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[Sequential changes of specific IgE, IgG4 antibodies and the development of allergic diseases in the first year of life].

Thirty infants who had siblings with major allergy were prospectively followed up to 12 months. Among 15 infants, in whom egg and milk were eliminated by the mother during third trimester and 12 months after birth, three infants developed food allergy. But, among 15 infants without any elimination either by the mother or the infant, 7 infants developed food allergy though this was not statistically significant. Among ten cases with food allergy, eight developed the symptoms during first six months. There were no correlations between allergic symptoms and Total IgE. Also, specific IgG4 did not show significant correlation with specific IgE and allergic symptoms except in several cases. Even though there was no significant decrease of food allergy by elimination of egg and milk during third trimester and 12 months after birth, elimination of egg and milk during that period give some benefit to the infant with strongly positive family history of major allergy under the close observation for growth and development of the infant.

Humans↗

Onset of speech-like vocalizations in infants with Down syndrome.

Canonical babbling of infants with and without Down syndrome was compared. Infants with Down syndrome and typically developing infants began canonical babbling in the first year of life, but the infants with Down syndrome began 2 months later. Once begun, their canonical babbling was less stable than that of typically developing infants. Age at onset of canonical babbling for the infants with Down syndrome was correlated with their scores at 27 months of age on the Early Social-Communication Scales. The results of this study suggest that Down syndrome influences vocal development in the first year of life and that early vocal development is related, possibly in combination with motoric and cognitive factors, to later social and communicative functioning of children with Down syndrome.

Child, Preschool↗

Studies on the development of infant foods from plant protein sources. Part III. Preparation, processing and properties of various products developed.

Studies have been carried out on the development of a low-cost, high-quality infant food of low paste viscosity from rice, chickpea (Cicer arietinum) and cow's milk. In order to improve the overall quality of the product, chickpea was processed by different methods prior to its incorporation. A number of formulations was prepared by mixing 52% rice, 30% each, the processed chickpea sample, and 18% whole milk powder. These mixtures were processed by extrusion cooking or drum drying. In the case of the extrusion cooking method, from the nutritional and technological points of view, it was found advantageous to incorporate milk powder after cooking a mixture of rice and chickpea. The values of net protein ratio (NPR) of the products developed, whether processed by extrusion cooking or drum-drying methods, were statistically equal, and not significantly different from those of casein. Supplementing the product with methionine and threonine showed no effect in improving the NPR value, suggesting that these amino acids were not limiting. There were slight differences in the digestibilities of proteins in the products developed and all were lower than that of casein. Depending on the processing method, differences were observed in paste viscosities of the products. After partial hydrolysis of the products with pounds amylase, both the cold and hot paste viscosities were greatly reduced and were comparable with those of whole milk powder. From the results herein reported, it can be concluded that the drum-dried product prepared using rice:chickpea (carbonate presoaked):milk (52:30:18) is the best of all the products developed. Its amino acid composition compares favorably with that of the milk proteins.

Amino Acids↗

Increase in interleukin-8 and soluble intercellular adhesion molecule-1 in bronchoalveolar lavage fluid from premature infants who develop chronic lung disease.

Interleukin-8 (IL-8), soluble intercellular adhesion molecule-1 (sICAM), elastase and neutrophils were assessed in bronchoalveolar lavage fluid from nine infants who developed chronic lung disease (CLD) after respiratory distress syndrome (RDS), seven who had recovered from RDS, and in four control infants. IL-8, sICAM, elastase and neutrophils in bronchoalveolar lavage fluid were increased in the CLD group, the differences being most pronounced at 10 days of age. When babies with and without CLD were compared at 10 days of age, bronchoalveolar lavage fluid from the babies with CLD had significantly increased IL-8 (114.0 vs 12.7 ng/ml), sICAM (19.0 vs 1.1 micrograms/ml), elastase (6.9 vs 0.9 micrograms/ml) and neutrophils (1.9 vs 0.4 x 10(9)/l). In serum the increased concentration of IL-8 observed at birth in the CLD (247 pg/ml) and RDS (192 pg/ml) groups decreased over three weeks to the concentrations observed in the controls (< 70 pg/ml). Persistent inflammation could be a major contributory factor in the development of CLD.

Bronchoalveolar Lavage Fluid↗

Parenting styles and risks in the vulnerable infant.

Risk factors for infant development are considered in three areas: infant temperament, postpartum depression, and prenatal cocaine exposure. Investigations of all three areas indicate that contextual characteristics of infant development must be incorporated into models attempting to link early risk factors with later behavioral adaptation.

Child Development↗

Development of infants' sensitivity to surface contour information for spatial layout.

The development of sensitivity to a recently discovered static-monocular depth cue to surface shape, surface contours, was investigated. Twenty infants in each of three age groups (5, 5 1/2, and 7 months) viewed a display that creates an illusion, for adult viewers, that what is in fact a frontoparallel cylinder is slanted away in depth, so that one end appears closer than the other. Preferential reaching was recorded in both monocular and binocular conditions. More reaching to the apparently closer end in the monocular than in the binocular condition is evidence of sensitivity. Infants aged 7 months responded to surface contour information, but infants aged 5 and 5 1/2 months did not. In a control study, twenty 5-month-old infants reached consistently for the closer ends of cylinders that were actually rotated in depth. As findings with other static-monocular depth information suggest, infants' sensitivity to surface contour information appears to develop at approximately 6 months.

Child Development↗

Early intervention for low birthweight, premature infants: participation and intellectual development.

The Infant Health and Development Program was an eight-site randomized controlled trial of comprehensive early intervention for low birthweight, premature infants during the first 3 years of life in which intellectual development was an outcome of major importance. At 24 and 36 months, but not at 12 months, higher Mental Development Index and IQ were associated with higher levels of participation in the intervention. In a longitudinal analysis of these data, we found that the intellectual development of children in the intervention group was associated with each of the three intervention modalities (the number of home visits received, days attended at child centers, and the number of parent meetings attended) but not with children's background characteristics (i.e., maternal education, birthweight). We suggest that these findings represent a dose-response relation between intervention and outcome.

Brain Damage, Chronic↗

Early language and communication development of infants later diagnosed with autism spectrum disorder.

It is well recognized that delayed "first words" is among the most common presenting symptoms of autistic spectrum disorders (ASD). However, data on earlier language and communication development in children with ASD are limited to retrospective reports from parents and from home videos. In this study, we prospectively collected parent report data on early communication and language development in 97 infant siblings of children with ASD and 49 low-risk controls. Parents completed the MacArthur Communicative Development Inventory--Infant Form at 12 and 18 months. Analysis compared 3 groups defined on the basis of diagnostic assessment at 24 months: (1) siblings with ASD (n = 15), (2) siblings not meeting diagnostic criteria for ASD (n = 82), and (3) low-risk controls, none of whom had ASD (n = 49). Children with ASD showed delays in early language and communication compared with non-ASD siblings and controls. At 12 months, the ASD group was reported to understand significantly fewer phrases and to produce fewer gestures. At 18 months, they showed delays in their understanding of phrases, comprehension and production of single words, and use of gestures. Siblings not diagnosed with ASD also used fewer play-related gestures at 18 months than low-risk controls, even when children with identified language delays were excluded. Overall, this prospective study confirms that delays in communication and language development are apparent early in life in children with ASD, and emphasizes that developmental surveillance should include monitoring for delays in gesture, which may be among the earliest signs of ASD.

Autistic Disorder↗

A study of Baroda Development Screening Test for infants.

Baroda Development Screening Test for Infants based on Baroda Norms on BSID-Research Form 1961 were studied at the Child Development Unit of the Department of Pediatrics in the K.E.M. Hospital, Pune. Screening validity, sensitivity, specificity, over-referrals and under-referrals were calculated in three samples--(i) 730 records of 130 babies evaluated on BSID-Baroda Norms during 1979 and December 1984; (ii) 101 records of babies tested at six months out of the first sample; and (iii) 50 babies screened by interviewing the mothers and tested on the full scales by the experts. Screening validity, sensitivity and specificity were more than 76, 66 and 77%, respectively. Over-referrals were highest (35%) in the sample screened by interview. Suggestions are made to improve the screening by interview. Baroda Development Screening Test for Infants is recommended for use in the field for further evaluation.

Child, Preschool↗

Long-term follow-up of premature infants treated with prophylactic, intratracheal recombinant human CuZn superoxide dismutase.

OBJECTIVE: To examine the long-term effects of treatment with recombinant human CuZn superoxide dismutase (rhSOD) in infants enrolled previously in two placebo-controlled trials. STUDY DESIGN: Records for 46 (88%) infants were examined, with 19 infants having received either single or multiple intratracheal (i.t.) doses of placebo, 12 having received a single i.t. dose of rhSOD, and 15 having received multiple i.t. doses of rhSOD. Mean age at follow-up was 28 months corrected age. Records were examined for neurologic dysfunction, developmental delay, and any significant medical disorders. RESULTS: Four placebo infants (21%) had evidence of neurodevelopmental abnormalities and four infants developed asthma. Four single-dose rhSOD infants (33%) had neurodevelopmental abnormalities and two infants developed asthma. One multiple-dose rhSOD infant had evidence of neurodevelopmental abnormalities and one developed asthma. No other differences were found between the placebo and rhSOD groups. CONCLUSION: Preliminary data suggest that rhSOD is safe and not associated with any long-term adverse effects. Further results will depend on the results of multicenter trials of rhSOD in preterm infants.

Administration, Inhalation↗

Infection and disease after perinatal exposure to Chlamydia trachomatis in Nairobi, Kenya.

A cohort of 49 infants exposed to maternal chlamydial infection and 40 nonexposed infants was studied after birth for a mean of 3.3 +/- 1.5 and 3 +/- 1.7 mo, respectively. Eighteen (37%) exposed infants had at least one positive culture for Chlamydia trachomatis, whereas C. trachomatis was not isolated from any of the nonexposed infants. Eighteen (37%) exposed infants developed ophthalmia neonatorum (n = 12) or infant conjunctivitis (n = 7), compared with six (15%) of the nonexposed infants (P = .04). Six (12%) exposed infants developed pneumonia, compared with none of the 40 nonexposed infants (P = .05). One infant in the exposed group died during follow-up. These results suggest that appreciable infant morbidity in Kenya may be associated with the high prevalence of maternal chlamydial infection.

Chlamydia Infections↗

Effect of age at cochlear implantation on auditory skill development in infants and toddlers.

OBJECTIVES: To investigate the effect of age at cochlear implantation on the auditory development of children younger than 3 years and to compare these children's auditory development with that of peers with normal hearing. DESIGN: Using a repeated-measures paradigm, auditory skill development was evaluated before and 3, 6, and 12 months after implantation. Data were compared with previously published data from cohorts with normal hearing. PARTICIPANTS: One hundred seven hearing-impaired children (age range, 12-36 months) who received a cochlear implant during clinical trials in North America. MAIN OUTCOME MEASURE: Auditory skill development was assessed using the Infant-Toddler Meaningful Auditory Integration Scale, a tool that provides a quantitative measure in children as young as newborns. RESULTS: Infants and toddlers who receive implants show rapid improvement in auditory skills during the first year of device use regardless of age at implantation, although younger children achieve higher scores. Children who undergo implantation at a younger age acquire auditory skills nearer to those of their peers with normal hearing at a younger age. The mean rate of acquisition of auditory skills is similar to that of infants and toddlers with normal hearing regardless of age at implantation. CONCLUSION: Performing implantation in children with profound hearing loss at the youngest age possible allows the best opportunity for them to acquire communication skills that approximate those of their peers with normal hearing.

Age Factors↗

Prospective, controlled study of developmental outcome in survivors of extracorporeal membrane oxygenation: the first 24 months.

OBJECTIVE: Survivors of venoarterial extracorporeal membrane oxygenation (ECMO) are considered to be at risk for developmental disabilities, but there are few controlled outcome studies. A prospective, controlled study of outcome was performed to quantify the degree and frequency of developmental disabilities in ECMO survivors compared with a matched control group. METHODS: From May 1987 through November 1990, 40 of 47 neonates treated with ECMO survived at the University of Texas Medical Branch in Galveston. Longitudinal developmental data were collected, using the Bayley Scales of Infant Development, on 22 ECMO infants and 29 healthy term control infants at 6, 12, and 24 months. Language was assessed at 24 months using the Sequenced Inventory of Communication Development. An additional 13 ECMO infants had developmental data for at least one time point. RESULTS: Healthy term infants performed significantly better than ECMO infants on the Bayley Scales of Infant Development at 6 and 24 months and on the Sequenced Inventory of Communication Development at 24 months. Mean scores of ECMO infants were well within the average range and 77% of the ECMO infants were developmentally normal. CONCLUSIONS: These data suggest that early developmental morbidity in ECMO survivors is low, considering the severity of their neonatal illness.

Analysis of Variance↗

Concentration of nitric oxide products in bronchoalveolar fluid obtained from infants who develop chronic lung disease of prematurity.

AIMS: To determine if nitric oxide (NO) products (nitrate and nitrite) are increased in bronchoalveolar lavage (BAL) fluid obtained from infants who develop chronic lung disease of prematurity (CLD). METHODS: One hundred and thirty six serial bronchoalveolar lavages were performed on 37 ventilated infants (12 with CLD, 18 with respiratory distress syndrome (RDS), and seven control infants) who did not receive inhaled NO. RESULTS: During the first week of life nitrate concentration was between 25-31 micromol/l in all three groups. Thereafter, the concentration of BAL fluid nitrate decreased to 14 micromol/l and 5.5 micromol/l, respectively in the RDS and control groups by 14 days of age. In contrast, nitrate in the CLD infants remained constant until 28 days of age (31.3 micromol/l at day 14; p<0.05). In all BAL fluid samples the mean concentration of nitrite was <1.2 micromol/l throughout the first 28 days with no significant differences noted among the three groups. CONCLUSION: The similar concentration of BAL fluid nitrate in all groups during the first week of life suggest that NO may be important in the adaptation of the pulmonary circulation after birth. However, persistence of nitrate in the BAL fluid of infants with CLD during the second week may reflect pulmonary maladaptation, or, more likely, persisting pulmonary inflammation.

Bronchoalveolar Lavage Fluid↗

[Comparative characteristics of physical development of first year infants].

Physical development data of 3740 first year infants born in 2002-2004 as compared with their 2782 coevals born in 1992-1994 is presented. Study results allowed to elaborate local standards of physical development of first year infants. It is established that in infants born in 2002-2004 increase of body mass and body height values occurs more steady than in their coevals born 10 years before. The reason is in altered approaches to infant feeding mode. Today, asthenization of first year infants relates to increase of chest circumference predetermining disharmonic development.

Body Height↗

Relation between polysomnographic measures during nocturnal sleep and a quotient of behavioral development in infants with developmental disabilities.

Polysomnographic features during nocturnal sleep were investigated in 27 infants with developmental disabilities. With the use of a multiple regression analysis, 78% of the variance of a Development Quotient (DQ) measured by a questionnaire on behavioral development for infants was explained by sleep measures. Of 14 sleep measures employed in the study, (1) cumulative awakening time during a nocturnal sleep time, (2) duration of REM stage, and (3) percentage of REM to total sleep time were important in association with the DQ. The findings are consistent with the sleep-cognition hypothesis proposed by Espie, et al.

Child Development↗

Effect of a fortified maize-meal porridge on anemia, micronutrient status, and motor development of infants.

BACKGROUND: Maize-meal porridge is used for infant feeding in many African countries, including South Africa. A low-cost, finely milled, maize-meal porridge was fortified with beta-carotene, iron, and zinc (100% of recommended dietary allowance), as well as ascorbic acid, copper, selenium, riboflavin, vitamin B-6, vitamin B-12, and vitamin E. OBJECTIVE: We assessed whether the fortified porridge could reduce anemia and improve the micronutrient status and motor development of infants. DESIGN: Infants aged 6-12 mo (n = 361) were randomly assigned to receive either the fortified or unfortified porridge for 6 mo. Primary outcomes were hemoglobin and serum retinol, zinc, and ferritin concentrations and motor development. Growth was assessed as a secondary outcome. Primary and secondary outcomes were assessed at baseline and 6 mo. RESULTS: Two hundred ninety-two infants completed the study. The fortified-porridge group had an intervention effect of 9.4 microg/L (95% CI: 3.6, 15.1 microg/L) for serum ferritin and 9 g/L (95% CI: 6, 12 g/L) for hemoglobin concentrations. The proportion of infants with anemia decreased from 45% to 17% in the fortified-porridge group, whereas it remained >40% in the control group. The fortified-porridge group achieved on average 15.5 of the 25 motor development score items, whereas the control group achieved 14.4 items (P = 0.007). Serum retinol concentration showed an inconsistent effect, and no intervention effect was observed for serum zinc concentrations. CONCLUSIONS: This low-cost fortified porridge can potentially have a significant effect in reducing anemia and improving iron status and motor development of infants in poor settings. The formulation needs some adjustment in terms of zinc fortification.

Anemia, Iron-Deficiency↗