Somatostatin Levels in Plasma in Nonsmoking and Smoking Breast-Feeding Women

ABSTRACT. The objective of the study was to record how somatostatin levels in plasma are altered in response to breast-feeding during the lactation period and to relate somatostatin levels to the success of the lactational performance and to smoking habits. Fifty-two women were investigated 4 days post partum and 3-4 months later. Blood samples were collected and the levels of somatostatin-like immunoreactivity (below referred to as SLI) were measured with radioimmunoassay. The periods of exclusive breast-feeding and of mixed feeding were assessed as well as the milk yield. Smoking habits were noted. SLI levels were found to be significantly lower on day 4 after delivery, compared to 3-4 months later. Also the type of response to breast-feeding was different. Thus, a significant fall of SLI was seen during breast-feeding at the maternity unit, but not 3–4 months later. Smoking women breast-fed fully for a significantly shorter time than nonsmokers and had significantly higher SLI levels at onset of breast-feeding day 4 post partum. Whether the high somatostatin levels recorded in connection with breast-feeding in smokers are related to the shorter period of breast-feeding seen in this group remains to be established. In addition, the highest levels of somatostatin were seen the day after the very last breast-feeding and a possible role for somatostatin in the weaning process should be explored.     

Somatostatin levels in plasma in nonsmoking and smoking breast-feeding women.

The objective of the study was to record how somatostatin levels in plasma are altered in response to breast-feeding during the lactation period and to relate somatostatin levels to the success of the lactational performance and to smoking habits. Fifty-two women were investigated 4 days post partum and 3-4 months later. Blood samples were collected and the levels of somatostatin-like immunoreactivity (below referred to as SLI) were measured with radioimmunoassay. The periods of exclusive breast-feeding and of mixed feeding were assessed as well as the milk yield. Smoking habits were noted. SLI levels were found to be significantly lower on day 4 after delivery, compared to 3-4 months later. Also the type of response to breast-feeding was different. Thus, a significant fall of SLI was seen during breast-feeding at the maternity unit, but not 3-4 months later. Smoking women breast-fed fully for a significantly shorter time than nonsmokers and had significantly higher SLI levels at onset of breast-feeding day 4 post partum. Whether the high somatostatin levels recorded in connection with breast-feeding in smokers are related to the shorter period of breast-feeding seen in this group remains to be established. In addition, the highest levels of somatostatin were seen the day after the very last breast-feeding and a possible role for somatostatin in the weaning process should be explored.     

Short-term effects of early suckling and touch of the nipple on maternal behaviour

The objective was to evaluate the effects of suckling within 30 min after birth when skin-to-skin body contact for mothers and infants was held constant in both cases (n = 32) and control groups (n = 25). Mother-infant interaction during breast-feeding, infants' time spent in nursery and different aspects of breast-feeding were evaluated. Prolactin and gastrin were measured in maternal serum before and after breast-feeding on day 4 post partum. The aim to evaluate effects of early post delivery suckling failed since only six of the 32 case infants did suck at this time. In spite of this, we found three significant differences among cases and controls. In the case group where all infants had touched or licked the areola and nipple, the mothers left the infants in the nursery for a significantly shorter time and significantly more mothers talked to their infants during the short breast-feeding observation. Median gastrin levels were significantly lower in cases than in controls both before (P less than 0.01) and after (P less than 0.03) breast-feeding. In conclusion, the infant's early touch of the mother's areola and nipple seemed to have positively influenced the mother/infant relationship during the first four days after birth. It was also associated with lower maternal gastrin levels which suggests that maternal neuroendocrine functions were also influenced. Ten months after birth, we found no differences between cases and controls.     

以全基因组关联分析大数据为基础的孟德尔随机化方法探索出生体重与儿童肥胖的关联

目的 利用全基因组关联分析(GWAS)大数据,通过孟德尔随机化(MR)方法,探讨出生体重与儿童肥胖之间的关联。方法 本研究采用MR研究方法,以基因工具变量探讨出生体重与儿童肥胖的因果关联。以早期生长遗传学联盟(EGG)公开发表的基因数据为参考依据(数据获取时间为2018年10月20日),借助MR-base平台,筛选出与出生体重关联有统计学意义的SNP作为工具变量(筛选参数为P＜5×10^-8、连锁不平衡r²＜0.1),通过逆方差加权分析法(IVW)、加权中值法和MR-Egger法分别判断出生体重与儿童肥胖(儿童肥胖定义:0~18岁按不同性别年龄别BMI≥P₉₅)的因果关联。绘制SNP相关的出生体重与儿童肥胖风险的森林图及散点图。结果 共筛选到33个与出生体重相关的SNP。共纳入5 530例肥胖儿童和8 318名正常儿童。IVW分析:OR=1.79,95％CI:1.29~2.47,P=4.24×10^-4;加权中值法:OR=1.30,95％CI:0.81~2.08,P=0.27;MR-Egger法:OR=1.73,95％CI:0.58~5.20,P=0.36。森林图IVW结果显示,儿童肥胖的遗传易感性与出生体重水平有关,rs7964361、rs11765649、rs3780573和rs1351394的分析均表明出生体重与儿童肥胖的关联差异有统计学意义。与出生体重相关的SNP及其儿童肥胖风险的散点图显示,IVW法、MR-Egger法和加权中值法的因果关联估计相近。结论 IVW法分析显示出生体重与儿童肥胖具有较强的相关性,但其他两种统计方法分析均差异无统计学意义,故二者的关联尚待进一步的证据支撑。     

Urinary acidification in extremely low birth weight infants

Premature infants often present metabolic acidosis without protein load in the early neonatal period, around days 4–6. In order to elucidate the cause of acidosis, we investigated urinary acidification of infants in the early neonatal period.

Urine pH, fractional excretion of HCO₃⁻ (FEHCO₃), excretion of HCO₃⁻ and NH₄⁺ of the appropriate-for-date infants were measured on days 0–2 and on days 4–6 of life.

Extremely low birth weight (ELBW) infants showed higher urine pH than more than 1500 g birth weight infants. FEHCO₃ and HCO₃⁻ excretion were of high values in ELBW infants on days 0–2, but decreased on days 4–6. Urine NH₄⁺ excretion rate was lower in ELBW infants than in birth weight more than 1000 g on days 0–2 of life and still remained at a low rate on days 4–6.

These data indicated that insufficiency of NH₄⁺ excretion is the main cause for metabolic acidosis of ELBW infants in the early neonatal period.     

Thyroid function in healthy normal,low birthweight and preterm infants

To delineate more precisely the role of gestational age, weight at birth and thyroid status at birth on the postnatal changes in thyroid hormone levels, serum T₄, T₃, TSH and in some cases FT3I were measured at birth and at 3–4 h, 24–30 h, 6–9 days and 13–20 days.Subjects studied were healthy appropriate-for-date (AFD) and small-for-date (SFD) term neonates and healthy AFD and SFD preterm children. At birth T₄ and T₃ are related to both gestational age and weight with T₄ and T₃ showing lower values in preterm and SFD term neonates than in AFD term children. After birth T₄ and T₃ concentrations show a better correlation with gestational age than with weight at birth.For TSH no correlation was found at birth, a positive correlation at 24–30 h, no correlation at 6–9 days and a negative correlation at 13–20 days both with gestational age and weight at birth. In term and close-to-term infants (36 weeks) individual T₄ levels at 6–7 days show a colse relationship with those at birth; in the younger children (34 and 35 weeks) lower T₄ values are found, despite equal cord blood values. The individual cord blood FT3I/TSH values correlate well with those at 6–7 days of age.It is concluded that after birth all children have changing T₄ and T₃ values, but the pattern and level are influenced by the maturity of the child and its thyroid status at birth measured by T₄ and by the FT3I/TSH ratio. Weight at birth influences T₄ at birth, but during the 1st week the weight of the child influences the T₄ and T₃ levels in only a minor way.Abbreviations AFD appropriate for date - SFD small for date - CHT congenital hypothyroidism     

Breastfeeding and maternal weight changes during 24 months post‐partum: a cohort study

The relationship between breastfeeding and the loss of weight gained during pregnancy remains unclear. This study aimed to investigate the association between breastfeeding and maternal weight changes during 24 months post‐partum. We studied a dynamic cohort comprising 315 women living in two cities in the state of Bahia, Brazil. The outcome variable was change in the post‐partum weight; the exposure variable was the duration and intensity of breastfeeding. Demographic, socio‐economic, environmental, reproductive and lifestyle factors were integrated in the analysis as covariates. The data were analysed using multiple linear regression and linear mixed‐effects models. The average cumulative weight loss at 6 months post‐partum was 2.561 kg (SD 4.585), increasing at 12 months (3.066 kg; SD 5.098) and decreasing at 18 months (1.993 kg; SD 5.340), being 1.353 kg (SD, 5.574) at 24 months post‐partum. After adjustment, the data indicated that for every 1‐point increase in breastfeeding score, the estimated average post‐partum weight loss observed was 0.191 kg at 6 months (P = 0.03), 0.090 kg at 12 months (P = 0.043), 0.123 kg at 18 months (P < 0.001) and 0.077 kg at 24 months (P = 0.001). Based on these results, we concluded that despite the low expressiveness, the intensity and duration of breastfeeding was associated with post‐partum weight loss at all stages of the study during the 24‐month follow‐up.     

系统性红斑狼疮产妇孕期体重增长对新生儿出生体重影响的巢式病例对照研究

目的 考察系统性红斑狼疮(SLE)产妇孕期体重增长(GWG)对新生儿出生体重的影响。方法 以上海交通大学医学院附属仁济医院(我院)产科分娩的SLE产妇及其新生儿为研究对象。采集产妇一般情况(年龄、身高、孕前体重、教育程度、GWG、既往疾病史、分娩孕周)、第一次产检指标(收缩压、舒张压、胆固醇、甘油三酯、空腹血糖)、新生儿性别、Apgar评分及出生体重。根据年龄和教育程度1:3匹配健康产妇及其新生儿作为对照。产妇GWG与新生儿出生体重关系采用一般线性回归分析。结果 共纳入SLE产妇45例和健康产妇135例。所有产妇平均年龄(29.0±3.0)岁,新生儿平均出生体重(3 198.8±501.8)g。SLE组GWG显著低于对照组,(12.4±5.5)kg vs (15.0±5.1)kg, P=0.004,GWG 低于适宜体重增长的比例显著高于对照组(37.8% vs 16.3%, P<0.01)。将所有产妇按GWG进行四分位分组,结果显示随着GWG增长,新生儿出生体重明显增加。与GWG处于最低四分位的SLE产妇相比,处于最高四分位的产妇的新生儿出生体重多(246.4±234.1)g,差异无统计学意义。结论 SLE产妇GWG明显低于正常产妇,随着GWG的增加,新生儿出生体重有增加趋势。     

Parity,lactation, and long‐term weight change in Mexican women

One post‐partum behaviour that may be protective against post‐partum weight retention and long‐term weight gain among women of reproductive age is lactation because of its potential role in resetting maternal metabolism after pregnancy. However, most of the evidence focuses on weight retention at 6, 12, or 24 months post‐partum, and data beyond 2 years after birth are sparse, and findings are inconclusive. Therefore, our aim was to assess the association of parity and mean duration of lactation per child with long‐term weight change in Mexican women. We assessed the association of parity and mean duration of lactation per child with long‐term weight change in 75,421 women from the Mexican Teachers' Cohort. Several multivariable regression models were fit to assess these associations. We also examined the non‐linear association between duration of lactation and weight change using restricted cubic splines. We found that parous women (≥4 children) gained 2.81 kg more (95% CI [2.52, 3.10]) than did nulliparous women. The association between mean duration of lactation per child and weight change appeared to be non‐linear. Women who breastfed on average 3–6 months per child had lower gain weight (?1.10, 95% CI [?1.58, ?0.47 kg]) than had women who did not breastfeed. This association was linear up to 6 months of lactation per child. Our findings suggest that parity alters weight‐gain trajectory in women and that lactation could reduce this alteration. These findings are important in the prevention of excessive weight gain through reproductive years and their future health implications.     

Periodic spectral components of fetal heart rate variability reflect the changes in cord arterial base deficit values: a preliminary report

Fetal distress changes the function of the autonomic nervous system. These changes are reflected in the fetal heart rate and can be quantified with power spectrum analysis of heart rate variability. The purpose of this study was to find out whether spectral components of fetal heart rate variability (FHRV) during labor are associated with fetal cord arterial base deficit values at birth. The association between FHRV and umbilical cord arterial base deficit was studied in 14 singleton fetuses with normal pregnancy at 35–40 weeks of gestation. Fetal ECG was recorded by scalp-electrode using a STAN^® Fetal ECG monitor (Cinventa Ab, Mölndal, Sweden). FHRV was quantified by computing Fast-Fourier-transformed heart rate (HR) spectra at three frequency bands: low-frequency (LF) 0.03–0.07 Hz, mid-frequency (MF) 0.07–0.13 Hz and high-frequency (HF) 0.13–1.0 Hz. We found that total FHRV and MF FHRV were lower in fetuses with cord arterial base deficit 8 to 12 mmol/L in comparison to the fetuses with normal cord arterial base deficit value (P=0.02 and P=0.01, respectively). A linear correlation was found between the spectral densities and the cord arterial base deficit values (r=0.4 and r=0.6, respectively). We conclude that the results suggest changes in the autonomic nervous cardiac control in fetuses with cord arterial base deficit between 8 to 12 mmol/L. The clinical applicability of our observations on FHRV in predicting fetal distress remains to be further studied.     

Weight‐related self‐efficacy in relation to maternal body weight from early pregnancy to 2 years post‐partum

Excessive gestational weight gain may lead to long‐term increases in maternal body weight and associated health risks. The purpose of this study was to examine the relationship between maternal body weight and weight‐related self‐efficacy from early pregnancy to 2 years post‐partum. Women with live, singleton term infants from a population‐based cohort study were included (n = 595). Healthy eating self‐efficacy and weight control self‐efficacy were assessed prenatally and at 1 year and 2 years post‐partum. Body weight was measured at early pregnancy, before delivery, and 6 weeks, 1 year and 2 years post‐partum. Behavioural (smoking, breastfeeding) and sociodemographic (age, education, marital status, income) covariates were assessed by medical record review and baseline questionnaires. Multi‐level linear regression models were used to examine the longitudinal associations of self‐efficacy measures with body weight. Approximately half of the sample (57%) returned to early pregnancy weight at some point by 2 years post‐partum, and 9% became overweight or obese at 2 years post‐partum. Body weight over time was inversely related to healthy eating (β = ?0.57, P = 0.02) and weight control (β = ?0.99, P < 0.001) self‐efficacy in the model controlling for both self‐efficacy measures as well as time and behavioural and sociodemographic covariates. Weight‐related self‐efficacy may be an important target for interventions to reduce excessive gestational weight gain and post‐partum weight gain.     

Post-partum weight change patterns in the WHO Multicentre Growth Reference Study

The interplay of factors that affect post‐partum loss or retention of weight gained during pregnancy is not fully understood. The objective of this paper is to describe patterns of weight change in the six sites of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) and explore variables that explain variation in weight change within and between sites. Mothers of 1743 breastfed children enrolled in the MGRS had weights measured at days 7, 14, 28 and 42 post‐partum, monthly from 2 to 12 months and bimonthly thereafter until 24 months post‐partum. Height, maternal age, parity and employment status were recorded and breastfeeding was monitored throughout the follow‐up. Weight change patterns varied significantly among sites. Ghanaian and Omani mothers lost little or gained weight post‐partum. In Brazil, India, Norway and USA, mothers on average lost weight during the first year followed by stabilization in the second year. Lactation intensity and duration explained little of the variation in weight change patterns. In most sites, obese mothers tended to lose less weight than normal‐weight mothers. In Brazil and Oman, primiparous mothers lost about 1 kg more than multiparous mothers in the first 6 months. In India and Ghana, multiparous mothers lost about 0.6 kg more than primiparas in the second 6 months. Culturally defined mother‐care practices probably play a role in weight change patterns among lactating women. This hypothesis should stimulate investigation into gestational weight gain and post‐partum losses in different ethnocultural contexts.     

Determinants of weight and adiposity in the first year of life

To overcome methodologic defects (failure to control for confounding factors, univariate statistical analyses) in previous studies of etiologic determinants of childhood adiposity, we carried out a prospective cohort study of 462 healthy, full-term infants observed from birth to 12 months. Postpartum, we obtained sociodemographic data and administered two recently validated scales of maternal attitudes toward feeding and infant body habitus. Parental heights and weights and infant feeding variables were determined by interview, and at 6 and 12 months we measured height and weight and triceps, subscapular, and suprailiac skinfolds. Multiple regression analysis was used to determine independently predictive factors for weight, body mass index (BMI = weight/height), and the sum of the three skinfold measurements. Birth weight, sex, age at introduction of solid, and duration of breast-feeding were all significant predictors of weight at 12 months (r2 = 0.296, P less than 0.0001). Significant determinants for BMI included birth weight, duration of breast-feeding, sex, and IBH (r2 = 0.125, P less than 0.0001); those for total skinfold were age at introduction of solid foods and birth weight (r2 = 0.038, P = 0.002). Similar results were obtained at 6 months, although slightly less of the variance was explained. We conclude that the ability to predict which babies will be heavy or obese during the first year is limited. Breast-feeding and delayed introduction of solid foods do offer some protective effect, however, and thus efforts to encourage these practices may be reaping some benefit.     

Iodine status during pregnancy and at 6 weeks, 6, 12 and 18 months post‐partum

Iodine deficiency during pregnancy and in the post‐partum period may lead to impaired child development. Our aim is to describe iodine status longitudinally in women from pregnancy until 18 months post‐partum. Furthermore, we explore whether iodine status is associated with dietary intake, iodine‐containing supplement use and breastfeeding status from pregnancy until 18 months post‐partum. We also assess the correlation between maternal iodine status 18 months post‐partum and child iodine status at 18 months of age. Iodine status was measured by urinary iodine concentration (UIC) during pregnancy (n = 1,004), 6 weeks post‐partum (n = 915), 6 months post‐partum (n = 849), 12 months post‐partum (n = 733) and 18 months post‐partum (n = 714). The toddlers' UIC was assessed at 18 months of age (n = 416). Demographic variables and dietary data (food frequency questionnaire) were collected during pregnancy, and dietary data and breastfeeding practices were collected at all time points post‐partum. We found that iodine status was insufficient in both pregnant and post‐partum women. The UIC was at its lowermost 6 weeks post‐partum and gradually improved with increasing time post‐partum. Intake of milk and use of iodine‐containing supplements significantly increased the odds of having a UIC above 100 μg/L. Neither the mothers' UIC, vegetarian practice, nor exclusion of milk and dairy products were associated with the toddlers UIC 18 months post‐partum. Women who exclude milk and dairy products from their diets and/or do not use iodine‐containing supplements may be at risk of iodine deficiency. The women possibly also have an increased risk of thyroid dysfunction and for conceiving children with nonoptimal developmental status.     

Ontogeny of gastric function in the pig: acid secretion and the synthesis and secretion of gastrin.

Gastric acid secretion, gastrin-releasing peptide (GRP)-stimulated gastrin secretion and concentrations of somatostatin in gastric tissues were studied in sucking pigs (n = 48). In addition, gastrin concentrations in plasma and antral tissue were measured in fetal and sucking pigs (n = 66) from 22 days before birth (93 days gestation) to 36 days of age. From 3 days of age littermate pairs were treated twice a day with either saline (n = 20) or adrenocorticotropin [ACTH (1-24); n = 20]. Pentagastrin-stimulated acid secretion per unit stomach weight was 39 +/- 7 mumol H+/g/h at 0-1 day, increased to 194 +/- 15 mumol H+/g/h at 5-7 days and plateaued. Antral gastrin concentration was 0.14 nmol/g 10 days before birth and increased to 2.7 nmol/g at 5 weeks of age. Plasma gastrin was 25 +/- 2 pmol/l at 22 days before birth, increased to 102 +/- 14 pmol/l at birth and decreased during the postnatal period. Somatostatin concentrations were higher in antral than fundic tissues (p < 0.05) and remained constant during the postnatal period. Increased levels of glucocorticoids in plasma following ACTH treatment had no effect on the studied parameters except that it reduced basal (p < 0.07) and GRP-stimulated (p < 0.05) plasma gastrin concentrations at 6-7 days of age. Development of acid secretion and its gastric regulatory peptides in the pig is different from that in the rat in that it occurs at an earlier age and does not appear to be greatly influenced by elevated glucocorticoid levels from 3 days after birth.     

Levels of insulin-like growth factor I in full- and preterm human milk in comparison to levels in cow's milk and in milk formulas

The content of insulin-like growth factor I (IGF-I) in human milk, cow's milk and cow's-milk-based infant formulas was determined by radioimmunoassay. The mean levels of IGF-I in full-term milk and preterm milk 0-4 days post partum 2.2 +/- 0.3 and 2.4 +/- 0.5 ng/mg protein, respectively. The IGF-I content in human milk was not affected by gestational age or birth weight and was constantly excreted up to 10 days post partum. The IGF-I content in human milk was significantly higher than that in cow's milk (0.6 +/- 0.1 ng/mg protein, p less than 0.01). IGF-I was not detected in the milk formulas. The IGF-I in human milk might be absorbed or could act locally in the intestine and may be of importance in the nutrition of neonates.     

Effects of sociodemographic factors on adherence to breastfeeding and other important infant dietary recommendations

Aim: To examine in an affluent and healthy population the association between sociodemographic factors and the adherence to key infant dietary recommendations. Methods: In a longitudinal prospective study, healthy newborns were selected randomly in maternity wards around Iceland and their diet recorded every month for one year (n=124). In addition, a 48-hour-weighed-record, including information on added sugar, fruits, vegetables and the use of A and D vitamin drops was completed by 91 (73%) mothers at 9 and 12 months. Information about the mothers' education, smoking, age, parity, and family income was collected (n=98; 79%). Results: Regression analyses, including sociodemographic factors, showed exclusive breastfeeding to be positively associated with more education (P=0.022) and non-smoking (P=0.013) explaining 22% of the variance, and total breastfeeding (exclusive + partial) with non-smoking (P=0.006). Multiple regression also showed children's intake of added sugar from 9-12 months to be positively associated with mother's smoking (P=0.022) and negatively with age (P = 0.026), explaining 30% of variance. Sociodemographic factors were associated with children's fruit and vegetable consumption but not with the administration of AD-vitamin drops. However, when tested for significance between groups, younger mothers with fewer children seemed less likely to give AD-vitamin drops.

Conclusions: In a group of mothers getting regular antenatal care and giving birth to healthy infants, sociodemographic factors can predict which mothers need special guidance concerning recommendations about diet in infancy. These were mothers with less education, who smoked, were younger and were having their first or second child.     

Predictors of post‐partum weight retention in a prospective longitudinal study

Post‐partum weight retention (WR) occurs in 60–80% of women with some retaining ≥10 kg with contributing factors reported as pre‐pregnancy body mass index (BMI), gestational weight gain (GWG) and breastfeeding. A longitudinal study of pregnancy, with 12‐month post‐partum follow‐up was conducted to determine factors associated with WR. Pregnant women (n = 152) were recruited from the John Hunter Hospital antenatal clinic in New South Wales, Australia. Pre‐pregnancy weight was self‐reported; weight was measured four times during pregnancy (for GWG) and in the first 12 months post‐partum. Infant feeding data were obtained via questionnaires. Breastfeeding was categorised as exclusive, predominant, complementary or not breastfeeding. Linear mixed models tested the predictors of WR, with and without adjustment for potential confounders. Compared with pre‐pregnancy weight, 68% of women retained weight at 12 months, median (interquartile range) [4.5 kg (2.1–8.9)]. After adjustment, GWG was positively associated with WR (P < 0.01), but pre‐pregnancy weight did not predict WR. For each additional week of any breastfeeding, 0.04 kg less weight was retained. Compared with women who retained weight, those women who did retain had higher rates of exclusive breastfeeding at three months (P < 0.05), but the number of weeks of exclusive breastfeeding failed to predict WR for all women. WR following childbirth is common and associated with GWG, while the number of weeks of ‘any’ breastfeeding contributed to post‐partum weight loss. Whether these factors are modifiable strategies to optimise the weight status of women at this life stage requires further research.     

Plasma gastrin and somatostatin levels in newborn infants receiving supplementary formula feeding

Plasma gastrin and somatostatin concentrations were measured by radioimmunoassay in exclusively formula-fed infants and in breast-fed infants receiving supplementary formula during the first five postnatal days. Infants exclusively formula fed had a progressive increase in mean plasma gastrin concentration from 109±42 pmol/l (mean±SD) on the first day to 236±103 pmol/l on the fifth day after birth ( p = 0.0001). Breast-fed infants receiving supplementary formula had similar hormone concentrations as formula-fed infants of corresponding postnatal age and they also had a significant increase in hormone levels from the first to the fifth day ( p = 0.0001). A positive relationship was found between gastrin concentration and ingested milk volume: Rs = 0.51, n = 105, p = 0.0001. The high gastrin concentrations most probably reflect enhanced hormonal release from the gastrin-producing cells in response to increasing volumes of milk ingested by the infant. The mean plasma somatostatin concentration on the first day after birth was 18 ± 6 pmol/l. No significant change occurred during the first five postnatal days, independent of feeding type.     

IV. Effects of Silver Nitrate Prophylaxis on Mother-Infant Relationship

The effects of silver nitrate versus Hexarginum on maternal behaviour during care and breast-feeding were examined in a double-blind study of 65 mother-infant pairs. Observations and interviews took place on day 4 or 5 post partum. A follow-up interview was conducted 6–8 weeks later. The Neonatal Perception Inventories (Broussard) were used on both occasions. Mothers of infants in the silver nitrate group had significantly less eye contact with their newborns during breast-feeding than those in the Hexarginum group. This difference was even greater for mothers with complicated deliveries. Since eye-contact behaviours were infrequent, the results should be judged with caution. The maternal attitude towards the child, delivery, and post-partum care as expressed at 4–5 days and at 6 weeks did not differ between the groups. The frequency of breast-feeding at 6 weeks was similar. Eye prophylaxis was administered about 2 hours after birth and rooming-in was practised in the maternity wards. It is discussed whether the postponed Credé prophylaxis and other contact-facilitating routines contributed to lessen possible adverse effects of the silver nitrate prophylaxis.