Public health and the anticorporate movement: rationale and recommendations

Institutions and informal networks have formed a movement that is challenging the growing power and pervasive influence of large corporations. The movement's analyses show that the historical development and current function of the corporate entity requires production of a profit regardless of consequences to health, society, or the environment. As a result, public health professionals frequently address health problems related to products, services, or practices of corporations. There are possibilities for links between public health and the anticorporate movement. Public health research and the professional preparation curriculum should focus on the corporate entity as a social structural determinant of disease.     

Feeding patterns of urban black infants

Feeding patterns of 116 urban black infants were studied from 3 weeks to 6 months of age. Dietary data were collected using a diet history and a food frequency checklist completed by trained interviewers at each well child clinic visit at 3 weeks and at 2, 4, and 6 months of age. At 3 weeks, 20% of the infants were solely breast fed, 58% were formula fed, and 22% were partially breast fed. Twenty percent of 3-week-old infants were receiving baby foods. This increased to 48% at 2 months, and to 72% at 4 months. By 6 months of age, 98% of infants received baby foods. Nursing mothers tended to introduce baby foods later than formula-feeding mothers. This is consistent with other studies. Commercially prepared baby foods were used much more commonly than were foods prepared at home. Infant cereal was most often introduced first, followed by strained juices, strained fruits, strained vegetables, combination dinners, desserts, and plain meats, in that order. Table foods contributed very little to caloric intakes of infants less than 4 months of age. Liberal amounts of water and sugar water were given to infants in this cultural group.     

Undernutrition among Bedouin Arab infants: the Bedouin Infant Feeding Study

Two hundred seventy-four healthy Bedouin Arab newborns in 1981 were followed for 18 mo to examine the relationship between infant-feeding practices and growth during planned social change. Although wasting was not prevalent, the prevalence rate of stunting (less than or equal to -2 SDs) increased from 12% to 19% to 32% at 6, 12, and 18 mo, respectively. After multiple-logistic-regression adjustment for covariates, the odds ratio (OR) of stunting at 6 mo was reduced among infants breast-fed only or fed with supplement compared with weaned infants. Infant-feeding practices were not associated with stunting in later infancy; however, those stunted at 6 mo had an OR of 13 of stunting at 12 mo and those stunted at 12 mo had an OR of 14 of stunting at 18 mo. In a multiple-linear-regression analysis, seasonality, duration of breast-feeding, hospitalized morbidity, and residual of height at 6 mo were negatively associated with daily average linear growth from 6 to 12 mo; these factors only explained 12% of the variation in daily linear growth.     

Feeding and growth characteristics of human milk-fed infants

Anthropometric measurements, milk intake, and nursing frequency data of 50 exclusively breast-fed infants were analyzed to determine the existence, extent, and nature of relationships among nursing frequency, quantity of milk consumed, and growth characteristics. In comparison with the National Center for Health Statistics growth standards, anthropometric measures for all infants fell within the 10th and 95th standard percentiles for the following growth parameters: Mean lengths ranged from 54 +/- 2.5 cm at 2 weeks to 64 +/- 1.6 cm at 16 weeks; mean weights ranged from 3,735 +/- 526 gm to 6,326 +/- 633 gm; mean head circumferences ranged from 36 +/- 1.2 cm to 41 +/- 1.0 cm. Significant associations were observed for milk intake with weight and length measures. Strength of association, however, was highly variable across age categories, ranging from 0.32 to 0.71 for weight and 0.16 to 0.70 for length. The coefficients indicate that 10% to 50% of the total variance in weight and 3% to 49% of total variance in length could be ascribable to milk intake. Average milk intakes were significantly correlated with infant length and weight at 2, 6, and 12 weeks. Average frequency of nursing was positively associated with infant weight at 12 weeks. Increases in average milk intakes between 2 and 4 weeks were significantly related to increases in length for the same period. Likewise, an increase in average milk intake between 8 and 12 weeks was associated with a corresponding change in mean length.(ABSTRACT TRUNCATED AT 250 WORDS)     

Managing febrile infants: impact of literature recommendations published during a physician's residency

The authors hypothesized that sepsis workup recommendations are associated with practice recommendations published during the physician's residency. The first published recommendations suggesting sepsis workups for nontoxic, young, febrile infants appeared in pediatric journals from 1975-1980 and in family practice journals from 1981-1987. Data are from the Community Tracking Study (3,272 pediatricians and 2,432 family physicians). "Percentage of sepsis workups recommended" was defined by response to a vignette about the percentage of well-appearing 6-week-old children with a fever of 101 degrees F for whom the physician would recommend a sepsis workup. Multivariable regression with piecewise linear functions evaluated workup recommendations by timing of literature recommendations during residency. Pediatricians recommended sepsis workups 81.6% of the time and family physicians 67.7% (p < .001). Increased recommendations occurred among pediatricians who completed residency from 1975-1980 (p < .05) and among family physicians who completed residency from 1981-1987 (p < .005), when specialty-specific journals published recommendations for sepsis workups for febrile infants. The association between publication of sepsis workup recommendations during a physician's residency and increased sepsis workup recommendations suggests an unrecognized and enduring impact of such publications.     

婴幼儿喂养方式与肥胖

目的了解北京市城区婴幼儿肥胖发生状况及家长喂养方式与婴幼儿肥胖的关系,为儿童肥胖的早期干预提供依据。方法选择北京市城区12个社区中1～35个月儿童4654人为研究样本,采用世界卫生组织身长别体重≥中位数+2个标准差计分为肥胖判断标准,对其中215名肥胖儿家长和215名正常体重儿家长进行问卷调查。结果调查人群肥胖发生率为4.7%。肥胖儿中父母超重和受教育程度低的比例高于正常体重儿,肥胖儿总的能量摄入高于正常体重儿,生后4个月内肥胖儿母乳喂养的比例低于正常体重儿、人工喂养和添加辅食的比例高于正常体重儿,差异均有统计学意义。结论婴幼儿肥胖的早期干预应关注喂养方式,包括提倡母乳喂养和避免过早添加辅食。     

Feeding tolerance in preterm infants: randomized trial of bolus and continuous feeding

OBJECTIVE: To test the hypothesis that continuous gastric infusion (CGI) is better tolerated than intermittent gastric bolus (IGB) in small very low birth weight (VLBW) infants. DESIGN: Two-center, prospective, randomized, unmasked clinical trial. PATIENTS: 28 VLBW infants (birth weight <1250 g). A strict feeding protocol was followed. INTERVENTION: Patients were randomized to IGB or CGI. MAIN OUTCOME MEASURES: Time to reach full feeds (160 cc/kg/d)(by design and real), daily weight, caloric intake, residual gastric volume and type of feeding (formula vs. human milk vs. both). RESULTS: Five infants failed to complete the study because of death (n = 4) or protocol violation (n = 1). The two groups did not differ by birth weight or gestational age; infants fed via IGB reached full feeds earlier (p = 0.03) and had less delay in reaching full feeds than infants fed via CGI. CONCLUSION: Contrary to our hypothesis, gravity IGB is more effective than CGI in improving feeding tolerance in small VLBW infants.     

Feeding infants and young children. From guidelines to practice

Following a workshop on infant feeding held at the Rowett Institute of Nutrition and Health, University of Aberdeen on March 17, 2010 experts were invited to exchange ideas and to review evidence on both pre and post natal dietary environments in shaping children's eating habits. A central theme during the workshop was the idea of “sensitive periods” during infancy for learning about foods and a particular focus was developed around acceptance and intake of fruits and vegetables. Presentations covered the guidelines provided by various governments on how to feed infants during weaning; the importance of the in utero experience; the impact of varying the sensory experience at weaning; the effect of parenting styles and practices on children's eating habits; the use of visual experience in promoting intake of vegetables; and reports from mothers regarding their decisions about weaning and the introduction of vegetables. This collection of papers seeks to review guidance from governments on feeding infants and to consider current evidence on parental feeding practices with the aim of enhancing insight into best practice in establishing healthy eating in children.     

常州市婴幼儿喂养状况及影响因素分析

目的了解江苏省常州市婴幼儿母乳喂养现状及影响因素。方法采用现况研究方法,自常州市所属的城市、乡镇及农村各随机抽取1个现场,以2006年1月1日至2008年12月31日出生的6 240名婴幼儿父母为调查对象进行面对面访谈,采用无序多分类Logistic回归分析喂养方式的影响因素,估计OR值及其95%CI。结果母乳喂养占50.64%,混合喂养占38.62%,人工喂养占10.74%,纯母乳喂养时间达到4个月或6个月的分别占56.4%与29.3%;调整混杂因素后,经无序多分类多因素Logistic回归模型拟合后发现,新生儿出生地域为乡镇和农村、母亲文化程度为大学以上、家庭子女数为多孩、母亲年龄为25~35岁、新生儿早产、分娩地点为乡镇卫生院等因素与混合喂养有关(P<0.05);新生儿出生地域为乡镇和农村、母亲文化程度为高中以上、家庭子女数为多孩、母亲年龄>33岁、新生儿早产、分娩地点为乡镇卫生院及其他等因素与人工喂养有关(P<0.05)。结论常州市婴幼儿母乳喂养率仍处于较低水平,6个月纯母乳喂养率明显降低,喂养方式主要与新生儿出生地域、母亲文化程度、母亲年龄、新生儿早产及家庭子女数等因素有关。