PubMed · 13813316
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M R CUNNINGHAM. 1960. Face the future.. https://pubmed.ncbi.nlm.nih.gov/13813316/
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Emergence of the deciduous teeth is generally considered to be robust to moderate environmental insults, malnutrition, and disease. Consequently, deciduous tooth emergence has been used to assess growth and development and for age estimation in children. In this paper, we examine the way in which nutritional status and other covariates affect deciduous tooth emergence in a sample of 114 Japanese children born in Tokyo in 1914 and 1924. Parametric survival analysis was used to quantify the effects of nutritional status, breastfeeding behavior, and sex on the hazard of deciduous tooth emergence. Children of poor nutritional status exhibited significantly delayed emergence of all deciduous teeth, with effects that ranged from 14-29% increases in mean emergence times. Children of medium nutritional status exhibited increases in mean emergence times of 5-9% for the canines and lower molars, and 13-17% for the incisors. Partial breastfeeding had no effect on tooth emergence, but children who were not breastfed at all showed delayed emergence of the upper incisors. No significant sex differences in emergence were found. The findings contradict the idea that moderate malnutrition has little effect on deciduous tooth emergence. Furthermore, nutritional differences may account for some of the observed differences among populations in the timing of tooth emergence.
BACKGROUND: In the Netherlands, the initiation rate of breast-feeding (BF) was 80% in 2002, but only 35% of the mothers continued to breast-feed for 3 months. This study examined the effectiveness of a breast-feeding promotion program to increase the continuation of breast-feeding. METHODS: A cluster-randomized intervention trial was used. Ten child health care centers in three regions of the home health care were randomly allocated to the program or usual care. Elements in the program were health counseling, measures to enhance cooperation, early signaling of breast-feeding problems and continuity of care, and lactation consultancy. Pregnant mothers who applied for home health care in the intervention or usual care regions were enrolled and were followed up from pregnancy until 6 months postpartum (n = 683). The primary outcome measure was the continuation of breast-feeding until at least 3 months. RESULTS: The 3-month breast-feeding rate was 32% in the intervention and 38% in the control groups (OR = 0.79, 95% CI = 0.58-1.08). CONCLUSION: The program was not effective. We discuss possible explanations from the design and execution of the trial and give some points for improvement of our program, such as the categories of caregivers involved and the number and duration of contacts after parturition.
OBJECTIVE: Firstly, to compare food, and macronutrient intake as obtained from a single 24-h recall and a frequency questionnaire (FQ) covering a 14-day period in breast-fed infants aged 4 months of age. Secondly, nonbreast milk water intake (NB-WI, ml/day) was used as an estimation of energy and macronutrient intake, and NB-WI as calculated from FQ (NB-WIFQ) was compared with NB-WI as measured using the dose-to-the-mother 2H2O turnover method (NB-WIDO) covering the same 14-day period. DESIGN: Cross-sectional. SETTING: Community-based study in urban Pelotas, Southern Brazil. SUBJECTS: In all, 67 breast-fed infants aged 4 months of age recruited at birth. MAIN OUTCOME MEASURES: (1) Bias in estimations of food and macronutrient intake of the 24-h recall relative to FQ; (2) Bias in NB-WIFQ relative to NB-WIDO. RESULTS: In infants with an energy intakeFQ from complementary foods above the 50th percentile (1.03 kcal/day), estimations of water, tea, juice, and milk intake were not different between 24-h recall and FQ (n=34). Nor were estimations of energy and macronutrient intake (protein, fat, and carbohydrates) different between the two methods, and bias was nonsignificant. NB-WIDO was divided into quintiles and compared with NB-WI(FQ). The first two quintiles included negative values for NB-WIDO as a result of random errors of the 2H2O turnover method. Subsequently, bias of NB-WIFQ relative to NB-WIDO was positive in the 1st (P=0.001) and 2nd quintile (P=0.638), respectively. Bias was negative for the three highest quintiles, and within this group, underestimation by FQ was significant for the 3rd and 4th quintile (-57.4%, P=0.019; -43.7%, P=0.019). CONCLUSIONS: Firstly, at the age of 4 months FQ covering a 14-day period provides similar results on food and macronutrient intake as compared to a single 24-h recall for estimations of complementary liquid foods. Secondly, NB-WIFQ appeared to be a good proxy for macronutrient and energy intake in breast-fed infants receiving other liquids. In infants with NB-WIDO>0, the method provides a useful tool for the detection of bias from FQ, and results indicate an underestimation from FQ relative to the 2H2O turnover method. This exercise could be applied wherever the 2H2O turnover method is used in combination with conventional food consumption techniques for measuring intake of nonbreast milk liquids of breast-fed infants in whom solid foods have not yet been introduced. It would help interpreting estimations of macronutrient intake, and could be relevant to studies of dietary intake of infants and its relationship with growth and health.