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Biomedical subjects

E Pollitt

Publications and source records attributed to E Pollitt.

At least 55 records · Page 3Linked to original sources
PubMed1994

Adverse effect of iron supplementation on weight gain of iron-replete young children.

The efficacy of iron supplementation for iron-deficient subjects is in no doubt. However, the assumption that iron supplementation of iron-replete subjects is harmless may not be valid. We have studied the effect of iron supplementation on growth rate in 47 iron-sufficient young children (12-18 months) in Indonesia. The children were randomly assigned either ferrous sulphate (3 mg/kg daily) or placebo every day for 4 months. Before treatment the length, weight, and arm circumference of the two groups were similar. During the 4 months of supplementation the rate of weight gain was significantly greater in the placebo group than in the iron-supplemented group (0.106 [SE 0.010] vs 0.070 [0.011] kg every 2 weeks, p = 0.02). The rates of gain in length and arm circumference did not differ significantly by treatment. There were no differences between the groups in rates of respiratory and gastrointestinal infections. These results suggest that iron supplementation of iron-replete children may retard their growth.

Analysis of Variance↗
PubMed1994

Infant feeding policies in maternity wards and their effect on breast-feeding success: an analytical overview.

OBJECTIVES: The purpose of this review is to examine the plausibility of a causal relationship between maternity ward practices and lactation success. METHODS: Studies were located with MEDLINE, from our personal files, and by contacting researchers working in this field. Of the 65 studies originally reviewed, 18 met our inclusion criteria (i.e., hospital-based intervention, experimental design with randomization procedures, or quasi-experimental design with adequate documentation). RESULTS: Meta-analysis indicated that commercial discharge packs had an adverse effect on lactation performance. The impact of early mother-infant contact on lactation success was unclear. Rooming-in and breast-feeding guidance in a rooming-in context had a beneficial impact on breast-feeding among primiparae. Breast-feeding on demand was positively associated with lactation success. In-hospital formula supplementation of 48 mL per day was not associated with poor breast-feeding performance. CONCLUSIONS: Hospital-based breast-feeding interventions can have a beneficial effect on lactation success, particularly among primiparous women.

Bottle Feeding↗
PubMed1994

Poverty and child development: relevance of research in developing countries to the United States.

Data from low-income countries are helpful in understanding the effects of poverty on child development in the U.S. Illustrative are 3 public health issues: (1) In the U.S., among poor African-American and Hispanic babies anemia is as high as 20%-24%, while in low-income countries, iron deficiency anemia (IDA) causes poor performance on mental and motor tests among babies and children. These data suggest that IDA is a major public health problem among poor minority children that requires prompt attention. (2) In 1993 the U.S. government appropriated $2.86 billion for the Special Supplemental Food Program for Women, Infants, and Children (WIC). Evaluations of WIC, however, have failed to yield conclusive information on the benefits of the program. In low-income countries, nutritional supplements targeted to at-risk groups have resulted in developmental benefits. Thus, WIC is likely to buffer intellectual development against the adverse effects of malnutrition observed among poor children. (3) Evidence from developing countries suggests that concurrent illnesses and poor nutrition interfere with schooling. However, in the U.S., attention to such issues has declined, while common illnesses have increased among the poor. A reappraisal of this issue is warranted to meet the education and health goals proposed for the year 2000 in the U.S.

Adolescent↗
PubMed1993

Reversal of developmental delays in iron-deficient anaemic infants treated with iron.

Iron-deficient anaemic infants perform worse in tests of mental and motor development than do iron-sufficient infants of a comparable age. A randomised, double-blind trial was done to monitor the effects of iron supplementation on performance in the Bayley scales of mental and motor development among 12-18-month-old infants in Indonesia. Iron-deficient anaemic infants (n = 50) were assigned randomly to receive dietary ferrous sulphate or placebo for 4 month. Similar treatment randomisation was done among nonanaemic iron-deficient (n = 29) and iron-sufficient (n = 47) infants. Before intervention, the mean mental and motor scores of the iron-deficient anaemic infants were significantly (p < 0.01) lower than those of the nonanaemic iron-deficient and iron-sufficient classes. After intervention, developmental delays were reversed among iron-deficient anaemic infants who had received iron but they remained the same among placebo-treated iron-deficient anaemic infants. Neither ferrous sulphate nor placebo had significant effects on the scores of the other two iron-status classes. The poor performance of 12-18-month-old iron-deficient anaemic infants in the Bayley scales of mental and motor development can be improved to the level of performance of iron-sufficient infants by treatment with ferrous sulphate.

Administration, Oral↗
PubMed1993

Determinants of lactation performance across time in an urban population from Mexico.

We identified determinants of breastfeeding and full breastfeeding among 165 healthy mothers from Hermosillo, Mexico who planned to breastfeed and delivered vaginally a healthy term infant. Deliveries took place in either a nursery (n = 58) or a rooming-in (n = 107) public hospital where formula supplementation was not allowed. Multivariate analyses indicated that at 1 week full breastfeeding was associated (P < or = 0.05) with early milk arrival, social support for full breastfeeding and planned breastfeeding duration. At 2 months, full breastfeeding was associated with social support for full breastfeeding and early milk arrival. Breastfeeding was positively associated with early milk arrival and inversely associated with early introduction of supplementary bottles, maternal employment, maternal body mass index and infant age. At 4 months, full breastfeeding was positively associated with social support for full breastfeeding and inversely associated with infant age. Breastfeeding was positively associated with planned breastfeeding duration and inversely associated with early introduction of a bottle and urban background. Rooming-in mothers reported that their milk came in earlier (P < or = 0.05) than did the nursery group. Milk arrival was later when a bottle was introduced in the first week; both of these variables might be important in explaining a positive effect of rooming-in on lactation performance.

Adult↗
PubMed1993

Early supplementary feeding and cognition: effects over two decades.

The study reported in this Monograph of the effects of early supplementary feeding on cognition included two data collection periods: a longitudinal investigation spanning the years 1969-1977 and a cross-sectional follow-up carried out in 1988-1989. The study was conducted in four rural villages in Guatemala and compared the differential effects of exposure in childhood (0-7 years) to an Atole supplement (11.5 g of protein; 163 kcal) or a Fresco supplement (59 kcal) on performance on a battery of psychoeducational and information-processing tests in adolescence and young adulthood (11-24 years). In this report, particular attention is given to a cohort of subjects who were exposed to the supplement prenatally and during at least the first 2 years of postnatal life. Data on this subsample are contrasted with those on a cohort of subjects who received the supplement only after 24 months of life. The Monograph also reports results from an analysis of the supplementation effects in infancy and early childhood. Consistent differences between groups on the psychoeducational tests were observed. Adolescents from Atole villages scored significantly higher on tests of knowledge, numeracy, reading, and vocabulary than Fresco subjects. Atole was also associated with a faster reaction time in information-processing tasks. Significant interactions helped identify two groups who benefited more from the Atole treatment: those at the lowest levels of socioeconomic status and those who attained the highest levels of primary schooling. The consistent differences in test performance established in the follow-up assessment contrast sharply with the few and less pronounced between-group differences observed in the infancy and preschool periods. After close scrutiny of alternative hypotheses, it is concluded that nutritional differences provide the strongest explanation for the test performance differences observed in the follow-up between the subjects exposed to the Atole and those exposed to the Fresco supplement.

Adolescent↗
PubMed1992

Effect of the maternity ward system on the lactation success of low-income urban Mexican women.

We compared the lactation performance of 165 healthy mothers who planned to breastfeed and gave birth by vaginal delivery, without complications to a healthy infant in either a nursery (NUR) (n = 58) or a rooming-in hospital where formula supplementation was not allowed. In the rooming-in hospital, women were randomly assigned to a group that received breastfeeding guidance during the hospital stay (RIBFG) (n = 53) or to a control group (RI) (n = 54). Women were interviewed in the hospital and at 8, 70 and 135 days post-partum (pp). The groups were similar in socio-economic, demographic, anthropometric, previous breastfeeding experience and prenatal care variables. Non-parametric survival analyses adjusting for potential confounding factors show that breastfeeding guidance had a positive impact (P < or = 0.05) on breastfeeding duration among primiparous women who delivered in the rooming-in hospital. Among primiparae, the RI and RIBFG groups had higher (P < or = 0.05) full breastfeeding rates than the NUR group in the short term. In the longer term, only the difference between the RIBFG and the NUR group remained statistically significant. The maternity ward system did not have a statistically significant effect on the lactation performance of multiparae.

Adolescent↗
PubMed1992

Effects of an iron supplementation trial on the Fe status of Thai schoolchildren.

A double-blind clinical trial was conducted among 9- to 11-year-old children in sixteen schools in the Chon Buri province of Thailand to assess the effects of an iron supplement combined with an anthelminthic agent (i.e. albendazole). In addition to the albendazole, Fe or placebo tablets were distributed to 2268 children enrolled in grades three to five without knowledge of the Fe status of the children. Criteria for case inclusion were: (a) absence of A E Bart's or haemoglobin (Hb) H disease, (b) absence of abnormal Hb EE, and (c) age, 108-144 months. The results showed a significant improvement in the Fe status of the children after 16 weeks of treatment. The increments were: Hb from 124 to 128 g/l, serum ferritin from 34.54 to 104.72 micrograms/l, transferrin saturation from 24.09 to 35.05%; free erythrocyte protoporphyrin decreased from 444.7 to 281.4 micrograms/l erythrocytes. These changes were significantly greater than in the control group that received only the anthelminthic agent. However, the administration of albendazole only also resulted in significant changes in the same Fe indicators.

Albendazole↗
PubMed1992

Causes and consequences of intrauterine growth retardation in Latin America.

The purpose of this article is to present a critical review of the literature on the causes and consequences of intrauterine growth retardation (IUGR) and of body proportions at birth among IUGR infants. IUGR is generally defined as a birth weight below the tenth percentile of a reference weight distribution according to gestational age. Chronic maternal malnutrition and other poverty-related factors are likely to be important determinants of IUGR in developing countries. IUGR has been associated with increased risks of neonatal morbidity and mortality and alterations in physical and mental development during early childhood. IUGR newborns can be classified as "symmetric" or "asymmetric" in terms of body proportionality. The available literature indicates that the risk of perinatal morbidity is higher among asymmetric newborns than among their symmetric counterparts, while symmetric newborns confront a higher risk of impaired physical and mental development. Obviously, the clinical and statistical usefulness of these IUGR and body proportionality assessments depends on the accuracy of the birth measurements (length, weight, and estimated gestational age) from which they are derived. Latin America now has the hospital infrastructure needed to obtain reliable birth data of this kind. It is important to use these resources effectively in order to improve the health assessment of newborns and gain a better understanding of the causes and consequences of IUGR.

Child, Preschool↗
PubMed1991

Developmental effects of short-term supplementary feeding in nutritionally-at-risk Indonesian infants.

This study assessed the developmental effects of supplementary feeding over 90 consecutive days on infants aged 6-20 mo at six tea plantations in West Java, Indonesia. Every day except Sunday, the infants attended day-care centers distributed throughout the plantations. Twenty centers and 113 infants were selected; the infants in 9 centers received a dietary supplement, while the infants in 11 centers served as control subjects. Supplements were given twice a day providing, on average, 10.66 kJ (400 kcal) and 5 g protein/d. Measurements of body growth, dietary intake, and mental and motor development were made on all infants. Supplementary feeding had significant effects on weight gain and on motor development. Changes in caloric intake were independently associated with changes in weight and in motor test scores. The data suggest that the effects of the supplement may not have followed a simple mechanistic relationship from intake to weight change to motor development, but, rather, intake may have affected both growth and development domains simultaneously.

Anthropometry↗
PubMed1989

Effects of iron deficiency on attention and learning processes in preschool children: Bandung, Indonesia.

A double-blind clinical trial was conducted in Indonesia to assess effects of iron supplementation on performance of iron-depleted and iron-deficient anemic children in discrimination and oddity learning tasks. Half these children received elemental Fe for 8 wk; the others received a placebo. There were significant changes from pre- to postintervention evaluations in ferritin, transferrin saturation, free erythrocyte protoporphyrin, and hemoglobin among the anemic and iron-depleted children; no changes were observed among the placebos or any of the iron-replete children. The magnitude of hematological changes in anemic children treated with iron was small; yet, after treatment the children's mean ferritin, transferrin saturation, and hemoglobin values were above the cutoff points used for the definition of iron-deficiency anemia (IDA). Pre- and posttreatment psychological test data show that IDA produces alterations in cognitive processes related to visual attention and concept acquisition, alterations reversed with iron treatment.

Adult↗
PubMed1989

Iron deficiency and educational achievement in Thailand.

This double-blind clinical trial was conducted in Thailand to assess the impact of iron treatment on the IQ and educational attainment of 1358 9-11-y-old children. The children were classified into one of three groups: iron replete, iron depleted, and iron-deficient anemic. The Raven Progressive Matrices was used to measure IQ. A Thai language and a math test were administered to assess school attainment. A 50-mg/d tablet of ferrous sulphate was given for 2 wk and a 100 mg/d tablet, for 14 wk. An anthelminthic drug was given on the day of the blood test before treatment and 3 mo after the intervention started. There is evidence of a positive association between iron status and IQ and a language school achievement test but there is no support for the internal validity of the hypothesis that this association is causal.

Anthelmintics↗
PubMed1988

Iron supplementation and physical growth of rural Indonesian children.

The effect of oral iron supplementation on blood Fe levels and physical growth in 119 rural Indonesian school children was assessed in this double-blind study. The children were classified into anemic and normal groups according to their initial hemoglobin and transferrin saturation levels and were randomly assigned to either Fe or placebo treatment for 12 wk. Hematological, anthropometric, and morbidity data were collected before and after the treatment period. Before treatment, anemic subjects were smaller and had higher morbidity than normal subjects. Treatment with 10 mg ferrous sulfate.kg-1.d-1 for 12 wk resulted in a significant improvement in anemic subjects' hematological status, growth velocity, and level or morbidity.

Anemia, Hypochromic↗
PubMed1987

Differences in the pattern of weight growth of nutritionally at-risk and well-nourished infants.

A mathematical model was used to examine the patterns of weight growth of two groups of infants exposed to various ecological and nutritional conditions and practices. Statistical comparison of the parameters of weight model estimated from longitudinal data demonstrated different level and profile contour of weight growth in these two populations. In addition to differences in the growth levels, the growth patterns of these two groups are significantly different. The Taiwanese infants experience more pronounced upward and downward changes in growth velocity than the United States (US) infants in the first 6 mo of life. In the second 6 mo, the US infants show a decline in growth velocity whereas the Taiwanese infants maintain a low and constant growth rate. Possible explanations for the different growth profile of the Taiwanese infants in the first 6 mo may be related to: catch-up growth after possible intrauterine undernutrition, genetic growth pattern of Taiwanese infants, and growth characteristics of breast-fed infants.

Adult↗
PubMed1986

Iron deficiency and behavioral development in infants and preschool children.

This paper selectively reviews the main findings of studies on the possible effects of iron deficiency on cognitive function among infants and preschool children published after 1976, and presents data from a study recently conducted in rural Guatemala. In comparison to infants without signs of sideropenia, infants with iron deficiency with and without anemia tend to score lower in the Bayley Scale of Mental Development; conversely, there is no evidence for an association between iron deficiency and delayed motor development. Iron repletion therapy implemented over a period of 7 to 10 days is likely to result in an improvement in mental development scale scores among infants with iron deficiency with or without anemia. In comparison with preschool children without sideropenia, preschool children with iron deficiency with or without anemia are less likely to pay attention to relevant cues in problem solving situations.

Administration, Oral↗