Influence of the coronavirus disease 2019 pandemic on maternal breastfeeding for very low birth weight infants / 中国当代儿科杂志

OBJECTIVES@#To investigate the changes in the rate and volume of mother's own milk (MOM) feeding for very low birth weight infants (VLBWIs) hospitalized during the prevention and control of the coronavirus disease 2019 (COVID-19) pandemic.@*METHODS@#A retrospective analysis was performed on the medical data of the VLBWIs with a gestational age of <32 weeks who were born and admitted to the Neonatal Intensive Care Unit of Nanjing Maternal and Child Health Hospital from January 2019 to December 2020. The changes in the rate and volume of MOM feeding for VLBWIs during hospitalization were examined.@*RESULTS@#A total of 301 VLBWIs were enrolled. According to the timing of COVID-19 outbreak, these infants were divided into a pre-CIVID-19 group with 205 VLBWIs and a post-COVID-19 group with 96 VLBWIs. Compared with the pre-CIVID-19 group, the post-COVID-19 group had a significantly lower rate of MOM feeding within 28 days after birth and during hospitalization (P<0.05), a significantly lower volume of MOM feeding within 0-7 days, 0-14 days, and 0-28 days after birth (P<0.05), and significantly higher incidence rates of moderate-to-severe bronchopulmonary dysplasia and feeding intolerance (P<0.05).@*CONCLUSIONS@#The COVID-19 pandemic has a significant impact on MOM feeding for VLBWIs, and there are significant reductions in the rate and volume of MOM feeding for VLBWIs within 28 days after birth, as well as a significant reduction in the rate of MOM feeding during hospitalization.

Efficiency and safety of milk feeding rescue for failed chloral hydrate sedation in infants with cyanotic congenital heart disease / 上海交通大学学报（医学版）

Objective·To evaluate the efficiency and safety of milk feeding to rescue failed chloral hydrate sedation in infants with cyanotic congenital heart disease who underwent transthoracic echocardiography.Methods·Clinical data of the infants with known cyanotic congenital heart disease were retrospectively analyzed,who were not adequately sedated after initial dose of chloral hydrate in 2015 in Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine.Vital signs and oxygen saturations were recorded every 5 minutes,and adverse events were noted.For rescue,efficiency and safety of milk feeding were compared with phenobarbital intramuscular injection.Results·A total of 129 infants were enrolled in this study.Fifty-two infants were rescued by intramuscular phenobarbital and the other 77 ones were rescued by milk feeding.The proportion of infants successfully rescued by milk feeding was 55.8％,which was higher than that of intramuscular phenobarbital (30.8％,P=0.005).There was no statistical difference in incidence of adverse events between the two groups (P=0.565).Conclusion·Milk feeding is an effective and safe choice for rescue sedation for infants with cyanotic congenital heart disease undergoing transthoracic echocardiography.

Multi-center Study of Enteral Feeding Practices in Hospitalized Late Preterm Infants in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the current enteral feeding practices in hospitalized late preterm infants in the Beijing area of China.</p><p><b>METHODS</b>A multi-center, cross-sectional study was conducted. Infants born after 34 weeks and before 37 weeks of gestation were enrolled from 25 hospitals in the Beijing area of China from October 2015 to October 2017. Data on enteral feeding practices were collected and analyzed.</p><p><b>RESULTS</b>A total of 1,463 late preterm infants were enrolled, with a mean gestational age (GA) of 35.6 (34.9, 36.1) weeks. The percentage of exclusive breastfeeding was 4.5% at the initiation of enteral feeding but increased to 14.4% at discharge. When human milk was not available, most infants (46.1%) were fed with preterm infant formula. The rate of exclusive human milk feeding in infants born at 34 weeks gestation was higher than at discharge (21.1% of infants born at 34 weeks' GA versus 12.1% of infants born at 35 weeks' GA versus 12.3% of infants born at 36 weeks' GA, P < 0.001). Only 28.4% of late preterm infants achieved full enteral feeding at discharge, and only 19.2% achieved 120 kcal/(kg•d) by enteral feeding at discharge. Importantly, 40.5% of infants did not regain the birth weight at discharge.</p><p><b>CONCLUSION</b>Enteral feeding support of late preterm infants has not been standardized to achieve optimal growth. Moreover, the human milk feeding rate was low, and many late preterm infants did not achieve the goal of enteral feeding and failed to regain birth weight at the time of discharge. More aggressive enteral feedings protocols are needed to promote human milk feeding and optimize growth for late preterm infants.</p>

Efficiency and safety of milk feeding rescue for failed chloral hydrate sedation in infants with cyanotic congenital heart disease / 上海交通大学学报（医学版）

Objective: To evaluate the efficiency and safety of milk feeding to rescue failed chloral hydrate sedation in infants with cyanotic congenital heart disease who underwent transthoracic echocardiography. Methods: Clinical data of the infants with known cyanotic congenital heart disease were retrospectively analyzed, who were not adequately sedated after initial dose of chloral hydrate in 2015 in Shanghai Children's Medical Center, ShanghaiJiao Tong University School of Medicine. Vital signs and oxygen saturations were recorded every 5 minutes, and adverse events were noted. For rescue, efficiency and safety of milk feeding were compared with phenobarbital intramuscular injection. Results: A total of 129 infants were enrolled in this study. Fifty-two infants were rescued by intramuscular phenobarbital and the other 77 ones were rescued by milk feeding. The proportion of infants successfully rescued by milk feeding was 55.8%, which was higher than that of intramuscular phenobarbital (30.8%, P=0.005). There was no statistical difference in incidence of adverse events between the two groups (P=0.565). Conclusion: Milk feeding is an effective and safe choice for rescue sedation for infants with cyanotic congenital heart disease undergoing transthoracic echocardiography.

Decreased Incidence of Necrotizing Enterocolitis after Introduction of Exclusive Breast Milk Feeding in a Single Neonatal Intensive Care Center

PURPOSE: To evaluate the effects of exclusive breast milk feeding (BMF) on the incidence of necrotizing enterocolitis (NEC) in preterm infants. METHODS: All newborn infants, born at <32 weeks of gestation and weighing <1,500 g, admitted to the neonatal intensive care center at Seoul National University Bundang Hospital during the study period, were included. The study was divided into period I: pre-exclusive BMF (January 2010–March 2014) and period II: exclusive BMF (April 2014–December 2016). RESULTS: A total of 374 infants were enrolled in this study, with 174 in period I and 174 in period II. The incidence of NEC was 11.5% in period I and 3.4% in period II. As the mean gestational age and birth weight were significantly greater in infants in period II, the difference in the incidence of NEC between the two periods was adjusted by gestational age. After adjustment, the incidence of NEC in period II was significantly lower than in period I (P=0.024). CONCLUSION: Exclusive BMF significantly reduced the incidence of NEC in a single neonatal intensive care center.

Performance of calves submitted to protocols using extruded or ground starter

Feed processing can affect rumen development in new born calves, and potentially define animal performance. Two feed management systems, extruded starter (Ruter) with possible early weaning and ground starter (control), were evaluated in thirty-two Holstein calves (16 females and 16 males). Animals were randomly assigned to the treatments using a randomized block design with birth weight as a covariate. They were weaned when starter intake reached 800 g for two consecutive days. Twenty-one days after the weaning, males were slaughtered and the stomach compartments were isolated. Rumen and omasum fragments were processed for morphological evaluation. Animal performance, clinical condition and stomach compartment weight did not differ between the treatments (P> 0.05), despite weaning weight of animals receiving extruded starter being 5.68% higher than the control animals. Extruded starter stimulated cell proliferation of the ruminal epithelium (P <0.05), but did not affect the dimensions of the papillary rumen and omasum mitotic index (MI). The Ruter feeding system was potentially beneficial for weight gain and morphofunctional rumen development in lactating animals; however, this treatment did not allow early weaning as proposed by the feeding system.

Desempenho e parâmetros sanguíneos de bezerros leiteiros que receberam sucedâneo lácteo ou silagem de colostro / Performance and plasma metabolites of dairy calves fed a milk replacer or colostrum silage

O objetivo deste estudo foi avaliar o desempenho e os parâmetros sanguíneos de bezerros que consumiram colostro bovino fermentado sob condições anaeróbias. Após o nascimento, 18 bezerros da raça Holandês foram alojados em abrigos individuais e passaram a receber 4L da dieta líquida, sucedâneo lácteo ou silagem de colostro, divididos em duas refeições. O consumo de concentrado inicial e o escore fecal foram registrados diariamente, enquanto a pesagem e as colheitas de amostras de sangue para a determinação das concentrações plasmáticas de glicose, nitrogênio ureico, ácidos graxos livres, β-hidroxibutirato e proteínas totais séricas foram realizadas semanalmente. Os animais alimentados com silagem de colostro apresentaram menores consumo de concentrado, ganho de peso diário e peso vivo. Todos os parâmetros sanguíneos avaliados foram afetados pelos tratamentos, exceto a concentração plasmática de proteínas totais. O escore fecal foi afetado pelos tratamentos durante a segunda semana de vida, com animais alimentados com silagem de colostro apresentando fezes anormais e secas. O fornecimento de silagem de colostro como dieta líquida exclusiva não resultou em desempenho animal adequado, não sendo uma boa alternativa de substituto de leite.

The aim of this study was to evaluate the performance and plasma metabolites of calves fed colostrum fermented under anaerobic conditions as an exclusive liquid feed during the whole milk-feeding period. After birth, eighteen Holstein male calves were housed in individual hutches and fed four liters of liquid diet, milk replacer or colostrum silage, divided into two meals. The starter feed intake and fecal scores were recorded daily, and body weight and blood samples for the determination of plasma glucose, urea nitrogen, free fatty acids, β-hydroxybutyrate and serum total protein were taken weekly. Animals fed colostrum silage had lower intake of starter feed during the experimental period. Significant effects were also observed for average daily gain and body weight. All blood parameters measured were affected by the treatments, except the total protein plasma concentration. The fecal score was affected by treatments during the second week of life, with animals fed colostrum silage presenting abnormal and very dry feces. Feeding colostrum silage as exclusive liquid diet during the whole milk-feeding period resulted in inadequate animal performance, being considered a bad alternative as milk replacer.

The Effect of Continuing Breastfeeding during Treatment of Breast Milk Jaundice / 대한주산의학회잡지

PURPOSE: Though it is a general and common method to temporarily stop breast feeding and use whole milk instead for neonatal breast milk jaundice, it may cause some difficulties in continuing breast feeding after the recovery. We study the effect of continuing breast feeding on the treatment of breast milk jaundice and the success of breast feeding afterwards. METHODS: We retrospectively analyzed the medical records of 59 neonates who were admitted to Cheil general hospital from Jan 2008 to Aug 2012 for phototherapy due to breast milk jaundice. Subjects were divided into two groups, one with continuing breast feeding (35 cases) during treatment and the other with stopping breast feeding (24 cases). We examined and compared the changes in the level of serum total bilirubin between two groups, as well as the difficulties the mothers might had in continuing or restarting breast feeding after the discharge. RESULTS: There was no significant difference in times of treatment (until reaching the level of serum total bilirubin <13 mg/dL) between two groups (P=0.066). However, the group with temporary stop of breast feeding had difficulties such as nipple confusion and breast engorgement compared to breast feeding group (P=0.001). In long-term follow up, the breast feeding duration (P=0.017) and the rate of exclusive breast feeding for 6 months (P=0.024) were also significantly higher in breast feeding group. CONCLUSIONS: We suggest that continuing breast feeding while treating breast milk jaundice is helpful both for successfully continuing breast feeding and preventing problems after discontinuing breast feeding.

Monitoring of Clostridium difficile Colonization in Preterm Infants in Neonatal Intensive Care Units / 대한소아소화기영양학회지

PURPOSE: To examine the prevalence of Clostridium difficile (C. difficile) colonization (CDC) and potential neonatal determinants of CDC in hospitalized preterm infants. METHODS: Fecal samples were serially collected within 72 h after birth and at 1, 2, and 4-6 weeks of age from preterm infants in the neonatal intensive care units (NICUs) of two different university hospitals. Total bacterial DNA was extracted from each fecal sample from 49 infants, and polymerase chain reaction (PCR) was performed with primers for the 16S gene of C. difficile and the toxin A and toxin B genes. The correlation between the results of C. difficile PCR assays and the clinical characteristics of the infants was analyzed. RESULTS: The prevalence rates of CDC were 34.7, 37.2, 41.3, and 53.1% within 72 h after birth and at 1, 2, and 4-6 weeks of age, respectively. The toxin positivity rate was significantly higher in the infants with persistent CDC than in those with transient CDC (8/12 [66.7%] vs. 6/25 [24.5%] (p=0.001). Among the various neonatal factors, only the feeding method during the first week after birth was significantly associated with persistent CDC. Exclusive breast-milk feeding (EBMF) significantly decreased the risk of persistent CDC compared to formula or mixed feeding (adjusted odds ratio: 0.133, 95% confidence interval: 0.02-0.898, p=0.038). CONCLUSION: The prevalence of CDC increased with the duration of hospitalization in preterm infants in the NICU. EBMF during the first week after birth in hospitalized preterm infants may protect against persistent CDC.

The active components of milk in human milk bank / 国际儿科学杂志

Human milk is the optimal feeding choice for neonats, especialy for premature infants. Besides lactose, protein and fat, human milk also contains many kinds of active components, such as immunoglobins,lacferrins, lysozymes, vitamins and so on. Human milk bank has been well developed worldwide, but after cold storage and Pasteurization, many different microcomponents in milk have been affected. There is still controversy on how to preserve and sterilize human milk

Comparison of the Effects of Breast Milk Feeding with Maternal Restriction and Hypoallergenic Milk Feeding on the Acquisition of Tolerance to Cow Milk / 소아알레르기및호흡기학회지

PURPOSE: The aim of this study was to compare the effects of breast milk (BM) feeding with those of maternal cow milk (CM) restriction and extensively hydrolyzed CM formula feeding on the duration of CM allergy as well as changes in specific immunoglobulin E (IgE) levels in infants with CM allergy. METHODS: Children diagnosed with CM allergy before 12 months age and BM fed were included retrospectively. CM allergy was diagnosed by CM specific IgE over 0.35 kU/L and 1) obvious clinical symptoms, 2) a suspicious history with positive provocation test, or 3) CM specific IgE over the 95% positive predictive value and subsequent documented report of clinical symptoms. The patients were classified into three groups by feeding regimen: BM group, extensively hydrolyzed formula (eHF) group, or mixed feeding (MF) group. Analysis of the groups regarding the duration of food allergy and changes in CM specific IgE was then performed. RESULTS: Forty-six children were included. Twenty-four children were in the BM group, 13 children were in the eHF group, and 9 children comprised the MF group. Thirteen patients reached tolerance. The means of the tolerance age were 69.7+/-5.4 months in the BM group, 36.6+/-4.6 months in the eHF group, and 38.2+/-7.9 months in the MF group. The survival curves of tolerance showed significant difference among the three groups (P=0.04). CM specific IgE levels measured at a second time period were 9.6 kU/L (interquartile range, 3.6-44.2) in the BM group, 2.0 kU/L (1.0-18.0) in the eHF group, and 4.8 kU/L (0.2-10.4) in the MF group (P=0.04). CONCLUSION: Feeding regimen influences the duration of CM allergy. Exclusively BM-fed children achieved tolerance later than eHF-fed children. Prospective and randomized controlled studies are required.

Incidence of Febrile Urinary Tract Infection According to Clinical Characteristics in Patients with Congenital Hydronephrosis and Hydronephrotic Patients Diagnosed at First Febrile Urinary Tract Infection

PURPOSE: The aim of this study was to evaluate the incidence of febrile urinary tract infection (UTI) according to clinical characteristics in patients with congenital hydronephrosis (CH) and hydronephrotic patients first diagnosed with hydronephrosis during treatment of febrile UTII. METHODS: In this study, 200 patients with congenital hydronephrosis were enrolled in group 1 and 252 patients first diagnosed with hydronephrosis during treatment of febrile UTI were enrolled in group 2. We counted the episodes of UTI in the two groups according to clinical characteristics, the presence of VUR, type of feeding, and clinical outcomes since 2000. And we compared those results between the two groups. and compared two groups as well. RESULTS: The incidence of recurrent UTI was 10%, 0.028 per person-year in group 1 and 16.7%, 0.051 per person-year in group 2, respectively (P <0.05). Group 2 had more VUR (3% vs. 27%, P <0.05) and higher incidence of UTI than group 1. The incidence of UTI in patients with CH of Society of Fetal Urology (SFU) grade 4 or grade 4-5 VUR was 80% and 44.4%, respectively. No significant differences were found in incidence of UTI between BMF (breast milk feeding) and artificial milk feeding group in both groups (P 1= 0.274, P 2=0.4). The time of resolution of CH had no correlation with either number of UTI episodes or the presence of VUR. CONCLUSION: The overall incidence of UTI is low in patients with CH as well as patients patients first diagnosed with hydronephrosis during treatment of febrile UTI except patients with SFU grade 4 or grade 4-5 VUR. BMF has no protective effect against UTI.

A Study on Knowledges and Attitudes about Breast Milk Feeding and Needs for Breast Milk Feeding Education among High School Students / 대한지역사회영양학회지

This study was carried out to investigate the experiences of breast milk feeding information and education, breast milk feeding knowledge and attitude and needs for breast milk feeding nutrition education of high school students to encourage breast milk feeding. The subjects were 565 (male: 250, female: 315) high school students from first to third grade. The results obtained were as follows: In this survey, only 30.0% of subjects experienced breast milk feeding information and only 6.1% of subjects had breast milk feeding education. And the subjects showed the average scores of knowledge of breast milk feeding were 0.29 points of 1 point. Subjects knew well about ingredients of breast milk but they didn't know well about the physiology and method of breast milk feeding and benefits of breast milk feeding for mothers. The average scores of attitude of breast milk feeding were 3.03 points of 4 points, showed slight positive attitudes of breast milk feeding, but they had negative attitudes of emotional and practical aspects. The future plan of feeding practices was breast milk feeding 35.9% and 60.0% of formula milk feeding. A concern was that the students showed high ratio of formula milk feeding plan and they decided by incorrect knowledge of breast milk feeding. The 33.5% of students answered high school students will need breast milk feeding nutrition education, and they thought hospital faculties were the proper educators of breast milk feeding education, but dietitians were recomended as educators because of easy access at school and good knowledge of life-cycle nutrition. Therefore, to encourage breast milk feeding by mothers and supporters of breast milk feeding, breast milk feeding nutrition education is needed urgently among high school male and female students. And nutrition education programs will have to contain benefits of breast milk for babies and mothers and physiology and practical methods of breast milk feeding to improve emotional and practical attitudes for breast milk feeding. Nationwide campaign to promote breast milk feeding at public areas will be needed.

Anaphylactic Shock in a Breast Milk-Fed Infant due to Skin Contact with Egg White / 대한소아소화기영양학회지

Food allergy is not uncommon among small children. Cow milk and eggs are most frequently incriminated as the major cause of food allergy. A 4-month-old female infant who did not have a previous history of contact with the egg developed anaphylactic shock when an emulsion of raw egg white was rubbed on the buttock by her mother to relieve erosive diaper dermatitis. She had been fed on breast milk. She had no past medical history of any other allergy and no family history of atopy, asthma or allergic rhinitis. Her IgE PRIST was 29.46 IU/ml and multiple antigen simultaneous testing chemiluminescent assay for food specific IgE antibody showed a level 4 positive value only to egg white.

Alterations of the TSH Levels in the Breast Feeding Newborn Infants after the Mother's Eating Brown Seaweed Soup / 대한주산의학회잡지

PURPOSE: After delivery, eating brown seaweed soup is a typical Korean tranditional habit. But, excessive intake of iodine transiently inhibits biosynthesis and secretion of thyroid hormones if a certain threshold of iodine is reached in the serum. The aim of our study was to demonstrate whether the observed the elevations of TSH level in the breast fed neonatal infants was caused by mother's eating brown seaweed soup or not. METHODS: We performed neonatal TSH test by enzyme linked immunosorbent assay(FRELISA Screenig TSH) and cheked TSH level for 178 newborns with a appropriate gestational age. We divided the study subject into 3 groups, the group used breast feeding, mother had taken brown seaweed soup and blood sampled at 6th day after birth was categorized Group A, formular feeding, blood sampled at the 4th days after birth was categorized Group B, breast feeding and had taken brown seaweed soup and blood sampled at the 19th day after birth was categorized Group C. RESULTS: 1) The mean TSH level was 1.5+/-1.3 uU/ml in Group A, 3.3+/-2.5uU/ml in Group B, 1.7+/-l.3uU/ml in Group C(Group A vs Group B: p<0.05, Group A vs Group C: p<0.05). 2) There was no statistical significances between the TSH levels and the amount of brown seaweed soup which mother had one day, the duration which mother had brown seaweed soup and duration of breast feeding. CONCLUSIONS: Mother had taken brown seaweed soup about 3 times a day in korea at present days, There was no significant changes of TSH levels in the beast fed newborn infants after the korean mother had taken brown seaweed soup.

The Impact of Prolonged Breast Milk Feeding and Large Amount of Whole Cow' s Milk Intake on Iron Status in Early Childhood

PURPOSE: The Large amounts of whole cow' s milk intake, just followed by prolonged breast milk feeding may induce a severe deficit of iron. We performed this study to investigate the severity of iron deficiency in these subjects. METHODS: Seventy-one subjects (12 to 48 months of age) were classified according to history of prolonged breast milk feeding and intake of large amounts of whole cow' s milk. Prolonged breast milk feeding and large amounts cow' s milk intake subjects were assigned as group A (n=15), the large amounts of cow's milk intake subjects as group B (n=15), the prolonged breast milk feeding subjects as group C (n=24) and the normal control subjects as Group D (n=17). The hematologic and iron status were evaluated and compared between each group. RESULTS: Although the mean of group A was lower than the mean of group B and C, the level of hemoglobin of group A was significantly lower than group D (P<0.01). The level of the ferritin of group A was significantly lower than group B, C (P<0.05, respectively) and group D (P<0.01). Of the 15 study subjects of group A, 14 (93.3%) had microcytic hypochromic anemia and 7 (46.7%) revealed that serum ferritin levels were at 1.0ng/dL, indicating severe deficit of storage iron. CONCLUSION: The intake of large amounts of whole cow' s milk, just followed by prolonged breast milk feeding induced iron deficiency anemia and a severe deficit of storage iron. It is necessary to inform parents to avoid irreversible recognition impairment and behavioral change.

Milk Feeding Methods and the Changes of Serum Lactate Level in Infants with Iron Deficiency Anemia

PURPOSE: Infants undergo critical and rapid stages of growth. Optimal nutrition during this period is therefore essential. Iron deficiency is especially impotant and common. The aim of this study was to determine the present status and problems of milk feeding methods in infants with iron deficiency anemia and, futhermore, to develop appropriate feeding guidelines for adequate iron nutrition. Latate is the end product of the anaerobic metabolism of glucose. Also we studied the changes of serum lactate level in this patients and calculated correlations between serum lactate level and diagnostic parameters of iron deficiency anemia. METHODS: We studied 42 children with iron deficiency anemia who visited Wonkwang university hospital from February 1995 to July 1996. We analyzed the type and duration of milk feeding method. And we measured serum lacate level and diagnostic parameters of iron deficiency anemia. RESULTS: The mean age was 17.0 months and male to female ratio was 7:1. On the analysis of milk feeding methods the breast feeding, the cow's milk, the mixed feeding were 73.8%, 11.9%, 14.3% respectively. The breast feeding group distributed mainly from 6 month to 18 month and 1 patient showed prolonged breast feeding until 48 month. We checked serum lactate level in 22 subjects. The mean serum lactate level was increased than normal adult level but there were no significant correlation between serum lactate level and diagnostic parameters of iron deficiency anemia (Hb, Hct, MCV, MCH, MCHC, serum iron, TIBC, ferritin). CONCLUSION: The most common problem of milk feeding method in infants with iron deficiency anemia was prolonged breast feeding and some infants fed excessive cow's milk. We need correct and proper education about merits and disadvantages of breast and cow's milk feeding to mothers. The mean serum lactate level in children with iron deficiency anemia was increased but serum lacate level can't use a diagnostic parameter of iron deficiency anemia.

Serum Concentration of Major Minerals, Trace Elements, Lipids and Fatty Acids Composition Related to Whole Cow's Milk Feeding in Infancy & Young Childhood / 대한지역사회영양학회지

This study was conducted to determine the effect of large amounts of whole cow's milk intake on serum levels of minerals and lipids. Subjects were normal infants who were brought to the pediatric hospital for vaccination at the age of 7-26 months after birth, living in Eumsung-Choongbuk area. The serum concentrations of the imnerals(calcium, phosphorus, magnesium, iron, zinc and copper), lipids and fatty acids composition were analyzed in 38 infants which consumed large amount of whole cow's milk(over 700ml/day). The results obtained are summarized as follows : 1) The mean levels of calcium, phosphorus and magnesium in the serum of the total subjects were 7.56+/-0.51mg/dl, 11.12+/-0.72mg/dl and 1.62+/-0.13mg/dl respectively. The serum concentrations of iron, zinc and copper in total subjects averaged 72.42+/-1.62 microgram/dl, 76.29+/-3. 62 microgram/dl and 86.44+/-2.98 microgram/dl respectively. 2) The mean serum concentrations of triglyceride, total cholesterol, HDL and LDL in the total number of subjects were 96.84+/-9.22mg/dl, 133.45+/-6.30mg/dl, 32.79+/-1.77mg/dl and 81.29+/-4.81mg/dl respectively. 3) The average percentages of SFA, MUFA and PUFA inth total serum fatty acids were 38.98+/-2.42%, 25.82+/-0.98% and 37.30+/-1.09% respectively and the mean omega6/omega3 fatty acids ratio was 13.48. In general, the levels of serum minerals and omega3 fatty acid composition in the subjects of this study, who were whole cow's milk fed infants were lower than those reported in breast milk or formula fed infants. Therefore, the intake of large amount of whole cow's milk in the weani ng period should be controlled and adequate for the infant's nutritional status.

Assessment of Infantile Mental and Motor Development Influenced by Breast Milk and Formula Feeding

PURPOSE: This study was undertaken to compare the mental and motor development, unsing Bayley Developmental Scale, during infancy(6-8 months of age) according to the choice of feeding, either breast milk of formula, as well as to evaluate its influence on physical growth. METHODS: The study population was 43 normal infants between 6 and 8 months of age, of birth at gestational ages between 37 and 42 weeks, and with birth weights greater or equal to 2500g and below 4000g, excluding high risk infants who were liable for poor neurological prognosis. The breast-fed group was defined as those whoe were breast-fed for at least 3 months after birth. Bayley Developmental Test was performed using Bayley Scales of Infant Development(BSID) test kt. To obtain the data for the analysis of factors influencing the choice of feeding, we used questionnaires. We also measured height, weight, and head circumference for the evaluation of physical growth. RESULTS: We analysed statistically the influence of the educational status of mother or father, the occupational status of mother, birth rank, sex and the mode of delivery on the choice of fedding, but there were no factors causing and significant difference between the breast-fed group(n=22) and the formula-fed group(n=21). The MDI's of the breast-fed and the formula-fed were 101.0 and 103.0, respectively, while the PDI's were 104.2 and 107.0, respectively, There was no statistical difference. The mean height, weight, and head circumference were greater in the breast-fed group but wighout statistical significance. CONCLUSIONS: We may cautiously conclude from the given results that the choice of feeding would not have a great impact on the growth and development of infants.

Anemia due to prolonged breast feeding without weaning diet or supplement food

The paramount importance of breast feeding for the health of the infants has been recognized by untritionists and physicians. Although many advantages of the breast feedng, exclusive breast feeding without weaning diet or supplement food during prolonged perind in infants may produce iron deficiencyh anemia. This study was conducted to find out the hematologic state in exclusively prolonged breast-fed infants among these anemic patients and the way of thinking about their baby's feeding method in their mothers. Mothers of the anemic patients has been surveyed with questionare. The results and problems obtained from this study are summerized as follows. 1) Among 40 patients of this study, 27 were male (67.5%) and 13 were female (32.5%). Mean age was 12.6+/-2.7 month and 9 & 11 month of age were the most common, respectively (15.0%). 2) Mean age of mothers was 29.5 year. The 25 34 year-old group was most common. 3) Education levels of mothers were primary 10%, middle 10%, high 60%, and college graduate 20%. 4) In motivatins of breast feeding. Persuasion of husband or the parent of husband' 19(47.5%). 'Convenience for use' 12 (30.0%), and 'Through mass media or public information' 9 (22.5%). 5) In the causes of prolonged breast feeding, 'Think that satisfactory nutrition for baby is possible with breast milk alone' 4(10.0%), 'Due to persuasion of husband or the parents of husband' 11 (27.5%), 'Baby did no suck milk bottle or eat other diet except breast milk' 25 (62.5%). 6) In whether or not acknowledgment of the necessity of weaning diet, 'Know it but not consider so important 22 (55.0)%, 'Do not know at all) 15 (37.5%), and 'Breast milk, that will do' 3(7.5%). 7) Hb level in patient group, from 6 to 6.9g/dl was 2 (50.0%), from 7 to 7.9g/dl was 3 (7.5%), from 8 to 8.9%g/dl was 15 (37.5%), and from 9 to 10 g/dl was 20 (50.0%). From 9 to 10g/dl was the most common. Hematologic findings were Hb 8.8+/-0.9g/dl, Hct 28.8+/-3.0%, MCV 64.7+/-6.7 fl, MCH 20.0+/-2.5pg, MCHC 30.8+/-1.5g/dl. Platelet 452.5+/-142.9x103/mm3, Reticulocyte count 1.4+/-0.6%, Fe 28.6+/-14.1 g/dl, TIBC 446.7+/-66.2 g/dl, Ferritin 10.5+/-7.0ng/ml. Transferrin saturation 6.6+/-3.5%. 8) In association with duration of breast milk feeding and hematologic findings, as duration was prolonged, Hb, Hct, MCV & MCH were significantly decreased (p<0.01).