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Biomedical subjects

K M Rasmussen

Publications and source records attributed to K M Rasmussen.

At least 37 records · Page 2Linked to original sources
PubMed1997

Documentation of second-by-second breastfeeding behaviors using a novel method.

The specific way nursing patterns influence the duration of postpartum amenorrhea is unknown. This may result from the shortcomings of available methods: the daily log and recall. We tested these against a novel method, an event monitor (EM), consisting of a wrist-worn stopwatch that stores events. Exclusively breastfeeding women (n = 11) were assigned randomly to use each of the three methods twice during a 2-week period surrounding Weeks 4, 8, and 12 postpartum. More nursing episodes were recorded with the EM than log during Week 4 (p < 0.03) and Week 8 (p < 0.02). EM captured more episodes than recall during all study periods (p < 0.004). The EM was considered as acceptable and accurate to mothers as the other methods and, therefore, is a useful option for documenting breastfeeding patterns.

Adult↗
PubMed1997

[A combined methodology for understanding the duration of breast feeding the poor neighborhoods of Managua, Nicaragua].

This study examined the relationship of several maternal variables to the duration of exclusive breast-feeding and the total duration of breast-feeding, along with attitudes, perceptions, and beliefs about breast-feeding among women living in poor neighborhoods of Managua, Nicaragua. The field work was carried out in December 1992 and January 1993 using qualitative and quantitative methods. A structured questionnaire was administered in interviews with 556 mothers of children under 12 months of age, and meetings of four directed discussion groups were held, in which a total of 20 women participated. At one week of age, almost all the children of the mothers who were surveyed had been breast-fed, but only 45% had been exclusively breast-fed. At 12 weeks old, 30% were already completely weaned. The discussion groups revealed the coexistence of positive opinions about both breast-feeding and bottle-feeding. However, exclusive breast-feeding was considered harmful for the mother, and breast milk was not thought to be sufficient nourishment for the child. Previous experience was strongly related to the duration of exclusive breast-feeding and to total breast-feeding duration. Attitudes, social support, and work situation were important factors influencing the total length of time women breast-fed a child. In general, the results obtained through the interviews and in the discussion groups were in agreement and showed that the elements needed to promote exclusive breast-feeding were social support, a favorable community environment, and policies that dealt with problems faced by working mothers. The complementary research methods were useful for obtaining information about the relative importance of different factors that determine the duration of breast-feeding and for understanding that practice in greater depth from the mother's point of view.

Adolescent↗
PubMed1996

Screening for nutrition interventions: the risk or the differential-benefit approach?

The risk approach has been promoted to improve screening for nutrition interventions on the premise that indicators of risk also predict greater response to interventions. This study tested whether the determinants of the risk of poor growth (eg, low length-for-age) at 36 mo of age were the same as the determinants of differential benefit from food supplementation. The sample included 460 Guatemalan children who were exposed to either a high-energy, high-protein drink (atole) or a low-energy, no-protein drink (fresco) during their first 36 mo of life [INCAP (Institute of Nutrition of Central America and Panama) supplementation trial]. Low maternal stature, poor socioeconomic status, inadequate home diet, high diarrhea rates, and low anthropometry scores at 3 or 6 mo were all determinants of the risk of poor growth. Only indicators of child's thinness at 3 or 6 mo of age (low weight-for-age, weight-for-length, or midupper arm circumference) were determinants of differential benefit from supplementation. Thus, the development of screening indicators should be based on analyses of the predictors of differential benefit, not on conventional risk-factor analysis.

Anthropometry↗
PubMed1996

Adherence to iron supplementation during pregnancy in Tanzania: determinants and hematologic consequences.

Limited adherence to iron supplementation is thought to be a major reason for the low effectiveness of anemia-prevention programs. In rural Tanzania, women at 21-26 wk of gestation were randomly given either 120 mg of a conventional (Con) iron supplement or 50 mg of a gastric-delivery-system (GDS) iron supplement for 12 wk. Adherence was assessed by using a pill bottle equipped with an electronic counting device. Adherence in the GDS group was 61% compared with 42% for the Con group. In both groups, women experiencing side effects had about one-third lower adherence. Fewer side effects were observed in the GDS group. In a subgroup of women with a low initial hemoglobin concentration (< or = 120 g/L), the response to the iron supplements suggested that both of the applied doses were unnecessarily high for adequate hematologic response in a population with a marginal hemoglobin concentration. The GDS group appeared to require a dose one-fourth as high as that of the Con group for an equal effect on improving hemoglobin to normal concentrations.

Anemia↗
PubMed1996

Naloxone administration does not relieve the inhibition of gonadotropin release in food-restricted, lactating rats.

Lactational anovulation is an important factor in determining birth spacing in women living in developing countries. Therefore, a more comprehensive understanding of the mechanisms involved in the relationships among lactation, nutrition and ovulation is important. This study was designed using the food-restricted, lactating rat to examine whether endogenous opioids might be involved in depressing gonadotropin release. Females were mated after 65 d of age and, beginning on d 42 of life, offered food in unrestricted amounts (control) or were food restricted to 50% of what the controls consumed. On d 15 of lactation, dams were injected with either naloxone hydrochloride (3 mg/kg body weight) or saline and killed 0, 15, 30 or 60 min later. Plasma was analyzed for luteinizing hormone, follicle-stimulating hormone and prolactin. Food restriction decreased plasma concentrations of luteinizing hormone and follicle-stimulating hormone (P < 0.005). Naloxone administration marginally influenced follicle stimulating hormone (P < 0.1), but not luteinizing hormone concentration regardless of diet group. The interaction among diet group, drug group and time of killing was significant for plasma prolactin concentration (P < 0.05). Food restriction lowered prolactin concentrations, but this effect was diminished with increasing time after injection of naloxone. Furthermore, the magnitude of the effect of food restriction was lessened and even reversed with treatment of naloxone. These results indicate that endogenous opioids are not the primary mechanism suppressing luteinizing hormone release in food-restricted lactating rats.

Animals↗
PubMed1995

Nutritional status and behavior during lactation.

Effects of chronic maternal food restriction and time of day on maternal and pup behaviors were examined in ovariectomized Sprague-Dawley rats (n = 26). Dams were fed ad lib (AL) or were restricted to 85% (85 AL) or 70% (70 AL) of ad lib intake. Dams and their 5-pup litters were observed for 45 min at night on days 9, 14, and 19 of lactation and during the day on day 14. A novel behavioral instrument was used to observe maternal and pup behaviors. At night, food-restricted animals engaged in more nursing behaviors than AL animals. Differential pup stimuli may account for this difference. AL animals engaged in more nursing behaviors during the day than night, whereas 70 AL animals demonstrated the opposite diurnal pattern. Time of feeding may explain this difference. On the other hand, 85 AL animals behaved similarly during the day and at night. Therefore, alterations in circadian behavior patterns are less pronounced in rats mildly restricted (85 AL) than in rats more food restricted (70 AL).

Animals↗
PubMed1995

Food restriction, gonadotropins, and behavior in the lactating rat.

This study sought to quantify effects of undernutrition on behaviors and to relate these to gonadotropin and prolactin concentrations in the lactating dam. Dams were studied in a 2 x 3 factorial design with litter size and food intake as the two factors. Behavioral data were collected from each dam and her litter on day 9, day 14, and day 19 of lactation, and maternal blood samples collected. Plasma was analyzed for luteinizing hormone, follicle stimulating hormone and prolactin. On day 15 of lactation, percent time nursing, number of pups actively nursing, total number of pups nursing and dam location acted as mediating factors of the effect of diet group on plasma luteinizing hormone concentration. No such relationships were seen for plasma follicle stimulating hormone, and only nest condition score appeared to be a mediator for plasma prolactin concentration. In conclusion, this analysis suggests that food restriction indirectly influences plasma concentration of luteinizing hormone, but not follicle stimulating hormone, by changing maternal and pup behaviors. The relationship among diet, behavior and circulating prolactin was less clear.

Animals↗
PubMed1995

Pre- and postweaning food restrictions interact to determine reproductive success and milk volume in rats.

This study was designed to determine if nutrient availability during gestation and early life modifies the effects of subsequent dietary intake on reproductive and lactation performance. Rat pups, whose mothers had been allowed free access to food or were food-restricted to 50% of ad libitum consumption were assigned to free access or food restricted groups after weaning, creating 4 groups (pre- and postweaning diet). Pre- and postweaning diets interacted significantly to influence age at conception, number of pups born, and milk yield on d 14 of lactation. Early undernutrition deterred conception in dams later allowed free access to food and resulted in fewer pups born to dams later allowed free access to food, but not those in the food-restricted group. By d 15 of lactation, only dietary treatment after weaning influenced litter weight. Milk yield per gram dam weight was not impaired in the food restricted-ad libitum group but was lowered in dams in the ad libitum-food restricted group. Milk yield per gram litter weight was not impaired in ad libitum-food restricted dams but was reduced in food restricted-ad libitum dams. These results extend to the preweaning period our previous finding that past or current food restriction impairs reproductive success and decreases milk yield in rats.

Animals↗
PubMed1994

Maternal energy depletion is buffered among malnourished women in Punjab, Pakistan.

Women's nutritional status is believed to deteriorate with increasing reproductive stress (so-called maternal depletion). To evaluate this phenomenon, a new theoretical framework has been suggested that incorporates the concepts of a full reproductive cycle, relative lengths of potential depletion and repletion phases, and initial plane of nutrition. We developed the corresponding statistical model and tested predictions provided by the framework about the effect of reproductive pattern on maternal overall weight change (deltaW) during one reproductive cycle. Seventy-six Pakistani women were classified as well-nourished, marginally nourished or malnourished. The relationship between deltaW and length of all phases of the reproductive cycle, each of which is characterized by varying degrees of reproductive stress, was evaluated with multiple regression analysis. Across the reproductive cycle, well-nourished women had a slight weight increase. Surprisingly, malnourished women gained weight in contrast to marginally nourished women. Also surprisingly, for the latter two groups, periods of moderate reproductive stress were associated with weight loss but periods of high reproductive stress were associated with weight gain. Mechanisms such as efficiency and nutrient partitioning are discussed.

Adult↗
PubMed1993

Nutritional status, suckling behavior, and prolactin release during lactation.

This experiment was conducted to determine whether suckling-induced prolactin (PRL) values in chronically food-restricted lactating rats resulted from the inability of their litters to suckle vigorously. Rats were randomly assigned to be fed ad lib (AL) or to be chronically restricted (CR) to 50% of AL before and during pregnancy and lactation. Rats nursed their own litter (own) or a litter of the opposite dietary treatment group (other) for 90-min periods at early or peak lactation. Blood was collected regularly through a catheter implanted several days earlier. Suckling contributed to differences in PRL between AL and CR dams in early lactation as demonstrated by an interaction between dietary treatment and type of litter. However, tests of AL own vs. AL other and CR own vs. CR other were not significant. This is probably because the inattentive behavior of CR dams attenuated the PRL response in this group. At peak lactation, PRL values were related to recovery time from catheter implantation; therefore, determinants of PRL release change over the course of lactation.

Animals↗
PubMed1993

Conjunctival impression cytology as an indicator of vitamin A status in lactating Indonesian women.

Conjunctival impression cytology (CIC) has been used to assess the vitamin A status of children but not women. We used CIC in a randomized controlled trial of high-dose vitamin A supplementation in Indonesian women. We report its association with biochemical indicators and evaluate its usefulness for several assessment functions, using two definitions for abnormal CIC. Serum retinol concentrations of all women and milk vitamin A concentrations of unsupplemented women decreased with worsening CIC category. CIC indicated risk of low milk vitamin A and low infant serum retinol with low sensitivity and high specificity. CIC did not identify women who benefited from supplementation. The usefulness of CIC to measure response to supplementation was limited by the low prevalence of abnormal status in these women. CIC may be a useful indicator of vitamin A deficiency in women or their breast-fed infants, or to measure response to supplementation, when a more sensitive cutoff point for abnormal status is used.

Conjunctiva↗
PubMed1993

Effects of maternal nutritional status and maternal energy supplementation on length of postpartum amenorrhea among Guatemalan women.

To investigate the extent to which better maternal nutrition leads to reduction in length of postpartum amenorrhea, multivariate-logistic and linear-regression analyses were applied to data on 339 mother-infant pairs from the longitudinal Guatemalan Four Village Study, 1969-1977. Maternal triceps skinfold thickness was negatively associated with length of amenorrhea when infant supplementation (a proxy for reduced suckling) was accounted for. However, its effect was small: amenorrhea was only 0.5 mo shorter among women at the 75th percentile than among those at the 25th, equivalent to less than even one additional child during the women's reproductive years. Maternal supplementation was not associated with length of amenorrhea when infant supplementation was controlled. This is in contrast to previous studies in which breast-feeding or infant supplementation was not controlled. These results suggest that infant, not maternal, supplementation influences length of postpartum amenorrhea, and that maternal nutritional status has minimal influence.

Amenorrhea↗
PubMed1993

Evaluation of indicators for use in vitamin A intervention trials targeted at women.

This paper examines the ability of three indicators to detect changes in women's vitamin A status. Serum retinol concentration, milk vitamin A concentration, and milk vitamin A per gram milk fat were used to assess the vitamin A status of mildly deficient Indonesian women before and after supplementation in a randomized intervention trial. Choice of indicator made a fourfold difference in the sample size required to measure a statistically significant change in vitamin A status. Milk vitamin A per gram milk fat was the best indicator of response, milk vitamin A concentration was intermediate, and serum retinol concentration performed most poorly. Serum retinol concentration was equally responsive across the range of vitamin A status in this population. The milk indicators were more responsive among women of lower status than women of higher status. Milk vitamin A is an efficient indicator for monitoring the effects of vitamin A interventions in women.

Adult↗
PubMed1993

High dose vitamin A supplementation of breast-feeding Indonesian mothers: effects on the vitamin A status of mother and infant.

For regions where vitamin A deficiency is common, high dose vitamin A supplementation of lactating mothers is currently recommended, but the effects of this intervention have not been carefully evaluated. We conducted a randomized, double-blind trial in which 153 Indonesian mothers 1-3 wk postpartum received either a capsule containing 312 mumol of vitamin A as retinyl palmitate or a placebo. Mothers' serum retinol concentrations in the vitamin A group tended to be lower than in the placebo group at baseline but higher at 3 mo postpartum (1.39 vs. 1.24 mumol/L, P = 0.03) and 6 mo postpartum (1.23 vs. 1.08 mumol/L, P < 0.01). The milk retinol concentrations of the vitamin A group were higher than those of the placebo group by 0.48 to 1.18 mumol/L at 1-8 mo postpartum (P < 0.05). Among the infants at 6 mo of age, the prevalences of low serum retinol concentration (< 0.52 mumol/L) were 36 and 15% in the placebo and vitamin A groups, respectively (P < 0.005), and the prevalences of low vitamin A stores (assessed by relative dose response) were 23 and 10%, respectively (P < 0.03). High dose vitamin A supplementation of lactating mothers is an efficacious way to improve the vitamin A status of both mother and breast-fed infant.

Adolescent↗
PubMed1992

Changes in plasma thyroid hormone concentrations in chronically food-restricted female rats and their offspring during suckling.

To examine the joint effects of lactation and dietary restriction on thyroid function, we studied chronically food-restricted rat dams at conception and dams and their pups during the nursing period compared with controls that had free access to food. As expected, both dietary restriction [plasma thyroxine and 3,3',5-triiodothyronine (T3) values were lower and reverse T3 (rT3) values were higher in food-restricted than in control rats] and stage of lactation (T3 values decreased in both groups) had independent effects on maternal thyroid function. There also were interactive effects: rT3 values decreased during lactation among the food-restricted dams but remained constant among controls. Maternal dietary restriction also did not have a consistent effect on pup thyroid function during the nursing period: in offspring of food-restricted compared with control dams, plasma thyroxine values were lower only at d 14, T3 values were lower at d 7-21, and rT3 values were higher from birth to d 14. These data demonstrate that dietary restriction and lactation have synergistic negative effects on thyroid status in lactating rats and their pups and that thyroid hormone ontogeny is retarded in the offspring of food-restricted rats. These hormonal effects may contribute to the impaired milk production of food-restricted rats and to altered growth characteristics of their offspring.

Animals↗
PubMed1992

Chronic food restriction amplifies the effect of lactation on the duration of postpartum anestrus in rats.

We studied the effects of food intake and lactation on the duration of postpartum infecundability in rats. Sprague-Dawley rats were given free access to a purified diet (AIN-76A) or a similar diet (modified to contain twice the concentrations of vitamins and minerals) in amounts equal to 50% of that consumed by controls. At -65 d of age, animals were bred. At parturition, dams were allowed to nurse 4-5 pups, or all pups were removed. Thus, four groups were created: lactating control (n = 11), nonlactating control (n = 11), lactating food restricted (n = 8), and nonlactating food restricted (n = 10). Vaginal cytology was observed twice daily for the detection of proestrus, which occurred at 4.5 +/- 0.5 and 6.7 +/- 0.5 d (mean +/- SD) postpartum in nonlactating control and food restricted groups, respectively (P less than 0.005), and at 16.5 +/- 0.5 and 28.8 +/- 0.5 d postpartum in lactating control and food restricted groups, respectively (P less than 0.0001). The interaction between food intake and lactation was significant (P less than 0.0001). These results indicate that maternal food restriction exacerbates the effects of lactation in prolonging postpartum anestrus.

Anestrus↗