Can early intake of dietary omega‐3 predict childhood externalizing behaviour?

Aim:  To determine whether maternal and child intake of dietary omega-3 (n-3) fatty acids (FA), together with the presence or absence of breast-feeding, predicted psychiatric diagnosis of externalizing disorders in childhood.
Methods:  Data concerning childhood externalizing disorders were collected from 8242 children aged 7.9 years in a large British cohort. Intake of n-3 FA was measured for the study mother during pregnancy and for the child at 3 years. Duration of breast-feeding was examined to account for moderating effects. Adjustment was made for a variety of potential confounders.
Results:  Maternal intake of n-3 and breast-feeding predicted oppositional/conduct disorder and comorbid externalizing disorder before adjustment for confounding factors. However, there was no association between intake of n-3 by mother or child and any type of externalizing disorder once socio-demographic factors were taken into account.
Conclusions:  Any association between intake of n-3 and childhood externalizing disorders appears to be strongly confounded with socio-demographic factors. This is important to note given the current popularity of n-3 as a possible treatment for behaviour problems related to inattention and impulsivity. Care must be taken that studies investigating this relationship account fully for factors associated with both behaviour and diet.     

指导职业女性持续母乳喂养的研究

经统计职业女性产假结束返回到工作岗位后，母乳喂养下降率达６０％～７０％。为此调查１１６例授乳期职业女性泌乳量及相关因素，进行因子分析后，将得出的三个更本质因子：职业女性自身条件；工作与母乳喂养的关系；家庭参与组成“旋转参与型”促乳护理模式。运用临床进行对比研究。分别观察产妇上班前７天、上班后７、１５、３０、４５、６０天泌乳量。结果：实验组母乳喂养率平均为９４．６％，混合喂养５．４％。对照组母乳喂养率平均为５２％，混合喂养３２．６％，人工喂养１５．４％。经统计学χ２检验处理，差异显著（Ｐ＜０．０１）。研究认为此种方法对指导职业女性持续母乳喂养有明显促进作用，能有效地控制工作后所致泌乳量下降。系统地解决了再职母亲母乳喂养中的诸多问题。     

Influence of duration of total breast-feeding on bone mineral density in a Turkish population: does the priority of risk factors differ from society to society?

Introduction Despite numerous studies on risk factors for osteoporosis the effect of breast-feeding on bone mineral density (BMD) is unclear. In this study our aim was to determine the influence of total duration of breast-feeding on BMD, and subsequent risk of osteoporosis. Methods A total of 1,486 postmenopausal women over the age of 40 were included in the study. Women with diseases or who were under drug treatments known to affect bone metabolism were excluded. The BMD of the lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry technique, using either the Norland XA-26 or Lunar DPX-IQ densitometers and were transferred to standard values. Patients were placed in groups of five with respect to the duration of their breast-feeding as never, 1–12 months, 12–24 months, 24–60 months, >60 months. Results One-way ANOVA test showed a significant difference between the lumbar spine and femoral neck BMD of these groups of women (p<0.001, p<0.001). Post hoc Bonferroni correction revealed that both the lumbar spine and femoral neck BMD results of women with longer duration of total breast-feeding were significantly lower than those of women with less duration of total breast-feeding. In subsequent analysis other potential risk factors were also considered in a multiple linear stepwise regression model. Years since menopause (p<0.001), weight (p<0.001), total duration of breast-feeding (p<0.001), and body mass index (p=0.001) were found to be the most important predictors for lumbar spine BMD; and age (p<0.001), weight (p<0.001), years since menopause (p<0.001), and total duration of breast-feeding (p<0.001) for femoral neck BMD. Conclusions This study showed significant associations between total duration of breast-feeding and BMD. In conclusion, total duration of breast-feeding might be an important risk factor besides age, weight, and years since menopause in postmenopausal osteoporosis.     

Factors predisposing to HTLV-1 infection in residents of the greater Tokyo area

Human T-cell leukemia virus type 1 (HTLV-1) is the etiological agent for adult T-cell leukemia. The geographic distribution of HTLV-1 carriers is quite uneven in Japan and the greatest prevalence is in southwestern Japan. Because many people move from endemic areas to the greater Tokyo area, the geographic distribution might have changed. Therefore, we investigated the factors predisposing to HTLV-1 infection, including birthplace, for 88 HTLV-1-infected individuals in greater Tokyo who visited our outpatient clinic. Of these, 39.5% were born in endemic areas, which include Kyushu/Okinawa, south Shikoku, Kii, Tohoku, and Hokkaido, whereas 38.3% were born in greater Tokyo and the proportion is presumed to be increasing. Half of the HTLV-1 infected individuals in greater Tokyo came from endemic areas, whereas around half of the remaining half was presumed to be involved in sexual transmission from a spouse from an endemic area. Overall, they constituted approximately 70% of the HTLV-1 carriers in greater Tokyo. These migration effects may increase the prevalence of HTLV-1 in the greater Tokyo area; nationwide surveillance is warranted.     

初乳HBV-DNA定量检测对乙肝产妇哺乳的指导价值

目的 探讨初乳HBV-DNA定量检测对乙肝产妇哺乳的指导意义.方法 选择住院分娩产妇325例,依据乙肝五项血清学指标分为五组感染模式.其中A组（65例）：乙肝HB、HBeAg和HBcAb均为阳性;B组（9例）：乙肝HBsAg、HBeAg、HBeAb和HBcAb均为阳性;C组（152例）：乙肝HBsAg、HBeAb和HBcAb均为阳性;D组（47例）：乙肝HBsAg、HBcAb为阳性;E组（52例）：乙肝五项指标全阴性为对照组.采用化学发光法检测产妇HBV标志物,同时采用实时荧光定量PCR检测产妇血清和初乳HBV-DNA载量,对相关数据进行组间卡方检验分析.结果 A组血清和乳汁HBV-DNA阳性率分别为100.00％（65/65）和83.08％ （54/65）,乳汁HBV-DNA载量平均为3.82 ×104copies·ml-1;B组血清和乳汁HBV-DNA阳性率分别为100.00％ （9/9）和77.78％（7/9）,乳汁HBV-DNA载量平均为1.26×104copies·ml-1;C组血清和乳汁HBV-DNA阳性率分别为17.10％（26/152）和1.97％ （3/152）,乳汁HBV-DNA载量平均为2.31×103copies·ml-1;D组血清和乳汁HBV-DNA阳性率分别为44.68％（21/47）和23.40％（11/47）,乳汁HBV-DNA载量平均为6.17×103copies·ml-1;E组血清和乳汁HBV-DNA阳性率均为0（0/52）,乳汁HBV-DNA载量为＜1.0×103copies·ml-1.A组与B组乳汁HBV-DNA阳性率（83.08％、77.78％）明显高于C组（1.97％）,差异有统计学意义（x2值分别为135.26和115.31,P ＜0.05）;产妇乳汁HBV-DNA与血清中HBV-DNA水平呈正相关.结论 血清乙肝免疫学检测呈HBsAg和HBeAg双阳性的产妇不宜哺乳,血清呈HBsAg、HBeAb和HBcAb阳性但同时乳汁HBV-DNA阴性者宜谨慎哺乳.     

Vertical transmission of cytomegalovirus, most probably by breast milk, to an infant with Wiskott-Aldrich syndrome with fatal outcome

A 4-month-old boy with prenatally diagnosed Wiskott-Aldrich syndrome became ill with a severe cytomegalovirus (CMV) infection, the outcome of which was fatal. The parents had isolated the infant from other children and adhered to standards of hygiene in order to avoid CMV infection because their first child had died of Wiskott-Aldrich syndrome and CMV infection. The mother breast-fed her child although she was CMV IgG positive. The source of infection was most probably breast milk, which contained CMV at the time the infant developed the generalized CMV infection. Conclusion In infants with immunodeficiency syn‐dromes, CMV infection may have a fatal outcome. Since the virus can be transmitted by breast milk, the advantages and disadvantages of breast-feeding should, therefore, be weighed in newborn infants with an immunodeficiency syndrome whose mother is a CMV carrier. Received 11 November 1996 / Accepted: 14 April 1997     

Breast-Feeding from the Viewpoint of Maternal and Child Health Education

Seeing the changes in breast-feeding and the sources of advice on that knowledge, I make reference to the necessity of breast-feeding education and point out the problems that we must take into account, in the case of carrying forward breast-feeding education.     

Genetic predisposition and environmental factors leading to the development of insulin-dependent diabetes mellitus in Chilean children

This study was designed to examine the hypothesis that some environmental factors increase the risk for insulin-dependent diabetes mellitus. Data on dietary history was collected from 80 diabetic children from the Santiago de Chile Registry and from 85 nondiabetic control subjects who were comparable in terms of age, sex, and ethnic characteristics. Early exposure was defined as the ingestion of food sources other than maternal milk before 3 months of age. To define genetic susceptibility to insulin-dependent diabetes mellitus each subject was typed in terms of HLA DQA1 and DQB1, and the possible conformation of susceptible heterodimers was considered as a risk marker. Fewer children were exclusively breast fed in the diabetic group than in the control group (21.55±15.05 vs. 33.95±20.40 weeks, P<0.01). In addition, exposure to cow's milk and solid foods occurred earlier in the diabetic group than in the control group (15.90±10.95 vs. 21.15 13.65 and 16.85±10.25 vs. 21.20±12.35 weeks, P<0.05). Our data show that a short duration of breast-feeding and early exposure to cow's milk and solid foods may be important factors in the development of insulin-dependent diabetes mellitus. The high relative risk observed in individuals genetically predisposed indicates an interaction effect between genetic and environmental components.Abbreviations IDDM Insulin-dependent diabetes mellitus - RR Relative risk     

人工喂养与母乳喂养婴儿的免疫功能检测及意义

目的 探讨人工喂养与母乳喂养婴儿的免疫功能,为大力提倡母乳喂养提供理论依据。方法 对本市人工喂养（n=220)和母乳喂养（n=260）两组4－6个月婴儿分别进行免疫功能检测,并调查半年内呼吸道感染发生率。结果 ①人工喂养组血清免疫球蛋白IgG,IgM与母乳喂养组差异无显著性（P＞0．05）,IgA明显降低（P＜0．01）,IgE明显升高（P＜0．01）;人工喂养组静脉血CD^3 与母乳喂养组差异无显著性（P＞0．05）,CD^4 明显下降（P＜0．01）,CD^8 明显升高（P＜0．01）,CD^4 /CD^8 比值明显下降（P＜0．01）。②人工喂养组呼吸道感染发生率较母乳喂养组明显升高（P＜0．01）。结论 人工喂养婴儿免疫功能失调,更易患呼吸道感染。     

Association of Prenatal Exposure to an Environmental Contaminant with Intellectual Function in Childhood

Polychlorinated biphenyls are a family of synthetic hydrocarbon compounds that were used historically for a broad range of industrial purposes. Although banned in the 1970s, they continue to be ubiquitous in landfills, sediments, and wildlife. Prenatal polychlorinated biphenyl exposure was evaluated in a sample of children born to women who had eaten relatively large quantities of polychlorinated biphenyl-contaminated Lake Michigan fish. This exposure was found to be associated with poorer intellectual function after controlling statistically for a broad range of potential confounding variables. Deficits included poorer recognition memory in infancy, lower scores on a preschool IQ test, and poorer verbal IQ and reading comprehension at 11 years of age. Although breast-fed children were exposed postnatally to elevated levels of polychlorinated biphenyls from maternal milk, the adverse effects associated with prenatal exposure were markedly stronger in the children who were not breast-fed. It is not clear whether the adverse effects were attenuated in the breast-fed children due to certain nutrients in the breast milk or due to better quality of intellectual stimulation provided by the breast-feeding mothers. Virtually no adverse effects were found in relation to postnatal exposure to polychlorinated biphenyls from breast-feeding, indicating that the fetus is particularly vulnerable to this exposure.