Pain response in Chinese and non-Chinese Canadian infants: is there a difference?

This study was designed to compare the behavioural pain responses of 2-month-old Canadian-born Chinese babies receiving a routine immunization to those of non-Chinese infants in similar situations. Two groups of 26 infants were obtained from a pediatric clinic held by a Chinese pediatrician and a suburban pediatric practice of a large Canadian city. Facial expression using the Neonatal Facial Coding System (Grunau, R.V.E., Craig, K.D., 1987. Pain expression in neonates: facial action and cry. Pain, 28, 395-410.) and cry using the Fast Fourier Transform were measured during 30 s following the insertion of the needle. Acculturation in Chinese mothers, circadian rhythm, gender, height and weight in infants were assessed. Multivariate analysis of variance revealed significant differences in pain response between these two groups with the Chinese babies showing greater response. No significant effect of circadian rhythm and gender was identified. These results suggest the presence of differences in acute pain response in relation to culture by at least 2 months of age.

Acculturation style and psychological functioning in children of immigrants.

Thirty-four immigrants, predominantly Asian, and their 48 children were assessed for relationship of acculturation style to children's psychological functioning. Children of parents accepting the majority culture scored higher in social competence. Many of the children reported as having extreme behavioral problems had rejected their ethnic culture.

Prevalence of iron deficiency among Chinese children aged 6 to 36 months in Montreal.

Screening for iron deficiency was undertaken among a group of Chinese children aged 6 to 36 months to determine the prevalence of the condition and its association with infant feeding. Of the 346 children studied, 12.1% were found to be iron deficient. The overall prevalence rate of thalassemia minor was 6.7%. Among the 166 children aged 6 to 12 months, more of those who were breast-fed for at least 2 months than of those who were bottle-fed were iron deficient (27.0% v. 7.0%; p less than 0.001). This difference persisted after controlling for the effect of iron-fortified formula. No such difference was found among those older than 12 months. The observed prevalence of iron deficiency was closer to the rate reported for black children than to that reported for white children in the United States. The findings stress the importance of conducting further studies of iron deficiency among Chinese subpopulations in North America.

Childhood choledochal cyst with intrahepatic enlarged cyst-like bile ducts.

A five-year-old boy was investigated for intermittent, crampy abdominal pain over several months. His abdomen was distended. Hepatomegaly and cystic masses were demonstrated in both lobes of the liver on ultrasound and computed tomographic examinations. An operative cholangiogram revealed a choledochal cyst of the cystic duct with massive dilatation of intrahepatic and extrahepatic bile ducts. After resection of the choledochal cyst and anastomosis of the jejunum to the common bile duct, the hepatic ducts have become near normal.

Promotion of breast-feeding in a Chinese community in Montreal.

Following a prospective survey that showed a very low rate of breast-feeding (10%) in 1977-79 among Chinese women in Montreal, a culturally targeted program, which included individual prenatal counselling and a community-wide promotion and education campaign, was developed to improve the rates. The study group consisted of all Chinese women delivering in 1980 and 1981 who had taken their infants to one pediatrician for continuing care. The rates of breast-feeding in the 88 women who had received prenatal counselling and the 93 women who had not were compared. Although the rates were substantially increased for both groups over the 1977-79 rate (54% and 34% in 1980 and 65% and 55% in 1981 respectively), the 2-year rate was significantly higher for the counselled group compared with the uncounselled group in the later study (59% v. 43%). The greatest effect of counselling was seen in young, primiparous women of higher socioeconomic status who spoke French or English in addition to Chinese. However, 33% of the counselled women who had started breast-feeding had stopped by 1 month, compared with only 15% of the uncounselled women. Thus, although the rates of breast-feeding in ethnic groups can be increased with the use of a language- and culture-specific approach, more support and encouragement must be given to women who start breast-feeding so that they will continue longer.