Whey hydrolysate compared with cow's milk-based formula for weaning at about 6 months of age in high allergy-risk infants: effects on atopic disease and sensitization

Ninety-one high atopy-risk infants were prospectively followed up to 18 months of age with regard to the development of allergic/atopic manifestations and sensitization. They were randomized into one of two feeding groups, i.e., a hydrolyzed, ultrafiltered cow's milk whey formula, Profylac® ( n = 32), or an ordinary cow's milk formula ( n = 39), for 12 months, started after exclusive breast-feeding for 0–9 (median 6.0) months. Lactating mothers avoided milk, egg, and fish, as did the infants up to 12 months of age. Twenty of the 91 infants were breast-fed exclusively for more than 9 months and regarded as a control group. All infants were followed-up by questionnaires, physical examinations, skin prick tests, and determination of serum total IgE and cow's milk-specific IgE. The frequency of allergic/atopic disease was similar in the three groups. However, all three infants who developed cow's milk allergy with skin symptoms belonged to the cow's milk formula group. The skin prick test with whey hydrolysate was negative in all, while with cow's milk it was positive in eight infants. Growth was similar in the three groups. The study comprises too few infants to allow us to make statistically based statements. However, the difficulties encountered and the limited effects obtained by the use of whey hydrolysate at weaning at about 6 months of age made us conclude that we can spare high atopy-risk families this extra burden.     

A sensitive enzyme-linked immunosorbent assay for determination of bovine β-lactoglobulin in infant feeding formulas and in human milk

We developed a sensitive sandwich-type ELISA for measuring low levels of cow's milk (CM) β-lactoglobulin. Purified anti-β-lactoglobulin was used as coating antibody and also as second antibody conjugated with alkaline phosphatase. Polyethylene glycol 6000 was added to the incubation buffers to improve sensitivity. The detection limit of the assay was 0.002 μg/l, which is much better than sensitivities reported for other β-lactoglobulin assays. The sensitivity was not impaired by the presence of other CM proteins. The recovery from breast milk was 93% and from the diluting buffer 127%. The coefficient of variation within day was 5–15% and between days 10%. One hour after oral intake of milk, P-lactoglobulin could be detected in the breast milk of three mothers at concentrations of about 1–2 μg/l. Widely different concentrations of β-lactoglobulin were measured in two protein hydrolysates based on CM whey and casein proteins; the observed concentrations were 200 and 0.0056 μg P-lactoglobulinμ/g dry weight, respectively.     

Infant Vocalization: An Index of Maternal Attitude Toward the Child

Brief observations of mother-stimulated infant vocalizationwere perform ed during pediatric clinic visits on 4- to 6-month-oldinfants to determine whether mothers with positive attitudestoward the pregnancy and/or the in fant would have infants whovocalized more during clinic visits. Mothers with more positiveattitudes toward the pregnancy, assessed prenatally, had infantswho showed significantly more vocalization during clinic visitsat 5 months, 6 months, and the combination of 5 and 6 months.Mothers with more positive attitudes toward the infant had infantswho showed signcantly more vocalization at 4 months and thecombination of observations at 4 months and 6 months. Resultssuggest that brief observations of vocalization during clinicvisits may be useful as a rough index of the quality of themother-child interaction.     

Developmental regulation of type 1 and type 3 interferon production and risk for infant infections and asthma development

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The effects of separation and reunion on the behavior of mother and infant squirrel monkeys

Mother and infant squirrel monkeys that lived together in a socially restricted environment were separated for a period of seven days after the infants had become relatively independent, and were then reunited. Behavioral observations before, during, and after separation indicated that (1) female infants became independent of their mothers earlier than males, (2) neither mothers nor infants were severely affected by separation, and (3) an increase in attachment occurred following reunion only when the mother had a limited history of maternal experience. These results suggest that (1) certain characteristics in the maternal behavior of the squirrel monkey facilitate readjustment in mothers and infants following maternal separation, (2) maternal experience can influence the mother-infant relationship following a period of separation, and (3) the independence of infants from their mothers may be a function of both sex and species.     

Extensive somatosensory innervation in infants with obstetric brachial palsy

In the pre-operative screening of infants with obstetric brachial palsy (OBP), the results of routine electromyography are often overly optimistic when compared to the peri-operative findings. This prompted us to include investigation of the sensory innervation of these infants using the N20 (the first cortical response to a peripheral stimulation) of the somatosensory evoked potentials (SSEP). Three to seven months after birth, SSEP were recorded at the skull after stimulation of the thumb and middle finger in infants with obstetric rupture of the upper trunk or avulsion of roots C5, C6, or C7, and in whom no clinical improvement of motor function was observed in the biceps brachii and deltoid muscles. In most infants, a normal N20 could be evoked, indicating the existence of peripheral sensory pathways. From the thumb, these sensory pathways would necessarily bypass the upper trunk and dorsal roots of spinal nerves C5 and C6, and from the middle finger bypass the middle trunk and dorsal root C7, before extending into the dorsal column and projecting toward the thalamus and cerebral cortex. These data suggest that in infancy the segmental sensory innervation of the hand is more diverse than is described in most textbooks.     

Cord blood IgE. III. Prediction of IgE high-response and allergy

Screening of total IgE in 2814 cord blood samples was analysed by Phadebas IgE PRIST in 2 1-year birth cohorts (1983–1984 and 1985–1986) in Denmark (n= 1189 + 1625). For follow-up we chose all infants with cord blood IgE≥0.5 kU/1 and a randomly chosen group of the same size with cord blood IgE < 0.5 kU/1. A total group of 762 infants were clinically evaluated at 18 months of age, and in 688 of these we evaluated total and specific IgE. A diagnosis of definite atopy, probable atopy or no atopy was established. In the present study we defined allergic disease as atopic disease combined with elevated total IgE. We found a statistically significant correlation between cord blood IgE and IgE at 18 months of age. Significantly more infants with elevated cord blood IgE had developed allergic disease at 18 months. A cut-off value of 0.3 kU/1 for cord blood IgE was superior to the originally suggested 0.5 kU/1. Significantly more infants with elevated cord blood IgE had developed specific IgE antibodies at 18 months. The most frequent specific IgE antibody was towards cow's milk. Specific IgE antibodies were very rarely found when total IgE was not elevated. A total IgE at the age of 18 months > 26 kU/1 could be regarded as elevated. With regard to allergic disease the positive predictive values of cord blood lgE≥0.3 kU/1 in the 2 series were 21 % and the corresponding sensitivities 67% and 46%, respectively. The risk of developing allergic disease was elevated with a factor 3 to 4 when cord blood IgE ≥ 0.3 kU/1. In a high-risk group based on atopic predisposition and elevated eord blood IgE ≥0.5 kU/1 the relative risk of allergic disease was 5, the predictive value of positive test 38%, the sensitivity 24% and the specificity 96%. Clinical aspects Cord blood IgE was a good predictor of allergic disease at the age of 18 months. A cord blood cut-off IgE value of 0.3 kU/l was superior to other cord blood IgE values with the Phadebas IgE PRIST method.     

Thrombocytosis in preterm infants: a possible involvement of thrombopoietin receptor gene expression

Transient thrombocytosis is commonly observed in preterm infants after birth, but its physiological mechanism is still unknown. To understand the mechanism of the transient thrombocytosis in preterm infants we firstly evaluated a correlation between platelet counts and thrombopoietin (TPO) levels in preterm infants and next c-mpl mRNA levels on platelets in healthy preterm infants longitudinally during a half-year of life. The mean platelet counts in 45 very low birth weight infants (mean gestational age 27.4±1.8 weeks, mean birth weight 1047±249 g) was 230±71×10⁹/l just after birth and thereafter gradually increased to 579±178×10⁹/l by 5 weeks of age. The platelet counts continued this level for about next 8 weeks. Serum TPO levels soon after birth and at 1 month of age were significantly higher than those at the age of 2–6 months. There was a significant negative correlation between platelet counts and serum TPO values. The c-mpl expression levels on platelets at birth and at 1 month of age tended to be lower than those on platelets from adults, and the c-mpl levels gradually increased through 6 months of age, although they were still lower than those of adults. Our results suggest that low expression of TPO receptor on platelets until 1 month after birth cause a decreased TPO clearance and keep a high level of free TPO in blood, thereby promoting platelet production from megakaryocytes or their progenitors in bone marrow, resulting in the subsequent thrombocytosis in preterm infants.     

Direct infant UV light exposure is associated with eczema and immune development

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