母乳库母乳喂养对早产儿生长发育及并发症的影响

目的探讨母乳库母乳喂养对早产儿生长发育及并发症的影响。方法68例早产儿根据喂养方式的不同分为两组各34例,对照组采用配方乳喂养,研究组采用母乳库母乳喂养,比较两组的生长发育及喂养情况、并发症。结果研究组的生长发育情况显著优于对照组(P<0.05)。研究组的喂养耐受时间、静脉营养时间以及住院时间均显著短于对照组(P<0.05)。研究组的并发症发生率显著低于对照组(P<0.05)。结论母乳库母乳喂养可促进早产儿生长发育,降低并发症发生率。     

Effect of traditional food supplements on nutritional status of lactating mothers and growth of their infants

ObjectivesDuring lactation, traditional food supplements (TFS) are commonly consumed in India to increase lactation performance and health of mothers. TFS are rich in fats, nuts, dry fruits, and sugars and indulging in such supplements for 3 to 6 mo postpartum may put the mother at risk for obesity. The aim of this study was to assess the nutrient quality of TFS and its effect on nutritional status of lactating mothers and infant's weight gain in first 6 mo after delivery.MethodsA random sample of 125 Indian urban lactating mothers (28.9 ± 3.2 y) was assessed within 6 mo postpartum for anthropometry, diet by 24-h recall on 3 random days, along with socioeconomic factors, lactation history, and infant's birth weight and current weight.ResultsAmong 18 different TFS, 50% TFS were rich in calcium, 33% rich in iron, 38% in zinc, and only 13% were good sources of vitamins. Mothers consuming TFS (n = 75) had significantly higher fat intakes than mothers consuming no TFS Supplements (NTS; n = 50). A higher weight gain was seen in TFS mothers (10.5%) than NTS mothers (8.8%) after adjusting for number of days after delivery, parity, mother's age, and breast-feeding practices (P < 0.05). Percent weight gain in infants of TFS mothers (120.7% ± 7.3%) was higher than in infants of NTS mothers (96.2% ± 7.8%; P = 0.024) after adjusting for infant's age and mother's breast-feeding practices.ConclusionTFS may be modified to increase its micronutrient quality and to reduce fat contents with the goal of reducing the risk for obesity in mothers, while still benefiting infant growth.     

Characteristics of allergic colitis in breast-fed infants in the absence of cow’s milk allergy

AIM: To investigate the characteristics of mucosal le-sions and their relation to laboratory data and long-term follow up in breast-fed infants with allergic colitis. METHODS: In this study 31 breast-fed infants were prospectively evaluated (mean age, 17.4 wk) whose rectal bleeding had not ceased after a maternal elimi-nation diet for cow’s milk. Thirty-four age-matched and breast-fed infants (mean age, 16.9 wk) with no rectal bleeding were enrolled for laboratory testing as con-trols. Laboratory findings, colonoscopic and histological characteristics were prospectively evaluated in infants with rectal bleeding. Long-term follow-up with differ-ent nutritional regimes (L-amino-acid based formula or breastfeeding) was also included. RESULTS: Iron deficiency, peripheral eosinophilia andthrombocytosis were significantly higher in patients with allergic colitis in comparison to controls (8.4±3.2 μmol/L vs 13.7±4.7 μmol/L, P<0.001; 0.67±0.49 G/L vs 0.33±0.17 G/L, P<0.001; 474±123 G/L vs 376±89 G/L, P<0.001, respectively). At colonosco-py, lymphonodular hyperplasia or aphthous ulceration were present in 83% of patients. Twenty-two patients were given L-amino acid-based formula and 8 contin-ued the previous feeding. Time to cessation of rectal bleeding was shorter in the special formula feeding group (mean, 1.4 wk; range, 0.5-3 wk) when com-pared with the breast-feeding group (mean, 5.3 wk; range, 2-9 wk). Nevertheless, none of the patients ex-hibited rectal bleeding at the 3-mo visit irrespective of the type of feeding. Peripheral eosinophilia and cessa-tion of rectal bleeding after administration of elemental formula correlated with a higher density of mucosal eosinophils. CONCLUSION: Infant hematochezia, after cow’s milk allergy exclusion, is generally a benign and probably self-limiting disorder despite marked mucosal abnor-mality. Formula feeding results in shorter time to cessa-tion of rectal bleeding; however, breast-feeding should not be discouraged in long-lasting hematochezia.     

Hypocalcemic Rickets and Dilated Cardiomyopathy: Case Reports and Review of Literature

Internationally, there have been isolated case reports published of children presenting with dilated cardiomyopathy (DCM) in the setting of undiagnosed rickets. Although there has been an increased prevalence of rickets in the United States, there has been only one documented case of associated DCM. At our institution, a hospital database search was conducted from year 1997 to year 2007 to identify patients with confirmed vitamin D deficiency in addition to DCM. Through this search, four exclusively breast-fed African American infants were identified. These infants presented with congestive heart failure secondary to DCM and, at their admission, were found to have laboratory evidence consistent with hypocalcemic rickets. These patients responded dramatically to treatment with vitamin D and calcium, and cardiac function returned to normal within months. Early recognition of vitamin D deficiency was an important factor in these patients’ clinical course. These case reviews present a rare, serious complication of vitamin D-deficient rickets and support evidence for prevention of this nutritional deficiency with vitamin D supplementation in exclusively breast-fed infants.     

Treading the tightrope between motherhood and an eating disorder: a qualitative study

Background

Pregnancy is a life event that involves a change in appearance, during which the eating behaviour and body of childbearing women is scrutinised by others. The impact this has on the thoughts and behaviours of individuals who have or have had an eating disorder has been little investigated.

Objectives

A qualitative project to provide a deeper understanding of the views of women with an eating disorder history about pregnancy and the early stages of motherhood.

Methods

Semi-structured interviews were conducted with eight women who were or had recently been pregnant. All had an eating disorder history. It explored how becoming a mother impacted on thoughts and practices relating to weight, using framework analysis.

Results

Interviews lasted approximately 80 min. The overriding concept identified through analysis was the divided loyalties participants experienced between putting their child first and disregarding the eating disorder. Interpretation of data resulted in the identification by the research team of four main themes: fear of failure, transforming body and eating, uncertainties about child's shape and emotional regulation.

Conclusions

Three types of women were identified among interviewees; those that seemed to be ‘cured’ of their eating disorder through motherhood, those that seemed able to put their condition on hold during pregnancy and those that seemed unable to relinquish dangerous behaviours. Issues relating to control, identity and perfectionism may impede some women's ability to enjoy pregnancy and motherhood if they have an eating disorder history.     

内源性1,25（OH）2D3缺乏对哺乳期小鼠牙齿矿化和牙本质形成的影响

目的:研究内源性1,25(OH)2D3缺乏对哺乳期小鼠牙齿矿化和发育的影响。方法:利用X线检测、HE染色、组织化学、免疫组织化学以及real-time RT-PCR等方法检测2周龄同窝的WT和1α(OH)ase-/-小鼠下颌牙齿。结果:和2周龄WT小鼠相比,1α(OH)ase-/-小鼠下颌磨牙的X线透光率明显增加;1α(OH)ase-/-小鼠下颌第一磨牙及下颌切牙前期牙本质厚度与WT小鼠厚度有统计学差异。1α(OH)ase-/-小鼠下颌磨牙总胶原阳性面积与WT小鼠有统计学差异;1α(OH)ase-/-小鼠下颌第一磨牙牙本质I型胶原阳性面积与WT小鼠有统计学差异(P<0.05);OCN在1α(OH)ase-/-小鼠下颌第一磨牙的牙本质和牙髓相对阳性面积与WT小鼠相对阳性面积有统计学差异(P<0.01);Biglycan在1α(OH)ase-/-小鼠下颌第一磨牙的牙本质相对阳性面积与WT小鼠相对阳性面积有统计学差异(P<0.01);OCN与ALP在1α(OH)ase-/-小鼠下颌切牙牙髓细胞中mRNA的表达水平较WT小鼠有明显降低,有统计学差异(P<0.05)。结论:内源性的1,25(OH)2D3缺乏导致哺乳期小鼠牙齿的牙本质矿化不良和牙本质的形成减少。     

Chiropractic management of breast-feeding difficulties: a case report

Objective

The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties.

Clinical Features

The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic.

Intervention and Outcome

Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days.

Conclusion

The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently.     

新生儿母乳喂养满月时体格发育的调查分析

目的:探讨母乳喂养对新生儿满月体格发育的影响。方法:母乳喂养新生儿250例,人工喂养200例,对450例健康的足月新生儿体格发育的情况进行调查,并进行新生儿高胆红素血症(简称高胆)和低血糖发病率的调查。结果:满月时,母乳喂养的新生儿,其体重和身长的增值明显优于人工喂养的新生儿(P<0.05),其新生儿高胆和低血糖的发病率也明显低于人工喂养喂养(P<0.05)。结论:新生儿母乳喂养能促进新生儿的体格发育,降低新生儿的高胆和低血糖的发病率。     

初乳对新生儿肠道双歧杆菌和肠杆菌的影响

目的 探讨初乳对新生儿肠道双歧杆菌和肠杆菌生长的作用.方法 采用厌氧菌培养技术,对5～7天的32名初乳喂养儿和24名人工喂养儿的粪便做双歧杆菌和肠杆菌定量培养.结果 初乳喂养儿粪便双歧杆菌的数量明显高于肠杆菌;人工喂养儿粪便肠杆菌的数量高于双歧杆菌.结论 初乳对早期新生儿肠道菌群演替发挥了重要作用,它促进双歧杆菌生长,抑制肠杆菌生长.