Growth of urban breastfed infants from low socio-economic group.

Breastfeeding has been considered the best mode of feeding the infant. In traditional countries like India, it has been the tradition among poor income groups of women and the universal adage breast feed as long as possible goes uncontested. However, the appropriate age at which supplementation should start is replete with controversy and varies between as early as 3-6 months. While the debate on when should supplementation be started continues, it is also important to know if the nutritional benefit is expressed in terms of growth of the infant, under the existing unhygienic conditions. This study was therefore undertaken.

Energy balance in lactating undernourished Indian women.

An energy balance study was conducted in eight lactating poor-income Indian women from delivery to 6 months. Energy intake and expenditure were assessed for 7 days every month (30-37 days). Every month, basal metabolic rate (BMR) and milk ingested by infants was measured. An energy balance was computed. As a group these women were in energy balance, indicated by small body weight changes with respect to time. However, only two of these women were in a positive energy balance. Women with higher body weight lost more weight. Estimated mean energy intake was higher than energy expenditure. BMR showed a slight but not significant fall during the second month of lactation and was not different from the BMR seen in 13 non-pregnant, non-lactating women matched for body weight from the staff of the Institute. The energy cost of lactation was 2.3 MJ (549 kcal), a figure that justifies the Recommended Dietary Allowance for energy recommended by FAO/WHO/UNU (1985) and ICMR (1989).

Relationship between maternal vitamins B2 and B6 status and the levels of these vitamins in milk at different stages of lactation. A study in a low-income group of Indian women.

Riboflavin and vitamin B6 status of mothers from a low-income group were assessed by erythrocyte glutathione reductase activation and erythrocyte aspartate aminotransferase activation tests respectively, at different stages of lactation. Levels of these vitamins in milk were also measured. The majority of the women had biochemical evidence of vitamins B2 and B6 deficiency. There was a bizarre reduction in erythrocyte glutathione reductase activation from 6 to 30 d post partum. Levels of riboflavin in milk were in general satisfactory, but vitamin B6 levels were lower than the values reported from developed countries. Clear-cut correlations between the enzymatic indices of vitamin status evaluation and milk levels of the corresponding vitamins were not apparent.

PIP: Riboflavin and vitamin B6 status of low-income mothers in Hyderabad, India, were assessed by erythrocyte glutathione reductase activation and erythrocyte aspartate aminotransferase activation tests, respectively, at different stages of lactation. Levels of these vitamins in milk also were measured. The 134 lactating women, who attended a maternal and child care clinic in a government hospital, were divided according to the duration of lactation into the following 6 groups: less than 5 days (Group I), 6-30 days (Group II), 1-6 months (Group III), 7-12 months (Group IV), 13-18 months (Group V), and more than 18 months (Group VI). 6 women had been using oral contraceptives (OCs) for 3-6 months (Group VII). Since OCs are not prescribed before 8 months of lactation, the lactational status of the OC users was comparable to that of the women in groups IV or V. Except for the pariurient mothers (Group I) who delivered in the hospital, the remainder of the women came to the hospital for routine pediatric care or contraceptive advice. Most women had had a frugal breakfast and had nursed their infants 2 hours prior to the sampling of blood and milk. 10 ml samples of foremilk (5 ml from each breast) were collected by manual expression. Samples of venous blood were draw after collecting the milk. Correlations between the maternal vitamin status and milk vitamin concentration were assessed by Pearson's correlation coefficient and frequency distribution. The majority of the women had biochemical evidence of riboflavin and pyridoxine deficiency, the incidence of the former being greater than the latter. Prolonged lactation did not worsen the vitamin status. Group II women showed a reduction in erythrocyte glutathione reductase activity (EGR-AC) values suggesting better riboflavin status than the other groups. A similar trend was not seen with regard to pyridoxal phosphate. Milk riboflavin concentration was similar in all the groups except Group II where the levels were significantly higher. Milk pyridoxine concentration increased 3-4 fold after 1 month of lactation and continued to be at that level beyond 18 months. There was no correlation between the maternal riboflavin and milk riboflavin status or maternal pyridoxine and milk pyridoxine status. The higher milk riboflavin concentration among the Group II women was seen regardless of the women's riboflavin status in that group. OC-treated women did not show any significant deviations from women not using OCs.

Side effects of oral contraceptive use in lactating women--enlargement of breast in a breast-fed child.

A case of breast enlargement in an eighteen-month-old breast-fed girl whose mother was using a combination pill containing 150/micrograms d-norgestrel and 30/micrograms ethinyl estradiol for three months is reported. Physical examination and endocrinological investigations in the girl did not reveal any abnormality. Breast enlargement subsided slowly over the next six months after discontinuation of breast-feeding.

Immune status of anaemic pregnant women.

Immune status during the third trimester of pregnancy was investigated in relation to maternal haemoglobin levels. The proportion of T and B lymphocytes showed a tendency to fall in anaemic women which was significant when haemoglobin levels were less than 8 g/dl. Immunoglobin G showed the opposite trend. There were no alterations in phytohaemagglutinin-induced lymphocyte transformation in relation to haemoglobin concentration.

Low dose injectable contraceptive norethisterone enanthate 20mg monthly--I. Clinical trials.

Clinical trials were undertaken with an injectable low dose progestational contraceptive, norethisterone enanthate 20 mg monthly (Net-en - 20). Data from the study indicate that Net-en - 20 is an effective contraceptive with lower incidence of menstrual cycle disturbances than the currently used injectable progestogens. There was a prompt return of fertility after the withdrawal of the drug. Net-en - 20 did not have any adverse effect on maternal nutritional status as assessed by anthropometric indices of nutritional status, and clinical sign of nutritional deficiencies or on lactational performance as assessed by mothers' impression on milk output and mean duration of lactation.