The development of maternal touch across the first year of life

The developmental trajectories of specific forms of maternal touch during natural caregiving were examined across the first year in relation to the development of mother-infant reciprocal communication. One hundred and thirty-one mothers and infants in four groups aged 3, 6, 9, and 12 months were observed in a cross-sectional design at home during natural caregiving and mother-child play sessions. Microanalytic coding of the caregiving sessions considered nine forms of maternal touch, which were aggregated into three global touch categories: affectionate, stimulating, and instrumental. Play sessions were coded for maternal sensitivity and dyadic reciprocity. Maternal affectionate and stimulating touch decreased significantly during the second 6 months of life. In parallel, dyadic reciprocity increased in the second half year. Dyadic reciprocity was predicted by the frequency of affectionate touch but not by any other form of touch. Results contribute to specifying the role of touch as it evolves across the first year of life within the global mother-infant communication system.     

Snoring in the first year of life

AIM: To describe the prevalence of snoring in infancy and the factors associated with snoring. METHODS: The investigation comprised a cross-sectional study of 1800 infants. Snoring was ascertained by interviewer-administered questionnaire. RESULTS: The prevalence of snoring was 15.8% in the first 4 wk of life and 26.1% in the past 2 wk. Snoring in the past 2 wk was associated with increasing age of the infant, male gender, maternal smoking, sleep position, number of respiratory infections and snoring in the first 4 wk of life after adjustment for potential confounders. No associations were found with snoring in the first 4 wk of life. CONCLUSION: Snoring is common in infancy. The identified risk factors for snoring are probably causally related to snoring. Further studies are needed to establish whether snoring in infancy is associated with current or subsequent morbidity.     

A non-linear model of growth in the first year of life

Weight gain curves in infancy and childhood show valleys and hills which cannot be simplistically ascribed to random variations, so that they are referred to as pulsatile or pulse growth. Classical mathematical models of human growth, upon which the statistical percentiles are based, do not account for these oscillations. Moreover, statistical curves can hide individual patterns of growth. In the present paper a system dynamics approach to modelling the first year weight gain is suggested which simultaneously accounts for the oscillations of weight gain, for its decreasing trend , and for a more or less marked initial spurt observed approximately in the second month of life. It is suggested that the overall weight growth in the first year is the output of complex hidden non-linear dynamics.     

Iron status in the first year of life

The iron status of babies of different race born at term to mothers in an inner city area was studied at birth and during the first year of life and related to maternal iron status. Haemoglobin and ferritin were measured in the mother at term (n = 81) and in the baby in cord blood (n = 81), at 6 months (n = 55), and at 1 year (n = 51). No relationship was found between the iron status of mothers and their babies at birth. However, iron stores at birth did affect later iron status, cord ferritin being significantly related to ferritin at 6 months (r = 0.42, p less than 0.01) and 1 year (r = 0.55, p less than 0.01) but not to haemoglobin at these ages. No relationship was found between haemoglobin iron at birth and subsequent iron status. Introduction of full cow's milk before the age of 6 months was associated with iron deficiency at this age and at 1 year. By the age of 1 year, iron deficiency was also associated with feeding greater than 900 ml whole cow's milk a day, inadequate feeding with solids, and higher weight gain. No stool parasites were found at the age of 1 year, and the presence of occult blood in stools did not significantly affect iron status at this age. At 1 year of age, 49% of these infants had low iron stores, including 20% with iron deficiency anaemia. Considerable improvement could result from simple changes in dietary practices.     

Arterial trauma in the first year of life

Traumatic vascular lesions in neonates are usually due to preoperative iatrogeny. In the last ten years, we attended 11 patients aged less than one year with arterial lesions due to deliberate puncture. All required endovascular, surgical or combined treatment. The intra- and postoperative follow-up of severe congenital malformations necessitates appropriate arterial access. This should be achieved following strict protocols, with a limited number of punctures carried out by experienced staff and only in large arteries. When a vascular lesion occurs, first an endovascular and then a surgical approach is required in the shortest time period possible. In conclusion, care of arterial routes of access and their maintenance is the best preventive therapy. Appropriate and early treatment in fistulas, pseudoaneurysms and thrombosis must be provided to prevent serious complications, especially in underweight patients.     

Serum immunoglobulins in the first year of life

Serum IgG, IgM, and IgA were measured in 316 infants younger than 12 months of age. Information including the child's race, sex, age, and past history of infections or atopy was collected. Birth records were also reviewed to ascertain the child's birthweight and gestational age. Serum IgG levels were higher in black infants than in white infants after the age of 4 months. Serum IgM levels were higher in black females than in black males for infants older than 1 month. For infants younger than 4 months of age, those weighing less than 2500 g at birth had lower IgG levels than those weighing more than 2500 g. Infants younger than 1 month whose gestational age had been less than 36 weeks had lower IgG levels than those greater than 36 weeks. Infants aged 1 to 4 months whose gestational age had been less than 36 weeks had lower IgG levels than did those 40 or more weeks. Infants with a positive history for atopy had lower IgG levels than similarly aged infants with a negative history.     

Decline of maternal hepatitis A virus antibody levels in infants

Hepatitis A is a common viral infection causing substantial morbidity and mortality. The anti-hepatitis A virus (HAV) vaccination in infants would guarantee control of the infection. However, the immunogenicity of the HAV vaccine in infants could be impaired by the presence of passively acquired maternal HAV antibodies. This study evaluated the prevalence of HAV antibodies in 103 women at delivery and in their babies in the first year of life. Eighteen mothers (17.5%) had anti-HAV serum level >10 mIU ml(-1). In their infants the anti-HAV level was still positive in 11 out of 18 (61.1%) at 12 mo. Two out of 85 infants born to anti-HAV-negative mothers and anti-HAV negative at birth were found to be positive at 5 mo of age. Conclusion: It is proposed that all women be screened at delivery for anti-HAV antibodies. Children born to anti-HAV-negative mothers could be vaccinated early during the first year of life, whereas vaccination could be postponed in children born to anti-HAV-positive mothers, if necessary.     

Costello syndrome: clinical diagnosis in the first year of life

We report on three patients with Costello syndrome (CS) diagnosed during the first year of life and try to outline the clinical characteristics facilitating early recognition of this syndrome, which can now be corroborated by testing the HRAS gene. Phenotypical overlap of CS with Noonan (NS) and cardiofaciocutaneous syndrome (CFCS), particularly in neonatal age, is well known. Diagnostic features useful for recognition of CS in the first year of life are the following: (1) fetal and neonatal macrosomia with subsequent slow growth due to severe feeding difficulties, (2) developmental delay, (3) particularly coarse facial dysmorphisms and gingival hyperplasia, (4) skeletal anomalies as osteoporosis and metaphyseal enlargement, (5) hypertrophic cardiomyopathy (HCM) with asymmetric septal thickening and systolic anterior motion of the mitral valve, and (6) specific atrial arrhythmias. Following a clinical suspect of CS based on specific features, molecular screening of HRAS gene mutations should precede analysis of the other genes in the Ras-MAPK pathway implicated in related disorders with overlapping phenotypes.