Macro- and trace-mineral intakes of exclusively breast-fed infants

Intakes of calcium, phosphorus, magnesium, zinc, sodium, potassium, iron, and copper of 45 exclusively breast-fed infants were determined during the first 4 mo of life. Direct 24-h measurements of milk intake and mineral contents of human milk were used to estimate mineral intakes. Daily intakes of Ca, P, Zn, K, Na, Fe, and Cu decreased significantly over the study period while the intake of Mg increased. With the exception of Mg, mineral intakes on a weight basis displayed significant quadratic trends over the 4 mo. In spite of seemingly low-mineral intakes, growth progressed satisfactorily.     

Zinc requirements and zinc intakes of breast-fed infants

Longitudinal changes in dietary zinc requirements for infants at different levels of net absorption were estimated using a factorial approach. Apart from variations in net absorption, the zinc needed for new lean body mass is the major determinant of requirements. As growth velocity declines progressively, estimated zinc requirements for growth and for replacement of urine and sweat losses decrease from a high for male infants of 780 micrograms/day at 1 mo to 480 micrograms/day in the 5th mo and then remain quite constant through the 1st yr. Calculated percentage absorption of zinc from human milk necessary to meet estimated requirements increases with duration of lactation. For infants of mothers whose zinc intake approximated 25 mg/day the calculated percentage absorption remained within plausible limits. It is suggested that the progressive decrease in milk zinc concentrations provides a mechanism for conserving maternal zinc while meeting infant needs.     

Growth pattern of exclusively breast-fed infants during the first six months of life in Ile-Ife,Osun State,Nigeria

Several studies to determine the growth pattern of exclusively breast fed infants have provided varying conclusions as to the sufficiency of breast milk alone to support adequate growth for the first six months of life. Disagreement exists concerning the optimal timing of introduction of complementary foods to exclusively breast fed infants. This prospective study thus examined the adequacy of breast milk alone to support normal growth during the first six months of life in our environment. The overall objective was to propose a scientifically sound national recommendation on the appropriate timing for the introduction of complementary feeding in Nigeria. Three hundred and fifty-two mother/infant pairs were serially recruited into the study; all babies were aged 14 days or less and weighed 2.5 kg and above. Three hundred and forty-five (98%) were successfully followed up till the infants were six months old. By six months, 264 (76.5%) were exclusively breast-fed, while 81 (23.5%) had commenced complementary feeding. Growth curves of exclusively breast-fed infants showed increasing weight from birth to six months. Although the 50th percentile birth weight for both boys and girls were the same (3.2 kg), boys gained weight faster than the girls from the age of one month to six months and were heavier at six months. Additionally, the 50th percentile curves of these infants (both genders) for the first six months were above the 50th percentile curve of the World Health Organisation and National Centre for Health Statistics (WHO/NCHS) reference currently used on our national "road to health" (growth monitoring) cards. It was concluded that exclusive breast-feeding supported adequate growth during the first six months of life for most of the children studied and that our national recommendation that infants be introduced to complementary feeding at six months is appropriate.     

Growth and dietary status of preterm and term infants during the first two years of life

This study compared growth, food intake and feeding problems in appropriate weight for gestational age sequela-free preterm and term infants at 4, 8, 12 and 24 months adjusted age. Growth deficits were frequent in the preterm infants, especially during the first year of life with a tendency to "catch up" during the second year. Normal head growth and arm muscle area were documented in this selected group of infants but triceps skinfold thicknesses were deficient, especially during the first year. Food consumption patterns and energy intake differed with higher energy intake in the preterm group. Feeding problems were only slightly more frequent in the preterm infants. The only factor associated with energy intake in the preterm infants was duration of neonatal hospital stay. Weight percentile was associated with birthweight and socioeconomic status in term infants, and birthweight, hospital stay and "fussy eater" in preterms at specific ages.     

妊娠期碘缺乏及补碘干预对后代神经智力发育的影响

  目的  调查中国高水碘和适水碘地区成年妇女膳食碘摄入量、碘来源以及贡献率,为指导不同水碘地区居民科学膳食提供依据。  方法  于2018年7 — 8月,在山东、河南两省选取1 320名18～60岁妇女开展食物频率问卷调查,记录膳食情况、饮水量和食盐摄入量,并结合食物碘、水碘及盐碘的实验室检测结果,计算日均膳食碘摄入量,根据中国膳食碘摄入量推荐标准对潜在风险进行评估。  结果  高水碘和适水碘地区成年妇女膳食碘摄入量分别为441.52和180.67 μg/d,介于推荐摄入量（RNI）和可耐受最高摄入量（UL）之间,均属于适宜水平。高水碘地区有18.12 %的被调查者碘摄入量高于UL,适水碘地区有27.14 %的被调查者碘摄入量低于RNI。2个地区碘盐食用率分别为8.96 %和25.93 %,对膳食碘的贡献率为0.03 %和8.39 %;水碘摄入量分别为383.06和93.06 μg/d,对膳食碘的贡献率为84.22 %和53.71 %,均有显著的地区差异。  结论  高碘和适碘地区成年妇女碘摄入量总体上是适宜和安全的,饮用水是膳食碘的主要来源,适碘地区碘盐食用率较低,导致部分人群存在碘缺乏的风险。     

Dietary energy and nutrient intakes and growth of healthy Australian infants in the first year of life

A prospective study of growth and nutrition in Australian infants has shown a high rate of breast-feeding, which was continued past 6 months in almost two-thirds. This trend back to breast-feeding was most pronounced in the highest social class. Protein intakes dominantly artificially fed infants. Intakes of sodium were less than recent reported figures. Body weight increases in this group when artificial feeding prevailed.     

Longitudinal study of diet and iron deficiency anaemia in infants during the first two years of life

The objectives of this study were: (i) to investigate the energy, iron, zinc, calcium and vitamin C intakes of a group of healthy term Caucasian infants resident in Dunedin, New Zealand, prospectively from age 9 months to 2 years; and (ii) to determine the prevalence of iron deficiency anaemia among these infants. A self-selected sample of 74 Caucasian mothers and their infants born in Dunedin, New Zealand, between October 1995 and May 1996 were recruited. Dietary intake was determined using estimated diet records at 9, 12, 18 and 24 months of age. Haemoglobin concentration, mean corpuscular volume andzinc protoporphyrin concentration were determined at the same ages. The infants' zinc, calcium and vitamin C intakes appeared adequate. Their median iron intakes ranged from 4.3 mg (at 12 months) to 7.0 mg (at 9 months) per day and were below estimated requirements at all ages. At 9, 12 and 18 months of age, 7% (n = 4) of the infants had iron deficiency anaemia. None of the infants had iron deficiency anaemia at 24 months. The iron intakes of this group of Caucasian infants and young children appeared inadequate. However, their rate of iron deficiency anaemia was lower than has been reported in previous New Zealand studies.     

Growth of full term low and adequate birth weight infants during the first two years of life

OBJECTIVE: To assess the growth pattern of full term low and adequate birth weight infants during the first two years of life and to identify the determinants at the time of the greatest growth deceleration. METHODS: A prospective cohort study was conducted with 148 full term infants in five small towns of the state of Pernambuco, Northeastern Brazil. Newborns were recruited from maternities between January 1993 and January 1994 and their anthropometric measurements were taken at one, two, four, six, 12 and 24 months of life. Risk factors were analyzed using multivariable linear regression. RESULTS: The increment of mean weight-for-age and length-for-age were more evident for low birth weight when compared with adequate weight infants, especially during the first two months after birth. From this point onward it was observed a progressive mean growth deceleration in both indexes up to 12 months of life. All infants had similar weight and length growth patterns. However, adequate birth weight infants remained in an upper level. Socioeconomic variables explained 23% of variation for weight-for-age, followed by 4% for birth weight. Socioeconomic condition was also the factor mostly affecting length-for-age, explaining 28% of its variation, followed by birth weight, maternal height and diarrhea. CONCLUSIONS: The study results suggest that interventions aiming to adequate growth should focus on prenatal care and social and environmental factors during childhood as a way of ensuring full expression of the genetic potential of this population.     

Fat elimination in parenterally fed low birth weight infants during the first two weeks of life

Eighteen low birth weight infants (27-34 wk gestation) were given supplementary parenteral nutrition via peripheral veins of a maximal dose of 8.5 g glucose, 2.5 g amino acids (Aminoven?s p?d 10%) and 2 g soybean oil egg lecithin emulsion (Intralipid 10%) kg body weight/24 hr. The fat emulsion was infused continuously at a rate of 0.084 g/kg body weight/hr. The elimination of Intralipid from the blood stream was controlled by enzymatic determination of serum triglyceride concentrations, and the fatty acid pattern of the serum lipids was determined by gas chromatography. The serum triglyceride concentrations were 0.60 +/- 0.16 mmol/liter on the 1st day, increased to 0.96 +/- 0.29 mmol/liter up to the 5th day, and approached a level around 0.90 mmol/liter in the further course. No hypertriglyceridemia was noted. The fatty acid pattern of the serum lipids showed a linoleic acid fraction of 8.1 +/- 4.0% in the beginning, which was followed by a continuous increase up to 27.8 +/- 4.8% on the 7th day. No significant changes were noticed thereafter. The levels were within the normal limits as found in 2-wk-old enterally fed preterm infants of comparative maturity (25.6 +/- 3.4%). We conclude that the preterm infants can eliminate Intralipid from the blood stream if maximal dosage and infusion rate, as described above, are applied.     

Efficacy, safety and immunogenicity of RIX4414 in Japanese infants during the first two years of life

A phase III, randomized, double-blind study evaluated the efficacy, reactogenicity, safety and immunogenicity of a human rotavirus vaccine, RIX4414 in Japanese infants aged 6-14 weeks when administered as two doses (0, 1-month schedule). Efficacy against any and severe rotavirus gastroenteritis leading to medical intervention caused by circulating wild-type rotavirus from two weeks post-Dose 2 until two years of age was 79.3% (95% CI: 60.5-89.8%) and 91.6% (95% CI: 62.4-99.1%), respectively. Solicited, unsolicited symptoms and serious adverse events were reported at a similar frequency in both groups. Serum anti-rotavirus antibody seroconversion rate one-month post-Dose 2 was 85.3% (95% CI: 68.9-95%) in RIXX4414 group. RIX4414 was efficacious, well-tolerated and immunogenic in Japanese infants and introduction of vaccination could help in reducing the disease burden.     

Serotype distribution of invasive pneumococcal disease during the first 60 days of life

A total of 8172 isolates from invasive pneumococcal disease was collected from 1992 to 2006 in Germany. From these, 88 were from children ≤60 days of age, where the leading serotypes were 7F (14.8%), 1 and 14 (13.6% each), 3 (8.0%), and 9V (6.8%). The serotype distribution found in this study suggests that pneumococcal infections are transferred to them both by older siblings and adults. The theoretical serotype coverages for the pneumococcal vaccines were 36.8% (7-valent), 67.8% (10-valent), 80.5% (13-valent) and 89.7% (23-valent). Since the serotype distribution among children ≤60 days differs considerably from those vaccinated against pneumococci (6 or 8 weeks up to 5 years), our data suggest, that future epidemiological surveys might profit from a separate presentation of serotype and coverage data from children ≤60 days to increase the accuracy especially of coverage data among children. Penicillin G resistance was observed in 3.1% of meningitis cases. In the non-meningitis group no penicillin G nonsusceptible strains were detected. Concerning cefotaxime, 3.1% of isolates from meningitis cases were resistant, while in the non-meningitis group all isolates were susceptible. Among the non-meningitis cases no nonsusceptibility to amoxicillin was found. Further resistance rates were 14.9% for macrolides, and 4.6% for clindamycin.     

Energy intakes and growth from two months to three years in initially breast-fed children

Quantitative longitudinal data of breastmilk and total food intake of 48 Cambridge children have been analysed to calculate total energy intake from two months to 3 years of age. All children were breast-fed until at least 4 months old, with very little formula milk being given. Energy intakes per kg body weight started at 114 and 110 kcal/kg at 2 months in the boys and girls, respectively, fell rapidly to 86 and 85 kcal/kg by 6 months, and rose to 89 kcal/kg in both sexes by one year. Although below Dietary Recommendations, these intakes were compatible with other recent measurements of total energy expenditure. Individual variation was wide, but there was strong longitudinal within subject correlation of energy intake, which could be partly attributed to body weight. It is suggested that level of eating in infancy establishes the pattern for early childhood. A smaller accumulation of subcutaneous fat is attributed to the less liberal feeding practices compared to a generation ago.     

Food and nutrient intake of infants during the first 18 months of life

Food and nutrient intakes of normal infants, from 1 to 18 months, in Toronto and Montreal were determined in a longitudinal survey. The energy content of the diets, except for the first month, was less than the recommended daily intake (RDI). However, the infants were growing at normal rates, suggesting that the RDI is high. The mean intakes of most nutrients were consistently above RDI. Dietary iron was low from 12 months onwards, whereas, the intakes of Vitamin A, Vitamin C and sodium were high. Low iron intake was due mainly to low intake of iron-fortified infant cereals. Vitamin supplements, containing Vitamins A and C were largely unnecessary since food alone provided sufficient amounts to meet RDI. High sodium intake was related to consumption of salted table foods. Milk was the main source of energy, protein, fat and most other nutrients. Infant cereals, fortified with iron, calcium, phosphorous, thiamin, riboflavin, and niacin were important sources of these nutrients. Fruit and fruit juices were the primary sources of Vitamin C and vegetables the main sources of Vitamin A. Meat provided much of the dietary protein in the later infancy. The results stressed the importance of infant diets comprising the four basic food groups.     

Selenium status in term and preterm infants during the first months of life

OBJECTIVE: We hypothesized that very low birth weight (VLBW) infants have reduced serum and red blood cell (RBC) selenium (Se) at birth, which decrease further with current nutrition and are associated with chronic lung disease and septicaemia. DESIGN: We studied Se intake, concentration in serum and RBCs and glutathione peroxidase (GSH-Px) activity in preterm and term infants from birth until 16 weeks. Data are mean+/-standard deviation (s.d.). SETTING: Seventy-two preterm infants in two groups, born in Berlin, gestational age 26+0/30+0 weeks, birth weight 845/1270 g, with low Se intake (2.2+/-0.8/2.5+/-1.2 microg/kg/day), and 55 term infants, gestational age 39+1 weeks, birth weight 3160 g, born in Venezuela (high Se intake: 29+/-8 microg/day). RESULTS: A balance study in 10 preterm infants showed that Se is well absorbed from human milk (77+/-9%). Serum concentration was higher in term (142.0+/-40.0 microg/l) than in preterm infants (17.8+/-8.1/19.9+/-2.2 microg/l) at 4/7 weeks. Serum and RBC concentration of Se declined in all infants, low values in preterm infants did not correlate with chronic lung disease and septicaemia. GSH-Px activity in RBCs remained stable until 6 weeks of age in all infants and was not correlated with Se in RBCs. CONCLUSIONS: Se concentration in serum decreases during the first weeks of life and depends on intake. GSH-Px activity is not useful as a marker for Se status in infants up to 16 weeks after birth.     

Child health clinic attendance during the first two years of life

Attendance at child health clinics in three contrasting urban areas is described. Sociodemographic analysis of clinic attenders in the inner city area showed that families in poor socio-economic circumstance attended child health clinics more frequently than their more fortunate contemporaries during the first six months of life. Health visitor home visiting was a major determinant in clinic attendance rates.     

Selenium and chrominium intakes of very low birthweight pre-term and normal birthweight full-term infants during the first twelve months

During a longitudinal study, dietary intake data were collected from 50 pre-term infants (mean birth weight=1054±2334 g, mean gestational age=29±2.5 weeks) and 60 full-term infants (mean birth weight=3509±269 g, mean gestational age=40±1 weeks) at 3,6 and 12 months of age. Mean daily selenium and chromium intakes were calculated from three day dietary records and testweight data for the breast fed infants. Food values were obtained from the literature and by instrumental neutron activation analysis. The mean selenium intake of the pre-term group at three months was lower (p<0.05) (7±4 ug/day) than the mean intake of the full-term group (9±3 ug/day). In contrast, mean chromium intakes in the pre-term group at 3 (39±21 ug/day) and 6 months (48±21 ug/day) were greater (p<0.05) than chromium intakes for the full-term group at these times (23±22 ug/day, 35±25 ug/day). These differences for selenium and chromium (P<0.05) were associated with the small percentage of pre-term infants who were breast fed compared to the full-term group. The mean selenium intakes for both groups met the proposed U.S. Food and Nutrition Board safe and adequate range only at 12 months whereas mean chromium intakes for both groups fell within these ranges at all times. Results suggest that very low birthweight pre-term infants fed commercial full-term milk formulas may have sub-optimal selenium intakes during the early months.