, and odds ratio = 3.37). More infant girls in the placebo than in the DHA intervention group had a visual acuity below average (P = 0.048). Maternal red blood cell ethanolamine phosphoglyceride docosatetraenoic acid was inversely related to visual acuity in boys (rho = -0.37, P pregnant women in our study population were DHA-deficient.

  7. Comparison of Neutrophil Apoptosis by the Pseudomonas Aeruginosa Exotoxins between Healthy Individuals and Term Infants

    Directory of Open Access Journals (Sweden)

    Soheila Khazaei

    2013-04-01

    Full Text Available Background: Pseudomonas aeruginosa may be colonized in different human tissues and result in some infections potentially. Thus, considering that these bacteria are resistance to most of the current antibiotics, an examination on pathogenesis mechanisms of such bacteria can be effective in controlling the infections developed by it.Materials and Methods: In this project, among 40 blood samples (20 healthy persons, 20 infants, an amount of 5 ml (2 ml in the infants heparinized blood was collected form each and then neutrophils were isolated by a standard method and were counted by neubauer lam. After culturing Pseudomonas bacteria in broth medium, some tubes with densities of 1, 2, 3 and 4 McFarland were prepared and the bacteria were isolated by centrifuge method with 3000rpm for 10 minutes and then its exotoxin were exposed to neutrophils of the groups under study. The effect of time and the bacteria count on the amount of the secreted toxin and in adjacency to neutrophils was measured.Results: There were 11 men and 9 women in the health group and the infants group consisted of 12 boys and 8 girls. Death cell percentage of neutrophils was 100% in the health group and 8.90% in the infants group. Percentage of bacterial growth in the medium 1 and 2 McFarland was zero; in the medium 3 McFarland, it was 12.5% in the healthy group and 1% in the infants group (p<0.10. The average rate of cell death in the minute 15th was different in two groups (68.5% in health group vs. 92.5% in the infants (p<0.0005. Conclusion: This study showed the effect of Pseudomonas bacteria on the development of early cell death in the infants very well. As it was shown, this effect is time-dependent and this cell death (apoptosis is occurred in the infants earlier than health people.

  8. Birthweight of term infants and maternal occupation in a prospective cohort of pregnant women. The ALSPAC Study Team

    OpenAIRE

    Farrow, A.; Shea, K. M.; Little, R. E.

    1998-01-01

    OBJECTIVE: To study the relation between birthweight of term infants and maternal occupation. METHODS: Information on job titles since the age of 16, and sociodemographic and other lifestyle factors were obtained by means of questionnaires as part of the Avon longitudinal study of pregnancy and childhood (ALSPAC), from a cohort of 14,000 pregnant women. The British 1990 standard occupational classification was used to code jobs within nine major job groups. RESULTS: For 9282 women who d...

  9. Assessment and Stability of Early Learning Abilities in Preterm and Full-Term Infants across the First Two Years of Life

    Science.gov (United States)

    Lobo, Michele A.; Galloway, James C.

    2013-01-01

    Infants born preterm have increased risk for learning disabilities yet we lack assessments to successfully detect these disabilities in early life. We followed 23 full-term and 29 preterm infants from birth through 24 months to assess for differences in and stability of learning abilities across time. Measures included the Bayley-III cognitive…

  10. Procollagen type I N-terminal peptide in preterm infants is associated with growth during the first six months post-term

    NARCIS (Netherlands)

    van de Lagemaat, Monique; van der Veer, Eveline; van Weissenbruch, Mirjam M.; Lafeber, Harrie N.; Rotteveel, Joost

    2014-01-01

    ObjectiveTo identify growth-related collagen and bone parameters in small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) preterm infants during the first six months post-term. In SGA preterm infants, increased growth and decreased bone acquisition, which we demonstrated

  11. Educational Intervention to Modify Bottle-Feeding Behaviors among Formula-Feeding Mothers in the WIC Program: Impact on Infant Formula Intake and Weight Gain

    Science.gov (United States)

    Kavanagh, Katherine F.; Cohen, Roberta J.; Heinig, M. Jane; Dewey, Kathryn G.

    2008-01-01

    Objective: Formula-fed infants gain weight faster than breastfed infants. This study evaluated whether encouraging formula-feeding caregivers to be sensitive to infant satiety cues would alter feeding practices and reduce infant formula intake and weight gain. Design: Double-blind, randomized educational intervention, with intake and growth…

  12. The genome sequence of bifidobacterium longum subsp. infantis reveals adaptations for milk utilization within the infant microbiome

    Science.gov (United States)

    Following birth, the breast-fed infant gastrointestinal tract is rapidly colonized by a microbial consortium often dominated by bifidobacteria. Accordingly, the complete genome sequence of Bifidobacterium longum ssp. infantis ATCC15697 reflects a competitive nutrient-utilization strategy targeting ...

  13. Irreversible Respiratory Failure in a Full-Term Infant with Features of Pulmonary Interstitial Glycogenosis as Well as Bronchopulmonary Dysplasia

    Directory of Open Access Journals (Sweden)

    Maresa E. C. Jiskoot-Ermers

    2015-10-01

    Full Text Available Pulmonary interstitial glycogenosis (PIG is a rare interstitial lung disease in the newborns. We report on the clinical presentation and pathological findings of a full-term male infant with pulmonary hypertension requiring extracorporeal membrane oxygenation (ECMO. An open lung biopsy demonstrated interstitial changes resembling pulmonary interstitial glycogenosis as well as bronchopulmonary dysplasia (BPD, without convincing evidence of maturational arrest, infection, alveolar proteinosis, or alveolar capillary dysplasia. The boy was treated with glucocorticoids and, after a few days, was weaned from ECMO. A few hours later, the patient died due to acute severe pulmonary hypertension with acute right ventricular failure. The etiology and underlying pathogenic mechanisms of PIG are unknown. The clinical outcomes are quite varied. Deaths have been reported when PIG exists with abnormal lung development and pulmonary vascular growth and congenital heart disease. No mortality has been reported in PIG together with BPD in full-term infants. In this article, we reported on a full-term infant with interstitial changes resembling PIG and BPD who expired despite no convincing evidence of an anatomical maturational arrest or congenital heart disease.

  14. Change-point analysis data of neonatal diffusion tensor MRI in preterm and term-born infants

    Directory of Open Access Journals (Sweden)

    Dan Wu

    2017-06-01

    Full Text Available The data presented in this article are related to the research article entitled “Mapping the Critical Gestational Age at Birth that Alters Brain Development in Preterm-born Infants using Multi-Modal MRI” (Wu et al., 2017 [1]. Brain immaturity at birth poses critical neurological risks in the preterm-born infants. We used a novel change-point model to analyze the critical gestational age at birth (GAB that could affect postnatal development, based on diffusion tensor MRI (DTI acquired from 43 preterm and 43 term-born infants in 126 brain regions. In the corresponding research article, we presented change-point analysis of fractional anisotropy (FA and mean diffusivities (MD measurements in these infants. In this article, we offered the relative changes of axonal and radial diffusivities (AD and RD in relation to the change of FA and FA-based change-points, and we also provided the AD- and RD-based change-point results.

  15. Early neuromotor development of high risk infants - Gross motor function in preterm and full-term born infants

    NARCIS (Netherlands)

    van Haastert, I.C.

    2011-01-01

    This thesis is the result of 20 years follow-up of preterm and full-term born ‘graduates’ of the neonatal intensive care unit of the Wilhelmina Children’s Hospital, Utrecht. The aim was to answer questions that arose during admission and follow-up assessments. Typical gross motor development of

  16. Efficacy and safety of long-chain polyunsaturated fatty acid supplementation of infant-formula milk: a randomised trial.

    Science.gov (United States)

    Lucas, A; Stafford, M; Morley, R; Abbott, R; Stephenson, T; MacFadyen, U; Elias-Jones, A; Clements, H

    1999-12-04

    We tested whether addition of n-3 and n-6 long-chain polyunsaturated fatty acids (LCPUFA) to infant-formula milk during the first 6 months promotes long-term cognitive and motor development, without adverse consequences. We did a double-blind, randomised, controlled, efficacy and safety trial of formula with and without LCPUFAs, with an additional breastfed reference group, in four hospitals in two cities in the UK. The participants were 447 healthy full-term babies. 309 were fed formula (155 without LCPUFAs) and 138 were breastfed for at least 6 weeks. The main outcome measures were: Bayley Mental and Psychomotor Development Indices (MDI, PDI) at 18 months (primary efficacy outcome) and Knobloch, Passamanick, and Sherrards test at 9 months (secondary outcome). Principal safety outcomes were: infection, atopy, growth, and gastrointestinal tolerance. Babies fed formula with and without LCPUFA did not differ in cognitive or motor development, growth, infection, atopy or tolerance. The mean (95% CI) MDI was 0.5 (-2.7 to 3.8) units and the PDI 0.6 (-1.8 to 3.0) units higher in the supplementation group. Formula-fed infants had similar developmental scores to the breastfed reference group after adjustment for higher social class and maternal education in the latter. There was no evidence of a beneficial or adverse effect on cognitive and motor development or growth up to 18 months. Although no significant differences in safety outcomes were observed, we suggest such data should be collected in future LCPUFA trials. Our trial does not provide support for addition of LCPUFA to standard infant formula but we are now doing further follow-up of this cohort.

  17. The crisis in infant feeding practices.

    Science.gov (United States)

    Berg, A

    1978-01-01

    This article maintains that the dramatic decline in breast-feeding in low-income countries is extracting a substantial cost, both in infant health and in outright economic loss. From the 6th to 12th month of life, breast-feeding can supply up to 3/4 of a child's protein needs. The breast-fed child has received about 375 liters of breast milk by age 2. The nutritional equivalent in cow's milk would cost about $65; in packaged dried milk formulas, close to $140. Yet in the few developing countries where surveys of breast-feeding have been conducted over the years, the common pattern is one of significant decline, with greatest decline in urban areas. As communication techniques become more effective in developing countries, urban life styles will have increasing influence on rural societies. Estimates show that losses in breast milk can produce losses in the billions of dollars to developing countries. In terms of national development, lactation has another major economic asset: its link to family planning as a major form of contraception. One investigation reports that the incidence of pregnancy in the 1st 9 months after childbirth of nonnursing mothers was twice that of mothers who breast-fed, including those who simultaneously used other foods. Just as breast milk can be the major source of nutrition, the failure to provide breast milk is a major cause of infant malnutrition and mortality. Poor parents often dilute milk formulas to extend their supply; many cannot read labels and instructions; and hygienic needs often cannot be met by the parents. Breast-fed babies are more resistant to a host of diseases. The costs and obstacles of designing campaigns to encourage breast-feeding in developing countries may be less imposing than those of alternate nutrition intervention programs designed to achieve the same ends. Such a campaign calls for: 1) attracting the public's attention to the benefits of breast-feeding and the dangers of foregoing it through the media

  18. The ratio of high-molecular weight adiponectin and total adiponectin differs in preterm and term infants.

    Science.gov (United States)

    Yoshida, Tomohide; Nagasaki, Hiraku; Asato, Yoshihide; Ohta, Takao

    2009-05-01

    Adiponectin consists of three subspecies (high-, middle- and low-molecular weight adiponectin). Among these, high-molecular weight adiponectin (H-adn) is suggested to be an active form of this protein. To assess the relationship between H-adn and postnatal growth in preterm infants (PIs), serum H-adn and total adiponectin (T-adn) were measured in 46 PIs at birth and at corrected term, and 26 term infants (TI) at birth. T-adn and H-adn concentrations, and the ratio of H-adn to T-adn (H/T-adn) were significantly greater in TI and PI at corrected term than in PI at birth (p adn and H-adn concentrations in PI at corrected term were similar to those in TI, but H/T-adn in PI at corrected term was less than that in TI (p adn and serum concentrations of T- and H-adn in PI at corrected term were different from those in TI. These data suggest that quality of early postnatal growth in PIs is different from that in normally developed TI. Postnatal growth accompanying adipose tissue similar to TI may be important for PI to prevent future development of cardiovascular disease.

  19. Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants

    Directory of Open Access Journals (Sweden)

    Ann Anderson-Berry

    2012-12-01

    Full Text Available Nutrition support practitioners are currently dealing with shortages of parenteral nutrition micronutrients, including multivitamins (MVI, selenium and zinc. A recent survey from the American Society of Enteral and Parenteral Nutrition (ASPEN indicates that this shortage is having a profound effect on clinical practice. A majority of respondents reported taking some aggressive measures to ration existing supplies. Most premature infants and many infants with congenital anomalies are dependent on parenteral nutrition for the first weeks of life to meet nutritional needs. Because of fragile health and poor reserves, they are uniquely susceptible to this problem. It should be understood that shortages and rationing have been associated with adverse outcomes, such as lactic acidosis and Wernicke encephalopathy from thiamine deficiency or pulmonary and skeletal development concerns related to inadequate stores of Vitamin A and D. In this review, we will discuss the current parenteral shortages and the possible impact on a population of very low birth weight infants. This review will also present a case study of a neonate who was impacted by these current shortages.

  20. Serum caffeine concentrations and short-term outcomes in premature infants of ⩽29 weeks of gestation.

    Science.gov (United States)

    Alur, P; Bollampalli, V; Bell, T; Hussain, N; Liss, J

    2015-06-01

    Caffeine is effective in the treatment of apnea of prematurity but it is not well known if the therapeutic concentration of the drug has an impact on other neonatal outcomes such as chronic lung disease (CLD). The aim of this study was to determine if there is an association between caffeine concentrations and the incidence of CLD in premature infants of ⩽29 weeks of gestation. A retrospective chart review of all the infants born ⩽29 weeks of gestation from 2007 to 2011, who survived until discharge or 36 weeks postmenstrual age, was conducted. Caffeine concentrations were obtained weekly on infants getting the drug. Average caffeine concentrations (ACCs) were determined for the duration of caffeine therapy and correlated with CLD, length of stay (LOS), oxygen at discharge (OD), duration of ventilation (DV) and total charges for hospitalization for each patient. Of the 222 eligible infants, 198 met the inclusion criteria. ACC for infants without CLD was 17.0±3.8 μg ml(-1) compared with infants with CLD 14.3±6.1 μg ml(-1) (P14.5 μg ml(-1)) had lower incidence of patent ductus arteriosus, lesser number of days on ventilator and oxygen, lesser need for diuretics, lower incidence of CLD, were more likely to go home without supplemental OD and had lower LOS and lower total hospital charges (all differences were significant Pcaffeine concentrations were significantly associated with decrease in CLD. Receiver operating curve analysis confirmed a significant predictive ability of caffeine concentration for CLD with a cutoff concentration of 14.5 μg ml(-1) (sensitivity of 42.6 and specificity of 86.8). The AUC (area under the curve) for the prediction of CLD was 0.632 (95% confidence interval 0.56-0.69, P=0.009). Caffeine concentrations >14.5 μg ml(-1) were strongly correlated with reduced CLD in infants born at ⩽29 weeks of gestation. Higher caffeine concentrations were associated with decreased total hospital charges, DV, OD and LOS

  1. Isolated acute non-cystic white matter injury in term infants presenting with neonatal encephalopathy.

    LENUS (Irish Health Repository)

    Barrett, Michael Joseph

    2013-03-01

    We discuss possible aetiological factors, MRI evolution of injury and neuro-developmental outcomes of neonatal encephalopathy (NE). Thirty-six consecutive infants diagnosed with NE were included. In this cohort, four infants (11%) were identified with injury predominantly in the deep white matter on MRI who were significantly of younger gestation, lower birthweight with higher Apgars at one and five minutes compared to controls. Placental high grade villitis of unknown aetiology (VUA) was identified in all four of these infants. Our hypothesis states VUA may induce white matter injury by causing a local inflammatory response and\\/or oxidative stress during the perinatal period. We underline the importance of continued close and systematic evaluation of all cases of NE, including examination of the placenta, in order to come to a better understanding of the clinical presentation, the patterns of brain injury and the underlying pathophysiological processes.

  2. Long-term physical and neurologic development in newborn infants with isolated single umbilical artery.

    Science.gov (United States)

    Chetty-John, Shilpa; Zhang, Jun; Chen, Zhen; Albert, Paul; Sun, Liping; Klebanoff, Mark; Grewal, Una

    2010-10-01

    This study compared birth parameters and the longitudinal course in physical and neurologic development between children with 2 and 3 vessel umbilical cords. Our study of the Collaborative Perinatal Project included singletons of at least 24 weeks' gestation with single umbilical artery at birth and no identifiable congenital anomalies. Demographics that were collected included maternal age, race, smoking status, and socioeconomic index. Delivery data included gestational age, birthweight, Apgar scores, placental weight, and umbilical cord insertion and length. Growth and neurodevelopmental parameters were collected at various intervals from birth to 7 years. There were 263 infants with isolated single umbilical artery and 41,415 infants with 3 vessel cords. A random effect model that controlled for potential confounders did not show clinically significant differences in the physical and neurodevelopment measures between these groups. Our study shows no evidence of differential longitudinal physical growth or neurologic outcomes between infants with 2 or 3 vessel cords. Published by Mosby, Inc.

  3. The contribution of attenuated selection in utero to small-for-gestational-age (SGA) among term African American male infants.

    Science.gov (United States)

    Goodman, Julia M; Karasek, Deborah; Anderson, Elizabeth; Catalano, Ralph A

    2013-07-01

    Natural selection conserves mechanisms allowing women to spontaneously abort gestations least likely to yield fit offspring. Small gestational size has been proposed as an indicator of fitness observable by maternal biology. Previous research suggests that exposure to ambient stress in utero results in more "culling" of small fetuses and therefore lower rates of small-for-gestational-age (SGA). However, African American women persistently have higher rates of SGA than non-Hispanic white women, despite experiencing more ambient stress. This paper tests whether attenuation of the stress response among highly stressed African American women, as suggested by the weathering hypothesis, may help to explain this apparent inconsistency. We apply time-series modeling to over 2 million African American and non-Hispanic white male term births in California over the period of January 1989 through December 2010. We test for the parabolic (i.e., "U" shaped) relationship, implied by an attenuated stress response, between unusually strong labor market contraction and the rate of SGA among African American term male infants, and a linear relationship among non-Hispanic whites. We find the hypothesized parabolic relationship among term male African American infants. As expected, we find a linear relationship between unexpected layoffs and the rate of SGA among term male non-Hispanic whites. These results are robust to sensitivity analyses. These results may help to explain the high rates of SGA among term male African American infants, despite greater maternal exposure to ambient stress during pregnancy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Dissociating Long and Short-term Memory in Three-Month-Old Infants Using the Mismatch Response to Voice Stimuli

    Directory of Open Access Journals (Sweden)

    Katharina Zinke

    2018-01-01

    Full Text Available Auditory event-related potentials (ERPs have been successfully used in adults as well as in newborns to discriminate recall of longer-term and shorter-term memories. Specifically the Mismatch Response (MMR to deviant stimuli of an oddball paradigm is larger if the deviant stimuli are highly familiar (i.e., retrieved from long-term memory than if they are unfamiliar, representing an immediate change to the standard stimuli kept in short-term memory. Here, we aimed to extend previous findings indicating a differential MMR to familiar and unfamiliar deviants in newborns (Beauchemin et al., 2011, to 3-month-old infants who are starting to interact more with their social surroundings supposedly based on forming more (social long-term representations. Using a voice discrimination paradigm, each infant was repeatedly presented with the word “baby” (400 ms, interstimulus interval: 600 ms, 10 min overall duration pronounced by three different female speakers. One voice that was unfamiliar to the infants served as the frequently presented “standard” stimulus, whereas another unfamiliar voice served as the “unfamiliar deviant” stimulus, and the voice of the infant’s mother served as the “familiar deviant.” Data collection was successful for 31 infants (mean age = 100 days. The MMR was determined by the difference between the ERP to standard stimuli and the ERP to the unfamiliar and familiar deviant, respectively. The MMR to the familiar deviant (mother’s voice was larger, i.e., more positive, than that to the unfamiliar deviant between 100 and 400 ms post-stimulus over the frontal and central cortex. However, a genuine MMR differentiating, as a positive deflection, between ERPs to familiar deviants and standard stimuli was only found in the 300–400 ms interval. On the other hand, a genuine MMR differentiating, as a negative deflection, between ERPs to unfamiliar deviants from ERPs to standard stimuli was revealed for the 200–300 ms

  5. Pattern of urine specific gravity in exclusively breastfed and water ...

    African Journals Online (AJOL)

    Background: Exclusive breastfeeding, an essential intervention for the reduction of infant mortality, is not widely practised. A major reason is the issue of thirst, especially in the hot regions of the world. Objective: To describe the pattern of specific gravity of breastfeeding infants aged 0-6 months as a measure of their ...

  6. Long-term oscillations in the sleep/wake cycle of infants

    Science.gov (United States)

    Diambra, L.; Malta, C. P.; Capurro, A.

    2009-11-01

    The development of circadian sleep-wakefulness rhythm was investigated by a longitudinal study of six normal infants. We propose an entropy based measure for the sleep/wake cycle fragmentation. Our results confirm that the sleep/wake cycle fragmentation and the sleep/wake ratio decrease, while the circadian power increases during the maturation process of infants. In addition to these expected linear trends in the variables devised to quantify sleep consolidation, circadian power and sleep/wake ratio, we found that they present infradian rhythms in the monthly range.

  7. Hábitos alimentares de crianças menores de 1 ano amamentadas e não-amamentadas Feeding habits of breastfed and non-breastfed children up to 1 year old

    Directory of Open Access Journals (Sweden)

    Graciete O. Vieira

    2004-01-01

    calculated. Statistical significance was determined using the chi-square test. RESULTS: Non-breastfed children aged four months or younger were 8.2 and 6.7 times more likely to receive the family food (95% CI: 3.23-20.66 or vegetable soup (95% CI: 3.84-11.78, respectively. In the same age group, the prevalence of non-breastfed children receiving water, juice, and fruit was significantly higher in relation to breastfed children (70.7 vs 19.7%, 63.3 vs 26.7%, 33.3 vs 4.9% and 14.4 vs 1.4%, respectively. CONCLUSION: Breastfed children had healthier habits than non-breastfed children in terms of the introduction of complementary foods.

  8. Factors affecting the course of body and kidney growth in infants with urolithiasis: A critical long-term evaluation

    Directory of Open Access Journals (Sweden)

    Kemal Sarica

    2016-12-01

    Full Text Available Objective: To investigate the possible effects of dietary, patient and stone related factors on the clinical course of the stone disease as well as the body and renal growth status of the infants. Patients and Methods: A total of 50 children with an history of stone disease during infancy period were studied. Patient (anatomical abnormalities, urinary tract infection - UTI, associated morbidities, stone (obstruction, UTI and required interventions and lastly dietary (duration of sole breast feeding, formula feeding related factors which may affect the clinical course of the disease were all evaluated for their effects on the body and renal growth during long-term follow-up. Results: Mean age of the children was 2.40 ± 2.65 years. Our findings demonstrated that infants receiving longer period of breast feeding without formula addition seemed to have a higher rate of normal growth percentile values when compared with the other children. Again, higher frequency of UTI and stone attacks affected the growth status of the infants in a remarkable manner than the other cases. Our findings also demonstrated that thorough a close follow-up and appropriately taken measures; the possible growth retardation as well as renal growth problems could be avoided in children beginning to suffer from stone disease during infancy period. Conclusions: Duration of breast feeding, frequency of UTI, number of stone attacks and stone removal procedures are crucial factors for the clinical course of stone disease in infants that may affect the body as well as kidney growth during long-term follow-up.

  9. MR imaging of term infants with hypoxic-ischaemic encephalopathy as a predictor of neurodevelopmental outcome and late MRI appearances

    Energy Technology Data Exchange (ETDEWEB)

    Twomey, Eilish; Ryan, Stephanie [Children' s University Hospital, Department of Radiology, Dublin (Ireland); Twomey, Anne; Murphy, John [National Maternity Hospital, Department of Neonatology, Dublin (Ireland); Donoghue, Veronica B. [National Maternity Hospital, Department of Radiology, Dublin (Ireland); Children' s University Hospital, Department of Radiology, Dublin (Ireland)

    2010-09-15

    detailed neurodevelopmental assessment at 2 years of age, infants were classified into two groups according to whether they had a favourable or unfavourable outcome. Of the 26 infants, 6 infants died before formal assessment at the age of 2 years. A further 5 infants had moderate to severe cerebral palsy in addition to severe cognitive impairment. The remaining 15 infants were categorized in the favourable outcome group. The US appearance performed well in terms of predicting final outcome (P = 0.005). The pattern of ischaemia seen on early MRI was a significant predictor of outcome (P < 0.0001). The BG, BG/W and S scores of the diffusion imaging were significantly associated with outcome (P < 0.0001, P < 0.0001 and P = 0.0005 respectively). DWI was predictive of outcome group (P < 0.0001), as were the early T1- and T2-W sequences (P = 0.002) and cranial US (P = 0.005). Assessment of the PLIC in infants with watershed or atypical patterns of ischaemia was found to be less reliable in predicting outcome. The measured ADC value in the PLIC was significantly reduced in those children who had an unfavourable outcome (P = 0.03). While early MRI performed better than cranial US, the sonography findings were useful. The pattern of ischaemia on early MRI was a good predictor of prognosis. All infants with watershed or atypical patterns had a favourable outcome. The majority of infants with central patterns of ischaemia had an unfavourable outcome and all infants with a diffuse pattern had an unfavourable outcome. DWI was predictive of outcome group, as were early T1- and T2-W sequences and cranial US. (orig.)

  10. Vitamin A supplementation to prevent mortality and short- and long-term morbidity in very low birth weight infants.

    Science.gov (United States)

    Darlow, Brian A; Graham, P J; Rojas-Reyes, Maria Ximena

    2016-08-22

    Vitamin A is necessary for normal lung growth and the integrity of respiratory tract epithelial cells. Preterm infants have low vitamin A status at birth and this has been associated with an increased risk of developing chronic lung disease. To evaluate supplementation with vitamin A on the incidence of death or neonatal chronic lung disease and long-term neurodevelopmental disability in very low birth weight (VLBW) infants compared with a control (placebo or no supplementation), and to consider the effect of the supplementation route, dose, and timing. For the original review and subsequent updates, we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, Science Citation Index, and the Oxford Database of Perinatal Trials. The reference lists of relevant trials, paediatric and nutrition journals, and conference abstracts and proceedings were handsearched up to 2010.For the 2016 update, we used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 4), MEDLINE via PubMed (1 May 2016), EMBASE (1 May 2016), and CINAHL (1 May 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised controlled trials comparing vitamin A supplementation with a control (placebo or no supplementation) or other dosage regimens in VLBW infants (birth weight ≤ 1500 grams or less than 32 weeks' gestation). Two review authors screened the search results, extracted data, and assessed the trials for risk of bias. Results were reported as risk ratios (RR), risk differences (RD), and number needed to treat to benefit (NNTB), all with 95% confidence intervals (CI). Trialists were contacted for additional data. Eleven trials met the inclusion criteria. Ten trials (1460 infants) compared vitamin A supplementation with a

  11. Length Normalized Indices for Fat Mass and Fat-Free Mass in Preterm and Term Infants during the First Six Months of Life

    Directory of Open Access Journals (Sweden)

    Ipsita Goswami

    2016-07-01

    Full Text Available Objective: Postnatal tissue accretion in preterm infants differs from those in utero, affecting body composition (BC and lifelong morbidity. Length normalized BC data allows infants with different body lengths to be compared and followed longitudinally. This study aims to analyze BC of preterm and term infants during the first six months of life. Methods: The BC data, measured using dual energy X-ray absorptiometry, of 389 preterm and 132 term infants from four longitudinal studies were combined. Fat-mass/length2 (FMI and fat-free mass/length2 (FFMI for postmenstrual age were calculated after reaching full enteral feeding, at term and two further time points up to six months corrected age. Results: Median FMI (preterm increased from 0.4 kg/m2 at 30 weeks to 2.5, 4.3, and 4.8 kg/m2 compared to 1.7, 4.7, and 6 kg/m2 in term infants at 40, 52, and 64 weeks, respectively. Median FFMI (preterm increased from 8.5 kg/m2 (30 weeks to 11.4 kg/m2 (45 weeks and remained constant thereafter, whereas term FFMI remained constant at 11 kg/m2 throughout the tested time points. Conclusion: The study provides a large dataset of length normalized BC indices. Followed longitudinally, term and preterm infants differ considerably during early infancy in the pattern of change in FMI and FFMI for age.

  12. Gentamicin pharmacokinetics in term newborn infants receiving high-frequency oscillatory ventilation or conventional mechanical ventilation: a case-controlled study.

    Science.gov (United States)

    Bhatt-Mehta, Varsha; Donn, Steven M

    2003-10-01

    To compare the pharmacokinetics of gentamicin in infants receiving high-frequency oscillatory ventilation (HFOV) with infants receiving conventional mechanical ventilation. A case-controlled study design was used to compare the pharmacokinetics of gentamicin in critically ill infants receiving HFOV and conventional mechanical ventilation. Medical records of all full-term newborn infants (> or =37 weeks gestational age) who received either high-frequency mechanical ventilation or conventional mechanical ventilation between 1991 and 2001 were reviewed and relevant patient demographics, renal function tests and gentamicin administration and plasma concentration data collected. Elimination rate constant, half-life, volume of distribution and clearance for both groups were calculated using standard kinetics equations. A tertiary care children's hospital. Newborn infants, > or =37 weeks gestational age, receiving gentamicin and high-frequency mechanical ventilation or conventional mechanical ventilation. In total, 18 patients were included in the conventional mechanical ventilation group and 15 in the HFOV group. The mean gentamicin dose for conventional mechanical ventilation and HFOV groups infants were 2.52+/-0.07 and 2.5+/-0.07 mg/kg/dose, respectively. Initial dosing interval was 12 hours in all of the conventional mechanical ventilation infants and 13 of the 15 HFOV infants. The dosing interval for the remaining two HFOV infants was 18 hours. No patient in either group demonstrated oliguria. Statistical analysis using the Student t-test for unequal variances yielded significant differences between the two groups with regard to elimination rate constant, half-life, volume of distribution and clearance, with a p value of mechanical ventilation group (13.4+2.23) (p>0.05). Infants receiving HFOV had reduced gentamicin clearance. Full-term infants receiving HFOV should be initiated at gentamicin dosing intervals of 18 hours rather than the traditional 12 hours

  13. Human milk peptides differentiate between the preterm and term infant and across varying lactational stages

    NARCIS (Netherlands)

    Dingess, Kelly A.; Waard, de Marita; Boeren, Sjef; Vervoort, Jacques; Lambers, Tim T.; Goudoever, van Johannes B.; Hettinga, Kasper

    2017-01-01

    Variations in endogenous peptide profiles, functionality, and the enzymes responsible for the formation of these peptides in human milk are understudied. Additionally, there is a lack of knowledge regarding peptides in donor human milk, which is used to feed preterm infants when mother's own milk is

  14. Good short-term outcomes of kangaroo mother care in infants with a ...

    African Journals Online (AJOL)

    Results. Regarding the mothers' obstetric history (n=87), gravidity ranged from 1 to 7 (median 3), with a 43% incidence of miscarriage. The median birth weight of the infants (n=87) was 1.5 kg (first assessment), the discharge weight (third assessment) was 1.8 kg, and a week after discharge (fourth assessment) it was 2.2 kg.

  15. Skin bilirubin measurement during phototherapy in preterm and term newborn infants.

    Science.gov (United States)

    Zecca, Enrico; Barone, Giovanni; De Luca, Daniele; Marra, Rosa; Tiberi, Eloisa; Romagnoli, Costantino

    2009-08-01

    The few existing studies evaluating the reliability of transcutaneous bilirubin monitoring during phototherapy gave controversial results. To evaluate the accuracy of transcutaneous bilirubin measurement in a large population of newborn infants, during phototherapy. Total serum bilirubin and transcutaneous bilirubin on patched and unpatched skin areas were simultaneously measured in newborn infants undergoing phototherapy. Transcutaneous measurements were performed with a multiwavelength transcutaneous bilirubinometer (Respironics BiliCheck). The Passing-Bablok regression and the Bland-Altman plot were used to estimate the relationship between serum and transcutaneous bilirubin. We studied 364 newborn infants with a mean (SD) gestational age of 34.6 (3) weeks and a mean birth weight of 2371 (805) grams. Total serum bilirubin, patched transcutaneous bilirubin and unpatched transcutaneous bilirubin were similar before phototherapy. After 52 (33) hours of phototherapy, the difference between serum bilirubin and patched transcutaneous bilirubin was 0.2 (3.1) mg/dL (not significant) while the difference between serum bilirubin and unpatched transcutaneous bilirubin was 3.2 (3.0) mg/dL (pBiliCheck can be safely used for the evaluation of bilirubin levels in newborn infants under phototherapy. Its reliability on patched skin of the forehead is high enough to consistently reduce blood draws and to ascertain when to discontinue phototherapy. Because of the individual variance, any clinical decision has to be taken on the basis of the transcutaneous bilirubin trend more than on a single value.

  16. Short-term Outcome of Pulmonary Hemorrhage in Very-Low-Birth-Weight Preterm Infants

    Directory of Open Access Journals (Sweden)

    Ting-An Yen

    2013-10-01

    Conclusion: This data suggests that our current strategy is effective for treating severe pulmonary hemorrhage in VLBW infants. Surfactant therapy for severe pulmonary hemorrhage may also be beneficial for improving lung function and may shorten the duration of high oxygen requirement.

  17. Relationships between Breastfeeding Patterns and Maternal and Infant Body Composition over the First 12 Months of Lactation

    Science.gov (United States)

    Rea, Alethea; Hepworth, Anna R.; Ward, Leigh C.; Lai, Ching T.; Hartmann, Peter E.; Geddes, Donna T.

    2018-01-01

    Breastfeeding has been implicated in the establishment of infant appetite regulation, feeding patterns and body composition (BC). A holistic approach is required to elucidate relationships between infant and maternal BC and contributing factors, such as breastfeeding parameters. Associations between maternal and breastfed term infant BC (n = 20) and feeding parameters during first 12 months of lactation were investigated. BC was measured at 2, 5, 9 and/or 12 months postpartum with ultrasound skinfolds (US; infants only) and bioimpedance spectroscopy (infants and mothers). 24-h milk intake (MI) and feeding frequency (FFQ) were measured. Higher FFQ was associated with larger 24-h MI (p ≤ 0.003). Higher 24-h MI was associated with larger infant fat mass (FM) (US: p ≤ 0.002), greater percentage FM (US: p ≤ 0.008), greater FM index (FMI) (US: p ≤ 0.001) and lower fat-free mass index (FFMI) (US: p = 0.015). Lower FFQ was associated with both larger FFM (US: p ≤ 0.001) and FFMI (US: p FM: p = 0.004; FMI: p < 0.011). Maternal BC was not associated with FFQ or 24-h MI. These results reinforce that early life is a critical window for infant programming and that breastfeeding may influence risk of later disease via modulation of BC. PMID:29303992

  18. Sensitive quantitative analysis of the meconium bacterial microbiota in healthy term infants born vaginally or by cesarean section.

    Directory of Open Access Journals (Sweden)

    Ravinder Nagpal

    2016-12-01

    Full Text Available For decades, babies were thought to be born germ-free, but recent evidences suggest that they are already exposed to various bacteria in-utero. However, the data on population levels of such pioneer gut bacteria, particularly in context to birth mode, is sparse. We herein aimed to quantify such bacteria from the meconium of 151 healthy term Japanese infants born vaginally or by C-section. Neonatal first meconium was obtained within 24-48 hours of delivery; RNA was extracted and subjected to reverse-transcription-quantitative PCR using specific primers for Clostridium coccoides group, Clostridium leptum subgroup, Bacteroides fragilis group, Atopobium cluster, Prevotella, Bifidobacterium, Lactobacillus, Enterococcus, Enterobacteriaceae, Staphylococcus, Enterococcus, Streptococcus, Clostridium perfringens, and C. difficile. We detected several bacterial groups in both vaginally- and cesarean-born infants. B. fragilis group, Enterobacteriaceae, Enterococcus, Streptococcus and Staphylococcus were detected in more than 50% of infants, with counts ranging from 105-108 cells/g sample. About 30-35% samples harbored Bifidobacterium and Lactobacillus (104-105 cells/g; whereas C. coccoides group, C. leptum subgroup and C. perfringens were detected in 10-20% infants (103-105 cells/g. Compared to vaginally-born babies, cesarean-born babies were significantly less often colonized with Lactobacillus genus (6% vs. 37%; P=0.01 and L. gasseri subgroup (6% vs. 31%; P=0.04. Overall, seven Lactobacillus subgroups/ species i.e. L. gasseri subgroup, L. ruminis subgroup, L. casei subgroup, L. reuteri subgroup, L. sakei subgroup, L. plantarum subgroup and L. brevis were detected in the samples from vaginally-born group, whereas only two members i.e. L. gasseri subgroup and L. brevis were detected in the cesarean group. These data corroborate that several bacterial clades may already be present before birth in term infants’ gut. Further, Remarkably lower detection rate

  19. Diffuse excessive high signal intensity in low-risk preterm infants at term-equivalent age does not predict outcome at 1 year: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Leitner, Yael [Tel Aviv Sourasky Medical Centre, Child Development Centre, Dana-Dwek Children' s Hospital, Tel Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Weinstein, Maya [Tel Aviv Sourasky Medical Centre, Functional Brain Centre, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Bar Ilan University, Department of Psychology, Gonda Multidisciplinary Brain Research Centre, Ramat-Gan (Israel); Myers, Vicki [Tel Aviv Sourasky Medical Centre, Functional Brain Centre, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Uliel, Shimrit; Geva, Karen [Tel Aviv Sourasky Medical Centre, Child Development Centre, Dana-Dwek Children' s Hospital, Tel Aviv (Israel); Berger, Irit; Marom, Ronella [Tel Aviv Sourasky Medical Centre, Department of Neonatology, Lis Maternity Hospital, Tel Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Bashat, Dafna Ben [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Tel Aviv University, Sagol School of Neuroscience, Tel Aviv (Israel); Ben-Sira, Liat [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Tel Aviv Sourasky Medical Centre, Department of Radiology, Tel Aviv (Israel); Geva, Ronny [Bar Ilan University, Department of Psychology, Gonda Multidisciplinary Brain Research Centre, Ramat-Gan (Israel); Gross-Tsur, Varda [Shaare-Zedek Medical Centre, Neuropediatric Unit, Jerusalem (Israel)

    2014-08-15

    The outcome of premature infants with only diffuse excessive high signal intensity (DEHSI) is not clear. We explored the relationship between DEHSI, white matter (WM) diffusion characteristics, perinatal characteristics, and neurobehavioral outcome at 1 year in a homogenous group of preterm infants without major brain abnormalities. Fifty-eight preterm infants, gestational age 29 ± 2.6 weeks, underwent an MRI at term-equivalent age (TEA). Griffiths Mental Developmental Scales, neurological assessment, and Parental Stress Index (PSI) were performed at 1 year corrected age. These measures were compared between preterm infants according to DEHSI classification (none, mild, moderate). Diffusion tensor imaging was used in major WM volumes of interest to objectively measure the degree of WM maturation. No significant differences were detected in the perinatal risk characteristics, neurobehavioral outcome, and PSI at 1 year between infants with different DEHSI classifications. In infants with DEHSI, increased axial and radial diffusivities were detected in the optic radiations, centrum semiovale, and posterior limb of the internal capsule, indicating less advanced maturation of the WM. Significant correlations were detected between the time interval from birth to MRI and the WM microstructure in infants without DEHSI. DEHSI in premature infants is neither a predictive measure for short-term adverse neurobehavioral outcome nor related to perinatal risk characteristics. Extrauterine exposure time had a differential effect on WM maturational trajectories in infants with DEHSI compared to those without. We suggest DEHSI may represent an alteration in WM maturational characteristics. Further follow-up studies may verify later consequences of DEHSI in premature infants. (orig.)

  20. Regional volumetric assessment of the brain in moderately preterm infants (30-35 gestational weeks) scanned at term-equivalent age on magnetic resonance imaging.

    Science.gov (United States)

    Niwa, Tetsu; Suzuki, Keiji; Sugiyama, Nobuyoshi; Imai, Yutaka

    2017-08-01

    Early volume analyses of the infantile brain may help predict neurodevelopmental outcome. However, brain volumes are not well understood in moderately preterm infants at term-equivalent age (TEA). This study retrospectively investigated the relationship between regional brain volumes and infant gestational age (GA) at birth in moderately preterm infants (30-35weeks' GA) on magnetic resonance imaging (MRI) at TEA. Forty infants scanned at TEA were enrolled. Regional brain volumes were estimated by manual segmentation on MRI, and their relationship with GA at birth was assessed. The regional volumes of the cerebral hemispheres and deep gray matter were larger (Spearman ρ=0.40, P=0.01, and Spearman ρ=0.48, P<0.01, respectively), and volumes of the lateral ventricles were smaller (Spearman ρ=-0.32, P=0.04) in infants born at a later GA. The volumes of the cerebral hemispheres of the infants born at 30weeks' GA were significantly smaller than those born at 33 and 35weeks' GA (P<0.05). No associations were found between the volume of the cerebellum and brainstem, and GA at birth (Spearman ρ=0.24, P=0.13, and Spearman ρ=0.24, P=0.14, respectively). The volumes of the cerebral hemispheres at TEA may be smaller in infants born at 30weeks' GA, whereas those of the cerebellum and brainstem may not be correlated with GA among moderately preterm infants. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Hyperglycemia - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007228.htm Hyperglycemia - infants To use the sharing features on this page, please enable JavaScript. Hyperglycemia is abnormally high blood sugar. The medical term ...

  2. Microbial Therapeutics Designed for Infant Health

    Directory of Open Access Journals (Sweden)

    Claire Watkins

    2017-10-01

    Full Text Available Acknowledgment of the gut microbiome as a vital asset to health has led to multiple studies attempting to elucidate its mechanisms of action. During the first year of life, many factors can cause fluctuation in the developing gut microbiome. Host genetics, maternal health status, mode of delivery, gestational age, feeding regime, and perinatal antibiotic usage, are known factors which can influence the development of the infant gut microbiome. Thus, the microbiome of vaginally born, exclusively breastfed infants at term, with no previous exposure to antibiotics, either directly or indirectly from the mother, is to be considered the “gold standard.” Moreover, the use of prebiotics as an aid for the development of a healthy gut microbiome is equally as important in maintaining gut homeostasis. Breastmilk, a natural prebiotic source, provides optimal active ingredients for the growth of beneficial microbial species. However, early life disorders such as necrotising enterocolitis, childhood obesity, and even autism have been associated with an altered/disturbed gut microbiome. Subsequently, microbial therapies have been introduced, in addition to suitable prebiotic ingredients, which when administered, may aid in the prevention of a microbial disturbance in the gastrointestinal tract. The aim of this mini-review is to highlight the beneficial effects of different probiotic and prebiotic treatments in early life, with particular emphasis on the different conditions which negatively impact microbial colonisation at birth.

  3. Microbial Therapeutics Designed for Infant Health.

    LENUS (Irish Health Repository)

    Watkins, Claire

    2017-10-01

    Acknowledgment of the gut microbiome as a vital asset to health has led to multiple studies attempting to elucidate its mechanisms of action. During the first year of life, many factors can cause fluctuation in the developing gut microbiome. Host genetics, maternal health status, mode of delivery, gestational age, feeding regime, and perinatal antibiotic usage, are known factors which can influence the development of the infant gut microbiome. Thus, the microbiome of vaginally born, exclusively breastfed infants at term, with no previous exposure to antibiotics, either directly or indirectly from the mother, is to be considered the "gold standard." Moreover, the use of prebiotics as an aid for the development of a healthy gut microbiome is equally as important in maintaining gut homeostasis. Breastmilk, a natural prebiotic source, provides optimal active ingredients for the growth of beneficial microbial species. However, early life disorders such as necrotising enterocolitis, childhood obesity, and even autism have been associated with an altered\\/disturbed gut microbiome. Subsequently, microbial therapies have been introduced, in addition to suitable prebiotic ingredients, which when administered, may aid in the prevention of a microbial disturbance in the gastrointestinal tract. The aim of this mini-review is to highlight the beneficial effects of different probiotic and prebiotic treatments in early life, with particular emphasis on the different conditions which negatively impact microbial colonisation at birth.

  4. The difference of bone mineral density of lumbar spine and wrist in the preterm and full-term infants: using dual energy X-ray absorptiometry

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Min Jung; Kim, Seung Cheol; Lee, Young Seok; Chang, Young Pyo; Park, Jin Young [Dankook University Hospital, College of Medicine, Dankook University, Seoul (Korea, Republic of)

    2000-09-01

    To assess the differences in bone mineral density (BMD) of lumbar spine and wrist between preterm infants of postconceptional age 40 weeks and normal full-term infants.Sixty-eight preterm infants born at conceptional age 26-36 weeks and 31 normal full-term infants born at 38-42 weeks were investigated. Bone mineral densities of the lumbar spine (from the second to the fourth segment) and wrist were measured by dual energy X-ray absorptiometry. In preterm infants, the corrected age of 0 month was defined as postconceptional 40 weeks. Full-term infants were compared. In the preterm group, birth weight and conceptional age were correlated with lumbar spinal and wrist bone mineral densities. Data were analyzed by student's t-test and Pearson's correlation coefficient, and a p value of less than 0.05 was considered significant. In preterm infants, the values of bone mineral densities of the lumbar spine and wrist were 0.137 {+-} 0.018 g/cm{sup 2} (0.061-0.202 g/cm{sup 2}) and 0.089 {+-} 0.013 g/cm{sup 2} (0.065-0.123 g/cm{sup 2}), respectively, while the respective values for full-term infants were 0.214 {+-} 0.030 g/cm{sup 2} (0.160-0.296 g/cm{sup 2}) and 0.118 {+-} 0.014 g/cm{sup 2} (0.096-0.162 g/cm{sup 2}). In the preterm group, lumbar spinal BMD correlated significantly with conceptional age (r=3D0.384, p less than 0.05) and birth weight (r=3D0.438, p less than 0.05). While wrist BMD correlated significantly with birth weight (r=3D0.281, p less than 0.05), its correlation with conceptional age was not significant (r=3D0.223, p greater than 0.05). The lumbar spinal and wrist BMDs of preterm infants at corrected age 0 were lower than those of normal full-term infants. In the preterm group, BMD values for the lumbar spine were lower in infants of lower conceptional age and birth weight. (author)

  5. Growth of infants born to HIV-infected women when fed a ...

    African Journals Online (AJOL)

    in part, relate to the characteristics of the intestinal micro-flora, which acts as a protective barrier against colonisation with pathogens, and also promotes certain gut immune functions.8 In breast-fed infants, bifidobacteria are the predominant anaerobic bacteria in the faecal micro-flora,9,10 whereas in infants receiving ...

  6. Complete Genome Sequence of the Commensal Enterococcus faecalis 62, Isolated from a Healthy Norwegian Infant

    DEFF Research Database (Denmark)

    Brede, Dag Anders; Snipen, Lars Gustav; Ussery, David

    2011-01-01

    The genome of Enterococcus faecalis 62, a commensal isolate from a healthy Norwegian infant, revealed multiple adaptive traits to the gastrointestinal tract (GIT) environment and the milk-containing diet of breast-fed infants. Adaptation to a commensal existence was emphasized by lactose and other...

  7. Lactose intolerance and gastrointestinal cow's milk allergy in infants and children - common misconceptions revisited.

    Science.gov (United States)

    Heine, Ralf G; AlRefaee, Fawaz; Bachina, Prashant; De Leon, Julie C; Geng, Lanlan; Gong, Sitang; Madrazo, José Armando; Ngamphaiboon, Jarungchit; Ong, Christina; Rogacion, Jossie M

    2017-01-01

    Lactose is the main carbohydrate in human and mammalian milk. Lactose requires enzymatic hydrolysis by lactase into D-glucose and D-galactose before it can be absorbed. Term infants express sufficient lactase to digest about one liter of breast milk daily. Physiological lactose malabsorption in infancy confers beneficial prebiotic effects, including the establishment of Bifidobacterium-rich fecal microbiota. In many populations, lactase levels decline after weaning (lactase non-persistence; LNP). LNP affects about 70% of the world's population and is the physiological basis for primary lactose intolerance (LI). Persistence of lactase beyond infancy is linked to several single nucleotide polymorphisms in the lactase gene promoter region on chromosome 2. Primary LI generally does not manifest clinically before 5 years of age. LI in young children is typically caused by underlying gut conditions, such as viral gastroenteritis, giardiasis, cow's milk enteropathy, celiac disease or Crohn's disease. Therefore, LI in childhood is mostly transient and improves with resolution of the underlying pathology. There is ongoing confusion between LI and cow's milk allergy (CMA) which still leads to misdiagnosis and inappropriate dietary management. In addition, perceived LI may cause unnecessary milk restriction and adverse nutritional outcomes. The treatment of LI involves the reduction, but not complete elimination, of lactose-containing foods. By contrast, breastfed infants with suspected CMA should undergo a trial of a strict cow's milk protein-free maternal elimination diet. If the infant is not breastfed, an extensively hydrolyzed or amino acid-based formula and strict cow's milk avoidance are the standard treatment for CMA. The majority of infants with CMA can tolerate lactose, except when an enteropathy with secondary lactase deficiency is present.

  8. Optimal breastfeeding practices and infant and child mortality: a systematic review and meta-analysis.

    Science.gov (United States)

    Sankar, Mari Jeeva; Sinha, Bireshwar; Chowdhury, Ranadip; Bhandari, Nita; Taneja, Sunita; Martines, Jose; Bahl, Rajiv

    2015-12-01

    To synthesise the evidence for effects of optimal breastfeeding on all-cause and infection-related mortality in infants and children aged 0-23 months. We conducted a systematic review to compare the effect of predominant, partial or nonbreastfeeding versus exclusive breastfeeding on mortality rates in the first six months of life and effect of no versus any breastfeeding on mortality rates between 6 and 23 months of age. A systematic literature search was conducted in PubMed, Cochrane CENTRAL and CABI. The risk of all-cause mortality was higher in predominantly (RR 1.5), partially (RR 4.8) and nonbreastfed (RR14.4) infants compared to exclusively breastfed infants 0-5 months of age. Children 6-11 and 12-23 months of age who were not breastfed had 1.8- and 2.0-fold higher risk of mortality, respectively, when compared to those who were breastfed. Risk of infection-related mortality in 0-5 months was higher in predominantly (RR 1.7), partially (RR 4.56) and nonbreastfed (RR 8.66) infants compared to exclusive breastfed infants. The risk was twofold higher in nonbreastfed children when compared to breastfed children aged 6-23 months. The findings underscore the importance of optimal breastfeeding practices during infancy and early childhood. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  9. Early stage cortical processing of language sounds is modulated by diet and gender influences in four month old infants: Variations in the ERP P1 component.

    Science.gov (United States)

    Early post-natal nutrition influences later development, but how different infant diets affect maturation of brain function is not well understood. We examined the effects of infant diet on the processing of language sounds in 4 month old awake infants, who were breastfed (BF: n = 18, 9 males), fed ...

  10. Effectiveness of skin-to-skin contact versus care-as-usual in mothers and their full-term infants: Study protocol for a parallel-group randomized controlled trial

    NARCIS (Netherlands)

    Cooijmans, K.H.M.; Beijers, R.; Rovers, A.C.; Weerth, C. de

    2017-01-01

    Background: Twenty-to-forty percent of women experience postpartum depressive symptoms, which can affect both the mother and infant. In preterm infants, daily skin-to-skin contact (SSC) between the mother and her infant has been shown to decrease maternal postpartum depressive symptoms. In full-term

  11. The creamatocrit, fat and energy concentration in human milk produced by mothers of preterm and term infants.

    Science.gov (United States)

    Kociszewska-Najman, Bozena; Borek-Dzieciol, Beata; Szpotanska-Sikorska, Monika; Wilkos, Ewa; Pietrzak, Bronislawa; Wielgos, Miroslaw

    2012-09-01

    The objective of this study was to investigate the composition of breast milk which had been gathered from mothers for over first 2 weeks of lactation and to compare the changes in composition of preterm and term milk. A prospective, single center study was provided in Warsaw, Poland. The samples of breast milk from 22 mothers who had delivered prematurely and 39 mothers who had given birth to term infants were collected. The creamatocrit, energy and fat concentration were estimated in each participant's breast milk sample twice a day (morning and night hours). The lowest creamatocrit, calories and fat concentration was indicated in the preterm milk obtained in the morning (4.86%, 663.8 kcal/L and 33.6 g/L, respectively). The highest milk parameters were observed in the night samples of full-term milk and measured (9.6%, 919.7 kcal/L, and 60.7 g/L, respectively). No significant differences in analysed parameters were observed between preterm and full-term milk (p>0.05). In summary, creamatocrit, calories and lipid concentration in breast milk shows the daily differences. Colostrum and mature milk from mothers of preterm neonates differed from colostum and mature milk from mothers of term neonates. They had lipid contents, creamatocrit level and calorific value.

  12. Socio-economic status and maternal BMI are associated with duration of breast-feeding of Norwegian infants.

    Science.gov (United States)

    Bjørset, Vilde K; Helle, Christine; Hillesund, Elisabet R; Øverby, Nina C

    2018-01-23

    To explore whether there is an association between socio-economic status and maternal BMI and duration of any breast-feeding/exclusive breast-feeding among Norwegian infants at 4 and 5 months of age in 2016. Cross-sectional design. Baseline data from a randomized controlled trial. Data concerning breast-feeding were collected by FFQ. Recruitment was done at child health-care centres and through Facebook in 2016. In total, 960 infants/parents registered for participating in the study Early Food for Future Health. A total of 715 infant/mother dyads completed the questionnaire when the child was between 5 and 6 months old. At 5 months of age, 81·0 % of infants were breast-fed and 16·4 % were exclusively breast-fed. Infants of highly educated mothers had higher odds of being breast-fed at 5 months compared with infants of mothers with less education. Infants of multiparous mothers had higher odds of being exclusively breast-fed for the first 5 months compared with infants of mothers with one child. Infants of mothers with overweight/obesity had reduced odds of both being breast-fed at all and being exclusively breast-fed at 4 months of age compared with infants of mothers with normal BMI. Our results show that duration of breast-feeding varies with socio-economic status and maternal BMI in Norway. Targeting groups with low socio-economic status and mothers with overweight or obesity is important, as they are less likely to breast-feed according to recommendations.

  13. Effects of basic developmental care on neonatal morbidity, neuromotor development, and growth at term age of infants who were born at <32 weeks.

    Science.gov (United States)

    Maguire, Celeste M; Veen, Sylvia; Sprij, Arwen J; Le Cessie, Saskia; Wit, Jan M; Walther, Frans J

    2008-02-01

    The goal of this study was to investigate the effect of basic elements of developmental care (incubator covers and positioning aids) on days of respiratory support and intensive care, growth, and neuromotor development at term age in infants who were born at Neuromotor development was defined as definitely abnormal (presence of a neonatal neurologic syndrome, such as apathy or hyperexcitability, hypotonia or hypertonia, hyporeflexia or hyperreflexia, hypokinesia or hyperkinesia, or a hemisyndrome), mildly abnormal (presence of only part of such a syndrome), or normal. A total of 192 infants were included (developmental care: 98; control: 94). Thirteen infants (developmental care: 7; control: 6) were excluded according to protocol (admitted for less than or died within the first 5 days: n = 12; taken out at parents' request: n = 1), which left a total of 179 infants who met inclusion criteria. In-hospital mortality was 12 (13.2%) of 91 in the developmental care group and 8 (9.1%) of 88 in the control group. There was no significant difference in the number of days of respiratory support, number of intensive care days, short-term growth, or neuromotor developmental outcome at term age between the developmental care and control groups. Duration of the intervention, whether only during the intensive care period or until hospital discharge, had no significant effect on outcome. Providing basic developmental care in the NICU had no effect on short-term physical and neurologic outcomes in infants who were born at <32 weeks' gestation.

  14. State of cavity microbiota of the colon in breastfed children with acute enterocolitis with infection of breast milk

    Directory of Open Access Journals (Sweden)

    L.I. Sydorchuk

    2017-02-01

    Full Text Available Background. Despite the significant progress made in the field of acute enterocolitis in children, many questions of etiology, pathogenesis, microecological relations, formation of intestinal dysbacteriosis/dysbiosis and taxonomic composition and population level of major, additional and accidental microbiota of intestinal microbiocenosis and other issues of enterocolitis require study, taking into account bacteriological and immunological researches of today. This is especially related to the children one to six months of age (who are breastfed with enterocolitis. Normally, breast milk is sterile, but during the inflammatory process in breast, it can be infected, so the disease have a threat to a child fed with this milk, and there is a threat to the life of the mother. The first reaction to such feeding will be from a side of cavity microbiota of the colon that characterizes the relevance of study of the colon microbiota in infants suffering from enterocolitis. Materials and methods. Contents of colon cavity of 53 children one to six months of age with enterocolitis (control — 35 children, who were breastfed, and, in fact, breast milk, by which the children were fed, underwent bacteriological and mycological examination. Results. To reveal the mechanisms of contamination of the colon in children one to six months of age, in patients with acute enterocolitis there has been used ecological method that revealed the specific characteristics of coexistence of taxons in ecosystem “host-microbiota” and identified the direction of disorders of colon microecology on the background of acute enterocolitis in children, who were fed by breast milk infected with bacteria of the genus Staphylococcus. The results of bacteriological studies have shown that in 49 (92.45 % patients Staphylococcus aureus was isolated and identified, and in 4 (7.55 % women — Staphylococcus epidermidis. Population level of the selected strains was 3.0–7.0 lg CFU/ml (M

  15. Transcutaneous bilirubinometer: its use in Chinese term infants and the effect of haematocrit and phototherapy on the TcB index.

    Science.gov (United States)

    Fok, T F; Lau, S P; Hui, C W; Fung, K P; Wan, C W

    1986-05-01

    The application of the transcutaneous bilirubinometer in screening for neonatal jaundice was evaluated in 259 full-term Chinese infants: 202 who had not received any treatment and 57 who were receiving phototherapy. The transcutaneous bilirubin index correlated well with the serum bilirubin level (SB) of the untreated infants and the coefficient of correlation was slightly higher for TcB readings obtained over the mid-sternal area (r = 0.91; P less than 0.001) than those over the forehead (r = 0.85; P less than 0.001). Transcutaneous bilirubinometry was unreliable in predicting the SB level in infants receiving phototherapy even if the SB readings were obtained over shaded skin. The haematocrit of the infants, though having a statistically significant effect on the TcB index, contributed only minimally to the regression line and correlation coefficient between the TcB index and SB level.

  16. Low-fat, high-carbohydrate parenteral nutrition (PN) may potentially reverse liver disease in long-term PN-dependent infants

    DEFF Research Database (Denmark)

    Jakobsen, Marianne Skytte; Jørgensen, Marianne Hørby; Husby, Steffen

    2015-01-01

    INTRODUCTION: Parenteral nutrition-associated cholestasis (PNAC) is a complication of long-term parenteral nutrition (PN). Removal of lipids may reverse PNAC but compromises the energy to ensure infant growth. The purpose of this study was to test whether a low-fat, high-carbohydrate PN regimen......, which prevents and reverses PNAC in adults, could do the same in infants. This regimen could potentially avoid the problem of diminished energy input after removing nutritional lipids. METHODS: Infants developing PNAC over a 2-year period were started on a low-fat PN regimen with calories primarily from...... carbohydrates. The fat-free PN, containing 314 kJ/ml, was provided 5-6 times a week and fat, including essential fatty acids and fat-soluble vitamins, 1-2 times a week. Enteral feeding was continued according to individual tolerance. RESULTS: The study included 10 infants with short bowel syndrome (six...

  17. [Breast- and bottle-feeding in preterm infants: a comparison of behavioral cues].

    Science.gov (United States)

    Lin, Shih-Chun; Lin, Chen-Hsiu; Zhang, Jia-Wen; Chen, Siao-Min; Chen, Chih-Ling; Huang, Mei-Chih

    2013-12-01

    Developmental care has been broadly applied to identify the behavioral cues and care needs of preterm infants. Past studies indicate a significantly higher level of physical distress in bottle-fed preterm infants than in preterm infants who are breastfed. However, no evidence has yet been reported that supports the influence of feeding methods on behavioral cues. This study compares differences in the type and frequency of behavioral cues between breast- and bottle-fed preterm infants. A comparison study design and secondary data analysis method were used to assess data from two previous research projects. Infant feeding behavioral cues were observed and compared between two groups: 7 preterm infants who were breastfed and 7 preterm infants who were bottle-fed. After cases were matched by infant gestational age, behavioral responses were coded according to the preterm feeding cues coding system (PFCCS) from 7 paired maternal-infant feeding videos that featured preterm infants of 25 to 32 weeks gestational age at birth. The PFCCS classifies 24 feeding behavioral cues into hunger cues, self-regulatory cues, stress cues, and satiety cues. Infants in the breastfeeding group had a higher hunger cue frequency than their bottle-fed peers (p = .013), while bottle-fed infants had a higher stress cue frequency than their breastfed peers (p = .041). Other significant differences in behavioral cues between the two feeding methods included "fluid spillage" (bottle- >breast-, p = .008), "central cyanosis" (bottle- >breast-, p = .024) and "hand pushing" (breast- >bottle-, p = .034). Preterm infants in this study who breastfed showed significantly fewer stress cues than those who bottle fed. These findings support the importance of enhancing care provider sensitivity with regard to behavioral-cue observation. Findings further support breastfeeding rather than bottle-feeding for preterm infants.

  18. A longitudinal study of urinary phthalate excretion in 58 full-term and 67 preterm infants from birth through 14 months.

    Science.gov (United States)

    Frederiksen, Hanne; Kuiri-Hänninen, Tanja; Main, Katharina M; Dunkel, Leo; Sankilampi, Ulla

    2014-09-01

    Some phthalates have shown antiandrogenic effects in rat offspring. Premature infants may be exposed to high amounts of specific phthalates during hospitalization, and thus are potentially at risk. We evaluated longitudinal phthalate exposure and metabolism in full-term (FT) and preterm (PT) infants. Fifty-eight FT and 67 PT (gestational age, 24.7-36.6 weeks) infants were recruited at birth and followed until 14 months (nine times). Urinary concentrations of metabolites of diethyl phthalate (DEP), dibutyl phthalate isomers (DiBP and DnBP), butylbenzyl phthalate (BBzP), di(2-ethylhexyl) phthalate (DEHP), and diisononyl phthalate (DiNP) were measured in 894 samples. Daily intake and a hazard index for antiandrogenic effects were estimated, and excretion patterns of DEHP and DiNP metabolites were analyzed. Metabolites of BBzP, DiNP, and DEHP were 5-50 times higher at day 7 (D7) and month 1 (M1) in PT than in FT infants. Thereafter, metabolite concentrations were similar between the two groups. The estimated hazard index for combined DiBP, DnBP, BBzP, and DEHP exposures 7 days after birth exceeded the antiandrogenic threshold in > 80% of PT and > 30% of FT infants, and after M2, in 30% of all infants. The excretion pattern of DEHP and DiNP metabolites changed with age. Most PT infants and approximately one-third of healthy FT newborns were exposed to phthalates during early life at a potentially harmful level according to the European Food Safety Authority's recommended limits of daily exposure. Changes in the relative proportions of secondary phthalate metabolites over time were consistent with maturation of infant metabolic pathways during the first year of life. Further research is needed on the health effects of phthalate exposures and the influence of changes in metabolic capacity in neonates and infants.

  19. Infant-feeding methods and childhood sleep-disordered breathing.

    Science.gov (United States)

    Montgomery-Downs, Hawley Evelyn; Crabtree, Valerie McLaughlin; Sans Capdevila, Oscar; Gozal, David

    2007-11-01

    Childhood sleep-disordered breathing has an adverse impact on cognitive development, behavior, quality of life, and use of health care resources. Early viral infections and other immune-mediated responses may contribute to development of the chronic inflammation of the upper airway and hypertrophic upper airway lymphadenoid tissues underlying childhood sleep-disordered breathing. Breastfeeding provides immunologic protection against such early exposures. Therefore, we sought to explore whether sleep-disordered breathing severity would differ for children who were breastfed as infants. The parents or guardians of 196 habitually snoring children (mean +/- SD: 6.7 +/- 2.9 years old) who were undergoing overnight polysomnography at Kosair Children's Hospital Sleep Medicine and Apnea Center completed a retrospective survey on the method(s) used to feed the child as an infant. Among habitually snoring children, those who were fed breast milk for at least 2 months had significantly reduced sleep-disordered breathing severity on every measure assessed, including apnea-hypopnea index, oxyhemoglobin desaturation nadir, and respiratory arousal index. Breastfeeding for longer than 5 months did not contribute additional benefits. Our findings support the notion that breastfeeding may provide long-term protection against the severity of childhood sleep-disordered breathing. Future research should explore mechanism(s) whereby infant-feeding methods may affect the pathophysiology of development of childhood sleep-disordered breathing.

  20. Same-sex twins are taller and heavier than opposite-sex twins (but only if breastfed): Possible evidence for sex bias in human breast milk.

    Science.gov (United States)

    Kanazawa, Satoshi; Segal, Nancy L

    2017-04-01

    Recent studies show that human and other mammalian breast milk may be tailored for the sex of the offspring. Such sex bias suggests that opposite-sex twins, who receive breast milk that cannot simultaneously be tailored for both sexes, may be at a disadvantage for growth compared with same-sex twins. An analysis of data from the National Longitudinal Study of Adolescent Health (Add Health) shows that, controlling for sex, age, birth weight, and zygosity, breastfed same-sex twins are, on average, about 1 inch taller and 12 pounds heavier than their opposite-sex counterparts through adolescence and early adulthood. In contrast, never-breastfed same-sex twins tend to be shorter and lighter than their opposite-sex counterparts. These results may be potential evidence for sex bias in human breast milk and its long-term effects. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Exclusive breastfeeding rate and factors associated with infant feeding practices in Indonesia

    Directory of Open Access Journals (Sweden)

    Yovita Ananta

    2016-05-01

    Full Text Available Background Breast milk is the ideal food for infants. According to the 2007 Indonesian National Household Health Survey, only 23% of mothers exclusively breastfeed for six months. Objectives To determine the rate of exclusive breastfeeding in Indonesia, to evaluate factors associated with infant feeding practices, and to compare the nutritional and developmental status between exclusively-breastfed and formula-fed infants. Methods A survey was conducted in hospitals located in 17 provinces in Indonesia. The rate of exclusive breastfeeding was calculated. Many variables were investigated as potential predictors for exclusive breastfeeding using a multivariable logistic regression analysis. Further analysis was performed to compare the nutritional and developmental status between exclusively breastfed and formula-fed infants at the time of survey. Results From 1,804 infant subjects, the overall rate of exclusive breastfeeding was 46.3%, ranging from 10.5% in East Java to 66.9% in Jambi. Predominant breastfeeding, complementary feeding, and formula feeding rates were 14.3%, 8.6%, and 30.7%, respectively. Maternal unemployment was associated with a longer duration of breastfeeding (P=0.000. There were significantly more formula-fed infants who were undernourished compared to exclusively-breastfed infants (14% vs. 8%, P=0.001. There were also significantly more infants in the formula-fed group who had abnormal head circumference compared to those in the exclusively-breastfed group (9% vs. 6%, P=0.031. Child development, as assessed by the Pre-screening Developmental Questionnaire, was similar between the two groups (P=0.996. Conclusion The overall rate of exclusive breastfeeding in Indonesia is 46.3%. Maternal unemployment is associated with longer duration of breastfeeding. Exclusive breastfed infants have significant better growth and head circumference compared to formula fed infants, while the development is similar between the two groups.

  2. Iodine nutrition in breast-fed infants is impaired by maternal smoking

    DEFF Research Database (Denmark)

    Laurberg, Peter; Nøhr, Susanne B; Pedersen, Klaus M

    2004-01-01

    the sodium-iodide symporter responsible for iodide transport in the lactating mammary gland. Smoking during the period of breastfeeding increases the risk of iodine deficiency-induced brain damage in the child. Women who breastfeed should not smoke, but if they do, an extra iodine supplement should...

  3. Comparison between infants receiving traditional supplements (camel thorn, flix weed, and sugar water and exclusively breast fed infants

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi

    2015-10-01

    Full Text Available Objectives: Although breast milk is considered the best nutritional option for neonates, use of traditional supplements such as sugar water, camel thorn, and flix weed in the first week of life of infants is quite common in Iran and many other countries. The aim of this study was to evaluate whether consuming such supplements has any impact on infant’s breastfeeding behavior. Materials and Methods: Four hundred fifty four term infants who were referred to the neonatal clinic of Ghaem hospital were enrolled and divided into two groups. Control (exclusively breastfed infants, N=243 and case (breast milk feeding plus traditional remedies such as sugar water, camel thorn, and flix weed, N=211. Spss 19.5 was used for statistical analysis. T-test and Man-Whitney tests were used. A p-value of Results: The two groups were similar in their baseline data. Regarding duration of breastfeeding and breastfeeding frequency, use of these supplements resulted in a reduction in both breastfeeding frequency and duration (p

  4. The influence of a pacifier on infants' arousals from sleep.

    Science.gov (United States)

    Franco, P; Scaillet, S; Wermenbol, V; Valente, F; Groswasser, J; Kahn, A

    2000-06-01

    The risk of sudden infant death during sleep was postulated to decrease with the use of a pacifier and by conditions facilitating arousals from sleep. We evaluated the influence of a pacifier on arousal from sleep in healthy infants. Fifty-six healthy infants were studied with polygraphy during 1 night; 36 infants used a pacifier regularly during sleep, and 20 never used a pacifier. Thumb users or occasional pacifier users were not included in the study. The infants were recorded at a median age of 10 weeks (range 6 to 19 weeks). To evaluate auditory arousal thresholds, the infants were exposed to white noise of increasing intensity during rapid eye movement sleep. Polygraphic arousals occurred at significantly lower auditory stimuli in pacifier users than in nonusers (P =.010). Compared with nonusers, pacifier users were more frequently bottle-fed than breast-fed (P =. 036). Among infants sleeping without a pacifier, breast-fed infants had lower auditory thresholds than bottle-fed infants (P =.049). Infants using pacifiers during sleep had lower auditory arousal thresholds than those who did not use a pacifier during sleep. Breast-feeding could be a further factor contributing to lower arousal thresholds. These findings could be relevant to the occurrence of sudden infant deaths during sleep.

  5. Long-term Effects of Hepatitis B Immunization of Infants in Preventing Liver Cancer.

    Science.gov (United States)

    Chang, Mei-Hwei; You, San-Lin; Chen, Chien-Jen; Liu, Chun-Jen; Lai, Ming-Wei; Wu, Tzee-Chung; Wu, Shu-Fen; Lee, Chuan-Mo; Yang, Sheng-Shun; Chu, Heng-Cheng; Wang, Tsang-Eng; Chen, Bor-Wen; Chuang, Wan-Long; Soon, Maw-Soan; Lin, Ching-Yih; Chiou, Shu-Ti; Kuo, Hsu-Sung; Chen, Ding-Shinn

    2016-09-01

    The incidence of hepatocellular carcinoma (HCC) increases with age, but protective antibody responses decrease with time after infants are immunized against hepatitis B virus (HBV). We investigated whether immunization of infants against HBV prevents their developing HCC as adults. We also searched for strategies to maximize the cancer-preventive effects. We collected data from 2 Taiwan HCC registry systems on 1509 patients (6-26 years old) diagnosed with HCC from 1983 through 2011. Data on history of HBV immunization and prenatal maternal levels of HBV antigens of all HCC patients born after July 1984 were retrieved from the HBV immunization data bank of the Taiwan Center for Disease Control. We collected data on birth cohort-specific populations (6-26 years old) of Taiwan using the National Household Registry System. Rates of HCC incidence per 10(5) person-years were derived by dividing the number of patients with HCC by the person-years of the general population. Relative risks (RR) for HCC were estimated by Poisson regression analysis in vaccinated vs unvaccinated birth cohorts. We stratified patients by age group to evaluate the association of birth cohorts and HCC risks. Of the 1509 patients with HCC, 1343 were born before, and 166 were born after, the HBV vaccination program began. HCC incidence per 10(5) person-years was 0.92 in the unvaccinated cohort and 0.23 in the vaccinated birth cohorts. The RRs for HCC in patients 6-9 years old, 10-14 years old, 15-19 years old, and 20-26 years old who were vaccinated vs unvaccinated were 0.26 (95% confidence interval [CI], 0.17-0.40), 0.34 (95% CI, 0.25-0.48), 0.37 (95% CI, 0.25-0.51), and 0.42 (95% CI, 0.32-0.56), respectively. The RR for HCC in 6- to 26-year-olds was lower in the later vs the earlier cohorts (born in 1992-2005 vs 1986-1992; P liver cancer. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. Effects of ultrasound pregnancy dating on neonatal morbidity in late preterm and early term male infants: a register-based cohort study.

    Science.gov (United States)

    Kullinger, Merit; Haglund, Bengt; Kieler, Helle; Skalkidou, Alkistis

    2016-10-31

    Assessing gestational age by ultrasound can introduce a systematic bias due to sex differences in early growth. This cohort study included data on 1,314,602 births recorded in the Swedish Medical Birth Register. We compared rates of prematurity-related adverse outcomes in male infants born early term (gestational week 37-38) or late preterm (gestational week 35-36), in relation to female infants, between a time period when pregnancy dating was based on the last menstrual period (1973-1978), and a time period when ultrasound was used for pregnancy dating (1995-2010), in order to assess the method's influence on outcome by fetal sex. As expected, adverse outcomes were lower in the later time period, but the reduction in prematurity-related morbidity was less marked for male than for female infants. After changing the pregnancy dating method, male infants born early term had, in relation to female infants, higher odds for pneumothorax (Cohort ratio [CR] 2.05; 95 % confidence interval [CI] 1.33-3.16), respiratory distress syndrome of the newborn (CR 1.99; 95 % CI 1.33-2.98), low Apgar score (CR 1.26; 5 % CI 1.08-1.47), and hyperbilirubinemia (CR 1.12; 95 % CI 1.06-1.19), when outcome was compared between the two time periods. A similar trend was seen for late preterm male infants. Misclassification of gestational age by ultrasound, due to size differences, can partially explain currently reported sex differences in early term and late preterm infants' adverse neonatal outcomes, and should be taken into account in clinical decisions and when interpreting study results related to fetal sex.

  7. Preservation of native esophagus in infants with pure esophageal atresia has good long-term outcomes despite significant postoperative morbidity.

    Science.gov (United States)

    Zani, Augusto; Cobellis, Giovanni; Wolinska, Justyna; Chiu, Priscilla P L; Pierro, Agostino

    2016-02-01

    To evaluate long-term outcomes of pure esophageal atresia (EA) repair with preservation of native esophagus. Infants with pure EA treated at our institution (2000-2010) and with minimum 5-year follow-up were reviewed (REB:1000046653). Data analysed included demographics, management and outcomes and are reported as mean ± SD/median (range). Of 185 infants with EA, 12 (7 %) had pure EA (gestational age: 36 ± 2.4 weeks, birth weight: 2353 ± 675 g). Ten had associated anomalies, including trisomy-21 (n = 2) and duodenal atresia (n = 1). 1 patient (short gap) underwent primary thoracoscopic anastomosis, 11 had gastrostomy (Stamm, n = 5; image-guided, n = 6) as initial procedure. At definitive repair (age: 128 ± 91 days; weight 5.5 ± 2.3 kg): ten had primary anastomosis and 1 had Collis gastroplasty. No patient had esophageal replacement surgery. three patients had gastrostomy dehiscence requiring re-operation. At post-operative esophagram, seven had anastomotic leak successfully treated conservatively. Seven patients developed strictures requiring balloon dilatations (median two dilatations, range 1-10), six received antireflux surgery. At 7-year follow-up (range 5-15 years), all patients had the gastrostomy closed and were on full oral feeds. The management of pure EA continues to be challenging. The preservation of native esophagus is possible with significant morbidity. The long-term outcomes are favourable.

  8. Lidocaine response rate in aEEG-confirmed neonatal seizures: Retrospective study of 413 full-term and preterm infants.

    Science.gov (United States)

    Weeke, Lauren C; Toet, Mona C; van Rooij, Linda G M; Groenendaal, Floris; Boylan, Geraldine B; Pressler, Ronit M; Hellström-Westas, Lena; van den Broek, Marcel P H; de Vries, Linda S

    2016-02-01

    To investigate the seizure response rate to lidocaine in a large cohort of infants who received lidocaine as second- or third-line antiepileptic drug (AED) for neonatal seizures. Full-term (n = 319) and preterm (n = 94) infants, who received lidocaine for neonatal seizures confirmed on amplitude-integrated EEG (aEEG), were studied retrospectively (January 1992-December 2012). Based on aEEG findings, the response was defined as good (>4 h no seizures, no need for rescue medication); intermediate (0-2 h no seizures, but rescue medication needed after 2-4 h); or no clear response (rescue medication needed Lidocaine had a good or intermediate effect in 71.4%. The response rate was significantly lower in preterm (55.3%) than in full-term infants (76.1%, p lidocaine was significantly better than midazolam as second-line AED (21.4% vs. 12.7%, p = 0.049), and there was a trend for a higher response rate as third-line AED (67.6% vs. 57%, p = 0.086). Both lidocaine and midazolam had a higher response rate as third-line AED than as second-line AED (p lidocaine were the following: higher gestational age, longer time between start of first seizure and administration of lidocaine, lidocaine as third-line AED, use of new lidocaine regimens, diagnosis of stroke, use of digital aEEG, and hypothermia. Multivariable analysis of seizure response to lidocaine included lidocaine as second- or third-line AED and seizure etiology. Seizure response to lidocaine was seen in ~70%. The response rate was influenced by gestational age, underlying etiology, and timing of administration. Lidocaine had a significantly higher response rate than midazolam as second-line AED, and there was a trend for a higher response rate as third-line AED. Both lidocaine and midazolam had a higher response rate as third-line compared to second-line AED, which could be due to a pharmacologic synergistic mechanism between the two drugs. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

  9. Effect of early, short-term supplementation on weight and linear growth of 4-7-mo-old infants in developing countries: a four-country randomized trial.

    Science.gov (United States)

    Simondon, K B; Gartner, A; Berger, J; Cornu, A; Massamba, J P; San Miguel, J L; Ly, C; Missotte, I; Simondon, F; Traissac, P; Delpeuch, F; Maire, B

    1996-10-01

    The effect of supplementation on growth was tested by means of four similar controlled randomized trials in the Congo (n = 120), Senegal (n = 110), Bolivia (n = 127), and New Caledonia (n = 90). Four-month-old infants were randomly allocated to supplement or control groups. A cereal-based precooked porridge was offered twice daily for 3 mo and consumption was monitored. Both groups were free to eat local food. At 7 mo of age, all infants were still breast-fed in the Congo, Senegal, and Bolivia compared with 47% in New Caledonia. Mean daily consumption of the supplement varied among countries (558-790 kJ/d). Mean length at 4 mo was lowest in Bolivia, higher in Senegal and the Congo, and near the National Center for Health Statistics reference in New Caledonia. The mean 4-7 mo length increment was 0.48 cm higher for supplemented than for control infants in Senegal (P < 0.05), whereas weight increments did not differ. No significant effect was found in the other countries.

  10. The qualitative assessment of general movements in preterm, term and young infants--review of the methodology.

    Science.gov (United States)

    Einspieler, C; Prechtl, H F; Ferrari, F; Cioni, G; Bos, A F

    1997-11-24

    We describe the state of the art of Prechtl's method for the qualitative assessment of general movements as a diagnostic tool for early detection of brain dysfunction. After discussing the optimal technique for video recording general movements in preterm, term and young infants, attention is focused on the proper analysis of this spontaneous motor pattern. Recently, a group of active researchers in the field reached consensus on the various qualities of normal and abnormal general movements. These definitions are reported here in full. Since it is a newly introduced method careful investigation into its reliability is required. Various groups of investigators have obtained data which demonstrate the robust character of the method (interscorer agreement: 78-98%). Finally, we discuss the validity of this early assessment method on the basis of the reports published so far. While the method's sensitivity is similar in all age groups studied (preterm, term, first month, second month, and third month age epochs), and averages 94.5%, the specificity of the method is age-dependent. It is low during the early ages, increases gradually and reaches 82 to 100% at 3 months post-term. This phenomenon is explained by spontaneous recovery of early dysfunction. In contrast, consistent abnormalities of general movements are linked to neurological deficits found at the 2 year follow-up.

  11. Dexmedetomidine sedation combined with caudal anesthesia for lower abdominal and extremity surgery in ex-preterm and full-term infants.

    Science.gov (United States)

    Waurick, Katrin; Sauerland, Cristina; Goeters, Christiane

    2017-06-01

    Awake caudal anesthesia is a potentially attractive option, because the administration of general anesthesia is associated with a high rate of respiratory complications and hemodynamic disturbances and potential neurotoxic effects. To facilitate the caudal puncture and subsequent surgical intervention, additional sedatives are commonly administered. We aimed to establish a new, safe, and effective anesthetic procedure for very young children with comorbidities. We retrospectively analyzed 23 children who underwent lower abdominal or lower extremity surgery with dexmedetomidine sedation and caudal anesthesia from January 2015 to August 2015. Dexmedetomidine was initiated with a total bolus infusion of 0.7-1.1 μg·kg(-1) followed by a continuous infusion of 1 μg·kg(-1) ·h(-1) . Bupivacaine (2.5 mg·kg(-1) ) was supplemented with 5-10 μg·kg(-1) epinephrine to strengthen and prolong motor block. According to maturity at birth, two groups were defined: ex-preterm and full-term infants. There were 12 ex-preterm and 10 full-term infants available for analysis. The median postmenstrual age was 44 (38-52) weeks in ex-preterm and 46.5 (40-72) weeks in full-term infants. Without any additional intervention, surgery was successfully accomplished in 82% of all cases. While respiratory complications were not a problem, hemodynamic disturbances commonly occurred. Maximum decreases in heart rate (HR) of 30% were accompanied by maximum decreases in mean arterial pressure (MAP) of 38%. No infant had a heart rate below 100 bpm. MAP declined in one ex-preterm infant to a minimum value of 32 mmHg. Caudal anesthesia combined with dexmedetomidine sedation is an effective anesthetic technique for lower abdominal and extremity surgery in ex-preterm and full-term infants with severe comorbidities. © 2017 John Wiley & Sons Ltd.

  12. Validity of behavioral and physiologic parameters for acute pain assessment of term newborn infants

    Directory of Open Access Journals (Sweden)

    Andrea Lübe de S Thiago Pereira

    1999-03-01

    Full Text Available CONTEXT: The subjectivity of pain causes enormous difficulties in evaluating neonatal pain with a single, practical and easy-to-apply tool. Pain evaluation in the neonatal period should be performed by valid, safe, useful and feasible methods. OBJECTIVE: To evaluate the validity of the Neonatal Facial Coding System (NFCS, Neonatal Infant Pain Scale (NIPS, heart rate (HR and O2 saturation (O2 sat for neonatal pain assessment. DESIGN: Prospective, double-blind randomized trial. SETTING: A secondary level maternity hospital. PARTICIPANTS: 70 healthy neonates requiring bilirubin dosage were randomly assigned to receive a venous puncture (P: n=33, BW 3.2kg, SD 0.6; GA 39wk, SD 1; 59h of life, SD 25 or an alcohol swab friction (F: n=37; BW 3.1kg, SD 0.5; GA 39wk, SD 1; 52h of life, SD 17. INTERVENTION: All measurements were taken prior to (PRE, during (T0, and 1(T1, 3(T3, 5(T5 and 10(T10 minutes after the procedure. MEASUREMENTS: A neonatologist evaluated NFCS, NIPS, HR and O2 sat by pulse oxymetry. RESULTS: Median NFCS and NIPS results at T0, T1 and T3 were higher in P group, compared to F. More P neonates presented NFCS >2 and/or NIPS >3 at T0, T1 and T3. HR was lower in P group at T1. Average O2 sat was above 90% during the whole study period in both groups. CONCLUSION: NFCS and NIPS are suitable instruments for neonatal pain evaluation. Heart rate and O2 saturation can be used only as auxiliary methods.

  13. Kernicterus in preterm infants.

    Science.gov (United States)

    Okumura, Akihisa; Kidokoro, Hiroyuki; Shoji, Hiromichi; Nakazawa, Tomoyuki; Mimaki, Masakazu; Fujii, Katsunori; Oba, Hiroshi; Shimizu, Toshiaki

    2009-06-01

    We sought to clarify the features of kernicterus in preterm infants. The subjects of this study were 8 preterm infants with athetoid cerebral palsy whose gestational ages were 15 mg/dL were observed in 3 infants. No infant showed neurologic symptoms characteristic of classical acute bilirubin encephalopathy during the neonatal period. Dystonic posture and abnormal muscle tone were first recognized within 6 months' corrected age in all patients. During infancy, MRI was performed in 7 infants. Abnormal high-intensity areas were observed in the bilateral globi pallidi in all 7 infants. However, MRI during the neonatal period or after 1 year's corrected age showed no abnormal findings. BAEP measurements were abnormal in 7 of the 8 infants. Preterm infants with athetotic cerebral palsy showed rather homogeneous features, similar to term infants with kernicterus, with marked hyperbilirubinemia. This combination of clinical, laboratory, neuroimaging, and neurophysiological data will contribute to the increased recognition of preterm infants with kernicterus.

  14. Effect of current breastfeeding on sleep patterns in infants from Asia-Pacific region.

    Science.gov (United States)

    Ramamurthy, Mahesh Babu; Sekartini, Rini; Ruangdaraganon, Nichara; Huynh, Duy Houng T; Sadeh, Avi; Mindell, Jodi A

    2012-08-01

      The aim of this study was to assess the relationship between breastfeeding and sleep patterns in infants from Asia-Pacific region.   Parents of 10 321 infants (0-11 months) from Australia, China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand and Vietnam completed an expanded version of the Brief Infant Sleep Questionnaire.   Overall, 4714 (45.72%) were currently being breastfed; 61.3% of those between 0 and 5 months and 36.6% of those between 6 and 11 months. Currently breastfed infants, when compared with not currently breastfed infants, had a significant increase in the number and duration of night-time wakings and less consolidated sleep. Interestingly, currently breastfed infants less than 6 months also showed longer duration of daytime sleep and obtained more sleep overall. Of note, of those who were currently breastfed, those infants who were nursed back to sleep during night, woke up more often at night (2.41 vs. 1.67 times) and had shorter continuous night-time sleep period (5.58 vs. 6.88 h; P sleep variable was controlled for in the analysis of variance.   Breastfeeding is associated with reduced sleep consolidation in infants. This relationship, however, may be moderated by parenting practices of nursing to sleep and back to sleep during the night. Thus, parents of infants with night waking problems should be encouraged to limit the association between nursing and falling to sleep, to improve sleep while maintaining breastfeeding. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  15. The Groningen LCPUFA study : no effect of postnatal long-chain polyunsaturated fatty acids in healthy term infants on neurological condition at 9 years

    NARCIS (Netherlands)

    de Jong, Corina; Kikkert, Hedwig K.; Fidler, Vaclav; Hadders-Algra, Mijna

    Long-chain PUFA (LCPUFA) supplementation of formula can have beneficial effects on neurodevelopmental outcome in early infancy, but uncertainty exists regarding effects after 6 months. The present study is the first to investigate whether consumption by term infants of formula containing LCPUFA for

  16. Test-retest reliability of computer-based video analysis of general movements in healthy term-born infants.

    Science.gov (United States)

    Valle, Susanne Collier; Støen, Ragnhild; Sæther, Rannei; Jensenius, Alexander Refsum; Adde, Lars

    2015-10-01

    A computer-based video analysis has recently been presented for quantitative assessment of general movements (GMs). This method's test-retest reliability, however, has not yet been evaluated. The aim of the current study was to evaluate the test-retest reliability of computer-based video analysis of GMs, and to explore the association between computer-based video analysis and the temporal organization of fidgety movements (FMs). Test-retest reliability study. 75 healthy, term-born infants were recorded twice the same day during the FMs period using a standardized video set-up. The computer-based movement variables "quantity of motion mean" (Qmean), "quantity of motion standard deviation" (QSD) and "centroid of motion standard deviation" (CSD) were analyzed, reflecting the amount of motion and the variability of the spatial center of motion of the infant, respectively. In addition, the association between the variable CSD and the temporal organization of FMs was explored. Intraclass correlation coefficients (ICC 1.1 and ICC 3.1) were calculated to assess test-retest reliability. The ICC values for the variables CSD, Qmean and QSD were 0.80, 0.80 and 0.86 for ICC (1.1), respectively; and 0.80, 0.86 and 0.90 for ICC (3.1), respectively. There were significantly lower CSD values in the recordings with continual FMs compared to the recordings with intermittent FMs (ptest-retest reliability of computer-based video analysis of GMs, and a significant association between our computer-based video analysis and the temporal organization of FMs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Dyadic Transition to Parenthood: A Longitudinal Assessment of Personal Growth among Parents of Pre- and Full-term Infants.

    Science.gov (United States)

    Porat-Zyman, Ginna; Taubman-Ben-Ari, Orit; Spielman, Varda

    2017-02-01

    This study examined the contribution of birth circumstances (premature and full-term birth) and individual and spousal factors (attachment orientations, parental self-efficacy and perceived infant temperament), measured 1 month post-partum, to the personal growth of first-time parents (n = 121) 1 and 5 months post-partum. The study overcame the limitations of prior research by accurately measuring actor effects while controlling for and assessing partner effects, by applying the actor-partner interdependence model. The findings confirm that becoming a parent, under normative and stressful circumstances, can lead to personal growth and parents of premature babies experience higher levels of growth than parents of full terms. Moreover, 1 month post-partum, actor effects were found for higher attachment anxiety and higher parental self-efficacy. Furthermore, personal growth at 1 month post-partum was found to be the strongest predictor of personal growth 5 months after childbirth. Five months post-partum, a positive partner effect was found for parental self-efficacy. Mothers reported higher growth than fathers only 5 months after the birth. It seems time plays an important role as to which variables contribute to personal growth. In the early stages of parenthood, personal growth is mostly an individual experience. Theoretical and clinical implications are discussed. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Prevalence and associated factors of strabismus in former preterm and full-term infants between 4 and 10 Years of age.

    Science.gov (United States)

    Fieß, Achim; Kölb-Keerl, Ruth; Schuster, Alexander K; Knuf, Markus; Kirchhof, Bernd; Muether, Philipp S; Bauer, Jacqueline

    2017-12-02

    Limited data exist collating most of the associated factors for strabismus in one analysis. The aim of this study was to assess the prevalence of strabismus and to analyse associated factors in former preterm and full-term infants. In this cross-sectional study, 239 former preterm infants with gestational age (GA) ≤ 32 weeks and 264 former full-term born infants with GA ≥ 37 weeks underwent detailed ophthalmologic examination in the age of 4-10 years and perinatal data assessment for risk factor analysis. Ophthalmologic examinations included cover testing, best corrected visual acuity, cycloplegic objective refraction, slit lamp as well as fundus examinations. For association analysis with strabismus, the following data was collected and included in multivariable analysis: sex, age at examination, anisometropia, myopic and hyperopic refractive error (≥ 3 dioptres), astigmatism, birth weight percentile, gestational age, retinopathy of prematurity occurrence, maternal age at childbirth, mother smoking, breastfeeding artificial ventilation, intraventricular bleeding, and other perinatal adverse events. Overall, 4/264 (2%) full-term infants, 15/125 (12%) preterm-infants with GA 29-32 weeks without ROP, 13/59 (22%) preterm infants with GA ≤ 28 weeks without ROP and 14/55 (26%) with GA ≤ 32 weeks with retinopathy of prematurity were affected by strabismus. In the multivariable regression model strabismus was associated with GA (OR = 0.84 per week; p = 0.001), hyperopic refractive error (OR = 4.22; p = 0.002) and astigmatism (OR = 1.68; p = 0.02). This investigation highlights that low gestational age and refraction of the eye are independent risk factors for strabismus, while the other factors show less independent influence.

  19. Looking for cues – infant communication of hunger and satiation during milk feeding

    OpenAIRE

    Shloim, N; Vereijkan, CMJL; Blundell, P.; Hetherington, MM

    2017-01-01

    It is known that duration of breastfeeding and responsive feeding are associated with decreased risk of obesity. It is however, not clear whether breastfed infants signal more to mothers to facilitate responsive feeding, compared to formula fed, nor what communication cues are important during the feeding interaction. The present study aimed to explore feeding cues in milk-fed infants and to examine if such cues vary by mode of feeding. Twenty-seven mothers and infants were filmed while breas...

  20. The Paradox of Prematurity: The Behavioral Vulnerability of Late Preterm Infants and the Cognitive Susceptibility of Very Preterm Infants at 36 months Post-term

    Science.gov (United States)

    Shah, Prachi E.; Robbins, Natashia; Coelho, Renuka B.; Poehlmann, Julie

    2013-01-01

    We explored associations among preterm status (very preterm infant (VPI: cognitive and behavioral outcomes. We hypothesized that LPIs would demonstrate better health and neurobehavioral outcomes compared with more premature infants, and that preterm status would moderate the association between parenting quality and 3-year outcomes. Sample included 123 preterm infants (gestation behavior at 36-months, and maternal depressive symptoms and parenting at all timepoints. Group differences were explored using MANOVAs while predictors of child outcomes were explored using hierarchical regression analyses. MANOVAs indicated that LPIs had more optimal neonatal health during the hospital stay, yet more externalizing (p= .043), aggressive (p= .006) and oppositional behaviors (p= .008) at 3-years compared with VPIs. There were no IQ differences between VPIs, MPIs and LPIs. However, preterm infants who experienced less negative parenting had higher IQs at 36 months (β = −3.245, p= .017), with the greatest effects seen in VPIs (β = 0.406, p = .01) compared with LPIs (β= 0.148, p= .381). LPIs manifested similar IQ, but more externalizing, oppositional and aggressive behavior symptoms compared to VPIs. VPIs appeared to be differentially susceptible to parenting effects, with VPIs demonstrating the highest cognitive scores in the context of more positive parenting. PMID:23261789

  1. Long-term development of low-risk low birth weight preterm born infants: neurodevelopmental aspects from childhood to late adolescence.

    Science.gov (United States)

    Reuner, Gitta; Hassenpflug, Anne; Pietz, Joachim; Philippi, Heike

    2009-07-01

    Most studies on clinical outcome of preterm born infants focus on high-risk infants, whereas little is known about the long-term prognosis of low-risk low birth weight preterm born infants (LBW). To examine physical growth, school outcome, behavioural aspects, quality of life, and intervention impact on LBW in late adolescence compared to term born controls and to analyse developmental pathways from childhood to adolescence for these groups. In late adolescence 65 LBW and 41 matched term born controls were assessed with a structured telephone interview and standardized questionnaires with regard to physical growth, school career, therapeutic interventions, behavioural aspects, and quality of life. Longitudinal analysis comprised data from birth, infancy, school age, and adolescence. Growth in height of LBW was highly variable, but correlated significantly with birth parameters and was below those of controls with regard to percentiles. School enrollment of LBW was more often delayed, and there was a trend toward lower school graduation in LBW. The groups did not differ with regard to general or health-related quality of life and behavioural aspects, but LBW received significantly more therapeutical interventions. In general, LBW showed no major deficits in late adolescence. However, a prolonged school career and a higher demand for therapeutic interventions indicate subtle neurodevelopmental deficits in LBW. This underscores the need for professional follow-up programmes for this majority of preterm born infants.

  2. Long-term serological outcome of infants who received frozen-thawed milk from human T-lymphotropic virus type-I positive mothers.

    Science.gov (United States)

    Ando, Yoshiya; Ekuni, Yutaka; Matsumoto, Yoshinari; Nakano, Shiro; Saito, Kensuke; Kakimoto, Kazuhiro; Tanigawa, Takuo; Kawa, Motohiro; Toyama, Takenori

    2004-12-01

    Human T-lymphotropic virus type-I (HTLV-I) infection occurs via mothers' milk during feeding. However, freeze-thaw processing can eliminate the infectivity of the mother's milk of HTLV-I carriers. A long-term follow-up survey was conducted to investigate the HTLV-I infectivity of frozen-thawed mothers' milk among infants whose mothers were HTLV-I seropositive. Infants fed frozen-thawed mothers' milk did not become HTLV-I antibody-positive up until 1 year old, and all children followed up until an age of 11-12 years were antibody negative. This study showed that freeze-thaw processing can eliminate the HTLV-I infectivity of mothers' milk, and that HTLV-I carriers can indirectly feed their infants using frozen-thawed mothers' milk as a way to prevent HTLV-I infection.

  3. Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review.

    Science.gov (United States)

    Gyan, Thomas; Strobel, Natalie; McAuley, Kimberley; Shannon, Caitlin; Newton, Sam; Tawiah-Agyemang, Charlotte; Amenga-Etego, Seeba; Owusu-Agyei, Seth; Forbes, David; Edmond, Karen

    2016-03-01

    There has been an expansion of circumcision services in Africa as part of a long-term HIV prevention strategy. However, the effect of infant male circumcision on morbidity and mortality still remains unclear. Acute morbidities associated with circumcision include pain, bleeding, swelling, infection, tetanus or inadequate skin removal. Scale-up of circumcision services could lead to a rise in these associated morbidities that could have significant impact on health service delivery and the safety of infants. Multidisciplinary training programmes have been developed to improve skills of health service providers, but very little is known about the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. This review aims to evaluate the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. The review will include studies comparing health service providers who have received education and/or training to improve their skills for infant male circumcision with those who have not received education and/or training. Randomised controlled trials (RCTs) and cluster RCTs will be included. The outcomes of interest are short-term morbidities of the male infant including pain, infection, tetanus, bleeding, excess skin removal, glans amputation and fistula. Long-term morbidities include urinary tract infection (UTI), HIV infection and abnormalities of urination. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL and DARE), WHO databases and reference list of papers will be searched for relevant articles. Study selection, data extraction and synthesis and risk of bias assessment using the Cochrane risk of bias assessment tool will be conducted. We will calculate the pooled estimates of the difference in means and risk ratios using random effects models. If

  4. Reference values of amino acids and of common clinical chemistry in plasma of healthy infants aged 1 and 4 months.

    Science.gov (United States)

    Haschke-Becher, Elisabeth; Kainz, Alexander; Bachmann, Claude

    2016-01-01

    To compare plasma levels of amino acids and clinical chemistry parameters in healthy infants at 1 and 4 months of age and to establish corresponding reference limits. Data of three multicenter studies assessing the safety of new infant formulas were used. During these studies infants of both age-groups were either breast-fed or received formulas of low or high protein content. All samples were analyzed centrally in the same accredited laboratory. Plasma was collected from 521 infants in total, 157 boys and 135 girls aged 1 month and 121 boys and 108 girls aged 4 months. At the age of 1 month, 62 infants had received exclusively breast milk, 198 exclusively formula, and 27 both; in the 4-months age group corresponding numbers were 49, 158 and 18, respectively; for 9 infants, diet was unknown. Concentrations of most amino acids and clinical chemistry parameters differed significantly between both ages. Regardless of age, most plasma amino acid levels were comparable or lower in breast-fed than in formula-fed infants whereas at 1 month of age most clinical chemistry parameters were higher. While in breast-fed infants the plasma urea concentration decreased over 4 months of age, it increased in formula-fed infants. There were significant differences between infants fed a low and high protein formula. At both ages, high protein formulas resulted in significantly higher threonine, 2-aminobutyrate, and urea concentrations. For clinical use, age- and diet specific reference limits in infants are warranted.

  5. Specific characteristics of spontaneous movements in preterm infants at term age are associated with developmental delays at age 3 years.

    Science.gov (United States)

    Kanemaru, Nao; Watanabe, Hama; Kihara, Hideki; Nakano, Hisako; Takaya, Rieko; Nakamura, Tomohiko; Nakano, Junji; Taga, Gentaro; Konishi, Yukuo

    2013-08-01

    The aim of this study was to investigate the relationship between the characteristics of spontaneous movements in preterm infants at term age and developmental delay at 3 years of age. We analysed video recordings of the spontaneous movements in the supine position of 124 preterm infants (44 males, 80 females) at 36 to 44 weeks postmenstrual age (PMA). The infants were born preterm (22-36wks PMA; birthweight 489-1696g) and had not received a diagnosis of a neurological or developmental disorder by the age of 3 years. The recorded spontaneous movements were quantified using six movement indices, which were calculated from two-dimensional trajectories of all limbs. The infants were divided into three developmental groups, normal, borderline, or delayed, based on their developmental quotient as calculated using the Kyoto Scale of Psychological Development 2001 (Kyoto Scale) at 3 years of age. Group differences in the movement indices were analysed. In the delayed group, average velocity of arms and legs were significantly lower (ppreterm infants. © 2013 Mac Keith Press.

  6. Short-term outcome of very-low-birthweight infants with arterial hypotension in the first 24 h of life.

    Science.gov (United States)

    Faust, Kirstin; Härtel, Christoph; Preuß, Michael; Rabe, Heike; Roll, Claudia; Emeis, Michael; Wieg, Christian; Szabo, Miklos; Herting, Egbert; Göpel, Wolfgang

    2015-09-01

    To evaluate lowest mean arterial blood pressure during the first 24 h of life (minMAP(24)) in very-low-birthweight (VLBW) infants and to identify associations between hypotension and short-term outcome. Retrospective cohort analysis of the minMAP(24) of 4907 VLBW infants with a gestational age Hypotension was defined as minMAP(24) being lower than the median value of all patients of the same gestational age. MinMAP(24) values correlated with gestational age. Median minMAP(24) values of VLBW infants ≤29 weeks' gestation were 1-2 mm Hg lower than gestational age in completed weeks. Hypotensive infants had a higher rate of intraventricular haemorrhage (IVH, 20.3% vs 15.9%, pHypotension during the first 24 h of life is associated with adverse outcomes in VLBW infants. This underlines the need for randomised controlled trials on the use of vasoactive drugs in this vulnerable patient cohort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Placental pathology in full-term infants with hypoxic-ischemic neonatal encephalopathy and association with magnetic resonance imaging pattern of brain injury.

    Science.gov (United States)

    Harteman, Johanna C; Nikkels, Peter G J; Benders, Manon J N L; Kwee, Anneke; Groenendaal, Floris; de Vries, Linda S

    2013-10-01

    To investigate the relationship between placental pathology and pattern of brain injury in full-term infants with neonatal encephalopathy after a presumed hypoxic-ischemic insult. The study group comprised full-term infants with neonatal encephalopathy subsequent to presumed hypoxia-ischemia with available placenta for analysis who underwent cerebral magnetic resonance imaging (MRI) within the first 15 days after birth. Macroscopic and microscopic characteristics of the placenta were assessed. The infants were classified according to the predominant pattern of brain injury detected on MRI: no injury, predominant white matter/watershed injury, predominant basal ganglia and thalami (BGT) injury, or white matter/watershed injury with BGT involvement. Maternal and perinatal clinical factors were recorded. Placental tissue was available for analysis in 95 of 171 infants evaluated (56%). Among these 95 infants, 34 had no cerebral abnormalities on MRI, 27 had white matter/watershed injury, 18 had BGT injury, and 16 had white matter/watershed injury with BGT involvement. Chorioamnionitis was a common placental finding in both the infants without injury (59%) and those with white matter/BGT injury (56%). On multinomial logistic regression analysis, white matter/watershed injury with and without BGT involvement was associated with decreased placental maturation. Hypoglycemia was associated with an increased risk of the white matter/BGT injury pattern (OR,5.4; 95% CI, 1.4-21.4). The BGT injury pattern was associated with chronic villitis (OR, 12.7; 95% CI, 2.4-68.7). A placental weight brain injury, especially for the BGT pattern (OR, 0.1; 95% CI, 0.01-0.7). Placental weight <10th percentile was mainly associated with normal cerebral MRI findings. Decreased placental maturation and hypoglycemia <2.0 mmol/L were associated with increased risk of white matter/watershed injury with or without BGT involvement. Chronic villitis was associated with BGT injury irrespective of white

  8. The low birthweight, term infant and the need for admission to special care nurseries.

    Science.gov (United States)

    Parry, Michael; Davies, Mark W

    2013-12-01

    We aimed to determine, in full-term newborns born between 2000 and 2499 g, what proportion develop problems or the need for interventions that would likely require admission to a special care nursery (SCN) (i.e., needed an intravenous line (IV) or a nasogastric tube (NGT). A multicentre, retrospective audit of all babies born from 1 January to 30 June 2011 was used. Eligible babies were term, inborn at one of four centres in south-east Queensland, with a birthweight between 2000 and 2499 g. The cohort of 98 babies had a mean (SD) birthweight of 2340 (122.3) g and a mean (SD) gestational age of 38.3 (1.0) weeks. Forty-three had at least one low temperature, 55 had at least one low blood glucose, 35 had an NGT, 22 had an IV cannula. In the entire cohort, 48 babies (49%) required either an IV cannula or an NGT. Fifteen per cent had a second problem (either low blood glucose or low temperature) at a median (interquartile range) age of 11 (5.5-25.5) h: none required a second NGT or IV. The proportion of babies that required either an NGT or an IV was larger in the 2000-2199 g group (P = 0.026). About half of the babies born with a birthweight of 2000-2499 g will require some intervention that will require them to be admitted to a SCN. However, about half would be able to avoid an SCN admission if they are well and admitted to the post-natal ward. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  9. Effects of antenatal corticosteroid administration on mortality and long-term morbidity in early preterm, growth-restricted infants

    NARCIS (Netherlands)

    Schaap, AH; Wolf, H; Bruinse, HW; Smolders-De Haas, H; Van Ertbruggen, [No Value; Treffers, PE

    Objective: To evaluate the effect of antenatal corticosteroids on mortality, morbidity, and disability or handicap rate in early preterm, growth-restricted infants. Methods: This case-control study in two tertiary care centers included all live-born singleton infants with growth-restriction due to

  10. The Infant Fish Oil Supplementation Study (IFOS): design and research protocol of a double-blind, randomised controlled n--3 LCPUFA intervention trial in term infants.

    Science.gov (United States)

    Meldrum, S J; D'Vaz, N; Dunstan, J; Mori, T A; Prescott, S L

    2011-09-01

    The Infant Fish Oil Supplementation Study is a double-blind randomised controlled trial investigating whether the incidence of allergic disease can be reduced and developmental outcomes enhanced through supplementation with omega-3 fatty acids. Infants at high risk of developing allergic disease will be randomised to receive either fish oil or olive oil supplements until 6 months of age and followed up at six postnatal clinic visits to assess allergy outcomes and infant neurodevelopment. Study groups to consist of a treatment group allocated to receive 650 mg of fish oil daily (250-280 mg docosahexaenoic acid and at least 60 mg eicosapentaenoic acid and a placebo group (olive oil) from birth to 6 months of age. Allergy outcomes will be assessed by clinical history, clinical assessments and allergen skin prick tests at the 12, 30 and 60 month visits. Neurodevelopmental assessments to be conducted at 18 months, and language questionnaires at 12, 18 and 30 months. Samples will be collected from mothers antenatally, from infants at birth, and at clinic visits from 6 months onwards for immunological assessments. Fatty acid composition to be measured in erythrocytes and plasma (at birth and after the supplementation period) to assess the effect of the intervention on fatty acid status. Information on medical history, diet and other lifestyle factors at an antenatal clinic visit and postnatal clinic visits will also be collected. This study is designed to examine clinically relevant effects of a novel, non-invasive and potentially low cost approach to reduce the incidence of allergic disease and facilitate neurodevelopment during early childhood. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Effect of Early Expressed Human Milk on Insulin-Like Growth Factor 1 and Short-Term Outcomes in Preterm Infants.

    Directory of Open Access Journals (Sweden)

    Francesca Serrao

    Full Text Available Preterm breast milk contains high levels of bioactive components, including insulin-like growth factor 1 (IGF-1, that are reduced by Holder pasteurization. Animal studies have shown that milk-borne IGF-1 is likely absorbed intact in a bioactive form by the intestines. The aim of this study was to assess if early non-pasteurized expressed breast milk nutrition may affect IGF-1 plasma levels in premature infants. We also investigated the possible association between early expressed milk nutrition and short-term outcomes.Fifty-two preterm infants with gestational age < 31 weeks were divided into two groups according to expressed breast milk intake (< or ≥ 50 mL/Kg/day until 32 weeks of postmenstrual age when blood sampling for IGF-1 analysis was performed.In our population, early expressed breast milk does not affect IGF-1 plasma levels (p 0.48. An association was observed between early expressed milk nutrition and a lower incidence of bronchopulmonary dysplasia, sepsis, feeding intolerance, need for parenteral nutrition and length of hospitalization.Contrary to the results in some animal studies, our results did not seem to show that early expressed breast milk can help to maintain postnatal IGF-1 near foetal levels in preterm infants. The observed protective effect of expressed breast milk on short-term outcomes can be the starting point for further study of the effects of non-pasteurized human milk in preterm infants.

  12. Breastfeeding the preterm infant

    Directory of Open Access Journals (Sweden)

    Luigi Corvaglia

    2013-06-01

    Full Text Available Due to its peculiar nutritional and non-nutritional contents, which include long-chain polyunsatured fatty acids (LC-PUFA, prebiotics, immunological factors, hormones and growth factors, breast milk shows significant advantages over infant formulas in nourishing preterm infants. Better neurocognitive outcomes, which are reported to persist far beyond the early childhood, have been largely observed in breastfed preterm infants; a role of LC-PUFA in promoting neural and retinal development is assumed. As far as the gastrointestinal tract is concerned, several evidences have reported a dose-related reduction in NEC incidence among preterm infants fed on human milk. Moreover, the higher amount of immunological factors as secretory IgA within preterm breast milk might play a remarkable role in reducing the overall infections. Despite breastfeeding in preterm infants is generally linked with lowered growth rates which might potentially affect neurocognitive outcomes, the beneficial effects of human milk on neurodevelopment prevail. Fortified human milk might better fulfill the particular nutritional needs of preterm infants. However, as breast milk fortification is difficult to carry out after the achievement of full oral feeding, some concerns on the nutritional adequacy of exclusive breastfeeding during hospitalization as well as after discharge have been raised. Finally, breastfeeding also entails maternal psychological beneficial effects, as promoting the motherhood process and the mother-child relationship, which could be undermined in those women experiencing preterm delivery. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  13. Traditional Long-Term Central Venous Catheters Versus Transhepatic Venous Catheters in Infants and Young Children.

    Science.gov (United States)

    Marshall, Amanda Marie; Danford, David A; Curzon, Christopher L; Anderson, Venus; Delaney, Jeffrey W

    2017-10-01

    Children with congenital heart disease may require long-term central venous access for intensive care management; however, central venous access must also be preserved for future surgical and catheterization procedures. Transhepatic venous catheters may be an useful alternative. The objective of this study was to compare transhepatic venous catheters with traditional central venous catheters regarding complication rate and duration of catheter service. Retrospective review of 12 congenital heart disease patients from September 2013 to July 2015 who underwent placement of one or more transhepatic venous catheters. Single freestanding pediatric hospital located in the central United States. Pediatric patients with congenital heart disease who underwent placement of transhepatic venous catheter. Cohort's central venous catheter complication rates and duration of catheter service were compared with transhepatic venous catheter data. Twelve patients had a total of 19 transhepatic venous lines. Transhepatic venous lines had a significantly longer duration of service than central venous lines (p = 0.001). No difference between the two groups was found in the number of documented thrombi, thrombolytic burden, or catheter sites requiring wound care consultation. A higher frequency of infection in transhepatic venous lines versus central venous lines was found, isolated to four transhepatic venous lines that had a total of nine infections. All but one was successfully managed without catheter removal. The difference in the proportion of infections to catheters in transhepatic venous lines versus central venous lines was significant (p = 0.0001), but no difference in the rate of infection-related catheter removal was found. Without compromising future central venous access sites, transhepatic venous lines had superior duration of service without increased thrombosis, thrombolytic use, or insertion site complications relative to central venous lines. Transhepatic venous

  14. [Long-term outcomes after cataract surgery in infants with congenital cataract].

    Science.gov (United States)

    Qi, J Y; Xiao, W; Wang, M Y; Zhao, D X; Pu, W

    2017-04-11

    Objective: To observe the long-term outcomes after congenital cataract surgery performed prior to 36 months of age. Methods: A retrospective case study was conducted. Thirty-two cases (57 eyes) of congenital cataract were included from January 2004 to January 2012. All patients received intraocular lens (IOL) implantation with posterior continuous curvilinear capsulorhexies and anterior vitrectomy after cataract extraction and were followed up. At the last visit, the best corrected visual acuity (BCVA) was determined and postoperative complications were evaluated during follow-up with a longest time of 13 years. Non-normal distribution showed in median M (minimum and maximum). Data were analyzed by Kruskal Wallis single factor variance analysis and multiple comparison. The independent Mann-Witney U test was used to analyze non-normal distribution data. Results: There were thirty-two cases (57 eyes) of congenital cataract including 7 unilateral cases and 25 bilateral cases. The median age at cataract extraction was 6.0months; the median IOL implantation age was 28.0 months and the median duration of follow-up after cataract extraction was 67.0 months. The median postoperative BCVA was (LogMAR) 0.52. Unilateral and bilateral cataract postoperative BCVA difference had no statistical significance (U=107, P>0.05). Patients received cataract surgery in 2 to 4 months, the postoperative BCVA was better than in 5 to 8 months. The difference was statistical significance (H=-15.33, Pcataract surgeries performed prior to 36 mouths of life together with the implantation of IOL can achieve good visual acuity. No serious complications occurred. (Chin J Ophthalmol, 2017, 53: 266-273).

  15. Leucocytes in human milk and lymphocyte subsets in cow's milk-allergic infants.

    Science.gov (United States)

    Järvinen, Kirsi-Marjut; Suomalainen, Hanna

    2002-08-01

    The breast-fed infant ingests an average of 108 leucocytes per day, with breast-feeding often continuing for several months. The precise role of human milk leucocytes is still unresolved. Breast-feeding has been recommended for infants at high risk of allergy to prevent or delay the development of food allergies and atopic eczema. However, studies dealing with distinct immunologic factors in the mother's milk, and their effect on health status or development of allergies in the infant, are scarce. We evaluated the relationship between the cellular composition of human milk and the development of cow's milk allergy (CMA) in the breast-fed infant. Leucocyte subsets in the breast-fed infants were also measured. The study population comprised 61 breast-feeding mothers and their infants. Thirty-nine mothers each had a cow's milk-allergic infant, 10 had an infant with atopic dermatitis without CMA, and 12 mothers had a healthy infant. Leucocyte subsets in mothers' milk were counted using a light microscope and confirmed by flow cytometry. In infants, peripheral blood lymphocyte subsets were determined by flow cytometry and were correlated with the health status of the breast-fed infant and leucocyte composition of the mother's milk. Human milk was found to be a non-homogenous morphological entity. In the milk of mothers of infants with CMA, the proportion of macrophages was significantly smaller than in the mothers with infants without CMA (p = 0.036, t-test). Mothers with high proportions of neutrophils in their milk (> 20%) had significantly more often infants with CMA than did those with low proportions of neutrophils (p = 0.02; Fischer's exact test). Eosinophils comprising > 1% of milk cells were only detected in the mothers who had infants with CMA. Furthermore, the proportions of CD4+ T cells were positively correlated with the proportion of milk macrophages and negatively with the percentage of milk neutrophils and eosinophils. The proportions of total B cells and

  16. Integrated Role of Bifidobacterium animalis subsp. lactis Supplementation in Gut Microbiota, Immunity, and Metabolism of Infant Rhesus Monkeys

    Science.gov (United States)

    He, Xuan; Dekker, James W.; Haggarty, Neill W.; Lönnerdal, Bo

    2016-01-01

    ABSTRACT To investigate the impact of probiotic supplementation of infant formula on immune parameters, intestinal microbiota, and metabolism, five individually housed infant rhesus monkeys exclusively fed standard infant formula supplemented with probiotics (Bifidobacterium animalis subsp. lactis HN019) from birth until 3 months of age were compared with five standard formula-fed and five breast-fed monkeys. Anthropometric measurements, serum insulin, immune parameters, fecal microbiota, and metabolic profiles of serum, urine, and feces were evaluated. Consumption of B. lactis-supplemented formula reduced microbial diversity, restructured the fecal microbial community, and altered the fecal metabolome at the last two time points, in addition to increasing short-chain fatty acids in serum and urine. Circulating CCL22 was lower and threonine, branched-chain amino acids, urea, and allantoin, as well as dimethylglycine in serum and urine, were increased in the group supplemented with B. lactis compared with the standard formula-fed group. These results support a role of probiotics as effectors of gut microbial activity regulating amino acid utilization and nitrogen cycling. Future risk-benefit analyses are still needed to consolidate the existing knowledge on the long-term consequences of probiotic administration during infancy. IMPORTANCE Probiotics are becoming increasingly popular due to their perceived effects on health, despite a lack of mechanistic information on how they impart these benefits. Infant formula and complementary foods are common targets for supplementation with probiotics. However, different probiotic strains have different properties, and there is a lack of data on long-term health effects on the consumer. Given the increasing interest in supplementation with probiotics and the fact that the gastrointestinal tracts of infants are still immature, we sought to determine whether consumption of infant formula containing the probiotic

  17. [Percentile curves on growth among breastfed 1-4 year olds in 8 urban areas].

    Science.gov (United States)

    Feng, W W; Huang, X N; Wang, H S; Gong, L M; Xu, Y Q; Pan, X P; Jin, X

    2017-04-10

    Objective: To construct the growth percentile curves of weight-, length/height-, head circumference and BMI for 1 to 4 year-olds who had been breastfed in urban areas. Methods: Data was from the longitudinal study on 1 025 breastfed children aged 1 to 4 years, in 8 urban areas during 2008-2012. MLwiN2.25 was selected to construct the multi-level models of weight-for-age,length for-age, head circumference-for-age and BMI-for-age. The models included many growth relevant factors including gender, age, family and social demographic characteristics, perinatal factors, parent biological characteristics, dietary patterns and diseases of childen. Based on these models, predicted values (P(3), P(15), P(50), P(85), P(97)) were estimated to fit the percentiles reference curves. Results: The percentiles reference curves of weight-, length/height, head circumferenceand BMI-for-age for the 1-4 year-olds who had been breastfed in the urban areas were developed. Differences of all the indicators between boys and girls were statistically significant (Pgrowth, constructed by the longitudinal observational data and scientific method, were important in reflecting the development of breastfed children in urban areas.

  18. Do Differences in Childhood Diet Explain the Reduced Overweight Risk in Breastfed Children?

    NARCIS (Netherlands)

    Scholtens, Salome; Brunekreef, Bert; Smit, Henriette A.; Gast, Gerrie-Cor M.; Hoekstra, Maarten O.; De Jongste, Johan C.; Postma, Dirkje S.; Gerritsen, Jorrit; Seidell, Jaap C.; Wijga, Alet H.

    2008-01-01

    Breastfeeding has been associated with a reduced risk of overweight later in life. This study investigates whether differences in diet and lifestyle at 7 years of age between breastfed and formula-fed children can explain the difference in overweight prevalence at 8 years of age. We studied 2,043

  19. Relationship of Breast-fed and Bottle-fed First Grade Students and I.Q.

    Science.gov (United States)

    Humphrey, Danette

    Previous studies have indicated some support for the hypothesis that breast feeding has a positive effect on intelligence and attainment among young children. This study examined the effects of breast-feeding versus bottle-feeding on the intelligence quotients (IQs) of first graders. A total of 26 breast-fed and 26 bottle-fed first graders from an…

  20. The 5-minute Apgar score: survival and short-term outcomes in extremely low-birth-weight infants.

    Science.gov (United States)

    Phalen, Ann Gibbons; Kirkby, Sharon; Dysart, Kevin

    2012-01-01

    The Apgar score is a standardized tool for evaluating newborns in the delivery room. Despite its long history and widespread use, debate remains over its reliability of predicting neonatal outcomes, especially in extremely low-birth-weight premature infants. The aim of the study was to examine the relationship between the 5-minute Apgar score of extremely low-birth-weight infants, as it relates to survival and morbidities associated with prematurity and length of hospital stay. A retrospective query of the Alere neonatal database from 2001 to 2011 examined all infants less than 32 weeks' gestation and less than 1000-g birth weight. The 5-minute Apgar score was divided into 2 groups, score of 4 or greater or less than 4. The study compared results of the 5-minute Apgar score and associated morbidities in surviving infants. Statistical analyses included chi-square, Fisher exact test, t test, and multivariate regression. The sample consisted of 3898 infants with an 86.4% (n = 3366) survival rate. Controlling for gestational age and birth weight, surviving infants with a 5-minute Apgar score of less than 4 were more likely to demonstrate nonintact survival. Infants with a low 5-minute Apgar score have greater risk for mortality and morbidities associated with prematurity.

  1. Case report of acute vitamin D intoxication in an infant

    Directory of Open Access Journals (Sweden)

    Radlović Nedeljko

    2014-01-01

    Full Text Available Introduction. Vitamin D intoxication represents a rare and potentially serious pathological condition caused by the excess of calcium and phosphorus. We are presenting an infant with vitamin D intoxication due to excessive daily administration, as well as therapeutic procedures that prevented its adverse effects. Case Outline. A 1.5-month-old female infant, born at term, exclusively breastfed and without any complaints and abnormalities of physical findings, was observed due to the data that during the preceding month, by her mother’s mistake, she had received about 200,000 IU of vitamin D3. Laboratory analyses showed a high serum level of 25(OHD (>400 nmol/L and calcium (2.72 mmol/L, lowered PTH (6.6 pg/ml and high urinary calcium/creatinine ratio (1.6, while other findings, including urotract ultrasonography image, were within normal limits. Treatment based on the discontinuation of vitamin D administration, infant’s forced water intake, as well as the application of 2-month prednisolone and 4-month phenobarbitone and furosemide, resulted in complete normalization of the laboratory indicators of vitamin D overdose, as well as the prevention of its adverse effects. Conclusion. By timely recognition and adequate treatment, including triple therapy with prednisolone, phenobarbitone and furosemide, adverse effects of acute vitamin D intoxication can be prevented.

  2. Effect of Tactile-Kinesthetic Stimulation in weight gaining of pre-term infants hospitalized in intensive care unit

    Directory of Open Access Journals (Sweden)

    Keshavarz M

    2009-08-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Many studies have demonstrated that pre-term neonates gained more weight over the 10 days stimulation period. This research has been conducted to determine the effects of five days Tactile- Kinesthetic stimulation (TKS on weight gaining of pre-term infants hospitalized in Fatemiye neonatal intensive care unit."n"n Methods: Fifty one babies who graduated from the NICU to the intermediate care nursery were randomly allocated into test and control groups (24 and 27 neonate respectively. TKS was provided for three 20 minute periods per day for five consecutive days to the test group, with the massages consisting of moderate pressure strokes in left and right lateral position and kinesthetic exercises consisting of flexion and extension of the limbs. They were observed for changes in physiologic parameters and weight gaining during five days stimulation in hospital."n"n Results: Over the five days TKS an increase in weight was seen in the test group (p=0.018, 43.1 vs 5.4. Infants in both the test and control groups were matched for mean weight before study and days in which they received antibiotics and photo therapy. Mean temperature and O² saturation had no meaningful difference, but an increase in

  3. Breastfeeding progression in preterm infants is influenced by factors in infants, mothers and clinical practice

    DEFF Research Database (Denmark)

    Maastrup, Ragnhild; Hansen, Bo Moelholm; Kronborg, Hanne

    2014-01-01

    BACKGROUND AND AIM: Many preterm infants are not capable of exclusive breastfeeding from birth. To guide mothers in breastfeeding, it is important to know when preterm infants can initiate breastfeeding and progress. The aim was to analyse postmenstrual age (PMA) at breastfeeding milestones...... in different preterm gestational age (GA) groups, to describe rates of breastfeeding duration at pre-defined times, as well as analyse factors associated with PMA at the establishment of exclusive breastfeeding. METHODS: The study was part of a prospective survey of a national Danish cohort of preterm infants...... based on questionnaires and structured telephone interviews, including 1,221 mothers and their 1,488 preterm infants with GA of 24-36 weeks. RESULTS: Of the preterm infants, 99% initiated breastfeeding and 68% were discharged exclusively breastfed. Breastfeeding milestones were generally reached...

  4. Iodine-Induced Hypothyroidism in Full-term Infants With Congenital Heart Disease: More Common Than Currently Appreciated?

    National Research Council Canada - National Science Library

    Thaker, V. V; Leung, A. M; Braverman, L. E; Brown, R. S; Levine, B

    2014-01-01

    Context: Iodine is a micronutrient essential for thyroid hormone synthesis. Thyroid hormone is critical for normal neurocognitive development in young infants, and even transient hypothyroidism can cause adverse neurodevelopmental outcomes...

  5. Infant food applications of complex carbohydrates: Structure, synthesis, and function.

    Science.gov (United States)

    Ackerman, Dorothy L; Craft, Kelly M; Townsend, Steven D

    2017-01-02

    Professional health bodies such as the World Health Organization (WHO), the American Academy of Pediatrics (AAP), and the U.S. Department of Health and Human Services (HHS) recommend breast milk as the sole source of food during the first year of life. This position recognizes human milk as being uniquely suited for infant nutrition. Nonetheless, most neonates in the West are fed alternatives by 6 months of age. Although inferior to human milk in most aspects, infant formulas are able to promote effective growth and development. However, while breast-fed infants feature a microbiota dominated by bifidobacteria, the bacterial flora of formula-fed infants is usually heterogeneous with comparatively lower levels of bifidobacteria. Thus, the objective of any infant food manufacturer is to prepare a product that results in a formula-fed infant developing a breast-fed infant-like microbiota. The goal of this focused review is to discuss the structure, synthesis, and function of carbohydrate additives that play a role in governing the composition of the infant microbiome and have other health benefits. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Zinc and infant nutrition.

    Science.gov (United States)

    Ackland, M Leigh; Michalczyk, Agnes A

    2016-12-01

    Zinc is essential for a wide variety of cellular processes in all cells. It is a critical dietary nutrient, particularly in the early stages of life. In the early neonatal period, adequate sources of zinc can be obtained from breast milk. In rare circumstances, the mammary gland produces zinc deficient milk that is potentially lethal for exclusively breast-fed infants. This can be overcome by zinc supplementation to the infant. Alterations to key zinc transporters provide insights into the mechanisms of cellular zinc homeostasis. The bioavailability of zinc in food depends on the presence of constituents that may complex zinc. In many countries, zinc deficiency is a major health issue due to poor nourishment. Young children are particularly affected. Zinc deficiency can impair immune function and contributes to the global burden of infectious diseases including diarrhoea, pneumonia and malaria. Furthermore, zinc deficiency may extend its influence across generations by inducing epigenetic effects that alter the expression of genes. This review discusses the significance of adequate zinc nutrition in infants, factors that influence zinc nutrition, the consequences of zinc deficiency, including its contribution to the global burden of disease, and addresses some of the knowledge gaps in zinc biology. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Tolerance and safety of Lactobacillus paracasei ssp. paracasei in combination with Bifidobacterium animalis ssp. lactis in a prebiotic-containing infant formula: a randomised controlled trial

    NARCIS (Netherlands)

    Vlieger, A.M.; Robroch, A.H.; Van Buuren, S.|info:eu-repo/dai/nl/074806777; Kiers, J.; Rijkers, G.; Benninga, M.A.; te Biesebeke, R.

    2009-01-01

    The addition of probiotics to infant formula has been shown to be an efficient way to increase the number of beneficial bacteria in the intestine in order to promote a gut flora resembling that of breast-fed infants. The objective of the present study was to evaluate the safety and tolerance of a

  8. Tolerance and safety of Lactobacillus paracasei ssp paracasei in combination with Bifidobacterium animalis ssp lactis in a prebiotic-containing infant formula: a randomised controlled trial

    NARCIS (Netherlands)

    Vlieger, Arine M.; Robroch, Afke; van Buuren, Stef; Kiers, Jeroen; Rijkers, Ger; Benninga, Marc A.; te Biesebeke, Rob

    2009-01-01

    The addition of probiotics to infant formula has been shown to be an efficient way to increase the number of beneficial bacteria in the intestine in order to promote a gut flora resembling that of breast-fed infants. The objective of the present study was to evaluate the safety and tolerance of a

  9. Body fat and bone mineral content of infants fed breast-milk, cow's-milk formula, or soy formula during the first year of life

    Science.gov (United States)

    Our objective was to characterize growth, fat mass (FM), fat free mass (FFM), and bone mineral content (BMC) longitudinally in breast-fed (BF), cow's milk formula-fed (CMF), or soy formula-fed (SF) healthy infants during the first year of life. Infants were assessed at ages 3, 6, 9, and 12 mo. Growt...

  10. Oscillometric and intra-arterial blood pressure in preterm and term infants: extent of discrepancy and factors associated with inaccuracy.

    Science.gov (United States)

    Shimokaze, Tomoyuki; Akaba, Kazuhiro; Saito, Emi

    2015-02-01

    Securing an arterial line to monitor continuous blood pressure (BP) is difficult in infants. We aimed to reveal the extent of discrepancies between oscillometric and direct BP. Infants who required continuous BP monitoring were prospectively enrolled. Direct and indirect BP were simultaneously recorded. Disposable BP cuffs matching one-half to two-thirds of the upper arm circumference were used. A total of 74 infants were studied (gestational age [GA], 24-42 weeks). The correlation coefficients of systolic, diastolic, and mean arterial BP of indirect and direct measurements were 0.87, 0.82, and 0.84, respectively (p Oscillometric measurements significantly underestimated systolic BP in light-for-gestational-age infants and diastolic BP in infants without fentanyl administration. There were no significant correlations between discrepant BP measurements and edema, vasopressor administration, arterial line location, GA, postnatal age, body weight, pulse rate, or hemoglobin level. In 4.1% of infants, systolic BP increased by 10 to 15 mm Hg at the time of cuff expansion. We recommend intra-arterial BP measurement when the BP values seriously influence the therapeutic protocol. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Characterisation of sucking dynamics of breastfeeding preterm infants: a cross sectional study.

    Science.gov (United States)

    Geddes, Donna T; Chooi, Kok; Nancarrow, Kathryn; Hepworth, Anna R; Gardner, Hazel; Simmer, Karen

    2017-11-17

    Full breastfeeding is the ultimate aim for preterm infants to ensure they receive the full benefits of human milk however, preterm