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Breastfed Infants (breastfed + infant)
Selected AbstractsThe mother-offspring dyad and the immune systemACTA PAEDIATRICA, Issue 3 2000LÅ Hanson A. The mother and the fetus. The mother's immune system reacts against the fetus and there is therefore a risk of destruction of or damage to the fetus. We are now beginning to understand some of the mechanisms that protect the fetus, but, when these are defective, intrauterine growth retardation or abortions may ensue. However, the cytokines of this maternal immune response to the fetus also monitor different phases of pregnancy, starting with effects on the ovarium and involving preparation of the decidua for the implantation of the fertilized egg, the growth of the trophoblasts, the production of hormones important for the pregnancy and finally of the prostaglandins that induce delivery. B. The mother and the child. Human milk contains anti-idiotypic antibodies which after transfer to the offspring are capable of enhancing antibody responses. Human milk contains numerous leucocytes especially during early lactation. There is increasing evidence that milk lymphocytes are taken up by the breastfed infant, which seems to have become tolerant to maternal HLA. Breastfeeding mothers are therefore good donors of renal transplants to their breastfed offspring in adult age, too. Conclusion: It is suggested that the milk lymphocytes may be taken up by the offspring and that immunological information is thereby carried over from the mother. This mechanism may explain why breastfeeding seems to confer enhanced protection against infections also some years after the termination of breastfeeding. [source] Effect of combined maternal and infant vitamin D supplementation on vitamin D status of exclusively breastfed infantsMATERNAL & CHILD NUTRITION, Issue 1 2009Hussein F. Saadi Abstract Severe vitamin D deficiency in mothers and their breastfed infants is a significant health problem in the Middle East. Supplementation of the breastfed infant alone with the recommended dose of vitamin D may be insufficient in high-risk population. We investigated the effect of combined maternal and infant vitamin D supplementation on vitamin D status of the breastfed infant. We examined also the effect of supplementation on vitamin D antirachitic activity of breast milk in a subset of mothers. Healthy breastfeeding mothers (n = 90) were randomly assigned to 2000 IU daily (group 1) or 60 000 IU monthly (group 2) of vitamin D2, and all their infants (n = 92) received 400 IU daily of vitamin D2 for 3 months. Most infants had vitamin D deficiency , 25-hydroxyvitamin D [25(OH)D] , 37.5 nmol L,1, at study entry. Serum 25(OH)D concentrations at 3 months increased significantly from baseline in infants of mothers in group 1 (13.9 ± 8.6 vs. 49.6 ± 18.5 nmol L,1, P < 0.0001) and group 2 (13.7 ± 12.1 vs. 44.6 ± 15.0 nmol L,1, P < 0.0001). Maternal and infant serum 25(OH)D concentrations correlated positively at baseline (r = 0.36, P = 0.01) and 3 months (r = 0.46, P = 0.002). Milk antirachitic activity increased from undetectable (<20 IU L,1) to a median of 50.9 IU L,1. In conclusion, combined maternal and infant vitamin D supplementation was associated with a threefold increase in infants' serum 25(OH)D concentrations and a 64% reduction in the prevalence of vitamin D deficiency without causing hypervitaminosis D. [source] A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil®) in the treatment of breastfed colicky infantsPHYTOTHERAPY RESEARCH, Issue 4 2005Francesco Savino Abstract Objective: The aim of this randomized, double-blind, placebo-controlled trial was to investigate the effectiveness and side effects of a phytotherapeutic agent with Matricariae recutita, Foeniculum vulgare and Melissa officinalis in the treatment of infantile colic. Methods: 93 breastfed colicky infants were enrolled, the diagnosis was made according to Wessel's criteria. After a 3 day observation period, the infants were randomly divided into two groups, one treated with phytotherapeutic agent (PA) and the other with placebo twice a day for 1 week. Crying time and side effects were recorded. Results: 88 infants completed the trial: 41 in the PA group and 47 in the control. The daily average crying time for the PA was 201.2 min/day (SD 18.3) at the baseline and 76.9 min/day (SD 23.5) at the end of the study; for the placebo it was 198.7 min/day (SD 16.9) and 169.9 min/day (SD 23.1) (p < 0.005). Crying time reduction was observed in 85.4% subjects for the PA and in 48.9% subjects for the placebo (p < 0.005). No side effects were reported. Conclusion: The present study shows that colic in breastfed infant improves within 1 week of treatment with an extract based on Matricariae recutita, Foeniculum vulgare and Melissa officinalis. Copyright © 2005 John Wiley & Sons, Ltd. [source] Dose-effect study of domperidone as a galactagogue in preterm mothers with insufficient milk supply, and its transfer into milkBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2008Elise W-X. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT , Domperidone is an effective treatment for some mothers with insufficient milk supply. , However, dose,effect data are not available, and the safety of domperidone use in both mother and infant has been questioned. WHAT THIS STUDY ADDS , Domperidone only increases milk production in about two-thirds of preterm mothers with insufficient milk supply. , On average, the responders showed increasing levels of milk production with dose escalation from 30 mg to 60 mg daily. , The amount of domperidone that transferred into breast milk was very low, and the risk to the breastfed infant is minimal. AIMS To investigate the possibility of a dose,response relationship for the use of domperidone in treating insufficient milk supply in mothers of preterm infants, and to quantify the exposure of the breastfed infant to domperidone. METHODS Six preterm mothers received domperidone (30 mg daily or 60 mg daily) in a double-blind, randomized, crossover trial. Milk production and serum prolactin were measured before and during the trial, and domperidone concentration in milk was measured during drug treatment. RESULTS For milk production, two of the mothers were ,nonresponders', whereas the other four were ,responders' and showed a significant increase in milk production from 8.7 ± 3.1 g h,1 in the run-in phase (mean ± SEM), 23.6 ± 3.9 g h,1 for the 30-mg dose (P = 0.0217) and 29.4 ± 6.6 g h,1 for the 60-mg dose (P = 0.0047). In all participants, serum prolactin was significantly increased for both doses, but the response was not dose dependent. Median (interquartile range) domperidone concentrations in milk over a dose interval at steady-state were 0.28 µg l,1 (0.24,0.43) and 0.49 µg l,1 (0.33,0.72) for the 30-mg and 60-mg doses, respectively. The mean relative infant dose was 0.012% at 30 mg daily and 0.009% at 60 mg daily. CONCLUSION In one-third of mothers, domperidone did not increase milk production. In the remainder, milk production increased at both domperidone doses, and there was a trend for a dose,response relationship. The amount of domperidone that transfers into milk was extremely low, and infant exposure via breastfeeding was not considered to be significant. [source] Introduction of solids and formula to breastfed infants: a longitudinal prospective study in Uppsala, SwedenACTA PAEDIATRICA, Issue 5 2001A Hörnell The introduction of solids and formula was studied among 506 breastfed infants in Uppsala, Sweden, based on daily recordings during the first year. The mothers had previously breastfed at least 1 infant for at least 4 mo. Thirty-four per cent of the infants were introduced to solids before the age of 4 mo (4,6 mo is recommended in Sweden). Accustoming the infants to solids was a lengthy process. Life-table analyses showed a median duration of 28 d from the first introduction of solids to consumption of >10 ml daily, and 46 d before the infants ate 100 ml of solids in 1 d for the first time. These durations were longer the younger the infant was at the introduction of solids. Thirty-two per cent of infants given formula consumed 100 ml the first time it was given, and 49% did so within 1 wk, regardless of infant age. Conclusion: Parents and healthcare personnel need to be aware that accustoming breastfed infants to solid food is a lengthy process, and that there is a strong age effect on this duration. It is also important to consider what consequences the (usually) more abrupt introduction of formula might have on breastfeeding. [source] Bed-sharing practices of initially breastfed infants in the first 6 months of lifeINFANT AND CHILD DEVELOPMENT, Issue 4 2007Helen L. BallArticle first published online: 28 AUG 200 Abstract This paper explores the manner in which bed-sharing is practised by breastfeeding infants in the UK, and examines how alternate definitions and interpretations of breastfeeding and bed-sharing can lead to confusion in understanding what bed-sharing entails. Longitudinal studies on parent,infant bed-sharing practices are scarce, but are vital to our understanding of normative bed-sharing behaviour. We present data from a longitudinal study of sleeping and feeding practices in England involving 97 initially breastfed infants from birth to 6 months of age whose behaviour was monitored weekly for a 6-month period. Results demonstrate that bed-sharing practices covary with breastfeeding practices, and that a single model of bed-sharing behaviour does not adequately reflect the experience of all infants. Our findings have ramifications for the way in which case,control studies attempt to ,measure' bed-sharing, and our understanding and interpretation of bed-sharing risk factors. Copyright © 2007 John Wiley & Sons, Ltd. [source] Effects of early breastfeeding on neonatal glucose levels of term infants born to women with gestational diabetesJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 2 2009I. R. A. Chertok Abstract Background:, Infants born to diabetic women are at higher risk for hypoglycaemia related to hyperinsulinism in response to maternal hyperglycaemia during pregnancy. As such, recommendations to prevent neonatal hypoglycaemia include infant feeding in the early postpartum period. The present study aimed to examine the effect of early breastfeeding and type of nutrition used for the first feed (human milk or formula) on glucose levels in infants born to women with gestational diabetes. Methods:, The prospective pilot study of 84 infants born to gestational diabetic women examined the glycaemic levels of infants who were breastfed in the delivery room compared to glycaemic levels of those who were not. The study also compared the glycaemic levels of infants who breastfed with those who received formula for their first feed. Results:, Infants who were breastfed in the delivery room had a significantly lower rate of borderline hypoglycaemia than those who were not breastfed in the early postpartum period (10% versus 28%; Fisher's exact test., P = 0.05,). Likewise, infants breastfed in the delivery room had significantly higher mean blood glucose level compared to infants who were not breastfed in the delivery room (3.17 versus 2.86 mmol L,1, P = 0.03). Additionally, breastfed infants had a significantly higher mean blood glucose level compared to those who were formula fed for their first feed (3.20 versus 2.68 mmol L,1, P = 0.002). Conclusions:, Early breastfeeding may facilitate glycaemic stability in infants born to women with gestational diabetes. [source] Breastfeeding protects against infectious diseases during infancy in industrialized countries.MATERNAL & CHILD NUTRITION, Issue 3 2009A systematic review Abstract Firstly, this review was performed to assess the effect of breastfeeding on infections during infancy in industrialized countries. Secondly, the effect of duration and exclusiveness of breastfeeding were explored. Studies were identified using Medline, Cochrane Library, Science Citation Index and by a manual search from bibliographies of articles from August 1986 to January 2008. Follow-up, case,control and randomized controlled trial (RCT) studies performed in an industrialized country, published in English, with breastfeeding as a determinant, with overall infections, gastrointestinal or respiratory tract infections as a major outcome, and at least 40 participants in the study were included. Using Bauchner's criteria published in a review in 1986, two reviewers and a peer reviewer assessed the internal validity of those studies. Twenty-one studies that met the inclusion and internal validity criteria were included. These included 16 follow-up and four case,control studies and one RCT. Four out of five studies observed decreased effects on overall infections in breastfed infants. With regard to gastrointestinal infections, six out of eight studies suggested that breastfeeding had a protective effect. Thirteen out of 16 studies concluded that breastfeeding protects infants against respiratory tract infections. Five studies combined duration and exclusiveness of breastfeeding. All studies observed a protective dose/duration-response effect on gastrointestinal or respiratory tract infections. These studies strongly suggest that breastfeeding protects infants against overall infections, gastrointestinal and respiratory tract infections in industrialized countries. The optimal duration of exclusive breastfeeding for protection against infectious diseases needs to be studied in more detail. [source] Effect of combined maternal and infant vitamin D supplementation on vitamin D status of exclusively breastfed infantsMATERNAL & CHILD NUTRITION, Issue 1 2009Hussein F. Saadi Abstract Severe vitamin D deficiency in mothers and their breastfed infants is a significant health problem in the Middle East. Supplementation of the breastfed infant alone with the recommended dose of vitamin D may be insufficient in high-risk population. We investigated the effect of combined maternal and infant vitamin D supplementation on vitamin D status of the breastfed infant. We examined also the effect of supplementation on vitamin D antirachitic activity of breast milk in a subset of mothers. Healthy breastfeeding mothers (n = 90) were randomly assigned to 2000 IU daily (group 1) or 60 000 IU monthly (group 2) of vitamin D2, and all their infants (n = 92) received 400 IU daily of vitamin D2 for 3 months. Most infants had vitamin D deficiency , 25-hydroxyvitamin D [25(OH)D] , 37.5 nmol L,1, at study entry. Serum 25(OH)D concentrations at 3 months increased significantly from baseline in infants of mothers in group 1 (13.9 ± 8.6 vs. 49.6 ± 18.5 nmol L,1, P < 0.0001) and group 2 (13.7 ± 12.1 vs. 44.6 ± 15.0 nmol L,1, P < 0.0001). Maternal and infant serum 25(OH)D concentrations correlated positively at baseline (r = 0.36, P = 0.01) and 3 months (r = 0.46, P = 0.002). Milk antirachitic activity increased from undetectable (<20 IU L,1) to a median of 50.9 IU L,1. In conclusion, combined maternal and infant vitamin D supplementation was associated with a threefold increase in infants' serum 25(OH)D concentrations and a 64% reduction in the prevalence of vitamin D deficiency without causing hypervitaminosis D. [source] Weight monitoring of breastfed babies in the UK , centile charts, scales and weighing frequencyMATERNAL & CHILD NUTRITION, Issue 2 2005Magda Sachs ba, ma (cantab) Abstract Weighing infants during their first 6 months is an important focus of growth monitoring and a common activity of child health care services worldwide. In these same months, health workers provide support for breastfeeding and promote continued exclusive breastfeeding. The literature on the practice of weighing breastfed babies is reviewed, as it applies to the United Kingdom. The shape of the growth curves for breastfed babies differs from that of formula-fed infants and also from centile charts previously in use. The World Health Organization commitment to the production of a new growth reference has generated discussion of the implications of charts in use. The country-specific charts in use in the UK are examined and the data used to construct them discussed with reference to clinical use for breastfed infants. Recent UK discussions on charts, as well as on the frequency of routine weighing for babies in the community are considered, and the available evidence on the accuracy of weighing in practice is noted. The choices made in constructing different charts; the physical condition of scales and their use in practice have implications for plotted growth. This paper aims to present a wide range of evidence available in this area in order to encourage debate on practice. A companion paper will discuss issues of interpretation, conveying information to parents, and interventions. [source] Nutritional Rickets: An Old Disease ReturnsNUTRITION REVIEWS, Issue 4 2002Steven A. Abrams M.D. Nutritional rickets, an ancient disease that was thought to have been cured in the early part of the 20th century, has made an unexpected comeback in recent years throughout the world. Although the frequency of its occurrence is poorly documented, increasing case reports of rickets are apparently related to low dietary intake of vitamin D and calcium and decreased sunshine exposure. Greater awareness of this problem is needed, as are further data regarding vitamin D status and incidence of rickets among infants and toddlers. Routine provision of supplemental vitamin D to all breastfed infants remains controversial, but may become more widely recommended. [source] T-lymphocyte subsets, thymic size and breastfeeding in infancyPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2 2004Dorthe L. Jeppesen We followed the changes in concentration of T-lymphocyte subsets (CD4+ and CD8+ cells) in peripheral blood and thymus size during infancy. Previous studies have found increased thymus size in breastfed infants. The present study analyzed the association between breastfeeding and the number of CD4+ and CD8+ cells. Two different populations of infants between birth and 1 year of age were examined. Study Group I: infants with a variable duration of breastfeeding. Study Group II: long-term breastfed infants. In both groups a correlation was found between CD8+ cells and the thymic index at 10 months of age. In Group I, infants still breastfed at the 8-month examination had a higher CD8% than formula-fed infants (p = 0.05), and infants breastfed at the 4-month examination had a higher CD4% at 10 months of age (p=,0.03). Group II showed an increase in the absolute number of CD4+ and CD8+ cells from 8 to 10 months of age; and a positive correlation between the number of breastfeedings per day at 8 months of age, and an increase in CD4+ cells from 8 to 10 months of age (p <0.01). In conclusion, a correlation was found between thymus size and CD8+ cells. Breastfeeding might have both a current and long-term immune-modulating effect on the developing cellular immune system. [source] Effects of the herbal formulation ColiMil® on upper gastrointestinal transit in mice in vivoPHYTOTHERAPY RESEARCH, Issue 10 2007Raffaele Capasso Abstract Clinical evidence suggests that the herbal formulation ColiMil® (which contains Matricaria recutita flowers extract, Foeniculum vulgare fruit extract and Melissa officinalis aerial parts extract) is effective in the treatment of breastfed colic in infants. Therefore the effect of this phytotherapeutic formulation and its herbal constituents on upper gastrointestinal transit was investigated in mice in vivo. Oral administration of the herbal formulation (0.4,0.8 mL/mice) dose-dependently delayed upper gastrointestinal transit. Among the herbal components, Matricaria recutita extract (0.89 and 1.78 mg/mouse) and Melissa officinalis extract (6.46 and 12.92 mg/mouse), but not Foeniculum vulgare (8.21 and 16.42 mg/mouse), reduced motility significantly. These results suggest that ColiMil® reduces upper gastrointestinal motility in mice, with a major contribution by Matricaria recutita and Melissa officinalis. These experimental data may be important to better understand the observation that the herbal formulation ColiMil® improves colic in breastfed infants. Copyright © 2007 John Wiley & Sons, Ltd. [source] Thimerosal exposure (from tetanus-diphtheria vaccine) during pregnancy and neurodevelopment of breastfed infants at 6 monthsACTA PAEDIATRICA, Issue 6 2010RC Marques Abstract Aim:, We studied the effect on neurodevelopment of infants who are exposed to thimerosal in tetanus-diphtheria (Td) vaccines during pregnancy. Methods:, We compared Gesell Developmental Schedules (GDS) of exclusive breastfed infants at 6 months born to mothers who received Td (1 to 3 doses) against those who were born to mothers who did not take such vaccines. Results:, Compared with the group of infants not exposed to ethylmercury in utero, the infants of exposed mothers showed no significant difference in neurodevelopment delays. Although there was a significant correlation between hair-Hg of mothers and hair-Hg of neonates (Spearman r = 0.353; p = 0.0011), there was no significant correlation between the level of in utero exposure to ethylmercury in Td vaccines and neonate's hair-Hg concentrations (Spearman r = 0.060; p = 0.5922). However, regression analysis showed that GDS at 6 months was significantly associated with total mercury concentration of neonate's hair but was not sensitive to the number of vaccines taken by the mother. Conclusion:, Early neurodevelopment of exclusively breastfed infants is sensitive to in utero exposure to mercury, but maternal thimerosal exposure in tetanus-diphtheria vaccines per se cannot portend clinical neurodevelopment delays measured by GDS at 6 months. [source] Evaluation of the acceptability of a new oral vitamin K prophylaxis for breastfed infantsACTA PAEDIATRICA, Issue 3 2010E-M Strehle Abstract Aim:, The aim of this study was to investigate the acceptability and tolerability of the oral food supplement Neokay for the prevention of vitamin K deficiency bleeding in newborns. Methods:, A questionnaire survey was conducted among 45 midwives in which they were asked 10 questions about their use of Neokay, its advantages and disadvantages, and their perceptions of parental attitudes towards this new prophylactic treatment. Results:, During a 6-month period one dose of Neokay was given to 1794 healthy newborns at birth and further daily doses were given to 812 breastfed infants for 3 months. The midwives listed as main advantages ease of administration, no need for prescription or written consent, and transfer of responsibility to parents. As disadvantages, they mentioned possible reduced compliance as a result of the frequency of dosing, decreased parental confidence in breastfeeding and technical issues with packaging. Conclusion:, A prophylactic vitamin K dosage regimen of 1 mg oral vitamin K (Konakion MM Paediatric or Orakay) given to all healthy neonates at birth, combined with daily doses of 50 ,g Neokay for 3 months for breastfed babies is well tolerated and acceptable to midwives and parents. [source] Molecular identification of coliform bacteria from colicky breastfed infantsACTA PAEDIATRICA, Issue 10 2009F Savino Abstract Objective:, To determine the presence of intestinal coliform bacteria in colicky vs healthy infants. Study design:, We isolated coliform strains from faeces and performed quantitative bacterial cultures in 41 colicky and 39 healthy breastfed infants, identified using PCR with species-specific primers, strain-specific Automated Ribotyping and the API-50E kit for Enterobacteriaceae to identify the most frequent strains. Results:, Coliform strains were more abundant in colicky infants (median 6.04 log10 CFU/g faeces, range 2.00,8.76) vs controls (median 4.47 log10 CFU/g faeces, range 1.00,8.08) (p = 0.026). Escherichia coli, Klebsiella pneumoniae, K. oxytoca, Enterobacter cloacae, E. aerogenes and Enterococcus faecalis were the predominant species in colicky and healthy infants. The counts of each bacterial species differed between the two groups, and the difference was significant (p = 0.002) for E. coli: median 6.30 log10 CFU/g faeces (range 3.00,8.74) in colicky infants, and median 4.70 log10 CFU/g faeces (range 2.00,5.85) in controls. Conclusions:, This is the first study to evaluate the colonization patterns of gas-forming coliforms in colicky infants and healthy controls identified by molecular methods. Coliform bacteria, particularly Escherichia coli, were found to be more abundant in colicky infants. Our data could help to shed light on the cause of infantile colic. [source] Natural evolution of regurgitation in healthy infantsACTA PAEDIATRICA, Issue 7 2009Badriul Hegar Abstract Objectives:, To determine the natural history of infant regurgitation during the first year of life. Methods: Parents recorded prospectively the frequency of regurgitation for 1 week before consultation during the first year of life. A sub-group analysis according to the method of feeding was planned. Results:, A total of 130 infants of an original sample of 163 (80%) newborns were followed up for 1 year. Daily spilling was highest during the first month of life (73%) and decreased gradually to 50% during the fifth month of life. During the first 2 months of life, 20% of the infants regurgitated more than four times per day. After the age of 12 months, only 4% of the infants had daily regurgitations. Exclusively breastfed infants did regurgitate less than partially breastfed infants. Weight gain was influenced by the frequency of regurgitation, especially in partially breastfed infants. Conclusion: Regurgitation in infancy is common, decreasing from birth, and tends to disappear by 12 months of age. Weight gain during the first 4 months of life is decreased in infants who regurgitate more than four times a day. Our data suggest that exclusively breastfed infants regurgitate less than partially breastfed babies. [source] A nationwide study on hospital admissions due to dehydration in exclusively breastfed infants in the Netherlands: its incidence, clinical characteristics, treatment and outcomeACTA PAEDIATRICA, Issue 5 2009Rolf AA Pelleboer Abstract 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 Paediatric Surveillance Unit (DPSU) between mid 2003 and mid 2005. Results: Nationwide 158 cases reported, correspond to an incidence of 58/y/100 000 breastfed infants; it is lower for severe dehydration at risk for hypernatraemia; 20/y/100 000. Sixty-five per cent of cases were <2 weeks old, their median weight loss was 9.3% and median age at admission 5 days; Serum sodium value was measured in only 12% of all cases. Insufficient volume intake and inadequate growth were most frequently reported (61% and 41%). Lethargy, jaundice or clinical dehydration was scored in 11,25%, seizures or shock in 3%. A breast pump at home was used in only 31%. In the hospital breast pumps were available (82%) as lactation consultants (73%). For treatment 65% was offered formula, in 30% by nasogastric drip. Most admissions lasted up to 3 days, all recovered fully and 33% were breastfed exclusively at discharge. Conclusion: The incidence of severe dehydration in the Netherlands is relatively low. With extended use of breast pumps at home it could be lower. To prevent complications, we recommend applying a reference weight chart, a full clinical examination and more extensive screening of serum sodium and glucose. [source] Nutritional relevance of trans isomeric fatty acids in human milkACTA PAEDIATRICA, Issue 12 2003T Decsi Trans isomeric fatty acids amount to about 2% of the fatty acid composition of human milk in Europe, whereas lower values were seen in Africa, and higher values were reported for North-America. At least five human studies indicate that trans fatty acids may interfere with the metabolism of long-chain polyunsaturated fatty acids. Conclusion: Trans isomeric fatty acids in human milk should be regarded as a potential confounding variable in studies investigating the role of long-chain polyunsaturated fatty acids in the development of breastfed infants. [source] Morbidity in children born to women infected with human immunodeficiency virus in South Africa: does mode of feeding matter?ACTA PAEDIATRICA, Issue 8 2003A Coutsoudis Aim: To examine infant morbidity risks associated with refraining from breastfeeding where it is used in an attempt to prevent mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV). Methods: The population consisted of infants born to HIV-infected women in South Africa who were participating in a vitamin A intervention trial to prevent MTCT of HIV. Women chose to breastfeed or formula feed their infants according to UNAIDS guidelines. Actual feeding practices and morbidity were recorded at clinic follow-up visits at 1 wk, 6 wk, 3 mo and every 3 mo thereafter until 15 mo of age or cessation of breastfeeding. The infant's HIV status was assessed according to a predetermined algorithm. Results: HIV-infected infants who were never breastfed had a poorer outcome than those who were breastfed; 9 (60%) of those who were never breastfed had 3 or more morbidity episodes compared with 15 (32%) of breastfed children [odds ratio (OR) 4.05, 95% confidence interval (95% CI) 0.91,20.63, p = 0.05]. During the first 2 mo of life, never-breastfed infants (regardless of HIV status) were nearly twice as likely to have had an illness episode than breastfed infants (OR 1.91, 95% CI 1.17-3.13, p = 0.006). Conclusion: The significant extra morbidity experienced in the first few months by all never-breastfed infants and at all times by HIV-infected infants who are not breastfed needs to be considered in all decisions by mothers, health workers and policy makers so as not to offset any gains achieved by decreasing HIV transmission through avoiding breastfeeding. [source] Fecal flora measurements of breastfed infants using an integrated transport and culturing systemACTA PAEDIATRICA, Issue 5 2003S Fanaro No abstract is available for this article. [source] Serum bilirubin levels at 72 hours by selected characteristics in breastfed and formula-fed term infants delivered by cesarean sectionACTA PAEDIATRICA, Issue 7 2001SR Hintz The present multicenter study analysed the relative impact of maternal and infant factors on serum bilirubin levels at 72 ± 12 h in exclusively breastfed vs formula-fed term infants. End-tidal carbon monoxide levels corrected for ambient air (ETCOc), an index of bilirubin production, were measured in exclusively breastfed (B = 66) or formula-fed (F = 210) term infants at 2,8 h of age. Inclusion criteria included cesarean section to ensure a 3 d hospitalization, birthweight ±2500 g, gestational age ±37 wk and absence of any illness. The ETCOc for B infants and F infants did not differ significantly (1.3 ± 0.7 ppm vs 1.3 ± 0.8 ppm). The serum bilirubin level at 72 ± 12 h was significantly higher in B infants than in F infants (8.5 ± 3.4mg dl,1 vs 6.7 ± 3.4 mg d l,1, p < 0.001), as was the percentage weight loss from birthweight. Serum bilirubin levels were significantly higher in infants who were male, who did not have meconium-stained amniotic fluid, and in those whose mothers were insulin-dependent diabetics or hypertensive. There was no difference between groups in the need for phototherapy or exchange transfusion. Conclusion: Although higher bilirubin levels were observed in group B at 72 ± 12 h compared with group F, this finding was not of clinical or therapeutic consequence in this study. The lack of difference in ETCOc between the groups may be a factor of the timing of ETCOc measurement in this study, or may suggest that early increased bilirubin production is not a significant contributor to jaundice observed in exclusively breastfed infants. [source] | ||||||||||||||||||||||