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Near-infrared spectroscopy is a promising noninvasive technique for monitoring the effects of feeding regimens on the cerebral and splanchnic regions.
Grometto, A, Pizzo, B, Strozzi, MC, Gazzolo, F, Gazzolo, D
Acta paediatrica (Oslo, Norway : 1992). 2018;(2):234-239
Abstract
AIM: The effects of different milk and, or, administration regimens on cerebro-splanchnic perfusion are still a matter of debate. We investigated the effects of the bolus administration of breast milk or formula on cerebro-splanchnic oximetry, function and perfusion, assessed by near-infrared spectroscopy (NIRS). METHODS This observational study of 30 infants fed with breast (n = 15) or formula (n = 15) milk, and matched for gestational age and birth weight, was carried out in the neonatal intensive care unit of the C Arrigo Children's Hospital, Alessandria, Italy, a tertiary-level referral centre, from October 2015 to December 2016. NIRS monitoring parameters, such as cerebral and splanchnic oximetry, fraction of tissue oxygen extraction and the cerebral-splanchnic ratio, were recorded before, during and after feeding. RESULTS Breast milk led to a significant increase in cerebro-splanchnic oximetry and tissue oxygen extraction (p < 0.001) during and after feeding, and the cerebro-splanchnic perfusion ratio was significantly higher (p < 0.001) in the breast than formula group. CONCLUSION Our study results suggest that breast milk was better tolerated than formula, requiring lower energy expenditure and lower cerebro-splanchnic haemodynamic redistribution. The findings could prompt investigations using NIRS as a promising noninvasive tool for cerebral and splanchnic longitudinal monitoring during neonatal feeding.
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Growth of breast-fed and formula-fed infants.
Ziegler, EE
Nestle Nutrition workshop series. Paediatric programme. 2006;:51-9; discussion 59-63
Abstract
Growth and nutrition during infancy are being viewed with renewed interest because of the possibility that they may be linked to cardiovascular and metabolic health in later life. Of particular interest are differences between breast- and formula-fed infants with regard to nutrient intake and growth because breastfeeding has been shown to be associated with a reduced risk of obesity in later life. During the first 6-8 weeks of life there is little difference in growth (gain in weight and length) between breast- and formula-fed infants. However, from about 2 months of age to the end of the first year of life formula-fed infants gain weight and length more rapidly than breast-fed infants. There are no consistent differences in adiposity during the first 4-5 months of life, but during the later part of the first year of life the preponderance of the evidence suggests that breast-fed infants are leaner than formula-fed infants. Formula-fed infants at 4-5 months of age show higher plasma levels of insulin-like growth factor-1 (IGF-1), insulin and certain amino acids than breast-fed infants. Whereas the protein intake of breast-fed infants decreases with age and closely matches the requirements for protein during the early months of life, the protein intake of formula-fed infants exceeds requirements after the first 1-2 months of life. The data are consistent with the hypothesis that differences in protein intake are mainly responsible for differences in growth between breast- and formula-fed infants. Differences in energy intake probably are responsible for differences in adiposity observed in older infants.
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Geographical variation in relationships between parental body size and offspring phenotype at birth.
Leary, S, Fall, C, Osmond, C, Lovel, H, Campbell, D, Eriksson, J, Forrester, T, Godfrey, K, Hill, J, Jie, M, et al
Acta obstetricia et gynecologica Scandinavica. 2006;(9):1066-79
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Abstract
BACKGROUND Size and body proportions at birth are partly determined by maternal body composition, but most studies of mother-baby relationships have only considered the effects of maternal height and weight on offspring birth weight, and few have examined the size of effects. Paternal size and body composition also play a role, primarily through the fetal genome, although few studies have investigated relationships with neonatal phenotype. METHODS Data from the UK, Finland, India, Sri Lanka, China, DR Congo, Nigeria and Jamaica were used to investigate the effects of maternal measures (derived at 30 weeks' gestation, n=16,418), and also paternal size (n=3,733) on neonatal phenotype, for singleton, live-born, term births. RESULTS After accounting for variation in maternal size and shape across populations, differences in neonatal phenotype were markedly reduced. Mother-baby relationships were similar across populations, although some were stronger in developing countries. Maternal height was generally the strongest predictor of neonatal length, maternal head circumference of neonatal head and maternal skinfold thickness of neonatal skinfolds. Relationships with maternal arm muscle area were generally weak. Effects of paternal height and body mass index were weaker than the equivalent maternal measurements in most studies. CONCLUSIONS Differences in maternal body composition account for a large part of the geographical variation in neonatal phenotype. The size of the effects of all maternal measures on neonatal phenotype suggests that nutrition at every stage of the mother's life cycle may influence fetal growth. Further research is needed into father-baby relationships and the genetic mechanisms that influence fetal growth.
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Gastric electrical activity in normal neonates during the first year of life: effect of feeding with breast milk and formula.
Riezzo, G, Castellana, RM, De Bellis, T, Laforgia, F, Indrio, F, Chiloiro, M
Journal of gastroenterology. 2003;(9):836-43
Abstract
BACKGROUND To evaluate the effect of feeding with milk on the gastrointestinal tract, we studied gastric electrical activity in 27 healthy fullterm newborns (15 formula-fed newborns and 12 breast-fed newborns) during the first 6 months of life. METHODS Three-hour electrogastrography (EGG) recordings were performed, using portable equipment, from the third to fifth day after birth until 6 months, at 3-month intervals. The EGG parameters were calculated as raw and integrated data, the latter as AUC of the whole postprandial period. RESULTS There was a significant difference in the fasting 3-cpm activity between the two groups (repeated measures analysis of variance [ANOVA] P=0.02; multiple comparisons: formula milk at birth vs breast milk at birth P<0.001). In addition, a significant change in the percentage of postprandial bradygastria was found at 6 months, 1 month after weaning (repeated measures ANOVA, P=0.01; multiple comparisons: formula milk at 6 months vs formula milk at 3 months, P=0.03, formula milk at 6 months vs formula milk at birth, P=0.02; breast milk at 6 months vs breast milk at 3 months, P=0.03, breast milk at 6 months vs breast milk at birth P=0.02). CONCLUSIONS An adult-like gastric 3-cpm activity can be observed in breast-fed newborns in contrast to formula-fed ones, probably as an effect of colostrum. The high bradygastria percentage recorded at 6 months of life might be the result of an increased low-frequency component of the EGG signal because of the transition to a mixed diet.
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The nutritional iodine supply of Belgian neonates is still insufficient.
Ciardelli, R, Haumont, D, Gnat, D, Vertongen, F, Delange, F
European journal of pediatrics. 2002;(10):519-23
Abstract
UNLABELLED Belgium used to be affected by mild iodine deficiency. Improvement in iodine nutrition has been recently documented in schoolchildren in Belgium in spite of the absence of any systematic programme of iodine supplementation. The question arises as to whether this 'silent iodine prophylaxis' affected also the neonates. A total of 185 random urine samples were collected from 90 full term and 65 preterm neonates in Brussels on day 5 and repeated on day 30 in 30 preterms who were bottle-fed with iodine-enriched formula-milk. The iodine content was also determined in 58 samples of breast-milk on day 5. The median urinary iodine on day 5 in full term neonates was 86 micro g/l, which is markedly higher than the figure of 48 micro g/L reported 15 years previously in neonates in the same area but still much lower than normal for this age group (150-200 micro g/l). The mean iodine content of breast-milk was 78 micro g/l, which is unchanged as compared to 15 years ago and is about 66% of normal. Finally, the median urinary iodine increased from 60 micro g/l on day 5 to 150 micro g/l on day 30 in preterms bottle-fed with iodine-enriched formula-milk. CONCLUSION the status of iodine nutrition has also improved spontaneously in Belgian neonates but has not yet normalised. Lactating and probably pregnant women remain clearly iodine deficient. The iodine-enriched formula-milk for preterms is efficient in correcting their iodine deficiency. National measures are urgently required for correction of iodine deficiency in Belgium.
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Effects of exclusive breastfeeding for four versus six months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras.
Dewey, KG, Cohen, RJ, Brown, KH, Rivera, LL
The Journal of nutrition. 2001;(2):262-7
Abstract
To examine whether the duration of exclusive breastfeeding affects maternal nutrition or infant motor development, we examined data from two studies in Honduras: the first with 141 infants of low-income primiparous women and the second with 119 term, low birth weight infants. In both studies, infants were exclusively breastfed for 4 mo and then randomly assigned to continue exclusive breastfeeding (EBF) until 6 mo or to receive high-quality, hygienic solid foods (SF) in addition to breast milk between 4 and 6 mo. Maternal weight loss between 4 and 6 mo was significantly greater in the exclusive breastfeeding group (EBF) group than in the group(s) given solid foods (SF) in study 1 (-0.7 +/- 1.5 versus -0.1 +/- 1.7 kg, P < 0.05) but not in study 2. The estimated average additional nutritional burden of continuing to exclusively breastfeed until 6 mo was small, representing only 0.1-6.0% of the recommended dietary allowance for energy, vitamin A, calcium and iron. Women in the EBF group were more likely to be amenorrheic at 6 mo than women in the SF group, which conserves nutrients such as iron. In both studies, few women (10-11%) were thin (body mass index <19 kg/m(2)), so the additional weight loss in the EBF group in study 1 was unlikely to have been detrimental. Infants in the EBF group crawled sooner (both studies) and were more likely to be walking by 12 mo (study 1) than infants in the SF group. Taken together with our previous findings, these results indicate that the advantages of exclusive breastfeeding during this interval appear to outweigh any potential disadvantages in this setting.
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The last fifty years of neonatal surgical management.
Rowe, MI, Rowe, SA
American journal of surgery. 2000;(5):345-52
Abstract
Neonatal surgical mortality has steadily fallen over the last five decades. Improved survival does not appear to be related to the introduction of new operative procedures. Most of the basic procedures were developed by 1960. Eight developments appear to be responsible: (1) The growth of pediatric surgery resulted in widespread availability of neonatal surgeons and dissemination of knowledge about newborn surgical emergencies. (2) The parallel growth of pediatric anesthesia, beginning in 1946, provided specialized intraoperative management of the neonate. (3) Understanding neonatal physiology is the key to successful management; major advances occurred between 1950 and 1970. (4) New inventions revolutionized patient care; the transistor (1947) made it possible for medical devices to sense, amplify and control physiologic responses and opened the communication and computer age. (5) Neonatal mechanical ventilation had a prohibitive mortality and was seldom utilized; the development of CPAP and a continuous flow ventilator in the 1970s allowed safe ventilatory support. (6) Total parenteral nutrition (1968) prevented starvation that frequently affected infants with major anomalies. (7) The effective treatment of infection began with the clinical use of penicillin (1941); antibiotics have reduced mortality but infants suffering from the septic syndrome have a prohibitive mortality; cytokine, proinflammatory agent research, and the development of anti-inflammatory and blocking agents in the 1980s have not affected mortality. (8) The establishment of newborn intensive care units (1960) provided an environment, equipment, and staff for effective physiologic management.