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Biomedical subjects

S M Imong

Publications and source records attributed to S M Imong.

14 recordsLinked to original sources
PubMed1996

The use of omeprazole for resistant oesophagitis in children.

Following failure of conventional therapy for reflux oesophagitis, 15 children were treated with omeprazole 20 mg daily for a period of up to three months initially. Treatment resulted in a marked symptomatic improvement as measured by incidence of pain, vomiting, dysphagia and haematemesis. Four children failed treatment and required fundoplication. No complications from the use of omeprazole were recorded and some children have continued long-term treatment.

Adolescent↗
PubMed1995

Maternal behaviour and socio-economic influences on the bacterial content of infant weaning foods in rural northern Thailand.

The bacterial contamination of infant weaning foods was examined in the context of a longitudinal study of lactation and infant growth, the Chiang Mai Lactation Study. Sixty-two mother-infant pairs were selected by random sampling from a rural area outside the city of Chiang Mai and studied for 48 hours in their homes on six occasions over the first year of life. Data on food hygiene practices and maternal factors were related to the total bacterial count per gram and coliform content of weaning foods. Bottle feeding, premastication, and mashing were significantly related to an increased bacterial content of weaning foods, while boiling foods to make soups, preparing in and feeding from a banana leaf, and using boiled water to prepare foods all reduced their bacterial content. Storage also increased the bacterial contamination in foods and foods were more highly contaminated in the rainy season. Maternal age and education were also related to some feeding practices. By promoting the feeding of traditional, but less contaminated weaning foods, an intervention is put forward which would aim to reduce weaning food contamination and thereby reduce incidence of diarrhoea in this area of Northern Thailand.

Adult↗
PubMed1992

Weaning practices and breast-feeding duration in Northern Thailand.

Current infant feeding guidelines recommend exclusive breast-feeding until the infant is about 4 months old to reduce the risks of early termination of breast-feeding, undernutrition and infection. In many societies, however, supplementary foods are given well before 4 months of age. The present paper describes weaning practices, factors associated with early supplementation and the effects of supplementation on duration of breast-feeding in a random sample of sixty northern Thai breast-fed infants studied prospectively from birth to 2 years of age. Composition of supplementary foods, energy and protein intake from supplements and changes in the supplementary diet with increasing infant age are also described. Rice-based foods were given from soon after birth; 81% of the sample had received supplements by 6 weeks of age. Early supplementary feeding was significantly associated with rural residence, large household size, maternal employment in agriculture and maternal age. Girls and infants with lower birth weights tended to be supplemented earlier. Despite early feeding of supplements, breast-feeding was prolonged, with median duration of 12 months. Early introduction of supplements and quantity of supplements consumed in the first 3 months were not associated with duration of breast-feeding. However, mothers who gave infant formula as the first supplementary food stopped breast-feeding slightly earlier, as did younger mothers living in households with more children.

Breast Feeding↗
PubMed1991

Successful sustained lactation following postpartum tubal ligation.

This study was undertaken to see whether tubal ligation performed within days postpartum, and associated with a delay in the initiation of breastfeeding, exerts a disruptive influence on successfully establishing lactation among the rural population of northern Thailand. Lactational performance of 12 rural northern Thai mothers was not affected by the delay in reunion of mothers with their babies as a result of postpartum tubal sterilization procedure when compared with a group of 8 other healthy mothers and babies. The volume of breast milk transferred, frequency of breastfeeding and the total feeding time spent on the breast were similar on days 15, 45, 90, 180 and 360 postpartum. This finding suggests that the pattern of intense breastfeeding activity as practiced by this group of mothers has a stronger influence on prolonged and successful lactation than early contact in the immediate postpartum period.

Adult↗
PubMed1989

Relationships between nursing patterns, supplementary food intake and breast-milk intake in a rural Thai population.

Relationships between nursing patterns, supplementary food intake and breast-milk intake were examined in a group of 52 Thai babies under 1 year of age. All data were collected over two consecutive days, 24 h/day. Total sucking time (min/day) and supplementary food intake (kcal/day) were significant predictors of breast-milk intake after allowing for the age of the baby: R-squared is 0.32 for sucking time and 0.39 for supplementary food intake. The two variables were themselves correlated (r is -0.47). The number of breastfeeds per day and their mean duration was determined for each case, counting each episode of attachment to the breast as a separate feed. Number and mean duration of breastfeeds were then evaluated as predictor variables. The duration of feeds had no predictive power. Number of feeds was linearly related to milk intake and combined with age was as good a predictor of milk intake as total sucking time (with R-squared 0.34). These results suggest that a simple count of breastfeeds is as valuable as more complex measures of sucking duration in predicting to breast-milk intake.

Breast Feeding↗
PubMed1989

The bacterial content of infant weaning foods and water in rural northern Thailand.

Samples of weaning food and supplementary water were collected for analysis of bacterial content from among a random sample of 65 infants under the age of 1 year living in a rural area of northern Thailand. Using geometric means, mean total bacterial count of infant's drinking water was 351 organisms/ml (95 per cent CIs 170-770), and the most probable number (MPN) of faecal coliforms/ml was 47 (95 per cent CIs 19-78). Mean total bacterial count of weaning foods was 38,000 (95 per cent CIs 25,000-59,000) organisms/g with 10 per cent recording counts greater than 1,000,000 organisms/g. Bacterial counts were similar to those reported in weaning food and water in other developing countries, and were above internationally recommended 'safe' levels. The bacterial count of water was not affected by boiling, due to poor cleaning and frequent re-use of utensils. Weaning foods were contaminated during preparation, in part through premastication and also via mode of cleaning of utensils.

Colony Count, Microbial↗
PubMed1989

Predictors of breast milk intake in rural northern Thailand.

A random sample of 52 mothers and infants from a rural area of Northern Thailand were studied in their homes for 48 h. Infants were breast fed on demand. Daytime feeds were test weighed with electronic averaging balances and nighttime intake estimated using a new method, Indirect Test Weighing. All feeds, both day and night, were timed to the nearest minute. Other variables measured by direct observation were infant weight, and supplementary food and water intake. Mean 24-h breast milk intake was 579 g (range 78-1,011 g) with a median between day coefficient of variation of 8.8%. The proportion of 24-h breast milk intake consumed at night ranged from 8 to 91%, and increased with increasing infant age. Significant positive associations were found between breast milk intake, and sucking time and infant weight. There were significant negative associations between breast milk intake and age, and supplementary food and water intake.

Body Weight↗
PubMed1988

Circadian variation in fat concentration of breast-milk in a rural northern Thai population.

1. Twenty-five northern Thai mothers, breast-feeding their infants on demand, were studied in their homes for 24 h. All breast-feeds were test-weighed and pre- and post-feed expressed breast-milk samples (0.5 ml) taken at each feed. 2. The fat concentration of milk taken during a feed showed significant circadian variation, with maximum values between 16.00 and 20.00 hours and minimum values between 04.00 and 08.00 hours. Fat concentration at the start and at the end of a feed also varied significantly over 24 h. 3. Multiple regression analysis showed that the most important predictor of fat concentration at a feed was the length of time elapsed since the previous feed--the longer this interval, the lower the subsequent fat concentration. Other significant predictors were the fat concentration at the end of the previous feed, and the milk intake at the previous and at the current feed. 4. Fat concentration declined between feeds in proportion to the length of time between feeds, but the decline was less between sleep feeds than between waking feeds. This would appear to be a reflection of the lower post-feed fat concentration and higher pre-feed fat concentration of sleep feeds compared with waking feeds, when other variables relating to feeding pattern are taken into account. 5. The larger the milk intake at a feed, the greater was the increase in fat concentration from the start to the end of the feed. The change in fat concentration was less in feeds taking place during the sleep period than in daytime feeds.

Adult↗
PubMed1988

Estimation of 24 h breast-milk fat concentration and fat intake in rural northern Thailand.

1. The present study assesses the accuracy with which mean 24 h breast-milk composition can be estimated if milk samples can only be collected during the daytime. 2. Twenty-five northern Thai mothers, feeding their infants on demand, were studied in their homes for 24 h. All feeds were test-weighed and 0.5 ml pre- and post-feed expressed milk samples taken at each feed. 3. If daytime sampling was restricted to two breast-feeds, it was found that the best estimate of 24 h fat concentration was given by two randomly chosen daytime feeds, predicting 24 h fat concentration with 95% confidence limits of +/- 7.0 g/l (equivalent to 21% of mean 24 h fat concentration). 4. Alternative sampling methods using the mean fat concentration of the feed after 08.00 hours and after 18.00 hours, or the first two feeds after 12.00 hours, predicted fat concentration with 95% confidence limits of +/- 9.7 g/l and +/- 8.9 g/l (28 and 26% of mean 24 h fat concentration) respectively. 5. If well-tolerated by mothers, it would be preferable to sample all daytime feeds, since this reduces the 95% confidence limits to +/- 3.3 g/l, equivalent to 10% of the mean 24 h fat concentration.

Adult↗
PubMed1988

Infant weight in relation to nutritional intake and morbidity in northern Thailand.

A cross-sectional study of 58 infants (age range 2-53 weeks) was carried out in a rural area of northern Thailand. Total dietary intake (energy and protein from breastmilk and supplementary food) was measured directly during continuous observation over 48 h of randomly selected study subjects in their homes. Associations between infant weight and total energy intake, total protein intake and morbidity were analysed by multiple regression analysis. Up to 6 months of age, heavier infants had larger energy intakes, when age and birthweight were taken into account. In the 7-12 months age group, heavier infants consumed more protein and had fewer respiratory infections. Weaned infants older than 6 months were significantly heavier and consumed more protein than infants of similar age who were still receiving breastmilk. The lower protein intakes of the latter infants were due to the low protein concentration of breastmilk compared with supplementary food.

Body Weight↗
PubMed1987

The automatic sampling shield: a device for sampling suckled breast milk.

The automatic sampling shield uses the negative pressure exerted by the breast-feeding baby during sucking to withdraw a series of small samples from the milk stream. Shield performance was studied at four feeds for each of 13 babies. Acceptance of the shield was good (96% of feeds) and samples were obtained in 88% of feeds. Sample weight was large enough for micro-biochemical analysis of composition (median weight 1.3 g), without depriving the baby of important amounts of milk (median percentage of weight of milk intake was 4.3% and sample weight was less than 5 g in all cases). The shield should sample a constant proportion throughout the feed, in order to obtain a sample that is representative of the infant's nutrient intake. Fractional test-weighing of feeds showed a tendency for a larger proportion of the feed to be collected at slower flow rates. Modelling on the basis of the observed flow profiles in conjunction with a theoretical fat concentration profile showed that the observed 'disproportionality' would have over-estimated fat intake by a mean of 2.6% per feed (S.D.9.1 range -18.9% to + 16.9%). Using the shield in random sequence at two out of the first four feeds after 0800 h, showed that an infant's mean milk intake with the shield was on average 32% less than on control feeds. Allowing for possible compensation by the infant when control feeds followed low shield intakes, mean milk intakes with the shield were 17% smaller than without the shield.

Breast Feeding↗
PubMed1987

Indirect test weighing: a non-intrusive technique for estimating night-time breast milk intake.

Indirect test weighing (ITW), for estimating night-time breast milk intake, is based on separate weighings of mother and infant before and after night-time sleep. Weight changes due to the exchange of milk overnight are reciprocal, so that if all other sources of weight change (eg, urine loss, supplementary fluid intake) are either controlled or measured, the difference between the mother's overnight weight loss and her infant's overnight weight gain represents their combined net evaporative water loss (EWL). The proportion of the combined EWL due to the infant is partitioned out as a function of the relative metabolic body sizes (kWt0.73) of mother and infant, and added to the infant's net overnight weight gain to provide an estimate of night-time breast milk intake. Validation studies, conducted in Northern Thailand, in which ITW was compared with direct test weighing (DTW) at each night feed, are reported for 13 infants over 3 nights at 5 d of age, and for 19 infants over 2 nights at 6 weeks of age or more. The regression equation for estimated milk intake against measured milk intake across all ages was y = 0.988x + 2.75, r = 0.927, n = 69 with 95 per cent prediction intervals of +/- 36 g for a range of intakes of 0-250 g. Rigorous control of data collection and taking account of the infant's age suggest that the prediction intervals for individual estimates can be improved to +/- 18 g at 5 d, and +/- 27 g at 6 weeks and over. Theoretical aspects of the relationship of EWL to body weight are discussed with a view to optimizing the accuracy of the technique.

Body Water↗
PubMedDate not supplied

Indirect test weighing: a new method for measuring overnight breast milk intakes in the field.

Indirect test weighing (ITW), a new method for measuring nighttime breast milk intake, is based on separate weighings of the mother and infant at the start and end of the nighttime sleep period. All other incidental weight changes overnight are measured, so that the corrected infant's overnight weight gain and the mother's overnight weight loss are then accounted for by breast milk transfer and evaporative water loss (EWL) alone. The combined EWL is partitioned between mother and infant on the basis of metabolic body size (body weight raised to the power of 0.73). The infant's EWL is added onto the corrected overnight weight gain to give nighttime milk intake. A field validation study on 24 northern Thai infants, conducted in the subject's homes, in which ITW was compared with nighttime direct test weighing (DTW) on the same night, gives 95% confidence intervals for the method of +/- 39 g for a range of milk intakes of 77-344 g. Confidence intervals for estimates using feeding patterns alone, or multiplying 12 h intakes by a constant, range from +/- 104 to 180 g, indicating that these methods are insufficiently accurate for individual estimates.

Body Weight↗