Nationwide Survey on Current Status of Formula Feeding in Infants

PURPOSE: Although breast milk is considered the best source of nutrition for infants because of its superiority over powdered milk, there are circumstances when breast milk is unavailable. Committee on Nutrition of the Korean Pediatric Society conducted an investigation into the current status of formula feeding in Korea. METHODS: This investigation was conducted using questionnaires produced by our committee and distributed to mothers of children under the age of two who were using formula feeding at 10 university hospitals and 22 public health centers nationwide between March 1999 to September 1999. A comparative analysis according to location, birth order, mother's occupation, education, housing tenure and normal birth status was performed on all 2696 questionnaires using the chi-square test. RESULTS: Formula feeding was found in 49.4% and formula feeding combined with breast milk were 21.5% of the respondents. The percentage of formula feeding was higher in working mothers who underwent a Cesarean section in metropolitan areas. The inadequacy of breast milk was the most common reason for feeding powdered rnilk followed by the unhealthy condition of the mother and mother's return to work. Of those investigated, 94.9% said that they changed products at each stage as recommended by the manufacturer. Promotions for special formulas were more active in metropolitan areas than other areas, and 57.7M said that they used special formulas based on recornmendations by the doctor and acquaintances(15.5%) or after seeing an advertisement(14.0%). CONCLUSION: This investigation revealed that many rnothers were misinformed concerning formula feeding and pediatricians should provide mothers with education, shedding light on proper feeding methods.

Usefulness of Pasma Atrial Natriuretic Peptide Concentration in the Diagnosis of Patent Ductus Arteriosus in Preterm Infants

PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus(PDA) that should be treated is difficult to determine by clinical and echocardiographic examinations. The aim of this study was to clarify the interrelationship of plasma atrial natriuretic peptide(ANP) concentrations and clinical signs or echocardiographic signs of PDA in preterm infants and use plasma ANP concentrations as a diagnostic indicator of a hemodynamically significant PDA. METHODS: Twenty-four preterm infants who were born at Guro Hospital, Korea Medical Center were evaluated on the 3rd day after birth. Clinical signs(cardiovascular dysfunction score 3) and echocardiographic signs[magnitude of left-to-right shunt across a PDA and left atrium(LA): Ao ratio] of a PDA and plasma ANP concentrations were measured. RESULTS: Plasma ANP concentrations and LA/Ao ratios of preterm infants with hemodynamically significant PDA were significantly higher than those of preterm infants without hemodynamically significant PDA. Plasma ANP concentrations were related to the magnitude of the left- to-right shunt across a PDA and LA: Ao ratio. Plasma ANP concentrations of LA/Ao of more than 1.3 were significantly higher than that of LA/Ao of less than 1.3. CONCLUSION: In preterm infants, high plasma ANP concentration may be a useful predictive indicator of a hemodynarnically significant PDA. Measurement of plasma ANP concentration may play a role in deciding the need for and timing of medical or surgical management of preterm infants with PDA.

Nationalwide Study on Body Mass Index, Skinfold Thickness, and Arm Circumference in Korean Children

PURPOSE: Body mass index(BMI), skinfold thickness and arm circumference are commonly used to evaluate obesity in children. There is a need for new standards of these items on Korean children. We performed this study to provide up-to-date reference percentile values and percentile charts for these three items. METHODS: Standardized measurements of height, weight, skinfold thickness(triceps, subscapular) and arm circumference on a total of 31,188 infants and children from age 1 to 18 years during January to December 1998 were used to calculate percentile values and to develop smoothed percentile charts. RESULTS: The mean BMI increased with age and showed similar values in both sexes, but 95th percentile values were slightly higher for boys than girls. The percentile values of BMI were consistently higher than those reported previously in Korea, particularly for the 95th percetile values. Triceps and subscapular skinfold thickness showed significant increase compared with previous studies and significantly higher for females than males. Arm circumference also showed significant increase compared with the previous studies. It was significantly higher for males than females. BMI was more closely related with arm circumference than skinfold thickness. CONCLUSION: The percentile values and percentile charts of BMI, skinfold thickness and arm circumference will allow pediatricians to evaluate obesity in Korean children.