Optimal Thermal Control with Sufficient Nutrition May Reduce the Incidence of Neonatal Jaundice by Preventing Body-Weight Loss Among Non-Low Birth Weight Infants Not Admitted to Neonatal Intensive Care Unit.

BACKGROUND: Neonatal jaundice is strongly attributable to excess body-weight loss as a result of insufficient calorific intake. OBJECTIVES: To examine the incidence of neonatal jaundice (defined by use of phototherapy) and body-weight loss, as well as their association, among neonates under optimal thermal control with sufficient nutrition, a local protocol for temperature and nutritional regulation. METHODS: We retrospectively identified a cohort of 10,544 neonates (birth weight ≥2,500 g) placed in thermo-controlled incubators for 2 h immediately after birth. Neonates were fed with 5% glucose solution 1 h after birth and breastfed every 3 h (with supplementary formula milk if applicable) according to basal maintenance expenditure. Total serum bilirubin levels at day 4 (peak level) were assessed. Phototherapy was performed on the basis of total serum bilirubin level ≥18 mg/dL. Risk ratio (RR) and 95% CI for the use of phototherapy against maximum body-weight loss were estimated using Poisson regression with robust variance. RESULTS: Incidence of phototherapy use was low (0.3%) and the mean total serum bilirubin level was 8.5 mg/dL (SD 2.7 mg/dL), with a low mean maximum body-weight loss (1.9%) and low incidence of excess body-weight loss ≥7% (0.4%). Maximum body-weight loss was associated with risk of neonatal jaundice (RR 1.27; 95% CI 1.04-1.54), and became significant at approximately 4% of maximum body-weight loss. CONCLUSION: Optimal thermal control and sufficient nutrition may greatly reduce the incidence of neonatal jaundice by preventing neonatal body-weight loss.

Factors associated with irregular breakfast consumption among high school students in a Japanese community.

BACKGROUND AND OBJECTIVES: This study evaluated the associations between the characteristics of high school students and irregular breakfast consumption and explored the association with knowledge regarding diet and dietary education in a community in Japan. METHODS AND STUDY DESIGN: A cross-sectional survey using a self-administered questionnaire was conducted in 2007 among all the high school students in the second grade in Imari, Saga. Data for 318 male and 292 female students were analyzed. Irregular breakfast consumption was defined as consuming breakfast three times or less in a week. The associations between the characteristics of students and irregular breakfast consumption were assessed using logistic regression with adjustments for sex and school. RESULTS: Among male students, a strong association between the consumption of juice or pop and irregular breakfast consumption was observed (OR comparing ">=2 servings" vs "rarely"=8.97, 95% CI=2.99-26.9). The associations with wake times and bed times were strong among male students, and the association with regular bowel movements was strong among female students. Students who had knowledge of regional agricultural and livestock products were more likely to consume breakfast regularly, and this association was significant among female students (OR=2.89, 95% CI=1.23-6.82). Significant associations were also observed with the consumption of snacks, and traditional greeting before meals. CONCLUSIONS: Several characteristics, including specific knowledge, were associated with the irregular consumption of breakfast. The results are of interest to policy makers, nutrition specialists, and educators working to enhance regular breakfast consumption among students.