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At least 469 records · Page 26Linked to original sources

PubMed2004

A review of feeding interventions for infants with cleft palate.

OBJECTIVE: A literature review was conducted to identify feeding interventions recommended for infants with cleft conditions. Selected articles were critically appraised using an evidence-based practice framework to determine the strength of the evidence underpinning each intervention. DESIGN: Electronic databases were searched for reports of cleft palate feeding interventions. The selected articles were coded as being data driven or not; those containing data were then critically appraised using a recognized evidence hierarchy. Finally, each report was ascribed a level of evidence (from I to IV), depending on the quality of data presented. RESULTS: Fifty-five articles published between 1955 and 2002 were reviewed. There are currently no completed systematic reviews relevant to this body of literature (level I evidence). Two well-designed randomized controlled trials (level II evidence) were found. These were considered to provide the strongest evidence for feeding intervention techniques. These articles described a combination of interventions, including early feeding and nutrition education, as well as assisted feeding methods for infants with isolated cleft conditions. Three examples of level III.3 evidence were also found. Fifty (91%) of 55 articles reviewed were non-data-driven reports of expert opinion (level IV). CONCLUSIONS: A paucity of evidence rated as either moderate or strong prevailed, underscoring the need for ongoing scientific evaluation of feeding interventions used with infants who have cleft palate. A number of factors, including the heterogeneity of samples studied, lack of replication of trials, and small sample sizes, affected the type and strength of evidence underpinning specific feeding interventions.

Cleft Palate↗

PubMed1994

Racial disparities in reported prenatal care advice from health care providers.

OBJECTIVES: The relationship between certain maternal behaviors and adverse pregnancy outcomes has been well documented. One method to alter these behaviors is through the advice of women's health care providers. Advice from providers may be particularly important in minority populations, who have higher rates of infant mortality and prematurity. This study examines racial disparities according to women's self-report of advice received from health care providers during pregnancy in four areas: tobacco use, alcohol consumption, drug use, and breast-feeding. METHODS: Health care providers' advice to 8310 White non-Hispanic and Black women was obtained from the National Maternal and Infant Health Survey. RESULTS: After controlling for sociodemographic, utilization, and medical factors, Black women were more likely to report not receiving advice from their prenatal care providers about smoking cessation and alcohol use. The difference between Blacks and Whites also approached significance for breast-feeding. No overall difference was noted in advice regarding cessation of drug use, although there was a significant interaction between race and marital status. CONCLUSIONS: These data suggest that Black women may be at greater risk for not receiving information that could reduce their chances of having an adverse pregnancy outcome.

Adolescent↗

PubMed1988

The effect of tropical ambient temperature on growth and metabolism in pigs.

Three experiments involving 34 individually fed pigs were conducted in Guadeloupe (16 degrees Lat. N., 61 degrees Long. W.) to determine the effects of environmental temperature (tropical, 22 to 32 degrees C, vs thermoneutral, 17 to 21 degrees C) and feeding method (restricted vs ad libitum) on performance, carcass characteristics and physiological and metabolic responses of pigs at three weight ranges (8 to 25, 29 to 50 and 54 to 79 kg live weight). Compared with the control environment, the tropical climate increased rectal temperature and respiratory rate but depressed growth rate and efficiency of feed utilization. In addition, in the heaviest weight group, feed intake was reduced and body fat increased. Changes in metabolic status, such as increased concentrations of plasma free fatty acids, triglycerides, cholesterol and adipose tissue lipoprotein lipase activity were observed in pigs housed in the tropical environment. Moreover, in these pigs, there was a decreased plasma concentration of thyroid hormones (triiodothyronine and thyroxine). These results indicate that tropical ambient temperature markedly affects the metabolism of pigs and, therefore, probably influences their nutritional requirements.

Animals↗

PubMed2006

[Dietary habits and early childhood caries intensity among young children].

The aim of this study was to evaluate the influence of a diet and the feeding method on caries intensity among children aged 36-48 months. Dental examination was carried out in 255 children and their mothers were asked about child's dietary habits. The population checked was divided into three groups: with dmf = 0, dmf 1-3 and dmf > or = 4. Statistically significant correlation between caries intensity and bottle feeding during sleep and frequency of eating cariogenic food were shown. Parents of young children should be educated about the influence of dietary habits on dental condition.

Catchment Area, Health↗

PubMed1979

[Nutritive antibiotic additives in animal feeding stuffs--a further form of environmental pollution (author's transl)].

Feeding domestic animals with mycelia, a by-product of vitamine production, gave rise to the side effect of markedly improved utilization of the fodder. This effect is not due to the vitamine and protein content but to the antibiotic content of this waste product. The nutritive effect was brought about by a larger number of different antibiotics in concentrations which were considerably lower than the therapeutically required doses. Therefore we speak, in this connection, of a nutritive addition of antibiotics to animal fodder. Since at the time of introducing this feeding method only the mutational resistance to antibiotics of pathogens was known and since the nutritive dosaging cannot select such therapeutically relevant degrees of resistance of the germs, no importance was attached to the development of the resistance and its effect on human medicine. However, during the last decade it has been found that the feeding of antibiotics is indeed capable of selecting the plasmidic resistance to antibiotics of the gram-negative intestinal bacteria in the faeces of the animals. For pigs, calves and hens--to quote only the most important animals--now contain a coliflora almost completely studded with R-factors. Owing to the transmissibility of the plasmids and the epidemiologically short path from animal to man, dangers emerge for the human medicine from this nutritive selection. Therefore the use of all antibiotics which select resistance plasmids, should be avoided in animal feed stuffs. It would be best, if antibiotics used in human medicine were not used in veterinary practice.

Animal Feed↗

PubMed1990

The need for action.

Nutrition workers speculated about why poor mothers should decide to bottle feed, when their community in the past had apparently always breastfed effortlessly and successfully. Surveys cross-tabulated feeding methods against socioeconomic variables, but it was difficult to make use of the results. Few thought that there was anything we needed to learn about HOW to make breastfeeding succeed. There was also a tacit assumption that if you had the resources--for example if you were yourself an employed health worker--you could bottle feed safely, so there was no need to worry.

Bottle Feeding↗

PubMed1990

Developing a dysphagia program in an acute care hospital: a needs assessment.

A needs assessment for a hospital-based dysphagia program was conducted to determine incidence, management procedures, and outcome for stroke patients with swallowing disorders. Using a chart review of 225 patients, it was found that 28% had documented evidence of dysphagia. When dysphagia co-occurred with stroke, significantly more functional problems and medical complications were reported, as well as increased need for dietary modifications and alternative feeding methods. The dysphagic patients were more often aphasic and dysarthric and less able to communicate. Mental status was more likely to be reduced and the need for staff supervision during mealtime was increased. Dysphagic patients had significantly longer hospital stays, thus increasing the cost of their care. At discharge, almost half of them continued to need feeding modifications, which may have delayed rehabilitation or transfer to facilities with other levels of care. The dysphagia group clearly displayed a wide range of clinical symptoms that would alert staff to their risk for medical complications because of swallowing problems. We believe that this needs assessment clearly showed that a multidisciplinary dysphagia management program has the potential to enhance patient care while decreasing the cost of health care delivery for the hospital.

Aged↗

PubMed1997

Can preterm twins breast feed successfully?

AIM: To compare the success of singleton and twin preterm infants in establishing and maintaining breast feeding, and to evaluate the effectiveness of current programmes to promote breast feeding. METHODS: All infants less than 37 weeks gestation discharged in one month from the special care baby unit at National Womens Hospital were studied. Data on the infants and their in hospital course was recorded from the neonatal records. The mothers were contacted by telephone 3 to 4 months after discharge, to elicit the subsequent breast feeding rates. RESULTS: Thirty of 33 preterm infants (29 to 36 weeks gestation) were breast fed at discharge from hospital: 93% of singletons, and 89% of twins. The twins were older and heavier at discharge (p < 0.004) due to their longer hospital stays (28.4 vs 16.3 days, p < 0.05). All but 2 infants progressed to exclusive breast feeding. There was a similar rate of decline in the rates of breast feeding in singletons and twins to 68% at 8-12 weeks and 49% at 12-16 weeks after birth. CONCLUSIONS: Preterm twins can breast feed as successfully as preterm singleton infants; as with sufficient assistance and encouragement, their rates of breast feeding were comparable to those of term infants. Although the resources of this hospital do not allow preterm infants to become fully breast fed before discharge, the current programme at National Womens Hospital is effective in establishing successful breast feeding in these high risk infants.

Breast Feeding↗

PubMed2004

[Foremilk and hindmilk retinol levels].

OBJECTIVE: To determine retinol levels in breast milk at the beginning and at the end of a feeding. METHODS: In 2003, 30 breastfeeding women receiving care at the Januário Cicco Maternity School, in the city of Natal, Rio Grande do Norte, Brazil, were interviewed between 24 hours and 15 days after delivery. A four mL sample of breast milk was expressed manually (2 mL at the beginning and 2 mL at the end of the feeding) in the afternoon, two hours after the preceding feeding. Retinol levels were determined by high performance liquid chromatography. Student's t test was used for statistical analysis. RESULTS: The mean retinol concentrations in the breast milk samples collected at the beginning and at the end of the same feeding were 69.3 +/- 41.4 microg/100 mL and 111.6 +/- 79.2 microg/100 mL, respectively; the mean concentrations were statistically different (P = 0.012). CONCLUSION: Our results suggest that hindmilk provides a higher intake of vitamin A. Therefore, it is important to guide mothers to not limit the baby's time at the breast and to avoid expressing only foremilk. In addition, it is important to standardize the time of breast milk collection in order to allow comparisons between the results of different studies on this topic.

Female↗

PubMed2004

A preliminary study on the use of experiential learning to support women's choices about infant feeding.

OBJECTIVE: To assess the impact of experiential learning methodologies in primiparous women on their choice and maintenance of an infant feeding method. STUDY DESIGN: A prospective controlled study into experiential learning methods applied to patients with four months' follow up. Seventy-three primiparous women attending the antenatal clinic at the West Suffolk Hospital for their 32 weeks check were allocated to two groups on the basis of date of attendance. Multiple pregnancy and serious illness were excluded. Thirty-three women attended a two hour seminar on breast feeding using experiential techniques. Forty had routine antenatal care and acted as controls. Breast feeding rates of the two groups were recorded at various stages. Assessment also included comments from questionnaires. RESULTS: The two groups did not differ significantly in the number of women proposing to breast feed their infants (Z = -0.0490, P = 0.9609) nor in the numbers of women breast feeding on day one ( Z = -0.6203, P = 0.5350). There were proportionally more women breast feeding their infants at two weeks ( Z = -1.4944, P = 0.1351) in the subject group, but this was not statistically significant. However, the difference at four months was significant, ( Z = -2.5784, P = 0.0099), more than double the percentage of controls maintaining some breast feeding to four months in the subject group. CONCLUSIONS: Experiential learning was associated with increased rates of prolonged breast feeding, possibly due to increased patient confidence in their choice. This learning approach could be applied to other areas of patient health education.

Breast Feeding↗

PubMed2002

Effects of feeding on albumin synthesis in hypoalbuminemic hemodialysis patients.

BACKGROUND: Hypoalbuminemia is a powerful predictor of morbidity and mortality in hemodialysis (HD) patients and results from a reduction in albumin synthesis. It is not known if this is associated with any impairment of the normal response to feeding. METHODS: Protein turnover and albumin synthesis were measured in the fasting and fed state using a primed constant infusion of L-[1-(13)C]leucine in seven hypoalbuminemic (albumin < or = 36 g/L) HD patients (HHD), seven normoalbuminemic (albumin > or = 40 g/L) HD patients (NHD) and nine age-matched normal controls. RESULTS: The increase in albumin synthesis on feeding was impaired in HHD patients (fasting 15.0 +/- 1.5 vs. fed 17.7 +/- 2.9%, P = NS) compared to NHD (fasting 13.7 +/- 0.9 vs. fed 17.4 +/- 1.0%, P < 0.05) and controls (fasting 12.9 +/- 0.6 vs. fed 15.2 +/- 0.6%, P < 0.05). In addition, body mass index and percent body fat were significantly (P < 0.05) lower in HHD (20.8 +/- 1.3 kg/m2, 23.4 +/- 2.0%) than NHD (26.7 +/- 1.3 kg/m2, 33.1 +/- 3.2%) or controls (26.2 +/- 1.1 kg/m2, 32.6 +/- 1.8%). There was no difference in dietary protein or energy intake in the three groups. CONCLUSIONS: There are differences of body composition and protein metabolism in HHD patients that may be related to an impaired metabolic response to feeding.

Adult↗

PubMed1999

Comparison of methods for introducing and producing artificial infection of ixodid ticks (Acari: Ixodidae) with Ehrlichia chaffeensis.

Only 29.5 +/- 8.91% of engorged Amblyomma americanum (L.) nymphs that we inoculated with Ehrlichia chaffeensis molted successfully to adults compared with 75.8 +/- 7.46% of engorged nymphs that were not inoculated. However, 65.4 +/- 6.02% of unfed nymphs of this species were exposed for 2 h to E. chaffeensis suspension introduced to them through glass capillaries gained weight. These nymphs were placed on rabbits, and approximately 50% of them completed their feeding and molted successfully to adults. Weight gained was higher (71.8 +/- 17.33% and 69.8 +/- 23.26%) for unfed A. americanum females that fed from capillaries for 2 and 24, h respectively, than for nymphs. Similar values were recorded for Dermacentor variabilis (Say) (61.0 +/- 16.23%) and Rhipicephalus sanguineus (Latreille) (59.0 +/- 18.62%) females after 24 h of capillary feeding. The amount of E. chaffeensis suspension taken in by females of A. americanum, D. variabilis, and R. sanguineus during 24 h of feeding was 11.2 +/- 3.56, 10.9 +/- 4.29 and 6.3 +/- 2.35 microliters, respectively. This volume is equivalent to approximately 12,969, 12,622, and 7,295 infected cells ingested by the species mentioned above. Positive correlation between the volume taken in by the ticks and the weight gained by the females was found, but the initial weight of the unfed females did not effect the weight they gained. The pathogen was found in the females of all 3 species by polymerase chain reaction procedures for at least 7 d, indicating that the capillary feeding method can be successfully used for infecting unfed ticks. The potential use of this method is discussed.

Animals↗

PubMed2003

Do perceived attitudes of physicians and hospital staff affect breastfeeding decisions?

BACKGROUND: In the United States, since a substantial percentage of mothers are not breastfeeding, research is needed to assess important influences on breastfeeding. The current study assessed the impact on breastfeeding of the perceived attitudes of health care providers about infant feeding. METHODS: A longitudinal mail survey (1993-1994) was administered to 1620 women prenatally through 12 months postpartum; the current study focused on the prenatal and neonatal periods (66% response rate). The outcome variable was failure to breastfeed beyond 6 weeks. Predictor variables were the mother's perceptions of her prenatal physician's and hospital staff's attitudes on infant feeding. Analysis controlled for mother's prenatal breastfeeding intentions, father's feeding preference, and demographic and psychosocial variables. RESULTS: Forty-one percent of the mothers were not breastfeeding at 6 weeks postpartum. Substantial percentages of mothers reported that physicians and hospital staff expressed a preference for breastfeeding (38% and 57%, respectively), or expressed no preference (61% and 42%, respectively), whereas few favored formula feeding. Adjusted analyses indicated that "no preference" by hospital staff was a significant risk factor for failure to breastfeed beyond 6 weeks. "No preference" by physicians did not significantly influence breastfeeding outcome in these analyses. Further analyses indicated that the effects of perceived hospital staff attitudes were only present for mothers who intended prenatally to breastfeed for 2 months or less. CONCLUSIONS: Many women did not report receiving positive breastfeeding messages from their health caregivers and hospital staff. A perceived neutral attitude from the hospital staff is related to not breastfeeding beyond 6 weeks, especially among mothers who prenatally intended to breastfeed for only a short time.

Adolescent↗

PubMed2000

Can percutaneous endoscopic jejunostomy prevent gastroesophageal reflux in patients with preexisting esophagitis?

OBJECTIVE: Percutaneous endoscopic jejunostomy has been used for preventing pulmonary aspiration arising from gastric contents by concomitant jejunal feeding and gastric decompression in susceptible patients. Our objective was to evaluate gastroesophageal reflux in patients with percutaneous endoscopic jejunostomy tube feeding. METHODS: Eight cerebrovascular accident patients with percutaneous endoscopic jejunostomy tube placement caused by reflux esophagitis with hematemesis, food regurgitation or vomiting, and/or recurrent aspiration pneumonia were tested for gastroesophageal reflux using 24-h esophageal pH monitoring during continuous jejunal liquid meal or saline infusion with concomitant gastric decompression. Twenty-four hour pH monitoring was also performed during intragastric feeding on a different day. RESULTS: During the liquid meal feeding period, percutaneous endoscopic jejunostomy feeding reduced esophageal acid exposure 46% [12.9% (4.9-28.2%) versus 24.0% (19.0-40.6%), p = 0.01], compared to intragastric feeding. However, in the period of the jejunal tube infusion, esophageal acid exposure was significantly lower during saline infusion than during meal infusion [3.2 (0.0%-10.8%) versus 12.9% (4.9-28.2%), p = 0.008]. CONCLUSION: Percutaneous endoscopic jejunostomy feeding reduced but did not eliminate gastroesophageal reflux, compared to intragastric feeding in patients with severe gastroesophageal reflux. However, gastroesophageal reflux during percutaneous jejunal feeding was associated with meal infusion. This might, in part, explain the failure of percutaneous endoscopic jejunostomy tube placement to prevent pulmonary aspiration.

Aged↗

PubMed2005

Effectiveness of home-based peer counselling to promote breastfeeding in the northeast of Brazil: a randomized clinical trial.

AIMS: To evaluate the effectiveness of home-based peer counselling to increase breastfeeding rates for unfavourably low birthweight babies. METHODS: Randomized clinical trial carried out in maternity hospitals and households in Fortaleza, one of the regions in Brazil with very low income; 1003 mothers and their newborns were selected in eight maternity hospitals. Newborns needed were healthy and weighed less than 3000 g. INTERVENTION: Breastfeeding counselling, conducted by lay counsellors from the community, during home visits carried out on days 5, 15, 30, 60, 90 and 120 after birth. MAIN OUTCOME MEASURE: Feeding methods in the fourth month of life. RESULTS: The intervention increased exclusive breastfeeding (24.7% vs 19.4%; p=0.044), delayed the introduction of formula and increased the time infants substituted breastfeeding to bottle milk (bottle milk 33.4% in the control group and 20.1% in the intervention group; p=0.00002). When comparing the frequency of artificial breastfeeding versus all other forms of breastfeeding (exclusive+predominant+partial), the intervention increased breastfeeding rates in 39% (RR=0.61; CI 95%: 0.50-0.75); 15% of children were free from artificial feeding (absolute risk reduction). The number of families to be visited to avoid one child receiving artificial feeding (NNT) was 7 (CI 95%: 5-13). CONCLUSIONS: Breastfeeding counselling, promoted by lay counsellors, can impact favourably on exclusive breastfeeding rates and contribute to delaying the utilization of milk formula and weaning. The intervention has great application potential because most cities in the northeast of Brazil count on community health workers that could do the counselling.

Adult↗

PubMed1999

Perinatal and neonatal determinants of childhood type 1 diabetes. A case-control study in Yorkshire, U.K.

OBJECTIVE: To identify environmental factors that exert their effect in the perinatal and neonatal period and influence the subsequent onset of insulin dependent (type 1) diabetes during childhood. RESEARCH DESIGN AND METHODS: A population-based case-control study of data abstracted from the hospital obstetric and neonatal records of 196 children with type 1 diabetes and 325 age- and sex-matched control subjects. Analysis of matched sets by conditional logistic regression was conducted for a range of perinatal and neonatal factors. RESULTS: A significantly raised risk was observed for illnesses in the neonatal period (OR 1.61, 95% CI 1.06-2.44), the majority of which were infections and respiratory difficulties. Exclusive breast feeding as the initial feeding method was significantly protective (OR 0.65, 95% CI 0.45-0.94). There were no significant associations with high- or low-birth weight, being firstborn or small-for-dates. All factors significant (5% level) for the entire dataset, that is, maternal age, type 1 diabetes in mothers, preeclampsia, delivery by cesarean section, neonatal illnesses, and initial breast feeding were modeled and the OR remained significant for all variables other than cesarean section. CONCLUSIONS: The findings are based on medical record data that cannot be subject to biased recall of mothers. Neonatal illnesses increased and initial breast feeding decreased the risk of childhood type 1 diabetes. Further determinants of risk are mothers with type 1 diabetes, older mothers, and preeclampsia during pregnancy.

Adolescent↗

PubMed2006

Effects of probiotic supplementation for the first 6 months of life on allergen- and vaccine-specific immune responses.

BACKGROUND: A reduction in microbial burden during infancy when allergen-specific memory is evolving has become a prominent explanation for the allergy epidemic. OBJECTIVE: We sought to determine whether probiotic dietary supplementation in the first 6 months of life could modify allergen- and vaccine-specific immune responses. METHODS: Two hundred and thirty-one pregnant women with a history of allergic disease and positive allergen skin prick test (SPT) were recruited into a randomized-controlled trial. The infants received either a probiotic (3 x 10(9)Lactobacillus acidophilus LAVRI-A1; Probiomics) or placebo (maltodextrin alone) daily for the first 6 months of life, given independent of feeding methods. One hundred and seventy-eight children completed the study; blood samples were available from 60 children in the placebo group and 58 children in the probiotic group. Infant cytokine (IL-5, IL-6, IL-10, IL-13, TNF-alpha or TGF-beta) responses to tetanus toxoid (TT), house dust mite (HDM), ovalbumin (OVA), beta-lactoglobulin (BLG), Staphylococcus enterotoxin B (SEB) and phytohaemaglutinin (PHA) were measured at 6 months of age. RESULTS: Children who received the probiotics showed reduced production of IL-5 and TGF-beta in response to polyclonal (SEB) stimulation (P=0.044 and 0.015, respectively). They also demonstrated significantly lower IL-10 responses to TT vaccine antigen compared with the placebo group (P=0.03), and this was not due to any differences in vaccination. However, there were no significant effects of probiotics on either Type 1 (Th1) or Type 2 (Th2) T helper cell responses to allergens or other stimuli. The only other effects observed were for reduced TNF-alpha and IL-10 responsiveness to HDM allergens in children receiving probiotics (P=0.046 and 0.014, respectively). CONCLUSIONS: In summary, although we did not see any consistent effects on allergen-specific responses, our study suggests that probiotics may have immunomodulatory effects on vaccine responses. The significance and clinical relevance of this need to be determined in further studies.

Allergens↗

PubMed2005

[Infant and toddler nutrition: WHO recommendations and information encountered by Czech parents].

BACKGROUND: During the last 15 years much effort with remarkable success has been devoted to the promotion and support of breast-feeding. Much less attention has been paid, until recently, to child nutrition during the period of transition from exclusively milk feeding to the family diet. The aim of presented study is to provide a qualitative review of information on feeding of children 6 - 24 months old available to parents from various sources and to compare it with the WHO recommendations based on the Global Strategy for Infant and Young Child Feeding. METHODS AND RESULTS: Within the frame of field practice, students of the Charles University, 1st Medical Faculty conducted interviews with 273 mothers of children under 5 years old, focused interview with 19 paediatric general practitioners, gathered 42 promotion materials, identified and evaluated 16 relevant publications and 14 web sites. All practitioners interviewed provided information on the nutrition, recommend exclusive breast-feeding up to the age of 6 months and the appropriate introduction of complementary food but they probably did not promote sufficiently breast-feeding beyond six months. Review of various information sources revealed, as expected, certain variations in feeding recommendations, which is partially a consequence of their changes during the last decade. Most publications emphasise breast-feeding as the ideal nutrition for up to 6 months. Recommendations for breast-feeding beyond 6 months are inadequate. Complementary feeding recommendations are, with exceptions, common for breast-fed and non-breastfed children as well as for those who need to start complementary feeding before 6 months of age. Except for sporadic notes, publications do not deal with the safe food preparation and feeding during and after a common disease. CONCLUSIONS: Consideration to all 10 areas of WHO guiding principles should be given. Also the clear formulation of breastfeeding recommendations, differentiation of information according to the target population, and recommendations based on the conditions of a thriving infant exclusively breast-fed for 6 months would contribute to the harmonization of information on the older infant and toddler nutrition with WHO recommendations.

Breast Feeding↗