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.     

Effect of a peer support service on breast-feeding continuation in the UK: A randomised controlled trial

Objective

to assess the effectiveness of a peer support worker (PSW) service on breast-feeding continuation.

Design

cluster randomised controlled trial (ISRCTN16126175).

Setting

Primary Care Trust, UK serving a multi-ethnic, socio-economically disadvantaged population.

Participants

2,724 women giving birth following antenatal care from 66 clinics: 33 clinics (1,267 women) randomised to the PSW service and 33 clinics (1,457 women) to usual care. 848 women consented to additional follow-up by questionnaire at 6 months.

Intervention

PSW service provided in the antenatal and postnatal period.

Measurements

any and exclusive breast feeding at 10–14 days obtained from routine computerised records and at 6 weeks and 6 months from a questionnaire.

Findings

follow-up: 94% at 10–14 days, 67.5% at 6 months. There was no difference in any breast feeding at 10–14 days between intervention and usual care, odds ratio (OR) 1.07 (95% CI 0.87–1.31, p=0.54). Proportion of women reporting any breast feeding in the intervention group at 6 weeks was 62.7% and 64.5% in the usual care group OR 0.93 (95% CI 0.64–1.35); and at 6 months was 34.3% and 38.9%, respectively, OR 1.06 (95% CI 0.71–1.58).

Key conclusions

universal antenatal peer support and postnatal peer support for women who initiated breast feeding did not improve breast-feeding rates up to 6 months in this UK population.

Implications for practice

with high levels of professional support part of usual maternity care it may not be possible for low intensity peer support to produce additional benefit. More intensive or targeted programmes might be effective, but should have concurrent high quality evaluation.     

醋酸甲羟孕酮针剂在哺乳期妇女避孕中的应用

目的:寻求哺乳期妇女运用醋酸甲羟孕酮(DMPA)避孕的最佳投药剂量。方法:将受试对象分为DM-PA组和未使用DMPA的产后哺乳期妇女,排除不符合研究标准者,纳入研究对象共319例,DMPA150mg组83例,100mg组80例,75mg组81例,未使用DMPA组75例,DMPA组每3个月深部肌肉注射1次,共4次。结果:非DMPA组避孕成功率为80.00%,150mg与100mgDMPA组避孕成功率均为100.00%,75mg组成功率为98.77%,3个不同剂量DMPA组避孕成功率均显著高于非DMPA组(P<0.01),但3组间差别无统计学意义(P>0.05)。发生的副反应中,点滴出血75mg组为4.94%,明显低于150mg组的16.87%(P<0.05)和100mg组的10.00%(P<0.05)。结论:75mgDMPA用于哺乳期妇女避孕不影响其有效性,且可减少副反应发生率,可作为我国哺乳期妇女运用DMPA避孕的最佳投药剂量。     

Breast feeding initiation and duration: comparison of French and German mothers

Background

approximately 56% of babies in France are breast fed at birth compared with approximately 91% in Germany. Few studies have compared these neighbouring countries despite the similarities in their social systems.

Objectives

to compare breast-feeding initiation and duration from birth to 3 months post partum between French and German mothers, as well as reasons for breast-feeding cessation in the first 3 months.

Design

mothers were contacted twice during the study: immediately after childbirth and at 3 months post partum.

Participants

126 French mothers were recruited during their maternity stay in hospital, and 80 German women were recruited by their midwives and contacted via regular mail. All women were primiparous.

Methods

breast-feeding rates at birth and 3 months post partum were collected and compared. In addition, reasons for breast-feeding cessation in the first 3 months were explored and analysed.

Results

96% of German women initiated breast feeding at birth and 83% were still breast feeding at 3 months post partum. In comparison, 67% of French women initiated breast feeding at birth and 34% were still breast feeding at 3 months post partum.

Conclusion

there is a need for postnatal follow-up care for French mothers who breast feed. Follow-up care available for German mothers shows encouraging results.     

陕西部分农村母亲婴幼儿喂养知信行现况调查

目的:了解农村婴幼儿喂养现状,为进一步干预提供依据。方法:采用定量方法利用自编问卷对陕西泾阳县6个乡的311名儿童母亲进行现况调查;采用定性方法组织12名儿童母亲进行专题小组讨论,了解影响母亲喂养行为的因素。使用中位数、均数、标准差、频数、卡方检验等方法分析定量资料;使用分类归纳法分析定性资料。结果:定量调查显示,88.4%的母亲认为婴儿6个月内纯母乳喂养好,但6个月内纯母乳喂养率为55.3%;44.4%的母亲了解正确添加辅食的时间,但适时添加辅食率为26.1%;分别有92.9%、97.4%、76.2%的母亲认为应该每天给6个月及以上的孩子吃鸡蛋、蔬菜或肉类,但每周给6个月及以上的孩子添加6次及以上鸡蛋的比例为38.9%、蔬菜47.9%;给7个月及以上孩子每周添加1次以上肉类的比例只有21.6%。定性结果表明,没有坚持纯母乳喂养的母亲主要是自认为母乳不足而过早加辅食;过晚添加辅食的母亲主要是认为8个月以下的孩子对乳类以外的食物难以消化;不给孩子添加肉类食物的母亲主要是认为孩子1岁牙长好了才能消化肉类。结论:6个月婴儿纯母乳喂养率和适时添加辅食率低于同期其他农村地区水平,辅食种类单调,动物性食物摄入明显不足。建议加强对妇幼保健人员的培训,更新相关知识,提高健康教育技能;开发适合农村家长的科普书报、杂志等健康教育材料。     

乙肝病毒携带产妇乳汁中乙肝病毒携带情况分析

目的 :分析乙型肝炎病毒携带产妇乳汁中乙肝病毒 (HBV)携带情况以及探讨母乳喂养的安全性问题。方法 :随机抽取 6 2例孕期检测有一项以上乙肝血清学指标 (HBVM)阳性且肝功能正常产妇及 10例乙肝标志物阴性的健康产妇作对照 ,采用PCR技术检测其初乳中的HBV -DNA ,并与血清乙肝标志物的检测结果进行比较。结果 :6 2例HBVM阳性产妇中有 35例检出HBV -DNA(5 6 5 % ) ,而对照组中无一例阳性。HBeAg阳性组产妇初乳排毒率明显高于HBeAg阴性组 ,有显著性差异(P <0 0 1)。结论 :对乙肝标志物阳性产妇 ,除对新生儿加强免疫外 ,还应检测其乳汁中的HBV -DNA。若乳汁中HBV -DNA阳性 ,则不以母乳喂养为好     

Infantile colic: occurrence and risk factors

The purpose of this work was to study the appearance of infantile colic and gas discomfort and to learn whether these problems are associated with factors in the child's social environment, allergic symptoms, or feeding. The study was made retrospectively by means of a questionnaire which was sent to mothers of every tenth child aged 14 to 38 months in Turku, Finland. Forty percent of the children, as many boys as girls, had colic or gas problems in early infancy, so severe in 20% that drug therapy was used. First born children in the family more often had colic and gas problems than did subsequent children. Siblings of colicky children had colic and gas problems more often than did siblings of the children who had no colic or gas problems. Neither family history or symptoms of allergy, duration of breast-feeding, mother's consumption of plain cow's milk during lactation, nor the age of introduction of cow's milk to the child were associated with the occurrence of colic. Children with colic grew as well as children without. However, their night sleep was more often disturbed by awakenings than the night sleep of children without colic or gas problems in early infancy.     

婴儿6个月前喂养方式与健康关系探讨

目的探讨婴儿6个月前不同的喂养方式与健康关系,宣传母乳喂养的好处,提高母乳喂养率.方法在2 003年1-6月份,针对我院儿保辖区内305例满6个月的婴儿及家长进行调查,其中母乳喂养儿168例,人工喂养儿137例,分别分组研究.侧量婴儿的身高、体重,了解婴儿患病情况及心理发育程度.其资料采用SPSS统计软件处理.结果婴儿6个月时母乳喂养组体格生长、抗病能力、心理发育方面均明显优于人工喂养组,差异有显著意义(P＜0.05).结论婴儿6个月前采用母乳喂养利于婴儿健康.必须提倡母乳喂养方式,提高母乳喂养率.     

Infant feeding and early neonatal jaundice

The feeding patterns and third day serum bilirubin levels were evaluated in 30 newborn infants receiving formula feeds in the neonatal special care unit and in 30 breastfed babies. Initiation of milk feeds were delayed in breast-fed babies and the frequency of feeding was significantly lower than in the formula-fed infants. Supplementary water was given only in the breast-fed group. Serum bilirubin levels were significantly higher in breast-fed infants (9·74±3·17 ml/dl) than those on formula (6·59±3·50 mg/dl), t=3·69, p<0·001). There appeared to be no influence of supplementation with water.     

Serum zinc concentration in exclusively breast-fed infants and in infants fed an adapted formula

Serum zinc concentrations have been determined in 28 healthy full-term Italian infants of both sexes at birth, as well as at 3 and at 5 months of age. Fourteen exclusively breast-fed infants who served as a control group were compared with 14 infants fed a cow's milk based adapted infant formula. No significant differences in serum zinc concentration between the breast-fed and the bottle-fed group became apparent during the study. The results of this study suggest a similar zinc nutriture in both groups. The availability of zinc from the adapted infant formula was not significatly different from that of human milk. These findings may be explained by the composition of the adapted formula tested, e.g. by a protein composition fairly close to that of human milk, by the presence of zinc derived from the natural ingredients only, by the low Fe/Zn ratio and by the elevated citrate content.