Rate of inactivation of cytomegalovirus in raw banked milk during storage at -20 degrees C and pasteurisation

Samples of milk from 23 mothers attending the department of obstetrics and gynaecology and 36 who donated milk to the department's milk bank were cultured for cytomegalovirus. Virus was isolated from samples from 12 of the milk donors but none of the mothers attending the department; follow-up studies during lactation in seven of these 12 women showed that five continued to excrete the virus. Samples were taken on three occasions from one woman who regularly excreted high titres of the virus. Storage at -20 degrees C for over three days reduced the titre by over 99%; after pasteurisation at 63 degrees C for eight minutes the milk did not contain any viable virus. It is recommended that raw banked milk used for feeding preterm babies should be kept frozen for at least 72 hours before feeding.     

Nutrient composition of milk produced by mothers of preterm infants in Nigeria

Nutrient composition was determined in breast milk obtained by manual expression from 12 mothers who delivered prematurely (mean 32 weeks) and 15 mothers who delivered at term (mean 39.4 weeks), on days 3, 7, 14, 21 and 28 postpartum. Complete 24-hour milk expressed by five term mothers and seven preterm mothers on days 7, 14, 21 and 28 lactational ages was also recorded. In both preterm and term mothers' milk, lactose and fact concentrations increased with lactational age, while protein and mineral concentrations decreased. The preterm mothers' milk contained higher concentrations of protein, fat and minerals and lower concentrations of lactose than term mothers's milk. The fat and caloric density of milk of the mothers in this study, who were mostly of low social class, was lower than that reported from Western countries. The implication of this finding for feeding premature infants in developing countries is discussed.     

广西三江县侗族乳母乳汁中钙、锌、铜、铁、锰元素含量的调查分析

目的了解广西三江县侗族乳母乳汁中的钙、锌、铜、铁、锰含量,指导产妇合理饮食。方法收集120名广西三江县侗族乳母产后0～6个月的乳汁,用火焰发射光谱法测定钙、用原子吸收分光光度法测定锌、铜、铁、锰的含量,并对乳母进行膳食调查。结果乳母铁每日平均摄入量高于DRIs标准（P〈0.05）,钙、锌平均摄入量低于DRIs标准（P〈0.01）;满月前乳母乳汁中铁含量高于参考值,满月后母乳汁钙、锌、铁含量低于参考值。结论乳母膳食中营养素摄取量对乳汁中元素含量有一定的影响,应加强对乳母尤其是少数民族农村地区乳母的营养指导,改变哺乳期不均衡的膳食习惯。建议广西三江县侗族乳母适当增加钙、锌、铁的摄入量。     

早产儿和足月儿母乳及牛乳铜铁锌含量测定

Sixty-eight samples of preterm human milk and 39 samples of term human milk were obtained during 4 weeks postpartum from 7 mothers delivering prematurely and 9 mothers giving birth at term. Eleven cow's milk samples were obtained at random from 11 healthy cows. Samples were measured by flame method using an atomic absorption spectrophotometer (Type WYX-402). The three trace elements content of PT and FT milks decreased significantly with duration of lactation, and the content of each mineral was higher during the first week than that measured during the fourth week. PT and FT milk did not differ significantly in the content of the three elements during the first month of lactation. Copper content of PT milk at each week, iron content of PT milk at the first week and zinc content of PT milk during the first two weeks of lactation are higher than those of cow's milk respectively. The intake of copper, iron and zinc of the preterm infant fed his own mother's milk or cow's milk was calculated. Comparison of the intake level of copper and zinc of breastfed and cow's milk-fed preterm infant with the recommended intake level of the two minerals was made. The results show PT milk is superior to cow's milk for copper, iron and zinc; may be helpful for promoting breast feeding and feeding the preterm infant with supplemental trace elements.     

Infant feeding practices among middle income urban Africans and Indians in Kenya

A longitudinal study conducted in Nairobi focused on 70 Africans, 35 Indian vegetarians, and 20 Indian non-vegetarians revealed significant differences between these 3 groups in terms of the choice of milk, breastfeeding duration, age of introduction of other foods to the infant's diet, and the choice of weaning foods. African mothers tended to exclusively breastfeed their infants for longer durations than either of the 2 groups of Indian mothers. At 6 weeks, 42% of African mothers, 19% of Indian vegetarian mothers, and no Indian nonvegetarian mothers were exclusively breastfeeding. Bottle feeding was widespread in all 3 groups; however, African mothers showed a pattern of mixed feeding (at 12 weeks, 68% of African infants were being fed both breast and formula milk), while Indian mothers tended to replace breastfeeding with bottle feeding (at 12 weeks, 10% of the vegetarian mothers and 19% of the non-vegetarian mothers were following this regimen). Indian nonvegetarian mothers made extensive use of formula, while their vegetarian counterparts relied more on cow's milk. All 3 groups introduced foods earlier than the recommended 4-6 months. By 18 weeks, 98% of African infants, 86% of Indian vegetarian infants, and 89% of Indian nonvegetarian infants were receiving semi-solid or solid foods in addition to milk. In all 3 groups, cereals were the most commonly introduced 1st food, followed by fruits and pureed vegetables. The use of commercial cereals was extensive, with 97% of African mothers, 90% of Indian vegetarian mothers, and 82% of Indian nonvegetarian mothers feeding such preparations to their 6-week-old infants. As the children grew older, use of commercial cereals decreased. Despite the differences in feeding practices, the pattern of weight gain was parallel for infants from all 3 study groups. Moreover, the mean energy and protein intakes of all 3 groups were 80% or more of recommended allowances.     

Dietary habits and oral health in infancy and early childhood of Kenyan children at the Kenyatta National Hospital Paediatric Demonstration Unit

The survey was conducted by the method of questionnaire in the Maternal Child Health (MCH) clinic. A total of ninety seven mothers brought their children to MCH clinic. The mean maternal age was 22 years, the youngest mother was 16 years old. The total number of children who attended the MCH clinic was 98 with an equal number of boys and girls. The age range was from 0.5-50 months with a mean age of 12 months. Most of the children were introduced to breastmilk substitutes or compliments from the age of 4 months but some of the children had been introduced to breastmilk compliments at an early age of one month. The commonly used breastmilk compliment at the age of one month was noted to be whole cow's milk, skimmed milk from Kenya Cooperative Creameries (KCC), cooked green bananas, ribena (only given to children of working mothers), fresh orange juice. The orange juice was noted to be given to children belonging to mothers who are either housewives or employed. For ages 2-3 months the commonly used breastmilk compliments or substitutes were noted to be maize meal, sorgum or millet porridge, whole cow's milk, KCC milk, ribena, orange juice, bananas and potatoes in order of preference. These same foods were given at ages 4 months up to 12 months. In addition pulses and eggs were introduced. The number of children who used the artificial formula was 33%. The method of feeding for the children attending the clinic was by using either bottle or spoon and cup. Twenty nine percent of these children were bottlefed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Incidence and duration of lactation and lactational performance among mothers of low-birth-weight and term infants.

The lactation experience of 55 mothers of 62 infants of low birth weight (2500 g or less) was prospectively compared with that of 55 mothers of 55 control infants (38 weeks' gestation or more, birth weight more than 2500 g) born at the same institution. The incidence rates of lactation at delivery were 73% for the control group and 58% for the low-birth-weight group; 11% of the infants of low birth weight fed breast milk were never put to the breast. The mean age at first suckling was 277.3 hours in the low-birth-weight group, compared with 3.3 hours in the control group (p less than 0.0005). At first suckling 81% of the low-birth-weight infants and 25% of the control infants sucked poorly or refused the breast (p less than 0.001). At discharge 65% of the breast-milk-fed control infants were exclusively breast-fed, compared with 3% of the low-birth-weight infants fed breast milk (p less than 0.001). The incidence rates of lactation over time were similar in the control and low-birth-weight groups (51% v. 44% at 1 month, 29% v. 13% at 3 months, 13% v. 4% at 6 months and 4% v. 2% at 12 months). The mean duration of lactation was 3.2 months for the control group and 2.5 months for the low-birth-weight group. In the long term 37% of the low-birth-weight infants fed breast milk failed to breast-feed, compared with 2% of the control infants, and only 31% were exclusively breast-fed, compared with 85% of the control infants (p less than 0.001). However, the degree of satisfaction with the lactation experience was similar in the two groups. We conclude that mothers of low-birth-weight infants have good potential for lactation.     

Reduced tar, nicotine, and carbon monoxide exposure while smoking ultralow- but not low-yield cigarettes

An unresolved public health issue is whether some modern cigarettes are less hazardous than others and whether patients who cannot stop smoking should be advised to switch to lower-yield cigarettes. We studied "tar" (estimated by urine mutagenicity), nicotine, and carbon monoxide exposure in habitual smokers switched from their usual brand to high- (15 mg of tar), low- (5 mg of tar), or ultralow-yield (1 mg of tar) cigarettes. There were no differences in exposure comparing high- or low-yield cigarettes, but tar and nicotine exposures were reduced by 49% and 56%, respectively, and carbon monoxide exposure by 36% while smoking ultralow-yield cigarettes. Similarly, in 248 subjects smoking their self-selected brand, nicotine intake, estimated by blood concentrations of its metabolite cotinine, was 40% lower in those who smoked ultralow but no different in those smoking higher yields of cigarettes. Our data indicate that ultralow-yield cigarettes do deliver substantial doses of tar, nicotine, and carbon monoxide, but that exposures are considerably less than for other cigarettes.     

早产儿和足月儿母乳及牛乳铜铁锌含量测定

用原子吸收分光光度计火焰法测定产后4周内早产儿母乳、足月儿母乳及牛乳的铜、铁、锌含量。早产儿和足月儿母乳中三种微量元素的含量均随产后周龄延长而降低,二者间无显著性差异。早产儿母乳铜含量、产后第1周铁含量显著高于牛乳。计算出的平均摄入量与推荐量比较,早产儿母乳铜、铁、锌营养价值优于牛乳。     

新生儿TORCH感染的检查及分析

本研究对北京城区新生儿的弓形体、风疹病毒、巨细胞病毒及单纯疱疹病毒感染(总称TORCH)进行了血清学检查及病毒分离并结合临床病历作了分析。结果说明55名新生儿及其母亲TORCH感染是严重的。55名新生儿中9例有临床表现,3例中分离出CMV。从其母亲中分离得6株CMV及1株HSV。CMV及HSV的病毒分离可补充血清学诊断的不足。对TORCH中4种病原体同时作血清学检查及病原体分离可能发现混合感染,避免单项检查的错误判断。     

ACQUIRED CYTOMEGALOVIRUS INFECTION OF BREAST MILK IN INFANCY

A cross-sectional study was conducted to examine the rate of cytomegalovirus (CMV) shedding through breast feeding and the rate of acquired infection by the infants. Among the 104 seropositive breast-feeding mothers, CMV was recovered in the milk in 19 cases, with a milk shedding rate of 18.3%. Isolation of CMV from the urine of the infants of the 188 seropositive mothers found 36 positive cases. Of the 36 cases, 15 of 19 fed on CMV-positive milk were infected through breast-feeding, with an infection rate of 78.9%; 11 of the 85 fed on CMV-negative milk were infected, the infection rate being 12.9%; and 10 (11.9%) of 84 fed on cow's milk were infected. These demonstrate that the rate of infection in infants fed on virus-positive milk was significantly higher than those fed on virus-negative milk or cow's milk (P less than 0.005).     

儿童食物过敏现状及影响因素分析

目的 探讨儿童食物过敏的现状及其影响因素,以期为食物过敏的预防及儿科临床工作提供一定的指导.方法 对403例食物过敏皮肤点刺试验(SPT)强阳性(++和+++)患儿进行回顾性分析.结果 2004、2005、2006年儿童食物过敏SPT强阳性率分别为3.55%、3.82%、3.58%,各年的SPT强阳性率比较差异无统计学意义(P＞0.05).403例患儿诊断食物过敏的平均月龄为6.10个月.在403例SPT强阳性患儿中,无变态反应性疾病家族史者256例(63.52%),有家族史者147例(36.48%);诊断食物过敏SPT强阳性时未添加辅食者有54例,月龄＜4个月时添加者55例,4～6个月时添加者254例,＞6个月时添加者仅有40例(9.93%);对鸡蛋过敏者344例(85.36%),对牛奶过敏者180例(44.67%).结论 婴儿的食物选择应遵循其发育的规律,不能过早地引入固体食物;有变态反应性疾病家族史的婴儿,应注重环境对疾病的影响;儿科医生特别是儿童保健工作者,在临床工作中应更新观念,正确指导婴儿添加辅食,以减少食物过敏的发生.     

Do babies need water in Sri Lanka?

OBJECTIVES: To study the prevalence of exclusive breast feeding and the reasons for water supplementation, and investigate whether water is necessary in the humid climate of Colombo. SETTING: Well baby clinic in De Soysa Maternity Hospital for Women, Colombo. SUBJECTS: 200 breast fed infants born in a baby friendly hospital between the ages of 1 and 4 months. METHODS: The study sample was randomly selected. Sick infants and those of working mothers were excluded. The mothers' knowledge of feeding practices was recorded in an interviewer administered questionnaire. The infants' weights, lengths and rectal temperatures were measured and the osmolality of urine estimated. The room temperature and relative humidity were recorded on each day of study. The data were analysed using the Chi-Square statistical test. RESULTS: 69% of mothers introduced supplementary fluids within the first 4 months, because of advice from grandmothers or relatives, thirst, hiccups or constipation. 45% had introduced water with "rathakalkaya", a fluid traditionally given to infants in Sri Lanka. 90% of mothers had attended antenatal clinics in the De Soysa Hospital for Women. 70% of mothers who gave supplementary fluids were aware of the importance of exclusive breast feeding. The range of urine osomolalities of exclusively breast fed infants was 60 to 204 mosmol/kg. There were no significant differences in core temperatures and number of times urine was voided daily, or urine osmolalities, between exclusively breast fed and fluids-supplemented group of infants. CONCLUSIONS: Despite delivery in a baby friendly hospital a majority of mothers supplemented breast milk with water or other fluids during the first 4 months. The advice of grandmothers had a significant influence on early feeding practices. Exclusively breast fed infants were found to maintain water homeostasis under the hot, humid climatic conditions of this study.     

产后骨密度恢复影响因素分析

目的探讨产后骨密度恢复的影响因素。方法单胎足月分娩的健康产妇144例,分别于产后3 d内、产后12个月测量骨代谢指标[血碱性磷酸酶(ALP)、尿钙/尿肌酐(Ca/Cr)]和一侧股骨颈骨密度,记录产妇的哺乳时间。将产妇随机分为3组,每组48例。A组产妇口服碳酸钙600 mg,牛奶250 ml,2次/d,指导运动;B组产妇口服碳酸钙600 mg,牛奶250 ml,2次/d,专人负责督导;C组无专人督导其服钙片、牛奶且无运动指导。结果 (1)产后3 d内骨量减少发生率为76.9%(100/130),3组间比较差异无统计学意义(P>0.05);(2)产后12个月3组左侧股骨颈骨密度差异有统计学意义(P<0.05),A组最高;3组的血ALP、尿Ca/Cr比较差异有统计学意义(P<0.05),A组最低;(3)产后是否补钙及运动、哺乳时间长短及产后早期骨密度值与产后12个月骨密度恢复有显著相关(P<0.05)。结论孕期容易发生骨量减少,产后骨密度恢复与孕期骨密度状况及哺乳时间长短密切相关。哺乳期适当的运动辅以高钙饮食可促进骨量恢复。     

Infant-feeding practices in Western Australia and Tasmania: a joint survey, 1984-1985

A joint survey of infant-feeding practices that was carried out in Western Australia and Tasmania in 1984-1985 showed a continuing trend back to breast-feeding in both States. In Western Australia and Tasmania, 86% and 81% of mothers, respectively, were breast-feeding their babies on hospital discharge. Forty-five per cent of all mothers were still breast-feeding at six months. The social rank of the family had a significant effect on both the prevalence of breast-feeding and on the length of lactation: more mothers in the higher social groups breast-fed their infants, and for longer periods than did mothers of lower social groups. Few infants were introduced to solid foods before three months of age; however, solid and non-milk foods were introduced earlier to infants who were fed artificially than those who were breast-fed.     

母婴分离产妇心理情绪对泌乳素及后期母乳喂养率的影响

目的 研究母婴分离产妇心理情绪对产妇泌乳素（PRL）及后期母乳喂养率的影响,探讨有针对性的早期干预措施.方法 选择192例母婴分离的产妇作为观察组,另选取同期住院分娩的176例母婴同室的产妇为对照组.采用症状自评量表SCL-90对产妇进行心理情绪评分,同时检测PRL水平,观察并比较产后乳汁分泌情况及后期母乳喂养率.结果 与母婴同室的产妇相比,母婴分离产妇的SCL-90心理情绪评分明显升高（P＜0.01）;伴随负面心理情绪的出现,母婴分离产妇PRL水平降低、泌乳始动时间延长、乳汁量减少、后期母乳喂养率降低,差异均有统计学意义（P＜0.01）.结论 母婴分离产妇应激引起的负面心理情绪影响产妇PRL水平,关注母婴分离产妇的心理变化,适时采取积极的护理干预措施,对保证和促进母婴健康有推动作用.     

Breastmilk yield and infant nutrition in relation to early infant growth in Njoro, Kenya

Breastmilk yields during the first six months of lactation were measured in 27 mothers from small-scale cooperative farms and 35 mothers from squatter villages in two commercial farms and one forest village. On average, mothers from small-scale farms produced 440g milk per 24 hours and the village mothers 510g per 24 hours. Mean birth weight and length for the whole group were all within 90% of the Harvard Standard. However between the 10th and 18th week when milk yield was high, mean child weight was parallel to the Harvard standard but then declined to 90% at 26 weeks. Male infants were heavier and longer at birth than female infants. Seasonal variations were not significant. However, this may have been affected by the failure of the long rains in 1984 which caused food shortages in that year and the following year.     

Somatic cell counts: associated factors and relationship to production

Factors affecting somatic cell counts and the association between somatic cell counts and milk production were evaluated. Data were collected from 748 Ontario Dairy Herd Improvement Corporation supervised herds that were on production and somatic cell count programs between April 1981 and March 1983. Two data files were created; one, the lactation summary file, contained one record per cow on each of 9406 Holsteins and the other, the test day file, included results of all tests during the complete lactation on each of the above cows. The latter file contained 85,236 records. Multiple curvilinear least squares regression was used to create five separate models. The dependent variables used in the models were natural logarithms (Loge) of the geometric mean of the somatic cell count for the lactation, 305 day milk production and breed class average for milk from the lactation summary file, and loge of the 24 hour somatic cell count and 24 hour milk production from the test day file. The somatic cell count at both the lactation and test day level increased with age up to approximately ten years and thereafter slowly decreased. The variable "days in milk" was not significantly associated with the lactation average somatic cell count. A curvilinear relationship was found between days in lactation at the time of test and the somatic cell count of 24 hour milk production. The somatic cell count increased until approximately 250 days in lactation and thereafter slowly decreased. It was found that the highest cell counts occurred in summer and the lowest in winter.(ABSTRACT TRUNCATED AT 250 WORDS)     

Patterns of breastfeeding practice during the first 6 months of life in Saudi Arabia

OBJECTIVE: To assess the breastfeeding practices in the first 6 months of infants at King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. METHODS: A cross-sectional study was carried out at KAMC in 2005. Infants who attended the primary care centers and well-baby clinic of the hospital for the 6-month's vaccine were included. Mothers were interviewed to collect information on the mothers, infants, and their breastfeeding practice. World Health Organization definitions were used for classification of infant nutrition patterns. RESULTS: Five hundred seventy eight infants were included in this study. The breastfeeding initiation among the sample was 95%. Most mothers supplemented the infants with milk formula (83.4%) or fluids (94%) during the first 6 months. The percent of exclusive breastfeeding was 1.7% and the partial breastfeeding breast milk with formula was the most common type of feeding (78.8%). Lactation duration dropped to 50% at 6 months of age. Factors favoring the milk formula use were introduction of the formula in the first day of life and maternal reasons of inadequate milk. Lactation duration and formula introduction were found to be significantly associated with mothers' parity, working status, and combined contraceptive pill use. CONCLUSION: Prevalence of exclusive breastfeeding was extremely low in our population. Partial breastfeeding was the trend for feeding in the first 6 months of life, which was accompanied with rapid decline in lactation duration.     

孕妇宫颈巨细胞病毒分离及其母婴传播的初步探讨

孕妇宫颈巨细胞病毒(CMV)排出率为4.12％(8/193)。宫颈排出CMV的母亲所分娩的6名婴儿中有4名受感染,其中1名从唾液和尿排出CMV长达7个月以上。从3名母亲的乳汁分离出CMV,其中1名特续存在1个月以上。3名从宫颈分泌物和乳汁排出CMV者,其婴儿均受到感染。结果表明CMV在母婴之间传播。