Breast feeding and the dietary habits of children in rural Somalia

Breast feeding and dietary habits were studied prospectively in a cohort of children under the age of five years in a rural Somali community. The median duration of breast feeding was 19.5 months. However, all the children also received cow's milk by cup from the first day of life and onwards. Energy supplements (mainly sugar and oil) as well as additional water were given daily from early infancy. Staples, protein-rich foods (beans and meat), vegetables and fruits were usually introduced when the children reached the age of 12-18 months. There was a seasonal variation with the lowest intake of protein-rich and vitamin-rich foods during the rains in May to June. Thus, there was a complete absence of exclusive breast feeding. Energy-reinforced cow's milk and human milk dominated the diet up to the age of one year. Staples were mixed with oil and supplemented with milk, thereby leading to a much higher energy density in the complementary food than is usually the case in African communities.     

喂养方式对婴幼儿轮状病毒腹泻的影响

目的探讨母乳与人工喂养对出生15d～18个月婴儿轮状病毒腹泻发生率、腹泻严重程度及病程的影响。方法2007年7月-2009年5月因腹泻来我院门诊及住院的患儿465例,喂养方式为母乳或人工喂养,年龄在出生15d～18个月,收集1h内新鲜粪便标本,进行大便常规+大便潜血检查,并同时检测轮状病毒。结果465例患儿中母乳喂养306例,82例粪便轮状病毒抗原阳性,阳性率26.8%;人工喂养患儿159例,69例粪便轮状病毒抗原阳性,阳性率43.4%。母乳喂养儿轮状病毒阳性率明显低于人工喂养儿,差异有统计学意义(P<0.01)。母乳喂养组发生脱水程度及并发症发生率较人工喂养组低,母乳喂养组腹泻病程亦较人工喂养组短,差异均有统计学意义(P均<0.05)。结论母乳喂养可保护婴幼儿减少轮状病毒感染率,或即便发生轮状病毒腹泻,其临床症状亦较人工喂养儿轻,病程短。提倡并推广母乳喂养,是减少婴幼儿轮状病毒感染和减轻腹泻症状、缩短病程的有效手段之一。     

Effect of exclusive breast‐feeding and early solid food avoidance on the incidence of atopic dermatitis in high‐risk infants at 1 year of age

The aim of this study was to assess the preventive effect of exclusive breast‐feeding and early solid food avoidance on atopic dermatitis (AD) in infancy. This study is part of a dietary clinical trial in a prospective cohort of healthy term newborns at risk of atopy. It was recommended to breast‐feed for at least 4 months and to avoid solid food in the same time‐period. Eight hundred and sixty‐five infants exclusively breast‐fed, and 256 infants partially or exclusively formula‐fed, were followed‐up until the end of the first year following birth. AD and sensitization to milk and egg were considered as study end‐points. The 1‐year incidence of AD was compared between the two study groups. Adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated by multiple logistic regression. The incidence of AD was calculated in relation to age at introduction of solid food and amount of food given. In the breast‐fed group, the adjusted OR for AD was 0.47 (95% CI 0.30–0.74). The strongest risk factor was the occurrence of AD in the subject's core family. The risk of infants with AD to be sensitized to milk was four times higher, and to egg eight times higher, than in infants without AD. Age at first introduction of solid food and diversity of solid food showed no effect on AD incidence. We conclude that in infants at atopic risk, exclusive breast‐feeding for at least 4 months is effective in preventing AD in the first year of life.     

Atopic dermatitis in infants and children

Atopic dermatitis is a common, chronic inflammatory skin disease triggered by a variety of irritative emotional and allergic factors. Education and simple prevention and maintenance measures such as proper moisturizing greatly reduce disease. Antibiotics and topical corticosteroids are therapeutic mainstays.     

Atopic dermatitis: quality of life of young Italian children and their families and correlation with severity score

The aim of this study was to determine the ways in which atopic dermatitis (AD) affects the lives of young Italian children and their families, in terms of quality of life, and correlate it with AD severity and the perception of severity as estimated by the family. The parents of 45 children aged 3-84 months affected by AD were asked to complete two validated questionnaires after clinical examination. The first questionnaire was about the child's quality of life (Infants' Dermatitis Quality of Life Index); the second regarded the family's quality of life (Dermatitis Family Impact questionnaire). In a further question parents were asked to estimate the severity of the disease of the child. Children's quality of life appeared slightly-moderately altered (mean score 10.2) compared with the value of a control group (3.3), and itching, sleep problems and the influence of the disease on the child's mood were the cause of greatest discomfort for the child. Family quality of life appeared moderately altered (mean score 11) compared with the value of the control group (7.4). The greatest problem was the disturbed sleep of the family members. Other important problems were the economic cost for the management of the disease and the tiredness and irritability caused by the disease in parents. Analysis of the responses confirms the incorrect estimation of the severity of the disease perceived by the family. In our opinion, the two questionnaires may be useful in clinical practice to understand better the difficulties suffered by a family with a child affected by AD. They also provide data that may help to improve the clinical approach for the child and the family, and to assess the degree of under-/overestimation of the disease by the family.     

Atopic diseases in Sami and Norse schoolchildren living in northern Norway

Among children in the western world, atopic diseases are a major cause of morbidity. However, several prevalence studies have indicated that the frequency of these diseases displays both geographic and ethnic variations. In 1995, we conducted a questionnairebased, crosssectional survey in northern Norway. Atopic diseases among 8676 schoolchildren, aged 713 years, including 491 children with Sami ethnicity, were studied. The role of ethnicity (Sami/white Caucasian) was determined by comparing the reported atopic disease rate in each of the respective groups. In the areas under investigation (the cumulative incidence, the point prevalence of asthma and allergic rhinoconjunctivitis and the cumulative incidence of atopic dermatitis), the Sami children scored higher than the white Caucasian Norwegian children. The relative risks (RR) in Sami children were: current asthma RR = 2.01 [95% confidence interval (CI) 1.482.73]; current allergic rhinoconjunctivitis RR = 1.51 (95% CI 1.141.99); lifetime atopic dermatitis RR = 1.39 (95% CI 1.181.63). We thus conclude that there is an association between Sami ethnicity and asthma and allergy among schoolchildren in northern Norway.     

Factors associated with the duration of breast feeding in a privileged society

130 highly motivated middle class women were interviewed 1 year after delivery to investigate the factors associated with successful breast feeding. 82% breast fed for 6 months or longer and 62% did not introduce solids before 4 months. The most common reason for weaning before 6 months was an insufficient milk supply. Weaning before 6 months was closely associated with a delay of more than 2 hours in the first suckling or an instrumental delivery. Insufficient milk was associated with an absence of the ‘let down’ reflex. The results suggest that breast feeding for 6 months or more and the introduction of solids after at least 3 months are feasible for most British mothers and babies.     

Are fathers prepared to encourage their partners to breast feed? A study about fathers' knowledge of breast feeding

In order to study fathers' knowledge of breast feeding and its relationship with paternal factors, fathers of 92 breast feeding and 89 non-breast feeding newborns were compared. Paternal factors included previous children and the way they were fed, participation in prenatal care, attendance at prenatal classes, breast feeding information provided by health professionals, use of reading materials and interest in learning more about the subject. The results indicated that fathers had poor knowledge about breast feeding, especially those whose children were being bottle fed. After adjustments for confounders, fathers who had previous breast-fed child(ren), had attended prenatal classes and who received information about breast feeding from medical personnel had a significantly higher chance of having a better knowledge of breast feeding. It seems that fathers need to be better prepared to assume their new role as breast feeding supporters. Prenatal care was shown to be a good opportunity to improve fathers' knowledge of breast feeding.     

Spontaneous release of histamine from basophils in children with atopic dermatitis

Spontaneous histamine release from basophils was evaluated in children with atopic dermatitis and in healthy controls. Patients were divided into 2 groups, one with specific IgE antibodies for food allergens (Group 1) and one without specific reaginic antibodies (Group 2). Group 1 showed significantly higher histamine release (median 7.25%) than Group 2 (median 4.2%) and healthy controls (median 2.05%). Histamine release was also significantly greater in Group 2 patients compared with healthy controls (p < 0.005). Group 1 was studied again after an exclusion diet which resulted in an improvement of symptoms and a significant reduction (p < 0.001) of histamine release. Children with atopic dermatitis both with and without IgE antibodies for food allergens present a degree of "basophil hyperreactivity" which decreases after an appropriate exclusion diet in children with associated food allergy.