Influence of Breast Feeding on Neonatal Behavior

Forty-six normal newborn infants were studied at the age of 6 to 7 days. Each infant was at first breast fed and at the next session was given a bottle feeding of the same amount of expressed breast milk on the same day. The neonatal behavior was assessed over two three-hour periods following each feeding, during which continuous polygraphic recordings and observations were made. Our study consisted of four steps: an expressed breast milk bottle feeding (step 1), an equal holding time period (step 2), an equal sucking time period (step 3), and an equal holding and sucking time period using two kinds of bottles (step 4). Infants who were breast fed had a longer period of quiet sleep and slow heart rate in active sleep compared with those who were bottle fed. In step 4, there were no significant differences in the amount of quiet sleep and low heart rate in active sleep between breast and bottle feeding. From our results, each component of breast feeding alone such as the breast milk itself, the holding time, or the time for sucking does not have any specific positive influence on neonatal behavior. Rather, the study suggests that the total mother-infant interaction during breast feeding results in positive influences on neonatal behavior.     

Influence of Fatty Diet on Neonatal Jaundice in Breast-Fed Infants

We studied milk samples from mothers of breast-fed full-term infants with “physiologic jaundice” and compared them with milk samples of healthy breast-fed control babies to investigate if the percentage of cream or “Creamatocrit” could be related to neonatal hyper-bilirubinemia. The results of this study confirm our hypothesis: a statistically significant difference was found between the two groups of patients (χ² -test, p < 0.002).     

BREAST FEEDING TRENDS AND RECENT INFORMATION ACTIVITIES IN SWEDEN

Abstract. Hofvander, Y. and Sjölin, S. (Department of Paediatrics, University Hospital, Uppsala, Sweden). Breast feeding trends and recent information activities in Sweden. The breast feeding rate has been declining steadily in Sweden since the 1930's up to the early 1970's. It is suggested that this was linked to the changing role of women, the development towards the nuclear family, the changing way of living, the influence of strict routines at the maternities and many other factors. A Committee was appointed in 1973 by the National Board of Health and Welfare, which initiated a number of breast feeding promoting activities: the editing of a Manual for health personnel, and booklets for mothers, the systematic arranging of workshops for key personnel in each county, stimulation to more flexible and breast feeding favouring maternity routines, backing of working groups of La Leche League-type, etc. Coinciding with these activities and probably a result of changed breast feeding attitudes among mothers, the breast feeding rate has increased considerably—at 2 months from an all time low of 31 % in 1972 to 62% in 1976/77, and at 6 months from 6% to 20%.     

新生儿人巨细胞病毒感染的诊断与治疗进展

人巨细胞病毒(HCMV)属B疱疹病毒亚科,是一种广泛传播的病原体,具有高度的种属特异性,仅在人与人之间传播.在健康人群中多数呈无症状或持续性感染,在免疫系统发育不成熟和免疫缺陷的人群中可引起严重疾病.除原发性HCMV感染外,潜伏感染的再发和继发性HCMV的感染亦导致先天性感染,造成出生缺陷的发生.因此,对HCMV感染早期诊治的重要性越来越受到关注.现就新生儿HCMV感染的现状、诊断、治疗方法及其进展作简要介绍.     

Bacterial antigen detection test in meningitis

Objective : To evaluate the role of bacterial antigen detection test in cerebrospinal fluid (CSF) for a rapid etiological diagnosis of bacterial meningitis.Methods : The study included 36 cases of bacterial meningitis and 14 controls. Latex particle agglutination test (LPA test) for detection of bacterial antigen was done in the CSF using slidex meningitis kit (Biomeriux, France).Results : Using LPA test, an etiological diagnosis could be made in 83% cases of bacterial meningitis. In contrast, CSF Gram stain and culture showed 36% and 6% positivity, respectively. The sensitivity and specificity of LPA test were 83% and 100%, respectively. The common etiological organisms were S.pneumoniae, H. influenzae type b andN. meningitidis A. S. pneumoniae was encountered in all age groups whileH. influenzae type b was found only below one year of age.Conclusions : LPA test is a rapid and superior diagnostic tool as compared to CSF Gram stain and culture. The study recommends LPA test as an adjunct laboratory test for rapid etioiogical diagnosis of bacterial meningitis for prompt institution of proper antibiotics.     

新生儿输血传播病毒感染及基因序列特征

目的分析引起新生儿感染的输血传播病毒（TTV）ORF1区基因序列特征。方法应用巢式PCR技术检测外周血TTV-DNA，15例中国新生儿确诊为TTV感染；对新生儿感染的TTV（中国株，C01～C15）ORF1区进行基因序列测定。结果引起新生儿感染的中国株TTV与日本株N22比较，同源性达87．1％～97．7％，但存在着点突变，如112、113位点的GG→TT和236～240位点的TTATC→CCTAT。结论TTV中国株与日本株具有同源性，某些TTV基因突变可增强其致病性，可导致新生儿肝功能损害和结合胆红素升高。     

哈尔滨地区早产儿母乳营养素含量的调查研究

目的 了解当前哈尔滨地区早产儿母乳中各种营养素的含量，为研制国内早产儿强化母乳提供科学依据，为更加合理喂养早产儿促进其健康成长提供科学依据。方法 收集哈尔滨市四个地区62名产妇的乳汁（早产儿初乳32份、成熟乳28份；足月儿初乳及成熟乳各30份），测定乳汁中蛋白质、脂肪、钙、磷、镁、铜、铁、锌、锰的含量。结果 哈尔滨地区早产儿母乳中蛋白质、磷、锌、镁在成熟乳期下降明显，铁、铜略有下降，但差异无统计学意义，脂肪、锰随泌乳期呈上升趋势，钙无明显变化。早产儿母乳在初乳及成熟乳期蛋白质含量均高于足月儿母乳，其他元素差异两者间无统计学意义。结论 早产儿母乳中蛋白质、锌、脂肪含量在成熟乳阶段含量偏低，建议适当补充，注意喂养。     

纯母乳喂养婴儿腹泻影响因素分析

目的通过分析纯母乳喂养婴儿腹泻影响因素,为重新定义“生理性腹泻”、预防腹泻、治疗腹泻、提高婴儿生活质量,降低远期过敏性及其他疾病的发生,提供理论依据。方法本组334例,均为2004年8月至2006年6月,在北京大学第三医院儿科门诊就诊的纯母乳喂养儿,其中男207名、女127名,平均年龄（3．0±0．4）个月。所有研究对象均通过问卷调查获悉父母的年龄、身高、文化程度、吸烟（支／d）、饮酒（g／月）情况、父亲的体重、母亲妊娠前体重、妊娠反应持续时间及程度、孕期有无感染及妊高征、母亲既往有无流产史、低体重儿生育史及慢性疾病史、新生儿的胎次、产次、分娩时孕周,家族过敏性疾病病史、消化道疾病家族史。母亲的饮食情况（哺乳期）。并观察患儿年龄、身高、体重、头围、胸围、有无皮疹、湿疹、纳食情况、呕吐、腹胀、哭闹、母乳的前列腺素E2、脂肪含量、乳糖含量、母、子血清的过敏原、点刺试验等。应用SPSS10．0软件进行Logistic回归分析。结果母乳喂养儿出现腹泻的相关影响因素有：母亲吸烟（OR=2．3）、母亲过敏史（OR=2．7）、家族过敏性疾病病史（OR=2．8）、母亲摄食海鲜（OR=1．8）、鸡蛋（OR=2．3）、花生（OR=2．0）,湿疹（OR=2．9）、哭闹（OR=2．7）、母乳前列腺素E：水平（OR=2．4）、脂肪含量（OR=3．0）、母子血清过敏原阳性（OR=4．0）、子点刺试验阳性（OR=2．7,P均〈0．05）等。结论通过研究发现,母亲或家族过敏史,母亲饮食结构、母乳前列腺素水平和脂肪水平增加等显示与母乳喂养儿腹泻有关。母乳喂养儿腹泻不单纯是一个生理过程,有环境因素和遗传学背景。其发病机制及预后值得进一步探讨。     

Bacterial Colonization and Neonatal Infections

In a prospective randomized study different regimens for skin and umbilical disinfection in newborn infants were tested: daily whole body soap wash (control group), daily whole body soap wash and umbilical cleansing with (i) benzine solution, or (ii) 0.05 % chlorhexidine, and daily whole body wash and umbilical cleansing with a 4 % chlorhexidine detergent solution (Hibiscrub^®). Bacterial cultures were taken from the nose and umbilical area at discharge. Clinical infections were registered in the nursery, and after discharge until 6 weeks of age. Cultures were taken from infected areas. In the control group a high colonization rate was found for S. aureus (91 %), E. coli (39 %), and group B streptococci (GBS) (20 %). The colonization rates were influenced by the Hibiscrub regimen (colonization rate for S. aureus 59 %, E. coli 23 %, and GBS 10 %), but not by the other regimens. Infections (pemphigus, paronychia, conjunctivitis, umbilical infection) occurred in 12.9 % of the infants, of whom 65 % got infection after discharge from the nursery. 96 % of the infections were caused by S. aureus, and 87 % caused by strains colonizing the infants in the nursery. None of the tested regimens reduced the rate of infections during the first 6 weeks of life.     

Knowledge and attitude among child development project officers towards breast feeding

A study was conducted to determine the knowledge and attitude about breast feeding (BF) amongst child development project officers (CDPOs) working in Integrated Child Development Services Scheme. A semi structured pretested questionnaire was administered. It was found that majority of respondent had correct knowledge about feeding of colostrum, age of initiation of breast feeding and introduction of semi-solid foods. Majority of CDPOs had the knowledge that consumption of dry fruits, milk and desi ghee would increase that breast milk secretion. The percentage of subjects who were aware that BF should be discontinued if mother is suffering from illness like breast cancer (48%) tuberculosis (57%), malaria (67%) and Diarrhoea (84%). There is need of continuing education of CDPOs for updating their knowledge.     

新生儿细菌性脑膜炎45例

目的 分析新生儿细菌性脑膜炎的临床表现、病原学特征及治疗方法,为早期诊断及治疗提供临床依据.方法 对本院新生儿科2005年12月-2010年7月收治的45例新生儿细菌性脑膜炎的临床资料进行回顾性分析.根据发病日龄分为≤7 d组(15例)和＞7 d组(30例),分析2组一般情况、临床表现、实验室检查及治疗方法等.结果临床表现以发热(86.7%)、抽搐(66 7%)、激惹(35.6%)为主,＞7 d组肌张力升高、脑膜刺激征阳性多见.脑脊液培养阳性11例(24.4%)、涂片阳性3例(6.7%)、血培养阳性18例(40.0%),其中,凝固酶阴性葡萄球菌12例,G-杆菌11例.脑脊液蛋白水平与白细胞计数在脑脊液培养阳性、涂片阳性或查见脓细胞(18例)患儿与未见明确病原学特征(27例)患儿比较,差异无统计学意义.选用β-内酰胺类联合第三或第四代头孢菌素治疗,培养有阳性细菌生长后,再根据药敏试验及临床疗效选用敏感抗生素.治愈33例(73.3%),无效1例(2.2%),放弃治疗11例(24.5%),包括症状缓解5例和未愈6例.结论 新生儿细菌性脑膜炎临床表现不典型,神经系统体征在发病日龄＞7 d 时表现相对明显;凝固酶阴性葡萄球菌为最常见的致病菌;治疗以β-内酰胺类联合第三代或第四代头孢菌素为主.     

Neonatal brucellosis

Three Arab children with neonatal brucellosis are described. The first presented with late neonatal hyperbilirubinaemia, the second with a septicoemia-like picture and the third was born prematurely and presented with respiratory distress. The diagnosis of brucellosis was based on a positive blood culture and on a high or rising titre of antibodies to the Brucella organism. All the three neonates responded well to antibiotic therapy as monitored by a Brucella titre of less than 140 and a negative blood culture 10 weeks after the onset of therapy. The three mothers had Brucella infections during pregnancy and the Brucella agglutination titre of the breast milk was high. No Brucella microorganism was isolated from the breast milk. The mode of transmission of brucellosis in neonates is discussed.Abbreviations B Brucella microorganism - FTND full term normal delivery - WBC white blood cell count - Hb Haemoglobin - ESR erythrocyte sedementation rate - Lymph lymphocytes - TSB total serum bilirubin - ELISA enzyme linked immunosorbant assay - TMP trimethoprim - SMX sulphametoxazole     

Supplementary feeding in the maternity ward shortens the duration of breast feeding

In a prospective study, feeding routines of a maternity unit and the subsequent feeding patterns of 521 newborns were analysed. During the stay in the maternity unit, 69% of newborns were exclusively breast fed and 1% received only donor's milk from the milk bank and/or formula. Nine percent received their mothers' milk by bottle at least once and 21% received one or more supplementary feedings with donor's milk from the milk bank. One-quarter of the children received supplementary feeds on the third day of life, the indications for this being birth weight less than 3.0 kg, maternal diabetes or gestational diabetes, “insufficient amounts” of milk or fussiness. At three months, 65% were being exclusively breast fed and 15% partially breast fed. In a multiple logistic regression analysis, the potential determinants (neonatal feeding, maternal characteristics, characteristics of the delivery and the child) for the duration of breast feeding were included. The adjusted relative risk (estimated as odds ratios, OR) of not being breast fed at three months was associated with maternal age (< 25 years, OR 4.2), maternal smoking (OR 4.0), neonatal feeding (supplements given, OR 3.9) and initial weight loss (10% or more, OR 2.8). Thus the administration of supplementary donor's milk or formula during the early neonatal period was associated with an increased risk of a short duration for breast feeding, even after adjustment for a number of potential confounders.