Role of breast feeding in preventing acquisition of roundworm and hookworm in Dhaka slum children

Breastfeeding was found to give protection against many gastrointestinal infections in infants. A study has been conducted to examine whether breastfeeding protects children contracting from ascaris lumbricoides and hookworm infections. A history of breastfeeding and supplementation in urban children from low economic strata were obtained and stools were examined for the ova of ascaris and hookworm. There was no significant difference in the presence of hookworm ova between the only breastfed group and breastfed with supplemented group by 2 years of age. By age 6 and 24 months, the presence of ascaris ova was significantly higher in the breastfed with supplemented group than the breastfed only group. It appears that exclusive breastfeeding may have some role in preventing acquisition of ascaris infection in urban slums with poor sanitation facilities.     

Effect of deworming on nutritional status of ascaris infested slum children of Dhaka,Bangladesh

This randomized double blind community trial was conducted on Ascaris infested children (n = 85) aged 2 to 12 years and was aimed to study the impact of deworming on nutritional status, in an urban slum of Dhaka, Bangladesh. The change of weight gain was significantly higher in children given anthelmintics than those given placebo (0.92 kg vs. 0.54 kg). A multiple linear regression model shows that after controlling sex, deworming and height were positively correlated while age and weight were negatively correlated with weight change.     

Role of prolonged breast feeding in infant growth

The growth of 238 healthy full-term infants was followed under a carefully monitored nutritional protocol during the first year of life. The infants were weaned at different ages either to a proprietary infant milk formula or to a home-prepared cow's milk formula. Solid foods were introduced at 3.5 months of age. The 56 infants who were breast-fed for a period of at least 6 months were compared to infants weaned prior to one month of age to one of the two milk regimens. In the breast-fed infants, the weight, weight-for-height-age, and skinfold thickness were similar to values in the proprietary formula-fed infants but were lower than the corresponding values in the cow's milk-fed infants at 6 months of age and subsequently. By using weight-for-height-age as a criterion, no obesity was found among any of the 238 infants, and only 1.7% were considered to be overweight. The results indicate that present recommendations for infant feeding in Finland--including prolonged breast feeding, the use of proprietary milk formulas after weaning, and later introduction of solid foods--prevent overnutrition.     

Nutritional problems in urban slum children

Nutritional problems like protein energy malnutrition (PEM), anemia and vitamin A deficiency continue to plague a large proportion of Indian children. The diets and nutritional status of urban slum children in India is far away from being satisfactory. The nutritional status of slum children is worst amongst all urban groups and is even poorer than the rural average. Urban migration has not provided them salvation from poverty and undernutrition. Another distressing feature is the lack of any significant improvement over the years in this population. Most common causes of malnutrition include faulty infant feeding practices, impaired utilization of nutrients due to infections and parasites, inadequate food and health security, poor environmental conditions and lack of proper child care practices. High prevalence of malnutrition among young children is also due to lack of awareness and knowledge regarding their food requirements and absence of a responsible adult care giver. With increasing urban migration in the years ahead, the problem of malnutrition in urban slums will also acquire increasing dimension unless special efforts are initiated to mitigate the health and nutrition problems of the urban poor. Improving nutritional status of urban poor requires a more direct, more focused, and more integrated strategy.     

Role of breast milk in acquisition of cytomegalovirus infection: recent advances

PURPOSE OF REVIEW: Congenital infection with cytomegalovirus is a major cause of disability in newborns. Recently, there has been increased emphasis on the study of postnatally acquired cytomegalovirus infection. One route by which cytomegalovirus infections are acquired in newborns is via consumption of breast milk from cytomegalovirus-seropositive, lactating mothers. The purpose of this review is to summarize recent studies of breast-milk-acquired cytomegalovirus infections in newborns, particularly in low-birth-weight premature infants. RECENT FINDINGS: Nearly all cytomegalovirus-seropositive women will reactivate and shed cytomegalovirus during lactation, as demonstrated by sensitive polymerase chain reaction techniques, as well as by viral culture of breast milk. A substantial proportion of infants exposed to cytomegalovirus in breast milk will acquire a primary cytomegalovirus infection. Although acquisition of cytomegalovirus by this route is seldom of consequence in healthy term infants, cytomegalovirus infections in low-birth-weight premature infants have been demonstrated to cause symptomatic illness, including hepatitis, neutropenia, thrombocytopenia, and a 'sepsis-like' state. SUMMARY: Cytomegalovirus is commonly shed in human milk, and cytomegalovirus-seropositive women can transmit this infection via breast-feeding. The benefits of breast-feeding greatly outweigh the minimal risk, if any, of infections transmitted to term infants. Caution is warranted, however, in low-birth-weight premature infants, who are at increased risk of cytomegalovirus disease. Interventions to screen breast milk, or to attempt to render breast milk noninfectious through treatments such as freezing, may be warranted in high-risk premature infants.     

捐献母乳喂养对极低出生体重儿院内感染发生的影响

目的 探讨捐献母乳在预防极低出生体重儿院内感染中的作用。方法 将105例极低出生体重住院早产儿纳入研究,根据其所接受的喂养方式分为亲母母乳、捐献母乳、早产儿配方奶喂养组,每组各35例。比较3组院内感染发生率、坏死性小肠结肠炎发生率、喂养不耐受发生率以及达到全肠道喂养时间、早期生长指标。结果 与配方奶组比较,捐献母乳组和亲母母乳组患儿院内感染及坏死性小肠结肠发生率明显降低,且捐献母乳组和亲母母乳组达到全肠道喂养的时间短于配方奶组,差异均有统计学意义（P < 0.05）。3组患儿头围、身长、体重增长速率比较差异无统计学意义。结论 极低出生体重儿在亲母母乳不足时可以采用捐献母乳替代喂养,有助于降低院内感染的发生。     

Atopic dermatitis and breast feeding of Somali children living in Somalia and in Italy

The aim of this study was to investigate the feeding habits in the first year of life and prevalence of atopic dermatitis (AD) in a group of Somali children born and living in Italy and in a group of Somali children born and living in Somalia. The first group comprised 59 children (median age 15 months; range: 12–24 months) and the second group 95 children (median age 16 months; range: 12–24 months). The mothers were asked to fill in a questionnaire on the duration of breast feeding and weaning age of their children. In the Somali children born and living in Rome we observed earlier introduction of cow's milk (p < 0.001), and earlier weaning (p < 0.001). The prevalence of AD was higher in the Somali children born and living in Italy (p < 0.001).     

Sources of lead exposure in urban slum school children.

A school based study was undertaken to trace various sources of lead exposure in urban slum children. Two cases with elevated venous blood lead (PbB) levels were detected and confirmed in 100 consecutive Bombay school children, referred to a hospital school clinic for clinical pallor. A common source of lead exposure in one suburb, was implied by the significantly higher PbB levels here. Systematic family and environmental studies identified the source was a nearby factory manufacturing lead storage batteries. Similar studies for the other index case traced the source to the dust produced by small scale foundries and secondary lead smelters. This study indicates that large scale screening studies are necessary to establish the magnitude and epidemiology of this problem in Bombay.     

Determinants for breast feeding and bottle feeding in Botswana

In the Botswana Primary Health Care Survey 1983-84 data on breast and bottle feeding were collected as well as characteristics of households, mothers, and children. The country-wide median breast-feeding duration was 1 year and 7 months, with a tendency towards shorter duration in the urban areas. Better hygienic conditions, higher education of the mother, and wage employment of the mothers were associated with shorter breast-feeding duration. Similarly, the risk of starting bottle feeding was higher in households with better hygienic conditions. However, a substantial proportion of the bottle feeding took place in households lacking piped water indoors. These data may indicate a current shift from traditional feeding patterns towards shorter breast feeding and introduction of bottle feeding, starting among well-off families, but also threatening the health of children in less privileged conditions. The association with maternal factors such as type of occupation calls for breast feeding promotion including improved conditions for the salary employed mothers.     

Nutritional status of pre-school children of urban slum communities in Delhi

Nutritional status of 486 preschool children residing in urban slums was assessed by making domiciliary visits. The overall prevalence of protein energy malnutrition (PEM) was found to be 81.8%, while 31.8, 44.1, 5.7 and 0.2% of children had Grades I, II, III and IV PEM, respectively. Age, sex and education had a significant association with PEM.     

Day-care centre supplementary feeding effects on child nutrition in urban slum areas of Nepal

We compared the nutritional status of children aged 1-5 years from slums attending two day-care centres (DCCs) in Nepal (one in an urban slum area) with that of non-attendees to evaluate the impact of supplementary feeding. We measured the anthropometrics of 23 children attending two DCCs and 23 matched controls from the same neighbourhood and interviewed their mothers. We found a better nutritional status, particularly the height-for-age Z-score, among the attendees of the DCC with children's longer attendance, but no difference at the other, although attendees who had been fed for longer tended to show better nutrition. Our study indicates that in the least developed countries good quality day-care of sufficient duration has the potential to improve child nutrition.